It is often referred to as ‘corona’, but officially the disease is called COVID-19. The disease is caused by the coronavirus: SARS-CoV-2. The symptoms can be similar to the common cold. The disease can cause severe pneumonia, and some people may die of it.

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 via coughing and sneezing. When someone coughs or sneezes, 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)

In addition, people with COVID-19 may sometimes experience fatigue, generalised pain, eye pain, muscle ache, dizziness, irritability/confusion, abdominal pain, weight loss and/or loss of appetite, diarrhoea, vomiting, nausea, conjunctivitis and various skin conditions, and generally do not feel well.

Incubation period

The time between the moment you become infected and when you start showing symptoms is called the incubation period. If you are infected with the coronavirus SARS-CoV-2 , it will usually be 5 or 6 days before you develop symptoms. The incubation period of SARS-CoV-2 is between 2 and 14 days. 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 has been shortened to 10 days, effective as of 19 August.

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. 
  • Do you have a fever (38 degrees Celsius or higher) and/or shortness of breath? And are there other people living in your household? Then your household members must also stay home if you have mild COVID-19 symptoms, and you also have a fever or shortness of breath. Read more about this on Government.nl.
    • 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 number for corona test appointments again on 0800- 1202.
      If you have severe symptoms, call your GP or the out-of-hours medical centre.
    • If the test shows that you are COVID-19 positive, household members who do not have symptoms should also stay home.

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 with COVID-19, 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 for which the Dutch government has issued an ‘orange’ travel advisory. 
  • 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.

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. We do know how many people have been discharged from Intensive Care and from the hospital. The website of the National Intensive Care Evaluation (NICE) Foundation has overviews of all Dutch intensive care patients with a COVID-19 infection in an ICU in the Netherlands or Germany. Take a look at the overviews (in Dutch) of intensive care patients and patients in the nursing wards of hospitals.

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 with COVID-19 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 COVID-19.

Is it possible to get COVID-19 more than once?

There have been a few reports in other countries of people who may have been infected with the coronavirus SARS-CoV-2 for a second time. If we look at the viruses that cause the common cold, it is not unusual for people to be reinfected. It is not yet clear exactly how this works for the coronavirus SARS-CoV-2. For example, we do not know yet if people build up sufficient immunity to the virus after they are infected. We also do not know how long they are protected from catching the virus after that, or how contagious they are at that time. This is currently being investigated in more depth. 

It is not yet possible to draw firm conclusions about reinfection. The number of reported reinfections is too low for that purpose. It is important to keep monitoring research studies in the Netherlands and abroad. RIVM is also conducting research. For example, we are asking Municipal Public Health Services (GGDs) in the Netherlands to report any suspected reinfections. In that case, RIVM will investigate exactly what is going on. The policy in effect in the Netherlands already takes possible reinfection into account. Even if you have already had COVID-19, the advice is: if you have symptoms, stay home and get tested

No registered treatment for COVID-19 (yet)

If you are ill in your own home, it is best to take paracetamol. This medication works well to treat 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 (currently only 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 Intensive Care Unit. 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). 

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 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.

How contagious is the coronavirus SARS-CoV-2?

Without measures, someone who is infected can infect 2 to 4 other people on average. This is called the infection rate (R0). It is possible to reduce the infection rate by implementing measures. Read more about the R0.

Measures to prevent the spread of the virus

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

Do you want to know more about the spread of the virus? Take a look at the special page about the spread of the coronavirus SARS-CoV-2.

Vaccine

In laboratories in various countries, researchers are working hard to develop a vaccine against COVID-19. The BioNtech/Pfizer and Moderna vaccines have been improved for use in the European Union. More information on COVID-19 vaccines.

 Research is also being done to investigate whether some existing vaccines could work against COVID-19:

  • Vaccination against tuberculosis: the Bacille Calmette Guérin (BCG) vaccine. There is no evidence at this time. A study on the efficacy of the BCG vaccine against COVID-19 will be launched shortly. For that reason, it is therefore not useful to inoculate risk groups or healthcare workers with the BCG vaccine at this time.
  • Vaccination against mumps, measles and rubella: the MUMR vaccine. There is no evidence at this time that the MUMR vaccine would also offer protection from coronaviruses. A study has been published that suggests that the antibodies generated by the MUMR vaccine (especially against rubella) might also be effective against SARS-CoV-2. However, these cross-reactive antibodies have not been demonstrated in the laboratory. There is currently insufficient evidence that a MUMR vaccination would actually offer protection from COVID-19. For this reason, it does not yet make sense to give extra vaccinations to people who have not previously received the MUMR vaccine.

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.

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. The Dutch Government has introduced far-reaching measures to prevent the coronavirus SARS-CoV-2 from continuing to spread. There are no measures that can currently cause the virus to vanish within the near future. Most people who have had COVID-19 recover. The World Health Organization (WHO) has stated that antibodies are still present in the blood for at least one month after recovery. 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. As a result, there is some doubt about whether people with mild symptoms will build up sufficient immunity against COVID-19, and whether they may possibly be able to become infected and/or transmit the virus a second time. This possibility is currently being investigated. Dutch policy is constantly being updated based on the latest insights.

How often does COVID-19 occur?

The special page on COVID-19 in graphs (only in Dutch) offers an overview of the development of COVID-19 in the Netherlands. This includes an overview of the total number of people who have tested positive for the virus and the number of patients who have been hospitalised.

  • 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 intensive care 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.
     

Click on the infographic 'The novel coronavirus in the Netherlands. What is the difference between the first wave and the second wave'  to view full size.

Frequently asked questions

Why has the quarantine period been shortened from 14 to 10 days?

The OMT has advised reducing the quarantine period to 10 days,  counting from the last high-risk contact with a person who has tested positive for COVID-19. The latest data from the Dutch source and contact tracing show that shortening the quarantine period is safe. 99% of all contacts of an infected person who later became ill themselves developed COVID-19 symptoms within ten days after the last high-risk contact.

Does the shortened quarantine period also apply to people who are already in quarantine?

Yes, as of August 19, people who are already in quarantine will be allowed to leave the quarantine after the 10th day of quarantine.

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 at about 1.3%.