The Aaron Institute | The Corona Crisis in Arab Society

The Corona Crisis in Arab Society
Marian Tehawkho and Kirill Moskalev

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A brief report published by The Aaron Institute in April looks at the current health risks and economic impact on Arab citizens towards recommendations for recovery plans.

Inter-Agency Task Force Translation

Over a month after the beginning of the Corona crisis in Israel, the two population groups that were marked with the highest likely morbidity rates are at the opposite ends of the scale. The Haredi communities have significantly higher morbidity rates than the rest of the population. On the other end, the Arab communities (including Druze and Christians) have the lowest morbidity rates in Israel. This is because the disease reached the Arab population at a much later stage than the general population in Israel, when awareness of the virus was high and the economy was already at the beginning of the closure. In addition, unlike the Haredi society, there was full cooperation from Arab clerics and heads of authorities to maintain procedures and obey instructions.

The severity of the damage to different populations from this crisis depends largely on the economic and social characteristics of these groups. The economic disparities between Arabs and Jews, which were large regardless, are expected to increase as a result of the crisis due to rising unemployment rates among Arabs. In order to avoid the gaps, crisis relief and closure policies need to be adapted to the unique characteristics of the Arab population, among them the low morbidity rate, the challenges posed by the upcoming month of Ramadan, lower risk of infection and severe morbidity among workers given their young age and job types, and the risk of rising crime following the closure.

Given these characteristics, the economic cost of “sweeping social distancing” in Arab communities can be higher than the cost of health, both among the Arab population and the economic level. Therefore, a number of steps should be taken in the immediate timeframe as part of the Arab exit strategy and the “smart social distancing” policy:

1. Differentiation in quarantines: The communities and areas where the risk level is low can be exempted, alongside as wide a range of sample tests as possible to detect a potential outbreak, especially among workers with a high chance of infection.
2. Opening small businesses within communities where the risk level is low. These businesses must establish clear guidelines on the necessary preventive measures and carry out tests to prevent the creation of new infection bases.
3. Enforcement and control of the instructions in the Arab communities should be handled by the Arab authorities, with the possibility of receiving help from the police, in order to avoid unnecessary friction and tension.
4. In light of the expected decline in local government revenue (mostly residential property) and the need for functioning and strong authorities that are the pillars of Arab society these days, assistance and financial support from the government’s authorities is needed, in order to prevent these authorities’ collapse.
5. Because most women working in Arab society are young mothers and thus were most severely affected by the crisis, kindergartens in Arab communities should be operating as soon as possible, allowing these women to return to the workforce.
6. Publicity and access to information in Arabic should be ensured in order to increase compliance and prevent loosening of civilian discipline, particularly during the days of Ramadan and especially among the younger generation.
7. Regular monitoring should be carried out in the Arab communities to identify communities with high morbidity rates, in order to close them and prevent the spread of the virus. Patients should also be encouraged to go to designated hotels to avoid infecting other family members and people.
8. Government assistance for workers and businesses affected by the crisis must be adapted to the unique needs and characteristics of Arab society. This requires an integration of experts from the Arab society into the forums and public teams discussing the policies required to deal with the crisis and its exit strategy.

Morbidity rates in Arab communities 

There are significant gaps in morbidity rates and the spread of the Coronavirus among the various populations in Israel, which are also reflected in the mortality rates among patients. There are various factors for these gaps, including the stage at which the first patients were discovered and the speed of response; the degree of exposure of different and wide audiences during work or leisure; population demographic structure, household composition, and residential density; availability of reliable and accessible information on the morbidity level; the existence of clear instructions in the appropriate language as to the ways to protect against the spread of the disease; and cultural differences that affect the degree of households and public opinion influencers’ personal responsibility, as well as the compliance with governmental directives.

At the beginning of the crisis, the Haredi and Arab societies were marked with the highest risk of infection due to their failure to comply with the Ministry of Health and the Government’s instructions. Reports in the Hebrew media mentioned these two populations in the same breath, but when the Ministry of Health began publishing daily statistics on the morbidity rates by communities, it became clear that while they were particularly high among the Haredi population, the Arab population was almost absent from the statistics. Discourse in Arab society was different, and the very low proportion of Arabs among the confirmed patients – which stood at less than 1% in the last week of March – raised suspicions from the population, the leadership, and the medical staff. They accused the Ministry of Health of disregarding Arab society, linking the low proportion of patients to the low number of tests in Arab communities due to a lack of awareness of their importance and lack of access to regular information in Arabic.

Following the pressure exerted on the Ministry of Health, efforts have been made since April to increase the scope of the tests, by placing testing points in central Arab localities and easing the testing criteria, as well as advocacy efforts to raise awareness of the importance of the tests. These efforts have led to a significant increase in the number of tests in the Arab localities, and in some days in the past two weeks, 30%-50% of the tests in Israel were conducted in Arab localities. At the time of writing this paper, over 29,000 tests had been carried out in Arab society, which constitutes about 12% of the tests performed in Israel. Increasing the testing rate in Arab communities has indeed increased the proportion of Arabs among the patients. It is currently 4.3%, while the proportion of Arabs in the general population is 20%. That is, even more than a month from the beginning of the crisis and after a significant increase in the volume of tests in Arab communities, the morbidity rate in Arab society remains low.

Table 1: Average number of patients per thousand people by the type of locality, 19.4.2020 

There are a small number of Arab communities with higher rates than the national average, headed by Deir al-Assad with 7.1 patients per thousand – the highest morbidity rate among the Arab communities. Far behind is the village of Dabburiya with 2.7 patients per thousand, Jasser al-Zarqa with 2.6 Patients per thousand residents and Umm El-Fahm with 1.04 patients per thousand residents. But even in these communities (apart from Deir al-Assad) the morbidity rate is low compared with Jewish society. The morbidity rate is low in the vast majority of Arab communities in Israel, as can be seen in table 3, and 95% of Arabs in Israel live in communities where the morbidity rate is below the national average (which stands at 1.5 patients per thousand residents).

Table 2: Average number of patients from tests by the type of locality, 19.4.2020

Table 3: Percentage of people living in localities with morbidity rate above the national average, 19.4.2020

The causes of the low morbidity rate in Arab communities 

In order to understand the causes of the low morbidity rate in Arab communities, we should go back to the beginning of the Coronavirus crisis. The first confirmed patients in Israel were discovered at the end of February, and most cases were imported from abroad by people in the 40-69 age group. In early March the Purim holiday began, and according to the Ministry of Health the following week, the rate of 20-39-year-olds among the confirmed patients increased significantly. Therefore, people returning from abroad brought the disease to Israel, and Purim holiday events helped spread the virus, especially among young people. Subsequently, with the partial closure of the economy and schools, the main source of the increase in morbidity was in the Haredi concentrations due to non-compliance with the closure instructions and the holding of prayers in the synagogues.

This data reveals a number of factors that have contributed to the low morbidity rate among Arab society. First, Jews travel abroad at an average of 55% more than Arabs do, so the chance of importing the disease from abroad to Arab communities was smaller. Arabs also travel less to work outside their localities, only 23% of those aged 15 and over in Arab localities go to work outside their communities daily, compared to 40% of Jews in the same age group (the proportion of non-Haredi is even higher). The low number of Arabs who work outside their communities derives from the low employment rates in these communities among the elderly and women, and because most Arab women work close to home.  Hence, their chances of being in contact with patients from other communities are significantly lower. Thirdly, Arabs did not participate in the Purim celebrations that caused the disease to spread among the Jewish population. Thus, the Coronavirus arrived in the Arab localities when the number of patients in Israel has already passed the threshold of 1000, awareness was high and the economy was already at the beginning of the closure.

The fourth reason, which is the key to the large disparities in Arab and ultra-Orthodox mortality rates, is the cooperation of clerics from all sectors of Arab society – Muslims, Druze, and Christians. These clerics immediately closed the houses of prayer and urged the public to obey directives and stay at home. In addition, the heads of Arab authorities and medical teams mobilized to raise awareness on the issue, and there was also a sense of enlistment of Arab families to keep the social distance, which was reflected mainly in calls on social networks to stay at home.

The fatality rate among Arabs is also extremely low. Two out of the 158 Coronavirus victims in Israel are Arabs – a 78-year-old woman from East Jerusalem, and another 90-year-old woman from Tamra (according to doctors’ reports at the Rambam Hospital she died due to other illnesses a few days after recovering from the Coronavirus).  This figure is not surprising given that most fatalities all over the world and especially in Israel are elderly, while the Arab population is relatively young. In addition, a very high proportion of elderly people who died in Israel were infected in nursing homes, whereas Arab society has almost no such institutions and seniors often live in houses near their offspring.

Hence, the question that arises is what caused the disease outbreak in the Arab communities. Reports we received from the Ministry of Health and the heads of the Arab authorities, which are based on the results of an epidemiological investigation by the Ministry of Health among the patients in these communities, indicate that in all cases the disease was brought by workers employed outside the communities who were exposed to Jewish patients. In Jasser al-Zarqa, the first patients were infected during their work in hospitals in Central Israel; in Umm al-Fahm the virus was brought by a young woman who was infected during her work at the Shufersal branch in Central Israel;  in Dabburiya the virus was brought by young people who were infected during their work in a nursing home in Yavniel; and in Deir al-Assad the first patients were infected by a Haredi employee during their work in a slaughterhouse in their area of residence. Since this slaughterhouse employs a large number of workers from the surrounding communities, the initial contagion circle was wide, thus explaining the high infection rates in Deir al-Assad and other small towns in the area. In all cases, employees also infected their immediate surroundings.

Impact of the Corona crisis on labor market gaps 

The pre-Corona crisis economic gaps between Arabs and Jews in Israel were great. The average income of Arab households is half that of non-Haredi households, and there is an over-representation of Arabs among poor families in Israel. The income gap stems from lower employment rates in Arab society, especially among women, and significant wage disparities, especially among men, which among other things are due to a lower level of human capital in Arab society and over-representation in jobs with low productivity.

With the beginning of the current crisis and the imposition of restrictions in the labor market, unemployment rates rose to levels not observed since the establishment of the state. According to the Employment Service, the number of unemployed in Israel on March 31 stood at 988,957, approximately 90% were dismissed or forced to take unpaid leave during March due to the Corona crisis. 17.3% of newcomers to the unemployment cycle are Arabs, while the percentage of Arabs in the job market in 2018 was only 13.9%, meaning there is an over-representation of Arabs among the newly unemployed.

It is likely that the reason for the over-representation of Arabs among the new unemployed lies in the different ethnic distribution among the economic sectors. For example, there are fewer Arabs in the high-tech sector, which was less affected by the crisis, and more in the education sector that was more affected. Also, the workers most affected by the crisis are the young and the low-income, and the rate of Arabs in these groups is high. This can also be added to the lack of Arab representation in the public sector, which was less impacted ‘by the crisis.

Crisis management and exit strategy in Arab society 

The worldwide crisis management policy is trying to balance the health consideration, which aims to reduce the number of patients and fatalities and prevent flooding the health systems, and the economic consideration, which aims to reduce the damage to the labor market and prevent significant damage that will take many years to recover from. The quarantine policy currently being implemented in Israel, which can be called “sweeping social distancing”, is massively imposed across the country almost indiscriminately and gives top priority to short-term health considerations. This closure can cause serious damage to the economy and society as a whole, and the severity of the damage can vary among different population groups, thus deepening the economic gaps among them.

In light of this, a “smart distancing” policy is required that will take into account short-term and long-term economic and social aspects and will be based on cost-benefit analysis. The main goal of such a policy is to open up the economy to minimize damage to GDP while managing health risks. This policy characterizes the preparedness and coping of leading Southeast Asian countries, especially Taiwan, and incorporates maximum medical information on every detail, multiple tests and the use of selective monitoring and closures to prevent infection. This policy has already been adopted in many European countries.

Because the vulnerability level of different populations in the short and long-term is mainly dependent on the economic and social characteristics of these groups, the relief policy needs to be adapted. In particular, there are a number of characteristics of unique characteristics of Arab society in Israel, including:

• The morbidity rate in most of the Arab communities is low and in some cases zero.
• The breathing length in Arab society is very short because it is a poor and weak population, so the economic impact of a prolonged closure will be deeper and will take longer to recover from.

• The upcoming Ramadan month presents unique challenges in all aspects, most notably the ability to enforce social distancing after breaking the fast in the evening and given that this is a one-month period.
• Arab workers are at lower risk of contagion and severe morbidity, both because the retirement age from the Arab labor market is low and therefore the vast majority of employed are young, and because the proportion of Arab employees in open places industries such as construction and agriculture is high.
• Crime rates in Arab society are high and can intensify as a result of economic hardship and inaction among young people following the general closure.