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What is the response of the Dutch government to the novel coronavirus in the Netherlands? And what are the approaches of other EU countries?


The three scenarios

The novel coronavirus has spread across the Netherlands by now. At this point, there are three possible approaches for how our country can respond. Since the televised address by Prime Minister Mark Rutte, they have been referred to as ‘the 3 scenarios’. What do these scenarios entail?

1. Maximum control of the virus.
The Netherlands has chosen the approach of maximum control of the virus. That means working together to ensure that people follow the hygiene rules, avoid public venues (such as cafés), and maintain physical distance from each other. By taking this approach, we can ensure that people will infect each other less easily. This is known as social distancing. The virus will not be able to spread as quickly, and we can spread out the infections over a longer period. That leads to a controlled spread among the groups least at risk. There are three strategic advantages to this approach:

  1. Most people will experience only minor symptoms and recover from the virus without medical assistance.
  2. Most people will build immunity, so the virus has less and less chance to make other people sick (the “protective wall around the vulnerable older people and people with underlying health issues”, as the Prime Minister put it).
  3. The hospitals, nursing homes and home care services are not overwhelmed, so there is always enough capacity in our healthcare system. And that includes the Intensive Care Units where the most vulnerable patients are placed.

2. Allowing the virus to run its course unchecked.
If we do not take steps to prevent it, the virus will spread faster and faster. Each new patient will infect two more people on average. The huge disadvantage is that our healthcare system would be completely swamped. In this scenario, there would not be enough capacity to help vulnerable older people and other high-risk patients.

3 Maximum containment of the virus.
This approach is also known as a lockdown. That means shutting down everything completely and requiring everyone to stay in their own homes. Such a rigorous approach may initially seem like an attractive option. The major disadvantage is that it has to be maintained for an extended period. Not just days or weeks. Essentially, all activities would have to be shut down for a year or even longer. That would have huge consequences for schools, for the economy, etc. Moreover, it is very likely that the virus would simply start spreading again once the lockdown is over. When everyone starts going outside again, the virus would be transmitted from person to person – and the lockdown and all its consequences would have been pointless. This risk remains until there is a drug or vaccine for the virus.

At this point in time, the Cabinet has opted for the first scenario. RIVMNational Institute for Public Health and the Environment is monitoring the progress of the outbreak very closely. Any new information or developments are always incorporated into the advisory reports that RIVM provides to the Cabinet, so our government leaders can decide whether to ease current restrictions or implement stricter measures.

Table

The table shows the COVID-19 measures in the Netherlands, Belgium and Italy. The measures are mostly the same, even though different scenarios are referred to. However, Belgium and Italy are stricter with regard to the reasons why people are allowed to be outside, and the closure of shops and markets.  All countries indicate that the measures can be relaxed or strengthened. That depends on the course of the COVID-19 crisis. The number of hospital and ICU admissions, the number of (deaths) and the care capacity play a role in the decision to adjust measures.

Measures 14-05-2020 Netherlands Belgium Italy
Scenario 1 1 3
Health      
Hand-and cough/sneeze-hygiene, no hand shaking  x x x
Use of face masks/ gloves in public   x  
Self-isolation light symptoms/ 
Self-isolation whole family if one family member has a fever 
x x x
‘Social distancing’ measures      
Keep distance/ work from home as much as possible/ groups prohibited  x x x
Allowed to go outside if working from home is not possible  x x x
Allowed to go outside for essential tasks (doctor’s visit, grocery shopping, or to help someone else) x x x
Allowed to go outside for physical activities, a stroll e.g. adhering to social distancing measures x x x
Allowed to go outside to sit in a park, picnic or sunbathing, adhering to social distancing measures x   x
Fill out a form with a reason for being outside to present to police when asked for      
No public transport available       
Child care & day care centres/ primary schools/ special education schools closed     x
Secondary schools closed x   x
Universities closed x x x
Shops/markets (not for food or daily necessities) closed    
Public locations (e.g.musea, concert halls and theatres) closed x   x
Restaurants/cafés (except take-away) closed x x  
Hotels/accommodations closed      
Foreign policy and travel advice      
Quarantine/self-isolation if travelling from country with many COVID-19 infections  x x x
General travel advice: essential travel only x x x

Joint European Roadmap towards lifting COVID-19 containment measures(ECDC)

 

Herd immunity in the Dutch COVID-19 policy

The Dutch COVID-19 policy aims towards keeping the health system in operation while protecting vulnerable groups in society. The government of the Netherlands has taken far-reaching measures to prevent further spreading of the coronavirus. However, there is no measure yet that can make the virus disappear in the near future. Most people infected with the coronavirus recover. According to WHO, people show antibodies in their blood for at least a month after recovery. This means that in the Netherlands immunity against corona is being built up. This is not a goal in itself, but a result of the fact that the virus is present in the Netherlands. One of the effects is that gradually more people become immune to the virus, which will eventually lead to herd immunity, as is the case for other viral infections. As we are dealing with a newly emerged virus, WHO correctly states that there is no certainty about the development of immunity against COVID-19, or about how long this immunity will last. More information about this will become available soon. The Netherlands will keep on adapting its policy, based on the latest findings. Read also RIVM las launched a study on coronavirus herd immunity.

How do calculations contribute in combatting the novel coronavirus?

To combat the outbreak of a virus, information is required in order to organise the necessary healthcare and to put the appropriate measures into place.  You need to know how many people are likely to become ill, how many will be hospitalised, and how many could die. We calculate very many different possibilities because there are so many uncertainties. This is called modelling. As an increasing amount of information is gathered, some possibilities will be disregarded. The remaining calculations provide a more reliable picture. The more we know about the virus and how it is spreading, the better the calculations will reflect the reality. Read more about modelling. 

How many people in the Netherlands have recovered from COVID-19?

This is currently unknown. There is an obligation to report all cases of people who have recovered from this illness. If someone has had no symptoms for 24 hours, they are considered cured.

How many people have left the ICU and hospitals?

The National Intensive Care Evaluation (NICE) Foundation provides overviews on its website showing all Dutch ICU patients with COVID-19 in a Dutch or German intensive care unit. Here are the overviews of patients in intensive care and in hospital nursing wards.