Abstract
BackgroundThe Arab ethnic minority makes up 21% of Israel’s population, yet comprised just 8.8% of confirmed cases and 3.6% of deaths from COVID-19, despite their higher risk profile and greater burden of underlying illness. This paper presents differences in patterns of morbidity and mortality from COVID-19 in the Arab, ultra-Orthodox and overall populations in Israel, and suggests possible reasons for the low rates of infection in the Arab population.MethodsData were obtained from the Israeli Ministry of Health’s (MOH) open COVID-19 database, which includes information on 1270 localities and is updated daily. The database contains the number of COVID-19 diagnostic tests performed, the number of confirmed cases and deaths in Israel.ResultsIn the first 4 months of Israel’s COVID-19 outbreak, just 2060 cases were confirmed in the Arab population, comprising 8.8% of the 23,345 confirmed cases, or 2.38 times less than would be expected relative to the population size. In contrast, the ultra-Orthodox made up 30.1% of confirmed cases yet just 10.1% of the population. Confirmed case rate per 100,000 was twice as high in the general Jewish population compared to the Arab population. The Arab mortality rate was 0.57 per 100,000, compared to 3.37 in the overall population, and to 7.26 in the ultra-Orthodox community. We discuss possible reasons for this low morbidity and mortality including less use of nursing homes, and effective leadership which led to early closure of mosques and high adherence to social distancing measures, even during the month of Ramadan.ConclusionsDespite a disproportionate burden of underlying illness, the Arab population did not fulfil initial predictions during the first wave of the COVID-19 outbreak and maintained low numbers of infections and deaths. This contrasts with reports of increased mortality in ethnic minorities and economically disadvantaged populations in other countries, and with high rates of infection in the ultra-Orthodox sector in Israel. Effective leadership and cooperation between individuals and institutions, particularly engagement of community and religious leaders, can reduce a group’s vulnerability and build resilience in an emergency situation such as the current pandemic.
Highlights
The COVID-19 pandemic has affected, at the time of writing (1/7/20) over 200 countries, with 10,495,019 confirmed cases, and 511,686 deaths
Public Health England published a report into the disproportionate number of cases experienced by ethnic minorities, reporting that people from ethnic minorities had between 10 and 50% higher risk of death from COVID-19 compared to white British [5]
This paper presents differences in patterns of morbidity and mortality from COVID-19 in the Arab, ultraOrthodox and overall populations in Israel, and suggests possible reasons for the low rates of infection and mortality in the Arab population
Summary
The COVID-19 pandemic has affected, at the time of writing (1/7/20) over 200 countries, with 10,495,019 confirmed cases, and 511,686 deaths. Various countries have reported social disparities, with racial and ethnic minority groups being hit harder, suffering disproportionately greater infection and mortality rates [1]. COVID-19 mortality was markedly higher for black Americans (61.6 deaths per 100,000) compared to all other ethnic groups (white Americans 26.2 deaths per 100,000; Latino Americans 28.2 deaths per 100,000) [2]. Public Health England published a report into the disproportionate number of cases experienced by ethnic minorities, reporting that people from ethnic minorities had between 10 and 50% higher risk of death from COVID-19 compared to white British [5]. The Arab ethnic minority makes up 21% of Israel’s population, yet comprised just 8.8% of confirmed cases and 3.6% of deaths from COVID-19, despite their higher risk profile and greater burden of underlying illness. This paper presents differences in patterns of morbidity and mortality from COVID-19 in the Arab, ultra-Orthodox and overall populations in Israel, and suggests possible reasons for the low rates of infection in the Arab population
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