It is often referred to as ‘the coronavirus’ or ‘corona’, but officially the virus is called SARS-CoV-2. The coronavirus SARS-CoV-2 causes the disease COVID-19. The symptoms often resemble the common cold at first. The course of illness varies. Some people do not become ill at all, or are only mildly ill from the virus. Others may become seriously ill and sometimes die from the effects of the disease.

What is COVID-19?

COVID-19 is the disease caused by the coronavirus SARS-CoV-2. The disease can cause respiratory symptoms and fever, and in severe cases it leads to breathing problems. The virus is spread by droplets. For example by coughing, sneezing, singing or talking. When that happens, the virus is released into the air in droplets. If other people inhale those droplets, or get them in their mouth, nose or eyes, for example via their hands, they may become infected with the virus.

The symptoms of COVID-19

The most common symptoms of COVID-19 are:

  • Cold symptoms (such as a nasal cold, runny nose, sneezing, sore throat)
  • Coughing
  • Shortness of breath
  • Elevated temperature or fever
  • Sudden loss of smell and/or taste (without nasal congestion)

Less common symptoms:

  • Tiredness
  • General aches and pains
  • Headache
  • Eye pain
  • Muscle aches
  • Dizziness
  • Irritability/confusion
  • Abdominal pain
  • Weight loss / loss of appetite
  • Diarrhoea
  • Nausea / vomiting
  • Eye infection (conjunctivitis)
  • Various skin abnormalities (such as a rash)
  • Feeling unwell

Incubation period

The time between the moment you become infected and when you start showing symptoms is called the incubation period. The incubation period of SARS-CoV-2 is between 2 and 14 days. If you are infected with the coronavirus SARS-CoV-2 , it will usually be 5 or 6 days before you develop symptoms. It has become apparent from source and contact tracing that 99% of the contacts who develop symptoms do so within 10 days after the last contact with the infected person. For that reason, the quarantine period was shortened to 10 days, effective as of 19 August 2020.

If you have symptoms that could indicate COVID-19

  • Do you have mild symptoms, such as a nasal cold, runny nose, sneezing, sore throat, mild cough or elevated temperature (up to 38 degrees Celsius)? And/or have you suddenly lost your sense of smell or taste? Get tested and stay home until the results are known. Do not do any shopping and do not receive any visitors. Ask someone else to do your shopping, or have your groceries delivered. Arrange for someone else to walk your dog. For household members without symptoms, the basic rules that apply to everyone in the Netherlands are also applicable here.
    • If the result of the test is negative, then you were not infected with the coronavirus SARS-CoV-2 at the time you were tested. You do not have to stay home any more, and can return to your normal routine (such as going to work or school). (This does not apply if you were required to stay indoors after having contact with a person who has COVID-19 and are in quarantine. In that case, you can be tested without symptoms from day 5 of the quarantine period.)  If the result is negative, then you do not have to stay home any more, even as a contact of a person who has COVID-19. However, it is important that you avoid contact with vulnerable people until 10 days after the last high-risk contact. Also keep following the rules that apply to everyone in the Netherlands: stay 1.5 metres apart from people who do not live in your household, wash your hands regularly, and cough and sneeze into your elbow.
      If you develop (new) symptoms that could indicate COVID-19, or if your symptoms get worse, then stay home and immediately call the national COVID-19 test line for a new appointment: 0800- 1202.
      If you have severe symptoms, call your GP or the out-of-hours medical centre.
    • If the test shows that you do have COVID-19, household members who do not have symptoms should also stay home. More information about what to do at home if you have COVID-19.

Isolation: if you are ill

If you have symptoms that could indicate COVID-19, or if you have COVID-19 (you have been tested and the result of your test was positive for COVID-19), then you will go into isolation. In that case, you must stay home. During this period, you are not permitted to travel or go on holiday. This prevents you from infecting others and continuing to spread the virus. Symptoms that could indicate COVID-19 are: cold symptoms (such as nasal cold, runny nose, sneezing, sore throat) and/or coughing, shortness of breath, elevated temperature or fever, or sudden loss of smell and/or taste (without nasal congestion). The recommendation is to get tested. Stay home until the test results are known. If the test is positive, this means you have COVID-19. In that case, the Municipal Public Health Service (GGD) will tell you what you need to know about the isolation period.  Isolation could take place in your own home (home isolation). People who are ill and receiving treatment in hospital are placed in isolation in the hospital.

Quarantine: If you have had close contact with someone who has COVID-19, and you are not yet (fully) vaccinated, you may also become ill.

If you go into quarantine, you are not ill. You have been in contact with someone who may (possibly) be infected. Most people who become ill from the coronavirus SARS-CoV-2 develop symptoms within 10 days after the last contact. This is why they must stay home for 10 days, in order to prevent the virus from spreading. During this period, you are not permitted to travel or go on holiday. If people do develop symptoms during the quarantine period, we recommend that they make an appointment to get tested right away.

In the following situations, people are supposed to go into quarantine:

  • If someone in your household tests positive for COVID-19, or if you have had close contact with an infected person.   For household members and close contacts, it is possible to be tested from day five of the quarantine period without symptoms. If the test results are negative, then you do not have to stay home any more. However, it is important to avoid contact with vulnerable people until the 10th day after your last contact with a person who has COVID-19.
  • If you have been to a country/area that has been designated as a COVID-19 risk area.

After the quarantine period, the basic rules still apply: if you have symptoms, stay home and get tested, stay 1.5 metres apart from others, and wash your hands often.

When should I call my doctor?

Call your GP if your symptoms grow worse, or if you require medical assistance. For example, call the doctor if you develop a high fever or have difficulty breathing. Do not go to your GP or visit the hospital; instead, call your GP or the out-of-hours medical centre.

Recovery after illness

The amount of time it takes to recover from COVID-19 can vary from person to person. There is much we still do not know about this. Some people only have cold symptoms and recover within a few days, but there have also been people who continued to have persistent symptoms (such as cold symptoms) for a long period of time, extending many weeks. If you are symptom-free for 24 hours (no fever, coughing or cold symptoms), and it has been one week since you became ill, you will no longer be able to infect other people. People with COVID-19 who have been admitted to hospital generally need more time to recover. This depends, among other things, on whether they are healthy other than the coronavirus infection.

Long COVID

Some people have long-term symptoms after a SARS-CoV-2 infection. This is referred to as ‘Long COVID’ or ‘PASC’: Post-Acute Sequelae of SARS-CoV-2. These symptoms may persist for several weeks after COVID-19, but could sometimes last several months. Read more about Long COVID.

Who is most vulnerable?

Anyone can become seriously ill from the coronavirus SARS-CoV-2, but some people have a higher risk of severe illness from COVID-19. Read more about risk groups here.

Children are less likely to have symptoms

Children who test positive for the coronavirus SARS-CoV-2 are less likely to have symptoms than adults, according to RIVMNational Institute for Public Health and the Environment research. They also seem to infect others less often than adults do. Read more about children and SARS-CoV-2.

Infected more than once

Some people become infected with the coronavirus SARS-CoV-2 more than once. After an infection with SARS-CoV-2, we can assume that you are protected against a new infection for 6 months, but people do sometimes catch the virus again. If we look at the viruses that cause the common cold, it is not unusual for people to be reinfected. SARS-CoV-2 reinfection is rare; about 1% to 2% of people who test positive for the virus had already tested positive previously. People who become reinfected generally seem to become less seriously ill. Most people in good health build up immunity to the virus after infection. We do not yet know exactly how long a person is protected and whether the immunity after infection also protects against the different variants of the virus. We also do not know the extent to which people are contagious if they are infected again. 

The policy in effect in the Netherlands already takes possible reinfection into account. If you have already had COVID-19 once, we can assume that you are protected against a new infection for 6 months. If you do develop symptoms that could indicate COVID-19, the recommendation is to stay home and get tested again. 

No registered treatment for COVID-19 (yet)

If you are ill in your own home, you can take paracetamol if you are suffering from pain and fever. Other painkillers (NSAIDs such as ibuprofen, diclofenac or naproxen) have more side effects. That is why paracetamol is safer. Paracetamol also works better to treat fever than ibuprofen. 

Various treatments are possible for seriously ill patients with COVID-19 who have to be hospitalised. For more details, see the guidelines on medication-based treatment options for patients with COVID-19 (in Dutch) provided by the Dutch Working Party on Antibiotic Policy (SWAB.) It has been established that there are two medicinal treatments that have a clinical effect in hospitalised patients with COVID-19:

  • Dexamethasone and other corticosteroids. These drugs suppress the immune system. Such substances have been shown to reduce the risk of death in hospitalised patients with COVID-19 who require supplemental oxygen. These drugs are not recommended for people with mild symptoms, who do not need to be admitted to hospital or require supplemental oxygen. In milder cases of COVID-19, the medicine could make the disease worse. Although these drugs have been used in patient care for a very long time, they are not used often to treat infectious diseases. 
  • Remdesivir, an antiviral. This drug is administered through an IV. It could potentially accelerate clinical recovery in hospitalised patients with COVID-19 who require supplemental oxygen. In July 2020, this drug was granted a conditional marketing authorisation as a treatment for COVID-19 in Europe. 

Major studies launched around the world since February 2020 that have since published results have not shown that any other antiviral drugs are effective. In the hospital, patients who are experiencing severe shortness of breath may receive supplementary oxygen, or even receive temporary respiratory support from a ventilator in the ICU. In addition, seriously ill people with COVID-19 receive anticoagulant medication when they are admitted to hospital, since there is an increased risk of thrombosis (blood clots). 

In most cases, COVID-19 vaccination prevents serious illness caused by the coronavirus SARS-CoV-2.

Infection and prevention

You may already be contagious shortly before you start showing symptoms. If you shout or scream, small droplets containing the virus could fly into the air from your nose and mouth. This could also happen as a result of talking, sneezing and coughing. Other people could become infected if they inhale those droplets, or get them in their mouth, nose or eyes, for example via their hands.  

If you maintain distance from others (staying at least 1.5 metres apart) and regularly wash your hands well, the chance that you will become infected by the droplets is very small. The risk that you yourself will infect others is very small if you keep your distance from others, sneeze and cough into your elbow, use paper tissues and discard them after use, and stay home if you have symptoms.

There are many different variants of the virus circulating by now.  The more recent variants are sometimes more contagious than the ‘older’ variants.  Read more about the different variants of the virus.

Measures to prevent the spread of the virus

The basic rules to prevent the spread of the virus are outlined on Government.nl.

More information about how the virus spreads is available here.

Vaccinations

Vaccination prevents you from becoming seriously ill from a SARS-CoV-2 infection. If you are vaccinated, you are less likely to become infected.

In the Netherlands, people are vaccinated with the COVID-19 vaccines made by Pfizer, Moderna, AstraZeneca or Janssen. For more information about the vaccination programme, go to the COVID-19 vaccination page.

The Coronavirus Dashboard shows how many vaccinations have been administered.

Flu jab offers no protection from COVID-19

There is no evidence that people who have had the flu jab are more susceptible to the coronavirus SARS-CoV-2. Having a flu jab does not weaken your immune system. Similarly, there is no evidence that the flu jab itself increases the risk of catching COVID-19. Also, a flu jab does not affect how severe the symptoms are if you do become ill. More about the flu jab and COVID-19.

Flu and COVID-19

What are the most important similarities and differences between flu and COVID-19? See the frequently asked questions about flu and COVID-19.

Herd immunity and the Dutch response to COVID-19

The Dutch policy in response to COVID-19 is aimed at maintaining the Dutch healthcare system and protecting vulnerable groups in society.  Most people who have had COVID-19 recover. That means that the Netherlands is building up immunity to the disease. That is not a goal, but a consequence of the fact that the virus is present in the Netherlands. It has also become apparent that a more severe course of illness due to infection with the virus leads to a corresponding increase in the amount of antibodies in the blood. People who have only mild symptoms develop fewer antibodies. Also, more and more people are building up immunity as a result of vaccination. Among others, the PIENTER Corona Study is currently researching how many people have antibodies against SARS-CoV.

The incidence of COVID-19; how widespread is it?

 The weekly update offers an overview of key figures on COVID-19 in the Netherlands. This includes the total number of people who have tested positive for the virus and the number of patients who have been hospitalised with COVID-19.

  • We do not know how many people in the Netherlands have recovered from COVID-19 at this time. COVID-19 is a notifiable disease, so confirmed cases must be reported. However, it is not required to report that someone has recovered from the disease. A person who is completely symptom-free for 24 hours is considered to be recovered.
  • The number of people who have been discharged from ICU and from hospital is reported on the site of the National Intensive Care Evaluation (NICE) Foundation. The NICE website has overviews of all Dutch intensive care patients with a COVID-19 infection in an ICU in the Netherlands or Germany. Here are the overviews of patients in intensive care and in hospital nursing wards.
     

Frequently asked questions

What is the IFR and how high is this number for the coronavirus SARS-CoV-2?

The Infection Fatality Rate (IFR) represents the number of deaths proportionate to the number of persons infected by a particular pathogen (in this case SARS-CoV-2). This ratio reflects the probability that someone will die from COVID-19. The number is an estimate. The IFR may vary from country to country, depending on demographics and the age groups affected. RIVMNational Institute for Public Health and the Environment has also estimated the IFR. To do so, RIVM looked at the total excess mortality and the number of people that are estimated to be infected with the virus. For that purpose, RIVM accessed mortality data from Statistics Netherlands and data from studies conducted by RIVM (the PIENTER Corona Study) and Sanquin on the number of people who have antibodies against the virus in their blood. The IFR is currently estimated between 1 and 1.3%.