surveillance of covid-19 in israel

Israel Center for Disease

Control

Surveillance of COVID-19 in Israel

Report for week 19 ending May 09, 2020

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Israel Center for Disease Control ministry of Health Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer 52621 [email protected] Tel: 03-7371500 Fax: 03-5349881

ICDC-Israel Center for Disease Control Ministry of Health Gertner Institute, Chaim Sheba Medical Center [email protected] Tel: 03-7371500 Fax: 03-5349881

Attention: Despite the changes in guidelines and the partial return to routine,

consumption of health services in the community continues to be low compared

to the same period in recent years, affecting the rate of visits due to respiratory

illness.

Summary: As of week 19, the low level of visits to community clinics and the emergency

departments due to respiratory morbidity is continued. This trend was also reflected in

the low number of samples from the sentinel clinics. All samples received were negative

for SARS-CoV-2.

Clinical: From the data provided by Maccabi and Clalit Health Service funds,

stabilization was observed in the rates of visits to community clinics due to upper

respiratory infections and pneumonia in all age groups. In the emergency departments,

there is not material change in the percentage and absolute number of visits due to

pneumonia.

Laboratory: On Week 19, 70 samples were collected from the sentinel clinics, in both

tracks. All samples were negative for SARS-CoV-2.

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1. Visits to Community Clinics due to Upper Respiratory Infections

(URI)

As of Week 19, there is continued stabilization in the rates of visits to "Maccabi

Health Services" community clinics due to upper respiratory infections in all age

groups (Figures 1 & 2). A similar picture was observed at “Clalit Health Services".

0

20

40

60

80

100

120

cases/1

0,0

00

week

Figure 1: Weelky rate of visits due to the upper respiratory tract infections,2017-2020, compared to multi-annual

average

- - -

0

20

40

60

80

100

120

140

160

case

s/1

0,0

00

year & week

Figure 2: Weekly rate of visits due to the upper respiratory tract infections by age and year, 2017-2020

- -

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2. Visits to community clinics due to pneumonia

On Week 19 stabilization in the rates of visits to "Maccabi Health Services"

community clinics due to pneumonia continues in all age groups (Figures 3 & 4). A

similar picture was observed at “Clalit Health Services".

0

2

4

6

8

10

12

14

16

case

s/1

0,0

00

week

Figure 3: Weekly rate of visits due to pneumonia, 2017-2020, compared to multi-annual average

- - -

0

5

10

15

20

25

30

case

s/1

0,0

00

year & week

Figure 4: Weekly rate of visits due to pneumonia, by age and year, 2019-2020

- -

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Calls to the nurses call center, Maccabi Health Services

Generally speakig, on Week 19 there is no material change in the number of calls to

"Maccabi Health Services’ nurses call center due to respiratory symproms, sore throat

and fever is continued (Figure 5).

0

200

400

600

800

1000

1200

Nu

mb

er

year and week

Fig. 5: Calls to the Nursing Call center due to sore throat and cough, Maccabi Health Services

Fever in adults sore throat cough shortness of breath fever in children

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3. Visits to hospital Emergency Medicine Departments (ED) due to

pneumonia (Based on the Ministry of Health's database managed by the Health

Information Division).

Generally speaking, on week 19, - there was no material change in the percentage

and the absolute number of visits to emergency departments at "Clalit Health

Services" hospitals due to pneumonia (Figures 6-8).

0

1

2

3

4

5

percen

tag

e

year & week

Fig. 6: Percentage of visits to internal medicine ERs due to pneumonia, Clalit hospitals, 2018-2020, compared to multi-annual average

0

1

2

3

4

5

6

percen

tag

e

year & week

Fig. 7: Percentage of visits to pediatric medicine ERs due to pneumonia, Clalit hospitals, 2018-2020, compared to multi-annual average

0

50

100

150

200

250

300

Nu

mb

er

Year & week

Fig. 8: Number of visits to Clalit ERs due to pneumonia, 2019-2020

pediatric ERs Internal ERs

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4. Clusters of respiratory morbidity

Identification of clusters is based on data obtained daily from Maccabi and Clalit

Health Services. The clusters are identified by focusing on two diagnostic categories:

upper respiratory tract infections and pneumonia. Data analysis is performed based

on statistical geographic areas.

During week 19 and as of 09/05/2020, areas with a clear consistency in the presence

of the clusters, of the two diagnostic categories and on the basis of data from the

two health funds, were:

Jerusalem

Beit Shemesh

Nazereth, Yafia

Tel Aviv, Ramat Gan, Givatayim and Azur

Cluster identified for the first time:

Rahat

Beitar Ilit area

5. Sentinel clinics in the community

Sentinel clinic activity for surveillance of morbidity caused by SARS-CoV-2 began on

week 12. As of Week 19, the network includes 41 clinics nationwide. At this time

there are two sampling tracks. In Track A, nasopharyngeal samples are taken from

patients attending clinics with fever and/or respiratory symptoms with or without a

diagnosis of pneumonia and with no known exposure to a confirmed COVID-19

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patient or returning from a foreign country in the 14 days prior to onset. In addition,

for patients who do not physically come to the clinic but rather consult their

physician using digital technology methods, testing is possible using track B, where

the sample is collected by Magen David Adom (MDA) Emergency Services in patients'

homes or at drive-thru centers.

5.1. Track A - samples obtained at sentinel clinics

Table 1. Number of patients that tested positive for SARS-CoV-2 of the total number of

patients sampled (track A)

Week 19 03/05-09/05/2020

Accumulated Data from Week 12

15/03-09/05/2020

Positive 0 (0%) 16 (2.1%)

Negative 67 (100%) 764 (97.9%)

Total 67 780

* There may be a retroactive update of the number of samples and their results.

5.2. Track 2 - Samples of sentinel clinic patients obtained by MDA

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Table 2. Number of patients that tested positive for SARS-CoV-2 of the total number of

patients sampled in Track B (Sentinel clinics - MDA)

Week 19 03/05-09/05/2020

Accumulated Data from Week 12

15/03-09/05/2020

Positive 0 (0%) 8 (6.4%)

Negative 3 (100%) 117 (93.6%)

Total 3 125

* There may be a retroactive update of the number of samples and their results.

5.3. Patients that tested positive for SARS-CoV-2 in both sentinel clinics’ tracks (Tables 3, 5 and Figure 9)

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Table 3. Patients that tested positive for SARS-CoV-2 in both sentinel clinics’

tracks during the surveillance period.

Week Positive Negative

Total

12 15/03-21/03/2020

0 (0%) 33 (100%) 33

13 22/03-28/03/2020

6 (2.3%) 253 (97.7%) 259

14 29/03-04/04/2020

13 (5.8%) 212 (94.2%) 225

15 05/04-11/04/2020

4 (3.8%) 101 (96.1%) 105

16 12/04-18/04/2020

1 (1.5%) 67(98.5%) 68

17 19/04-25/04/2020

0 (0%) 97 (100%) 97

18 26/04-02/05/2020

0 (0%) 47 (100%) 47

19 03/05-09/05/2020

0 (0%) 70 (100%) 70

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Table 4. Number of Patients that tested positive for the COVID-19 by location in both

monitoring tracks during the surveillance period

(Only the localities in which there was at least one positive sample during the surveillance period

are specified)

Municipality Number of positive samples

(Total no. of samples) Week 19

03/05-09/05/2020

Accumulated number of positive samples

(Total no. of samples) since Week 12

15/03-09/05/2020

Elad 0 (0) 3 (18)

Beit Shemesh 0 (0) 1 (53)

Bnei Brak 0 (0) 1 (5)

Jerusalem 0 (8) 12 (127)

Acre 0 (1) 1 (35)

Rosh HaAyin 0 (3) 1 (21)

Ramat HaSharon 0 (0) 1 (31)

Sderot 0 (0) 2 (11)

Tel Aviv 0 (3) 2 (51)

As of Week 19, no SARS-CoV-2 -positive samples were detected in both surveillance tracks.

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Cumulative national SARS-CoV-2 morbidity (the data are updated for

the end of Week 19 ending May 09, 2020) (Figure 10)

(The figure is based on the official data provided by the Public Health Services)

0

50

100

150

200

250

300

Number

Week

Fig.9: Specimens positive for SARS-coV-2 out of total specimens collected by sentinel network, 2020

Positive Negative

0 18 23 42 1941029

3916

8166

10958

13544

153111606716357

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

Nu

mb

er

Week

Fig.10: Number of national cumulate morbidity cases of COVID-19,2020

cases

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6. Pneumonia mortality (updated for week 18 ending on May 02, 2020)

As of Week 18, the percentage of mortality due to pneumonia is within the

seasonally expected range (Figure 11).

0

4

8

12

16

20

24

Pe

rce

nta

ge

Year and week

Fig.11: Deaths from pneumonia as a percentage of all deaths, 2017-2020' compared to multi-annual seasonal prediction

percentage of deaths from pneumonia seasonal prediction epidemic thershold

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8. Global COVID-19 snapshot

The upward trend in the number of people contracting SARS-CoV-2 is continued. As of

10/05/20, the total number of confirmed COVID-19 cases was 3,916,654, of which 61,578

were new cases. The total number of deaths is 274,348, of which 8,499 were new deaths.

Countries with the highest number of deaths were: USA (75,364), United Kingdom

(31,587), Italy (30,395), Spain (26,478), France (26,268), Brazil (9,897), Belgium (8,581),

Germany (7,395) and Iran (6,589). (The data was gathered from the World Health

Organization Report - Status Report 111).

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200510covid-19-sitrep-

111.pdf?sfvrsn=1896976f_2

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200510covid-19-sitrep-111.pdf?sfvrsn=1896976f_2

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200510covid-19-sitrep-111.pdf?sfvrsn=1896976f_2

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