Israel has only 50 ventilators in storage for use in emergency situations, according to a Health Ministry document revealed Tuesday by Channel 13.

The letter sent on Monday by Health Ministry deputy director Avi Ben Zaken to the head of his office’s emergency logistics team, Ron Edelstein, states that 192 ventilators have already been distributed to hospitals across the country and that just over a quarter of that number remain.

Meanwhile, the number of Israelis in serious condition and already hooked up to ventilators due to the complications from the virus climbed to 34 on Tuesday evening, with Health Ministry officials expecting that number to balloon in the coming weeks.

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Israel had around 3,000 ventilators prior to the coronavirus crisis, the Globes financial newspaper reported, which has led to efforts to purchase more.

Earlier Tuesday, Prime Minister Benjamin Netanyahu announced that he had ordered Mossad intelligence agency chief Yoram Cohen to lead an emergency team in charge of acquiring medical equipment from around the world. The Mossad already led an operation last week airlifting some 100,000 coronavirus test kits to Israel, though Health Ministry deputy director-general Itamar Grotto told the media afterward that the agency had brought the wrong materials, specifying that what was lacking were swabs.

The revelation of the document on Tuesday came hours before State Comptroller Matanyahu Englman announced he was in self-isolation due to coming in contact with someone diagnosed with the coronavirus, just a day after his office issued a report concluding that Israel’s health care system is not prepared for the pandemic.

Drafted before the coronavirus crisis struck, the State Comptroller’s report offers a chilling warning of the damage the outbreak can wreak, given the lack of strategic planning, funding, equipment and general readiness of the Israeli health service.

The report warns of a lack of hospital beds, isolation rooms, ill-equipped intensive care unit and a lack of cooperation between the health and defense ministries.

Based on an audit of various ministries that was conducted between February and October 2019, the report, titled “The health system’s readiness to deal with pandemics,” deals with the possibility of a COVID-19-like outbreak, but also reviews the government’s preparedness for other epidemics that have happened more recently, such as measles or Leishmania.

The report revealed that the Health Ministry does not have a plan to stock its hospitals with enough beds and staff ready for such scenarios.

The report also determined that the phone lines of health care providers are not prepared to provide responses to thousands of citizens who would be in need if a pandemic were to break out.

Regarding cooperation between the various government offices, the report cited a drill that was conducted by the defense and health ministries in December 2018 that exposed significant gaps in their preparedness to work together in a time of an outbreak.

“The [ministries] must formulate a plan to reduce the gaps that have arisen in the drill, including the need to regulate the issue of authority and responsibility of the various bodies, the lack of prescription drugs and vaccines and how they are to be distributed,” the report said.

Moreover, the audit highlighted an insufficient stock of anti-viral medications, which currently is only able to supply 16% of the public, when the doomsday scenario practiced for expects 25% of the public needing them. The report also revealed that many of the drugs currently in stock are past their expiration dates.

The state comptroller urged the Health Ministry to test the ventilators to ensure that they’d all work in a time of an outbreak.

The report also expresses alarm over the steady decline in Israelis receiving vaccinations for the common flu, calling on the Health Ministry to take a more active role in encouraging the public to vaccinate.

The report was based on a World Bank prediction that in the next 15 years there’d be a high chance of a pandemic outbreak that could result in the deaths of millions and economic losses in the trillions.

Preparing for such a doomsday scenario, the Health Ministry drafted a comprehensive martial law plan for a deadly flu pandemic in 2005. The government office then updated it in 2018 based on recent conclusions from the US Centers for Disease Control.