Thread by @Adderabbi

Why this analysis of Israel by @Humble_Analysis is simply bad analysis. A thread:

https://twitter.com/Humble_Analysis/status/1358457353792720898

First, metrics like "highest cases per capital (sic) in the world" change every day and are misleading. The charts show that @Humble_Analysis is using a 7-day rolling avg, and he picked the day that Israel passed Portugal to give the analysis. Tomorrow it'll be different. 2/n

But the truth is that Israel's per capita infection rate since the beginning is among the highest in the world. Among similar-sized nations (5-20 mil population), it's behind only Czechia, running neck-and-neck with Portugal. Not good. 3/n

This is, however, mitigated slightly by the high testing rate. I.e., states that do lots of tests find lots of asymptomatic cases that other states miss. In that 5-20 million cohort, Israel is conducting more tests than any other state. I mention this because... 4/n

the ration of asymptomatic cases to total new cases will be extremely important going forward. This is the fatal flaw of @Humble_Analysis's thread. Ze doesn't seem to understand how the vaccine works. 5/n

https://twitter.com/Humble_Analysis/status/1358458121643954176

The vaccine does not affect spread. It does not prevent people from contracting or transmitting the virus. What it does is prevents people from getting sick and dying from the virus. As vax rates go up, the importance of new cases (total and per capita) goes down. 6/n

So saying that Israel has a high new case rate despite having the best vax rate is simply nonsensical. Vaxing doesn't stop the spread. Eventually, it will probably mean more spread because there won't be as much at stake. 7/n

Which brings us to another important point. From the beginning, and throughout the past year, Israel has been really bad at some things and really good at other things.
It's been really bad at containing spread. Some of this is on the population, and some is on the gov't. 8/n

But Israel has been really GOOD at keeping people alive. The COVID-19 case fatality rate, globally, is c. 3%. In Israel, it's 0.8%, among the lowest in the world. It's outstanding even if you adjust for Israel's relatively young population. 9/n

The problem is that when you have so many cases, even a low case fatality rate will mean lots of deaths. And Israel has seen lots of deaths, although, on a per capita basis, about half of the EU average (1106 deaths per million in the EU vs. 586 in Israel). 10/n

Now, one can *correctly* claim that this is apples and oranges, in a sense. The EU is a much older population, etc. But just as it's easier to keep younger people alive, it's also harder to keep them in lockdown. So the entire comparison is, by that token, apples to oranges. 11/n

Israel has other comparative disadvantages. C. 25% of its population is from communities that historically distrust the state (often with good reason). Israel threw caution to the wind in letting people travel to the UAE to participate in this new love-fest. 12/n

It also has comparative advantages. An excellent state medical system, for example. (Hence, in terms of vaccine rollout, testing, and case fatality rate, it is among the world leaders.) 13/n

To look at Israel and say "Israel is the best at..." or "Israel is the worst at..." is, by definition, to look at a small part of the picture.
This applies, mutatis mutandis, to every country. Belgium was never gonna be Taiwan because Belgium isn't Taiwan. 14/n

At present, Israel is experiencing lockdown fatigue, governmental mistrust exacerbated by (another) election campaign - all true. All contribute to high new case counts. 15/n

And it's possible that vaccination stations turned into superspreader events, though I'm not convinced.
What's *also* true is that, with 80+% of citizens over the age of 70 now fully vaccinated, folks aren't as worried. 16/n

The rolling average of daily deaths has declined significantly since soon after the lockdown started, which is exactly what you expect. Hospitalizations are still high, and I have no good explanation for that, though there are several theories out there. 17/n

I am optimistic that the numbers of deaths will continue falling, and that new hospitalizations will start dropping more discernably. However, I don't expect total new cases to slow any time soon, not with the country opening back up. 18/n

This, too, is a gamble that the vaccine will provide enough immunity for long enough that the virus remains under control despite the high new case rate. Hopefully new strains will not make this gamble into a complete catastrophe. 19/n

But at the very least it plays to Israel's strengths. It's essentially the next level of the present strategy of letting the virus rage but keeping people alive, locking down when the medical system starts to strain. With mass vaccination, it'll mean even more cases... 20/n

...but even fewer hospitalizations and deaths - hopefully.
Now for a final takeaway, about Israel but really about every country and state.
The early Hasidic Rabbi Zusha of Anipol famously said: "I'm not afraid that when I die they'll ask me why I wasn't Moses." 21/23

"Rather, I'm afraid they'll ask me why I wasn't Zusha." Why he wasn't the best possible Zusha.
Likewise, Israel shouldn't be judged - or judge itself - based on whether it's the best at this or the worst at that. It has a unique set of strengths and weaknesses. 22/23

Some factors are under its control, some aren't, some may have been at some point but are no longer.
Its handling of the COVID crisis should be judged by the extent to which it was the best possible Israel. And that goes for everywhere else, too. /end

I should walk this back a bit and explain, as preliminary studies indicate that the vaccine decreases transmissibility.
Reduced transmissibility can & will be offset by increased interaction. It won't necessarily result in fewer new cases. 1/2

https://twitter.com/Adderabbi/status/1358768255058460674?s=19

2. The goal of the New Zealand approach is Zero COVID. That's not the goal of a mass vaccination campaign like Israel's. If vaccination reduces spread, great, but that's just gravy. If, theoretically, everyone gets a mild case, it's a success, even if the new case rate is high.