It is often referred to as ‘corona’, but officially the disease is called COVID-19. The disease is caused by a novel (new) 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 it?

COVID-19 is the disease caused by a novel 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-like 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)

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, it will usually be 5 or 6 days before you develop symptoms, but you could start showing symptoms as soon as 2 days after infection, or as late as 12 days (but never after 14 days).

If you have symptoms that could indicate the novel coronavirus

  • 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 at home until you have the results of the test. 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 you have no symptoms for 24 hours, you can go outside again. People working in crucial professions or critical processes should also stay at home with mild symptoms.
  • In addition to your cold symptoms (as listed above), do you also have a fever (38 degrees Celsius or higher) and/or shortness of breath? Then other household members are also not allowed to go outside until the test results are known. As an exception, household members who have no symptoms are briefly allowed outside to go shopping. If other household members also have symptoms, then they should get tested too.
    • If the result of the test is negative, then you were not infected with the novel coronavirus 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 COVID-19 patient. In that case, you must stay home for the remaining days of the 14-day quarantine period.) 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.
      Have you developed new symptoms that could indicate COVID-19, or have your symptoms worsened after you were tested? Then stay home and 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. People working in critical sectors or crucial professions should also stay home. Exceptions can only be made for people working in critical sectors or crucial professions in consultation with the GGD and the company doctor, and only if the people who tested positive for the coronavirus do not have symptoms. More information about the household routine and what you should do if you have COVID-19 is available here.

Isolation: if you are ill

If you may possibly have COVID-19 (the disease caused by the novel coronavirus), then you go into isolation. In that case, you stay home. This prevents you from infecting others and continuing to spread the virus. The recommendation is to get tested. You should get tested if you have 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 or taste (without nasal congestion). You may be in isolation in your own home (self-isolation or home isolation), or you may be treated in isolation in a hospital. This depends on the severity of the symptoms.

  • More information if you are in home isolation.
  • More information if a household member is in home isolation.
     

Quarantine: just to be sure

If you go into quarantine, you are not sick. You have been in contact with someone who may (possibly) be infected. As a result, you may become ill or contagious yourself in the next 14 days. Just to be sure, you must stay at home, in order to prevent the virus from spreading in the Netherlands. This may be the case in the following situations:

 

  • If someone in your immediate family or household has cold symptoms that could indicate COVID-19, and also has a fever and/or shortness of breath, then everyone in the household stays home.
    • If a test shows that the person is not infected, then everyone can go outside again.
    • If a test shows that the person is infected, then you need to stay home for longer. If you are still not sick 14 days after your last contact with this person, you will know for sure that you are not infected. Then the quarantine ends and you can go outside again. 
  • If you have been in close contact with someone outside your family or household who tested positive for COVID-19, you should also stay home. If this is the case, the GGD will notify you.
  • When you return from an area where there are many people who have COVID-19, there is a possibility that you may have been infected with the novel coronavirus. You can find more information about this at government.nl.
     

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 novel coronavirus, 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 have 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?

It is not certain whether someone can get COVID-19 a second time. There is some doubt about whether people with mild symptoms will build up sufficient immunity against the novel coronavirus. People who have only mild symptoms develop fewer antibodies and 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.

Treatment

There is no registered treatment for COVID-19 at this time.

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 are hospitalised. For more details, see the preliminary 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). In the hospital, patients who are experiencing severe shortness of breath may receive supplementary oxygen, or even be placed on a ventilator in the Intensive Care unit.

Several clinical studies are currently being conducted on the effects of different medicines:

  • Blood plasma from people who have recovered from COVID-19. Erasmus MC in Rotterdam is currently investigating this, together with the Sanquin national blood bank and about 15 other hospitals. According to South Korean doctors, two seriously ill people who had the novel coronavirus were cured after receiving blood plasma from recovered COVID-19 patients. This strategy may work because you often have protective antibodies in your blood when you recover from an infection. We may be able to use those antibodies as a medicine to treat other patients. It is not yet certain how effective this method is. The first results are expected in a few months.
  • Chloroquine, a medicine used to treat malaria and other medical conditions, and hydroxychloroquine. It is uncertain whether these drugs will help in the treatment of COVID-19. This does not seem to be the case for the patients who received these drugs in the hospital studies that have been published so far. However, there are risks of serious side-effects, particularly cardiac arrhythmia.
  • Remdesivir is a new antiviral drug that can be administered via IV drip for 5 or 10 days to sick patients in hospital. It has not yet been registered, although research has been done on the efficacy and side-effects of the experimental drug. Full information about possible side-effects is not yet known. Published studies show varying results. One study showed that recovery was faster, especially in people who received treatment before being put on a ventilator. It is not yet clear whether remdesivir helps in cases of very severe COVID-19 pneumonia in which patients need to be put in a ventilator in intensive care. Registration of the drug by the European Medicines Agency is expected this summer (2020).

Infection and prevention

You can transmit the virus by coughing and sneezing. When someone coughs or sneezes, the virus is released into the air in small 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.

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.
Even before you get sick, you may already be carrying the virus with you. Even before you start showing symptoms, you may already be contagious, which means you could infect others as well. But the more symptoms you have, such as coughing and/or sneezing, the more you can spread the virus.

The risk that you 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 us, and stay at home if you have symptoms.

Infection rate dropping steadily

Without measures, someone who is ill 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. Because measures were implemented in March, the infection rate (R0) has now fallen below 1. That means that a patient infects less than one other person on average. 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 novel coronavirus.

Vaccine

In laboratories in various countries, researchers are working hard to develop a vaccine against the novel coronavirus. Even so, it will be a long time before the vaccine is available. It will not be available in the next few months. Once a vaccine is available, it will still need to be tested to make sure that it does not cause side-effects.
Research is also being done to investigate whether some existing vaccines could work against coronaviruses:

  • 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 the novel coronavirus. 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 the novel coronavirus. For this reason, it does not yet make sense to give extra vaccinations to people who have not previously received the MUMR vaccine.

More information about the development of a vaccine against the novel coronavirus will be available soon.

The flu shot

The flu shot does not offer any protection from the novel coronavirus. There is no evidence that people who have had the flu shot are more susceptible to the novel coronavirus. Having a flu shot does not weaken your immune system. Similarly, there is no evidence that the flu shot itself increases the risk of catching COVID-19. Also, a flu shot does not affect how severe the symptoms are if you do become ill.

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 patients who have tested positive for the virus and the number of patients who have been hospitalised.

Symptoms COVID-19

People with COVID-19 often have symptoms such as:

  • Cold symptoms (nasal cold, runny nose, sneezing, sore throat)
  • Coughing
  • Shortness of breath
  • Elevated temperature or a fever (above 38 degrees Celsius)
  • Sudden loss of taste and smell (without nasal congestion)

Do you have one or more of these symptoms?

Stay at home, get tested, recuperate. 

If you have a fever and/or difficulty breathing, everyone in your household must stay at home.

When to call a GP

Call your GP if your symptoms grow worse:

  • Do you have a fever (above 38 degrees Celsius) and a cough and difficulty of breathing?
  • Are you over 70-years old, and have an underlying health condition or are more susceptible, AND have a fever

Important: do not go to your GP, instead call the GP or the out of hours medical centre (huisartsenpost in Dutch). If you are experiencing severe symptoms, contact a doctor immediately.