The Israeli health system had a critical role in leading the response to the COVID-19 pandemic facing a wide-range of challenges following the length and the unique characteristics of this health emergency. This study evaluated the weaknesses and strengths of the different parts of the system, relying on WHO building blocks to promote better coping with large-scale health emergencies.

The experiences of 13 high-level senior experts in the Israeli health system who directly managed COVID-19 were examined, using in-depth semi-structured interviews conducted during 2021. Critical and snowball sampling were used to select participants. Interviews were recorded and transcribed. Data analysis was conducted using ATLS.TI 22 software and reviewed by peers. The interviews were analyzed using the thematic analysis method. A theme expresses a broad central idea that tends to appear and reoccur in the analytical material in different forms of expression. Specifications and ideas were discussed among the researchers while engaging in repeated rereading of the transcriptions until saturation was achieved with the final themes.

The role of the Ministry of Health in integrating the health response and importance of spokespersons providing professional information increase trust as a crucial role of community health services in emergencies having political tensions reflected in the medical response. The Israeli Health system differ from hospital systems abroad by the relationships between preparedness during routine and emergency response. The importance of trust was highlighted.

The study demonstrates a deep understanding of the way the Israeli health system dealt with the pandemic, revealing needs, resources, weaknesses and strengths. The results offer a rare opportunity to learn how integration of service-delivery can be improved within the health system in all levels. These lessons should be translated to advance better handling of future emergencies.