Reasons to convene an OMT

An Outbreak Management Team (OMT) is often convened after a signal indicating an outbreak has been provided by a coordination meeting or response team. This may happen if an outbreak is growing larger and larger, for example, or based on an international alert issued by the ECDC or WHO. Various aspects play a role here:

  • A local problem can have national consequences.
  • There may be widespread unease in society.
  • There may be an international threat.
  • Issues relevant to government and society are involved.
  • The situation requires cooperation with other, non-medical sectors.

First OMT in 1995

The concept of an Outbreak Management Team (OMT) was first introduced in the Netherlands after the evaluation of the polio outbreak in 1992. The first OMT was convened in 1995 as part of the RIVM National Coordination Centre for Communicable Disease Control (LCI), which was established in 1994. Since then, OMTs have been convened for infectious diseases such as polio, avian flu (H5N1), Q fever, new influenza A (H1N1), measles, and the COVID-19 (SARS-CoV-2).

Composition of the OMT

The people who take part in an OMT depend on the infectious disease involved in the outbreak.  The permanent members are the director of the CIb (chair) and the head of the National Coordination Centre for Communicable Disease Control (LCI) at RIVM (secretary). The OMT always includes a doctor specialising in infectious diseases from the Municipal Public Health Services (GGDs). This GGD doctor will usually come from the (primary) region where the outbreak is occurring, but may sometimes join the OMT from the national infectious disease consultation. In the event of an Outbreak Management Team for Zoonoses (OMT-Z), the team includes the dean of the Faculty of Veterinary Medicine at Utrecht University, who becomes vice-chair.

The participants are determined by the topic of the OMT. The chairperson invites experts as they see fit, based on the infectious disease and the current situation. For example:

  • Experts in the field, often nominated by their professional association. Examples include virologists, but also medical specialists in internal medicine, gynaecology, paediatrics, pulmonology, geriatrics, epidemiology and other areas.
  • An expert from an organisation who contributes a specific expertise or role. Examples could include an expert from the Sanquin national blood bank in the event of bloodborne diseases, or a representative from the Medicines Evaluation Board (CBG-MEB) for prion diseases. The point here is to have OMT members who contribute scientific expertise (academic research) and practical expertise (GPs, disability care specialists).
  • A representative from a specific region, in the event of a local problem. Examples could include a medical microbiologist from a regional laboratory.
  • All the experts who join an OMT take part on their own, not as representatives of an organisation. The LCI keeps records of the meeting and drafts the advisory opinion, and acts as the secretariat for the OMT.

How an OMT works

  • The Centre for Infectious Disease Control (CIb) reviews the situation, identifies the area of a crisis, and assesses the potential consequences of a crisis. This information provides the basis for the OMT meeting.
  • The people who attend the OMT meeting can discuss the substance of the matter without restraint. Their discussions are confidential.
  • The OMT comes up with the ‘best possible professional advice’, based on the latest scientific knowledge and the practical expert opinions of the participants. To the best of their ability, the advisory opinion is clear, concrete and comprehensive.

Components of an OMT advisory opinion:

  • Risk assessment: What is the risk? How severe is the risk? What options are possible to mitigate the risk?
  • Assessment of the effects of the proposed measures.
  • Assessment of the probability (degree of uncertainty) regarding the risk and the possible effects of the proposed measures.
  • The differing analyses and positions, if the advisory opinion is not unanimous.

Presenting and publishing an advisory opinion

  • Each time that an OMT is convened, the result is a written advisory opinion presented to the Administrative Coordination Consultation (BAO). An LCI policy official also drafts a confidential report of the OMT meeting. This report outlines the considerations and discussion items that came up during the meeting.
  • The OMT report and advisory opinion are sent to the OMT members, so they can add supplementary comments, correct factual errors and/or indicate insurmountable objections. 
  • The OMT chair presents the OMT advisory opinion to the BAO chair. The BAO is chaired by the Director-General of Public Health at the Ministry of Health, Welfare and Sport (VWS). In the event of an OMT-Z, the advisory opinion is also presented to the Director-General of Agriculture and Nature at the Ministry of Agriculture, Nature and Food Quality (LNV).

The OMT advisory opinion is made available to the general public.

Regulations outlining OMT agreements and principles

The quality of an OMT advisory opinion is dependent on finding experts who are willing to contribute their knowledge and expertise to protect public health. Their voluntary input is essential in arriving at the best possible medical and epidemiological advice.

 RIVM has drawn up a framework of regulations for the OMT, which describes the agreements, principles, rights and obligations of participating members.

Declaration of interests

The OMT gives independent advice. In order to be transparent and avoid conflicts of interest, each member completes a declaration of interests before taking part in an OMT.Based on the ‘Code of conduct to prevent undue influence as a result of conflicts of interest’, they provide information on employment positions, ancillary positions, personal financial interests, and research funding. After review and signature, the declaration is made public on the RIVM website.

Compensation for participating

The members of an OMT receive financial compensation for their time, in the form of attendance fees.These attendance fees are determined annually by government decree. The attendance fees are not provided to civil servants.