The scene disclosed by an Israeli television report last week inside a Meah Shearim basement — the nerve center of a medical chesed network that has been providing home care for thousands of COVID patients over the last six months — stunned both health care professionals and the public. But the initial outrage over this medical “fifth column” notwithstanding, the public discovery has subsequently sparked a serious discussion about benefits of the home-care alternative to overcrowded, understaffed hospitals.
The subterranean storage room, home of the Chasdei Amram medical-supplies gemach, holds up to 220 oxygen machines that are loaned out to coronavirus patients for free, as well as dozens of oxygen saturation monitors and other medical equipment for the COVID-19 battle. Volunteers visit coronavirus patients in their homes several times a day, closely monitor their vitals, oxygen saturation levels, and other symptoms, and medical professionals who work with the organization decide when and if the patient should be transferred to a hospital.
Yitzchok Markowitz, founder and director of Chasdei Amram, is adamant that his program provides more hands-on treatment than the current medical establishment and lifts some of the burden off the health care system.
At least 170 people currently being treated by the volunteer network are in serious condition, and over 2,000 patients have received Chasdei Amram’s assistance over the past six months. Markowitz claims that only 10 to 15 of his patients have ended up in the hospitals, and only three out of several thousand have died.
The home-care phenomenon quickly spread beyond the insulated Meah Shearim community to other frum communities in Jerusalem and other cities, but volunteers are not discriminating — anyone who calls gets helped.
“We generally provide initial consultation, and we immediately send out the oxygen-saturation monitor and blood-pressure gauge,” Yitzchak Markowitz tells Mishpacha. “A doctor and a nurse come to their homes to take blood samples, and we transfer the samples to one of two recognized labs we work with.”
According to the strict definitions of Israeli health protocol, a patient with a saturation level of 93 or lower is considered to be in “serious” condition, so it’s safe to assume that this organization and others, such as Yad Sarah, working outside the established health system are caring for about one-fifth of the patients classified as seriously ill in Israel.
The lack of official virus figures in large swathes of the chareidi community make it difficult to draw statistical conclusions with regard to the clandestine chareidi home care network. But this trend, which Chasdei Amram was happy to finally make public, may actually upend existing systems and provide original thinking with regard to how this disease is being treated. Perhaps, as some officials have allowed themselves to wonder out loud, this model, with the proper oversight and direction, is a solution.
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“The patients who ask us for help will do anything to stay out of the hospital, and these days it’s not about anti-Zionist ideologies,” he says. “No one in Israel wants to go to the hospital, to be dumped in a COVID ward. No one. Secular, religious, chareidim, more extreme sectors, none of them. I get phone calls now from secular people, asking me what to do to avoid hospitalization. People are frightened of being thrown into an overworked, understaffed ward, isolated from their families, alone and helpless.”
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That said, Markowitz believes that patients are psychologically better equipped to fight when they’re home with family than when they’re isolated in a hospital coronavirus ward. In addition, many elderly COVID-19 patients suffer cognitive decline when out of their familiar surroundings, and especially if they find themselves surrounded by alien-looking workers in their PPEs, with no family close by.
“I would say that 70 percent of recovery depends on the patient’s mood,” he says. “When the patient is in good spirits, we see his saturation go up, along with his other indices. These are facts you can’t deny.”
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The idea of home hospitalization didn’t start with an underground Meah Shearim gemach. Twenty-five years ago, Yad Sarah founder Rabbi Uri Lupolianski was awarded a special honor by the Health Ministry for creating a prototype for home hospitalization, a model that would greatly alleviate the burden on hospital wards, save thousands of dollars daily for insurance companies and state coffers, and increase the rate of healing and patients’ wellbeing; people have more fight and devotion to get healthy when they’re surrounded by the love and care of their families, as opposed to the confusion of an isolated, frightening ward, even with the best care.
But according to Yad Sarah’s director-general Moshe Cohen, all that remains of that forward-thinking program is a plaque on the wall. He says that 18,000 people have received home medical devices since the virus began, and very few of them were subsequently hospitalized. Without Yad Sarah’s home care, says Cohen, the health care system would be overwhelmed.
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