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25 October 2020

The Coronavirus Crisis: Recommendations for Israel | Team of Experts Led by Lt. Gen. (ret.) Gadi Eisenkot

Mor Yahalom

The following article summarizes the insights and policy recommendations of an INSS research project on the coronavirus crisis in Israel, which focused on six main issues: national security, regional cooperation, economy, technology, healthcare ,and aliyah.

Introduction

The Covid-19 pandemic spread throughout the world in early 2020, leading to a global crisis. Although the worst-case scenarios of morbidity and mortality have not played out in Israel as of today, the pandemic has confronted Israel's civilian population and leadership with complex challenges. Furthermore, because the repercussions of the pandemic will have an impact on the dynamic situation in the Middle East—on a scale and timeline that are yet to be fully understood—it is already clear that this is a global turning point. These repercussions will not bypass Israel, and will indeed influence Israel's national security. The pandemic brought important components of national security—beyond the security apparatus and the military—to center stage of the public discourse. Areas that were of particular prominence included the economy, education, healthcare, and social resilience.

The coronavirus crisis has not only posed and accentuated challenges; it has also created opportunities for deep changes to strengthen both the State of Israel and Israeli society. Government officials are still focused on managing the complex events, which makes it difficult to think ahead. It is therefore important that there be a body that thinks strategically and creatively about the future and about the opportunities that the current challenges present. Following a request by the National Security Council (NSC) of the Institute for National Security Studies (INSS) to assess such opportunities, a group was formed to undertake this task. The papers compiled in this study are designed to shed light on these opportunities and suggest ways to realize and leverage their potential.

The project was led by Lt. Gen. (ret.) Gadi Esienkot. The various teams included experts who examined the respective subjects and formulated insights and principal recommendations. Members of the steering committee were Dr. Ran Goshen, Yoram Yaacovi, Yoram Tietz, Maj. Gen. (ret.) Nitzan Alon, Amir Levi, Maj. Gen. (ret.) Yishai Beer, Mor Yahalom, and Sara Greenberg.

The opportunities facing Israel in the wake of the coronavirus crisis were divided into seven categories: security, regional cooperation, economy, technology, healthcare, aliyah, and education.[1]

Many aspects of these areas are intertwined, such that there is some overlap between the opportunities and recommendations presented in different categories. Thus, for instance, the recommendation to sign a regional economic agreement appears both in the economic section and in the section about regional cooperation, and the recommendation that the government invest in remote medical technology can be found both in the section about healthcare and in the section about technology.



The recommendations detailed in the various papers were divided into three different types:

Recommendations that are relevant independent of the Covid-19 crisis, but whose relevance is highlighted by the crisis.

Recommendations for taking advantage of opportunities created by the Covid-19 crisis.

Recommendations for improving the function of the State of Israel in future similar crises.

These recommendations are mainly for the short to medium term: from the time of publication through the following five years. The insights, recommendations, and detailed ideas described here can be advanced through a broad framework or smaller programs. The various articles are available to any individual or entity that sees fit to use them, in other words, to realize opportunities toward enhanced national security—opportunities that emerged alongside the damages inflicted by the pandemic on important aspects of security and national resilience.

Main Opportunities and Recommendations toward their Realization

Security

Strengthening Solidarity in Israeli Society
The coronavirus endangers all sectors of society, and this understanding connected all these sectors. The connection was evident in expressions of mutual responsibility, and there were even opportunities created for strengthening national resilience. For instance, the IDF's involvement in community organization opened the door for improving the IDF's image in the haredi society, as well as creating a basis for improving the relationship between the IDF and the police and the Arab sector. Thus, an opportunity was created for strengthening national resilience in Israeli society.

Recommendation 1: Adopt and implement a model of civil service for all, so that everyone who does not engage in military service will volunteer in various civilian frameworks: the education system, Magen David Adom, ZAKA [disaster victim identification], the healthcare system, and more.

Recommendation 2: Strengthen the character of the IDF as a people's army through its diversity, professionalism, and the way it shows appreciation for its soldiers and commanders.

Recommendation 3: Provide basic training in various fields to all those who are not drafted into the military, in order to create a national reserve for dealing with national emergencies and disasters.

Adapting the National Security System for the Challenges of the Future
The variety of threats and disasters that could potentially befall Israel demands newly adapted organization of the state response. The pandemic exposed gaps in the performance of Israel's national security system in a state of emergency, and created the opportunity for profound change through reorganization.

Recommendation 1: Prepare and issue essential national security documents for the State of Israel: national security doctrine, national security policy, and organizational strategy of each security force. These documents must include content relating to the role of each organization or system in a state of emergency.

Recommendation 2: Reorganize the national security establishment, redefine the responsibilities of the respective security organizations, and define the overarching organization, the means of control, and the chain of command in the transition from routine to emergency.

Recommendation 3: Update the security budget in light of the economic crisis that the Covid-19 pandemic created, and create a multi-year framework that will include a plan for full use of all capabilities and resources of the various security branches.

Improving Israel-US Relations
The coronavirus crisis, the ensuing economic challenges in the United States, and the threats facing Israel in the Middle East constitute a basis for deepening the cooperation between Israel and the US.

Recommendation: Strive for signing an updated agreement on special relations between Israel and the US, which will include an alliance regarding technological innovations, cooperation in cases of natural disasters and pandemics, and cooperation on regional issues.

Regional Cooperation

Advancing the Regional Economy
The most urgent issue in the Middle East today is employment and economic growth. Israel and its neighbors have an opportunity to create an economic region that will provide employment, advance self-sufficiency, and allow for the relative advantages of each state to be fully realized. This region should include Egypt, Jordan, and the Palestinian Authority, as well as Greece and Cyprus, and be open to additional countries as well. In the framework of a regional economic agreement, there is potential for cooperation in healthcare, tourism, energy, water, agriculture, industry, innovation, and hi-tech, among others.

Moreover, the Covid-19 crisis and the regional economic crisis it created provide an opportunity to formalize cooperation between Israel and other states in the region, and create an official regional strategy to advance Israel’s national interests in the region, both during times of calm and in times of emergency.

Recommendation 1: Advance Israeli-Palestinian negotiations while making efforts to reach a regional agreement for integrating the economies of Israel, Egypt, Jordan, and the PA, as well as Greece and Cyprus.

Recommendation 2: Establish an integrated government platform that will formulate and lead the strategy and execution of regional cooperation.

Economy

Stabilizing the Economy and Setting Fiscal Objectives
Changes to stabilize the economy in the wake of the crisis must be formulated.

Recommendation 1: Adopt a responsible budgetary policy so that from 2022, the government will begin gradual reduction of debt with the goal of returning to a debt-to-GDP ratio of 60 percent within eight years. The road to debt reduction and the fiscal steps necessary for reaching this objective, which involve both spending (including increasing the efficiency of salary scales in the public sector) as well as income (canceling tax exemptions), should be legislated immediately.

Recommendation 2: Reduce the amount of illegitimate capital in the economy by reducing use of cash, to the point of a complete transition toward full digitalization of payments.

Increasing Growth by Integrating Populations into the National Economy
Not all sectors of Israeli society are full participants or highly productive members of the work force, and the coronavirus crisis has increased the need for their joining the ranks of the employed. This has serious potential for increasing growth, as well as contributing to the integration of these sectors into the society at large. General civil service training for all could constitute a tool for integration into industry.

Recommendation: Adopt a policy to integrate Arabs and haredi Jews in the work force and increase the employment of women and reduce gender-based pay gaps—through use of incentives for studying core subjects, Hebrew, and English from a young age, as well as through programs for integration in universities and mass transportation to urban centers.

Changing the Structure of Local Government
There are high inherent costs in the decentralized local government structure in Israel, and this structure is a major contributor to inequality. Advancing a new, regional layer of government will allow regional management and lead to improvements in educational achievements in smaller towns and to economic and industrial development. Regional government will be a new layer of government that will offer advantages for dealing both with future pandemics as well as with other emergency situations.

Recommendation 1: Establish an additional regional layer of government that will incorporate local authorities, and have authority over educational matters, economic planning, and development—authorities that will be transferred both from the central government as well as from the local governments that fall under the new regional layer.

Recommendation 2: Establish metropolitan authorities for transportation that will receive full statutory authority over planning, execution, and operation of transportation, with an emphasis on mass transit.

Technology

Strengthening Innovative Industries and Technologies
The Covid-19 pandemic underscored the importance of local industry. Furthermore, the crisis raised opportunities in many areas where Israel is strong and has relative advantages in the global realm—areas that could increase growth if strengthened. These include: agro-tech and food-tech, renewable energy, information security, digital health, remote working technology, delivery technology, and distance learning technology.

Recommendation: Initiate cooperation between the government and the private sector with these industries in order to create a productive regulatory environment and to encourage government investment in research and development in the defined preferential areas.

Ensuring Reserves of Technological Manpower for the Next 20-30 Years
In recent years, the tech market in Israel has experienced a shortage of technological manpower. Presumably this shortage will only grow as technological needs and opportunities grow.

Recommendation 1: Ensure reserves of technological manpower through technological education in schools and training for weaker populations.

Recommendation 2: Map future trends, including the strengths and weaknesses of the Israeli market, and allocate resources for relevant training and for leveraging these strengths.

Improving Remote Working Capabilities and Internet Services
Remote working or Working from Home (WFH) in addition to online consumption of goods and services will remain relevant for daily life and work routines even after the crisis, and therefore there will be a need for better infrastructure for advanced technology and user experience technology.

Recommendation 1: Invest in advanced communication infrastructure.

Recommendation 2: Urge government ministries and schools to adopt methods and technologies for remote working and provide online services.

Recommendation 3: Encourage the establishment of communal workspaces in cities and towns that will allow remote work close to home.

Healthcare

Consolidating Medical Information to Advance Technological Solutions
Israel is one of the most advanced countries in the world in the use of electronic medical files, but there is still a long way to go in creating a uniform medical file for the community, hospitals, and pharmacies. A uniform medical file for all parties would allow distance treatment both in routine times and in emergencies, and create reliable information for decision makers when a pandemic breaks out.

Recommendation 1: Formulate regulations that will allow for the consolidation of medical files and encourage the development of technologies that will allow for interoperability.

Recommendation 2: Develop technological tools that identify "hotspots" and predict outbreaks to be used by decision makers in times of pandemics.

Upgrading Medical Lab Capacity
From experience acquired thus far, it seems that lab work is the bottleneck that delays receipt of information in real time. Laboratory infrastructures that operate in parallel must be available for use in times of emergency.

Recommendation 1: Plan and implement use of robotic systems in labs.

Recommendation 2: During routine and non-emergency times, prepare academic labs and determine guidelines for use of such labs during times of emergency.

Recommendation 3: Plan ahead for the possibility of pooling samples, based on epidemiological and mathematical "combat doctrine" tools.

Improving Hospitalization Services
Hospitalization-related distress and lack of available beds in hospitals (which exist in non-emergency times as well) made patient care all the more difficult during the peak of the coronavirus crisis, and therefore steps were necessary to flatten the curve of the virus's spread, but at a heavy social and economic price. Hospitalization capabilities must be improved in order to allow better management of higher morbidity rates both in routine times and in times of emergency.

Recommendation 1: Increase the number of hospital beds to alleviate the national shortage.

Recommendation 2: Establish independent hospitalization corporations that will help regulate hospitalizations during times of emergency.

Recommendation 3: Develop and implement home hospitalization arrangements in routine times in order to increase hospitalization capacity during emergencies.

Recommendation 4: Optimize the hospitalization process during times of pandemic by developing capabilities for monitoring patients without human contact.

Upgrading Training for Healthcare Professionals
When a pandemic breaks out, the issue of training for medical professionals, and especially clinical medical professionals, becomes more urgent. Sixty percent of all new doctors in Israel are graduates of foreign institutions, and in a pandemic, they are expected to work alongside physicians trained in Israel. Israeli educational institutions do not have the means to complete training for physicians who studied abroad.

Recommendation 1: Open medical simulation centers at medical schools that will provide training during routine times and support studies during emergencies.

Recommendation 2: Train community health centers to engage medical students in times of emergency.

Recommendation 3: Develop content and remote learning tools for medical professions.

Remote Community Healthcare
Use of remote healthcare services increased during the Covid-19 pandemic. At the same time, the pandemic exposed weakness in health coverage for the most vulnerable populations, especially in facilities for seniors. In addition, it became clear that the public avoided receiving routine medical treatment.

Recommendation 1: Determine guidelines for assigning community doctors to at-risk zones during times of emergency.

Recommendation 2: Make medical files remotely available to service providers.

Recommendation 3: Implement technologies for measuring vital physiological signs remotely, as well as technology for analyzing voice and video.

Aliyah

Support for Diaspora Jewry and Encouragement of Aliyah
The coronavirus crisis was accompanied by a troubling increase in antisemitic speech and violence against Jews in Europe and the US. At the same time, Jews in many countries were exposed to the failures of their countries' healthcare systems. In certain cases (especially in the US), the cost of medical care is very high. In contrast, the State of Israel and its healthcare system have dealt with the pandemic relatively well. This fact, along with other factors, could increase the willingness among Jews to make aliyah to Israel.

Recommendation 1: Renew efforts to encourage aliyah and return of Israelis who moved abroad; improve the absorption of new immigrants and returning Israelis.

Recommendation 2: Allocate resources to support diaspora Jewish communities both in the battle against the pandemic, as well as in the battle against antisemitism.
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[1] In the education category, we present the external work of the National Public Board of Education ; their conclusions are recommended although they were not part of this group's work.

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