Doctors are asked to play god less than 10 days after Yom Kippur.

Hospitals across the country are overcrowded. Their coronavirus departments are collapsing and the doctors trying to treat all of these patients are collapsing. There is not enough rescue equipment, nor qualified personnel to manage it.

We read in the prayer of Unetaneh Tokef: “How many will pass from the earth and how many will be created?” … Who will die at his predestined hour and who before his hour… who of famine, who of thirst… who of pestilence?

Will Israeli doctors be the only ones to decide?

“We are very close to a situation of choice among patients” in the coronavirus wards, said Dr Masad Barhoum, director of the Galilee Medical Center this week.

A 53-year-old man was hospitalized in serious condition, but not from the coronavirus, at a relatively small hospital that lacked an ECMO machine. He died when the hospital had been trying for too long to find a larger medical center that could treat him, N12 reported.

It’s not just the number of devices, but also the manpower to manage them. Every patient on an ECMO machine requires 24/7 nursing care.

“We don’t have the staff to take care of these people,” Dr Yael Haviv-Yadid, head of an intensive care unit and coronavirus intensive care unit at Sheba Medical, told The Jerusalem Post. Center. “We can always have spare machines, but we won’t have the staff to operate them. “

While the ministries of health and finance have provided additional funds for hospitals to hire new staff, not everything has come and certainly not on time.

Junior doctors need to be trained, explained Haviv-Yadid.

Minister of Science and Technology Izhar Shay receives coronavirus vaccine, Sheba Medical Center, December 20, 2020 (credit: SHEBA MEDICAL CENTER)

“With great pain, we are forced to turn patients away,” said Moshe Cohen, CEO of Yad Sarah. “We were begging for oxygen tanks in order to make room on coronavirus wards and save lives.

There are also not enough hospital beds.

During the first wave of COVID, the government asked hospitals to refrain from offering voluntary surgeries or treatments, isolating themselves to almost everyone except urgent and COVID patients. In subsequent waves, many people were still afraid of seeking treatment in hospitals where they thought they could contract the virus.

Plus, the closures kept people inside.

However, once the country resurfaced in the spring, doctors and hospitals saw an influx of patients, many of whom arrived sicker and in need of more care. Beds were full at the start of wave four – even before COVID patients started arriving.

Doctors now cannot place some ventilated COVID-19 patients in the coronavirus intensive care units of their hospitals where they belong, but must instead leave them in the coronavirus internal medicine departments where they will be treated by nurses. and other less qualified and experienced physicians. Staff.

At Ziv Medical Center in Safed, Dr Shimon Edelstein, who heads the hospital’s infectious disease unit, said the hospital was just full. She has already started closing units, from geriatrics to neurology.

“We had to take staff from these units to treat coronavirus patients,” Edelstein said. “It means we can’t do operations. It’s not just about saving lives, but also about quality of life.

Ziv does not have ECMO machines, nor personnel trained to use them. This means that if patients need such care, they must be transferred elsewhere.

On the evening of Yom Kippur, a medical team from Hadassah University Medical Center had to travel all the way from Jerusalem to Safed (approximately 2 hours and 40 minutes) to urgently obtain and connect a 40-year-old man to an ECMO machine before he was dead.

Between Haifa and Tel Aviv, there are no ECMO machines, according to Dr Mickey Dudkiewicz, director of Hillel Yaffe Medical in Hadera. With most of the machines at the center already taken, Edelstein said the only option was Jerusalem.

The pressure is starting to crush the medical staff.

Ziv is a hospital with only 330 beds. Among them are 31 coronavirus patients, including 11 who are being treated in intensive care. But there are also patients in regular intensive care. The hospital has only four intensive care experts, which Edelstein says are now overworked.

He said the hospital lacks the specialists it needs, so those it does have are forced to go back and forth between departments.

“They work so hard, 24 hours a day, and they have to endure all the suffering of these COVID patients and their families. It’s very depressing and very tiring, ”he said.

All while the numbers are not decreasing.

The Arab sector, where schools have been fully opened, has seen a 150% increase in severe morbidity over the past five weeks. A similar pattern can be expected, if nothing changes, when Jewish schools resume after Simhat Torah.

Haviv-Yadid said most of the serious patients are under 60 at this stage and, at least in Sheba, none of them are vaccinated.

“I have one who has 30, 34, 35, 38, 50, 57…”, recited Haviv-Yadid. “I don’t think someone who hasn’t been vaccinated deserves a death sentence. But if coronavirus patients are left untreated, it means death. “

Last month, an average of 23 people died from COVID-19 every day.

“Each of these deceased people has a name, a face and a shattered and saddened family,” the former chairman of the Constitution, Law and Justice Committee, MP Yakov Asher, said on Wednesday. “Prime ministers convey to the public that the value of life is no longer above everything on the scale of Israeli values. “

The National COVID-19 Expert Committee on Thursday warned the government that its policy of relying on a third recall and minimal economic restrictions was not working.

They also said Israel, like other countries, would likely face the tragic dilemma of prioritizing young patients in need of intensive care for coronavirus or otherwise over elderly patients and called for a change in policy. .

Without one, the government silently issued a death decree – at least for those unfortunate enough to be gravely ill.