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 coughing, sneezing, singing, talking and so on. During those activities, 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 most common symptoms of COVID-19 are:
- Cold symptoms (such as a nasal cold, runny nose, sneezing, sore throat)
- Shortness of breath
- Elevated temperature or fever
- Sudden loss of smell and/or taste (without nasal congestion)
Less common symptoms:
- General aches and pains
- Eye pain
- Muscle aches
- Abdominal pain
- Weight loss / loss of appetite
- Nausea / vomiting
- Eye infection (conjunctivitis)
- Various skin abnormalities (such as a rash)
- Feeling unwell
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, it will usually be 5 or 6 days before you develop symptoms. Source and contact tracing shows 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.
What to do 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 by the GGD right away 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). If you had contact with a person who has COVID-19 and are in quarantine, other rules may apply. Read more on the page about quarantine and isolation.
- If the test shows that you do have COVID-19, then stay home and start self-isolating in a separate room. Avoid all contact with your household members. Exceptional rules may also apply to the other people in your household. Read more on the page about quarantine and isolation.
When should I call my doctor?
Call your GP or the out-of-hours medical centre 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.
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 for a long time, extending many weeks. If you are symptom-free for 24 hours (no fever, coughing or cold symptoms), and it has been at least 7 days since your symptoms started, we assume that you are no longer contagious. 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.
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.
Treatments for COVID-19
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.
There are a number of treatment options available for hospitalised patients with COVID-19:
- Dexamethasone and other corticosteroids. These registered medications have been used in patient care for many years, and are known to 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.
- Tocilizumab is recommended for seriously ill patients who are hospitalised. This well-established drug is known to suppress inflammation. It is used to treat rheumatoid arthritis and other systemic inflammatory disorders. It must be administered through an IV.
- Remdesivir is an antiviral that was granted authorisation in 2020. This drug is administered through an IV. It could potentially accelerate clinical recovery in hospitalised patients with COVID-19 who require supplemental oxygen.
- In addition, there are also drugs that have not yet been officially registered, which can already be used in patients who do not have their own antibodies against the SARS-CoV-2 virus. In that case, the patients are given IV treatment in hospital to receive factory-produced antibodies, known as monoclonal antibodies. Many people make their own antibodies soon after they start having symptoms, but there are people with reduced immunity (immunocompromised patients) who are not able to produce antibodies in sufficient amounts. Most people do not have their own antibodies right after developing the first symptoms, unless they were previously vaccinated. Treatment with monoclonal antibodies can reduce the risk of hospitalisation, if it is administered at an early stage of COVID-19 to people with a SARS-CoV-2 infection who do not yet have any antibodies of their own. People who have to be admitted to hospital due to COVID-19 and do not (yet) have any antibodies of their own due to vaccination or previous infection may have a less severe course of illness in hospital if they are treated with monoclonal antibodies.
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 and get tested by the GGD if you have symptoms.
There are many different variants of the virus 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.
For more information about how the virus spreads, see the page on the spread of COVID-19.
Vaccination prevents you from becoming seriously ill from a SARS-CoV-2 infection. If you are vaccinated, you are less likely to become infected. If you are infected, your illness will be less severe. You are also less contagious.
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.
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.
Immunity in the Netherlands
More and more people are building up immunity as a result of vaccination. 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. People who have only mild symptoms develop fewer antibodies. 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. See also the information about IFR in the LCI guidelines (in Dutch).