Flattening the Curve in Israel

During times of uncertainty, whether in war or a global pandemic, securing mental health is just as important as securing physical health. Over the last few months, we’ve seen that ensuring the mental state of first responders is paramount to ensuring public health.  

To this end, Magen David Adom (MDA), Israel’s National Emergency Medical and Blood Services that is mandated by national law, has made it a priority that its volunteers stay healthy during the coronavirus outbreak.

Every few years, MDA performs mental health surveys, measuring the psychological health of its volunteers—especially its youth volunteers. Over the past 20 years, each survey has revealed that MDA volunteers show high levels of resilience and low incidence of mental symptoms including PTSD. Resilience was the norm during the difficult times of the Second Intifada, when MDA teams treated thousands of terror victims of mass casualty attacks. Such is the case today as MDA has acted on the front lines of the coronavirus, thereby helping to flatten Israel’s curve.

We have ensured such resilience among our providers by following our mental health guidelines—such as performing a debriefing following a potentially traumatic event—to safeguard proven resilience factors. Over the last three years, we have expanded our mental health program with lectures, seminars and a mental health manual reaching MDA staff, medics and paramedics, volunteers and employees.

Our secret to resilience and staying mentally healthy has been threefold, and begins with our teams' display of confidence in their own abilities as well as those of the organization. The personal and professional skills taught in MDA training have led to this assurance. Second, our teams are confident in the MDA’s social and professional cohesion, as well as in the unit leader's abilities. Last, MDA staff believes in the importance of MDA’s mission.

This year, we completed a "COVID-19 edition" of our first mental health manual after understanding MDA’s crucial role in the country’s struggle against the virus.

Until recently, the handling of each COVID-19 test was coordinated by MDA with hundreds of youth volunteers supervised by professional MDA staff coordinating the administration of many of these tests through the dedicated COVID-19 call center. Early in the outbreak of the pandemic, MDA formed the "Corona Call Center,” open 24-7, in which thousands of callers were evaluated daily.  Callers who needed coronavirus tests were directed to one of several locations or were tested in their homes. Those who needed to be taken to a hospital were transported by MDA ambulances using full protective clothing and equipment.

Establishing the call center helped prevent overcrowding of Israel's hospital emergency rooms and other health clinics and prevented transmission of the virus at the national level—all while MDA continued its regular life-saving activities. MDA acted as the key factor in Israel’s quick diagnosis, prevention and treatment of the coronavirus outbreak, flattening our national curve that’s allowed the gradual return to normal.

Acutely aware that the relentless efforts of our staff could cause both fatigue and burnout, we constantly encouraged them to talk to their teammates and staff if they were feeling stressed or tired. We asked them to take stock of their mental state, devote time to friends and family, and rest and recharge their batteries with sleep and proper nutrition.

The main concern of MDA staff—being exposed to the virus at work and in turn infecting their families—became quite rapidly minimal, as only a few MDA staff have been infected by COVID-19 to date.

As MDA has successfully coordinated and treated patients during this dangerous epidemic, their resilience has remained strong. We at MDA are eternally proud and grateful for our employees and volunteers who make great contributions to the health of Israel’s diverse citizenry.

There is one aspect that could increase MDA’s resilience even further—the ongoing gratitude of the Israeli public. The crucial role of MDA in the successful treatment of the COVID-19 epidemic must be saluted.

Haim Y. Knobler is mental health advisor for Magen David Adom.

Eli Jaffe is deputy director general—community for Magen David Adom.