Preventing, treating and controlling infectious diseases

What does RIVMNational Institute for Public Health and the Environment do when there is an outbreak of infectious disease?

In the event of a nation-wide outbreak of infectious disease in the Netherlands, the Centre for the Control of Infectious Disease at RIVM (RIVM-CIb) coordinates efforts to control the disease. This is also the case for the novel coronavirus. This involves identifying and advising on outbreaks and threats of infectious diseases and how to control them. During this time, RIVM is working closely with municipal public health services, experts and representatives from various organisations. By doing so, we advise many different parties in the Netherlands on how to control this outbreak as effectively as possible.

RIVM gives advice on control measures, contributes to the development of new laboratory diagnostics, maps epidemiological trends by means of surveillance and research. In addition, RIVM develops guidelines and scenarios for professionals that present the best way to respond to an epidemic. These are based on scientific insights. If there is a cross-regional outbreak of infectious disease, or if there is an international threat of infectious disease, RIVM can convene an Outbreak Management Team (OMT).

The current approach

The Netherlands response to the novel coronavirus is the maximum control approach. That means working together to ensure that people follow the hygiene rules, maintain physical distance from each other and that some venues are only open to a limited extent. 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.

 


What does the Outbreak Management Team do?

RIVMNational Institute for Public Health and the Environment can convene the Outbreak Management Team (OMT) in the event of a cross-regional outbreak of infectious disease, or an international threat of infectious disease. Specialists and experts with different backgrounds and knowledge about that specific disease are invited to join the OMT. They discuss how to control the outbreak based on the latest information, their own professional expertise and available scientific literature. They also discuss the risks and uncertainties of measures. The OMT provides an advisory report to the Ministry of Health, Welfare and Sport (VWS) via the Administrative Consultative Committee (BAO). The BAO assesses the substantive advice in terms of administrative feasibility and implementation, and ultimately determines the control policy.

Participation in the OMT

The director of the RIVM Centre for Infectious Disease Control chairs the OMT. The head of the RIVM National Coordination Centre for Communicable Disease Control is secretary of the OMT. Other permanent members of the OMT are invited to take part in all OMTs by default, regardless of the subject matter. They are invited because they have a position within an organisation or association that plays an important role in infectious disease control in the Netherlands.

Other participants in the OMT are invited on the basis of their field of expertise, or their specific expertise with the disease in question, or their experience in controlling this disease. For that reason, the composition of the OMT may vary depending on the subject and the items on the agenda.

The guiding principle is that all those participating are in the OMT in a personal capacity. This is because it is important for them to be able to discuss freely with each other, without feeling inhibited by their backers. The task of the OMT is to arrive at the best possible advice at that moment.

OMT advisory report

New threats are often caused by a new infectious disease. In such situations, a great deal is initially still unknown. Accordingly, the OMT bases itself on the data available at that time, current international literature, Dutch research, modelling, and general knowledge about infectious disease control.

The reports of the OMT consultations are confidential. After every meeting of the OMT, RIVM drafts an advisory report for the Ministry of Health, Welfare and Sport (VWS). After that, the OMT advisory report is discussed in an Administrative Coordination Consultation (BAO) and by the government ministers. The administrators in the BAO assess the OMT advice on administrative and political feasibility. The Cabinet ultimately decides what happens with the recommendations and whether measures are implemented. After that, the OMT advisory is made public.

Declaration of interests

The OMT members give 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. This ‘Code of conduct to prevent undue influence as a result of conflicts of interest’ requests 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.

Declaration of interests by civil servants

A civil servant in the national government is bound by rules of conduct in which, by taking an oath or making a promise, he or she swears or promises to comply with these rules; civil servants are also required to adhere to the standards of integrity. This does not apply to people who are not civil servants. Therefore, anyone who is a member of the OMT and is not officially sworn in as a civil servant is required to sign a declaration of interests in order to be part of the OMT.

Compensation for OMT members

Members of the OMT, with the exception of civil servants, receive attendance fees of a maximum of €200.00 per meeting, on the basis of a decree by the Dutch Government regarding attendance fees.


OMT for COVID-19

Since January 2020, RIVMNational Institute for Public Health and the Environment has convened an OMT several times to advise on the COVID-19 outbreak. The permanent OMT members are experts from the Dutch College of General Practitioners (NHG), the Netherlands Center for Occupational Diseases (NCvB), the Netherlands Association for Internist-Infectiologists (NVII), the Infectious Diseases Society of the Netherlands (VIZ), the Dutch Society of Medical Microbiology (NVMM) and the National Consultation on Infectious Disease Control (LOI). Invitations were also sent to experts from the Dutch Association for Intensive Care (NVIC), the Dutch Association of Elderly Care Physicians (Verenso) and the Dutch Paediatrics Society (NVK) have been invited, as well as a regional physician consultant, a representative from the reference laboratory, various representatives from RIVM centres, and other specialists (internist-infectiologist, virologist, medical microbiologist, epidemiologist).

Participants in the COVID-19 Outbreak Management Team 

The persons listed below have participated in a consultation of the COVID-19 OMT on one or more occasions.

Permanent members

  • Prof. Jaap van Dissel MD PhD (chair), professor of internal medicine specialising in infectious diseases, Director of the Centre for Infectious Disease Control, RIVM, CIb *
  • Prof. Aura Timen MD PhD (secretary), OMT Secretary, head of the National Coordination Centre for Communicable Diseases Control, medical specialist in community medicine and infectious disease control, RIVM, CIb, LCI *
  • Dr Masja Loogman MD, primary care physician / senior scientist with the Dutch College of General Practitioners (NHG), Declaration of Interests
  • Dr Jaap Maas MD PhD, senior occupational physician and epidemiologist, Amsterdam UMC – AMC/ Netherlands Center for Occupational Diseases (NCvB), Declaration of Interests
  • Dr Emile Schippers MD PhD, internist-infectiologist, Haga Ziekenhuis / chair of the Infectious Diseases Society of the Netherlands (VIZ), Declaration of Interests
  • Dr Anja Schreijer MD PhD, infectious disease control specialist, interim chair of the National Consultation on Infectious Diseases (LOI) / Head of Infectious Disease Control at GGD Amsterdam, Declaration of Interests
  • Prof. Annelies Verbon MD PhD, infectious disease specialist, chair of the Department of Medical Microbiology & Infectious Diseases at Erasmus MC / Netherlands Association for Internist-Infectiologists (NVII), Declaration of Interests
  • Dr Ann Vossen MD, medical microbiologist, associate professor of clinical virology at Leiden UMC / president of the Dutch Society of Medical Microbiology (NVMM), Declaration of Interests
  • Dr Anne de Vries MD MSc, medical specialist in community medicine and infectious disease control, GGD Kennemerland / National Consultation on Infectious Diseases (LOI), Declaration of Interests

Invited experts

  • Dr Arend Arends MD MSc, clinical geriatrician, Maasstad Hospital / chair of the Netherlands Society for Clinical Geriatrics (NVKG), Declaration of Interests
  • Dr Marleen Bakker MD PhD, pulmonologist, Erasmus MC, Declaration of Interests
  • Dr Chantal Bleeker-Rovers MD PhD, internist specialising in infectious diseases and acute medicine, Radboud UMC, Declaration of Interests
  • Dr Marije Bomers MD MSc, medical specialist in internal medicine, cardiovascular sciences, diabetes and metabolism, and infectious diseases, Amsterdam University Medical Center – VUmc, Declaration of Interests
  • Prof. Marc Bonten MD PhD, internist, infectious disease specialist and clinical microbiologist, research experience in gastrointestinal colonisation in ventilator-associated pneumonia , head of the Medical Microbiology Department and professor of molecular epidemiology of infectious diseases, Utrecht UMC, Declaration of Interests
  • Prof. Martien Borgdorff MD PhD, infectious disease epidemiologist specialising in TB and HIV as well as disease burden estimates, emeritus professor of epidemiology at Amsterdam UMC, Declaration of Interests
  • Froukje Bosma MSc, medical microbiologist, LabMicTA microbiology laboratory, Declaration of Interests
  • Prof. Jako Burgers MD PhD (replacing Masja Loogman), primary care physician / senior medical strategy consultant at the Dutch College of General Practitioners (NHG) / professor promoting personalised care in clinical practice guidelines, Maastricht University, Declaration of Interests
  • Prof. Bianca Buurman MD PhD, professor of acute geriatrics, Amsterdam UMC – AMC, Declaration of Interests
  • Dr Sylvia Debast MD PhD, medical microbiologist, Isala Hospital, Declaration of Interests
  • Trudie van Duin MSc, Programme Manager, Ambulance Services, Declaration of Interests
  • Dr Menno van der Eerden MD, pulmonologist, department head at  Erasmus MC, Declaration of Interests
  • Dr Pauline Ellerbroek MD PhD, internist-infectiologist specialising in immunodeficiencies and outbreak management at Utrecht UMC / outbreak coordinator at Major Incident Hospital, Declaration of Interests
  • Prof. Alex Friedrich MD PhD, medical microbiologist, head of the Medical Microbiology Department at Groningen UMC / Acute Care Network of the Northern Netherlands, Declaration of Interests
  • Emilie Gieling MSc, hospital pharmacist and clinical pharmacologist, Utrecht UMC, Declaration of Interests
  • Prof. Diederik Gommers MD PhD, internist-intensivist specialising in mechanical ventilation, ECMO and light sedation in the ICU, chair of the Adult Intensive Care Department at Erasmus MC / chair of the Dutch Association for Intensive Care, Declaration of Interests
  • Prof. Cees Hertogh MD PhD, former elderly care physician, professor of geriatrics and geriatric ethics, Amsterdam UMC – VUmc, Declaration of Interests
  • Prof. Christian Hoebe MD PhD, professor of social medicine and infectious disease control, Maastricht University Medical Centre / head of the Department of Sexual Health, Infectious Diseases and Environmental Health at GGD Zuid-Limburg, Declaration of Interests
  • Prof. Hans van der Hoeven MD PhD, professor of intensive care specialising in lung damage attributed to ventilation, chair of the Critical Care Medicine Department, Radboud UMC, Declaration of Interests
  • Patricia Houtman, expert on infection prevention, Spaarne Gasthuis hospital, Declaration of Interests
  • Károly Illy MD MBA, paediatrician at Ziekenhuis Rivierenland Tiel specialising in paediatric diabetes and pulmonary disease / president of the Dutch Paediatrics Society (NVK) / chair of the Secondary Care Council for the European Academy of Paediatrics (EAP), Declaration of Interests
  • Prof. Menno de Jong MD PhD, clinical microbiologist, head of the Medical Microbiology Department at Amsterdam UMC – AMC / professor of clinical virology at the University of Amsterdam, Declaration of Interests
  • Prof. Jan Kluytmans MD PhD, physician and medical microbiologist at Amphia Hospital / professor of epidemiology of healthcare-related infections at Utrecht UMC / professor of microbiology and infection control at Amsterdam UMC – VUmc / Network for Acute Care Brabant, Declaration of Interests
  • Prof. Marion Koopmans DVM PhD, virologist specialising in emerging infectious diseases, head of the Department of Viroscience at Erasmus MC / National Influenza Centre, Declaration of Interests
  • Dr Nienke Nieuwenhuizen MD MSc, specialist in geriatrics, president of the Dutch Association of Elderly Care Physicians (Verenso), Declaration of Interests
  • Dr Astrid Oude Lashof MD, internist-infectiologist, Maastricht UMC, Declaration of Interests
  • Dr Tamara Platteel MD (replacing permanent OMT member for NHG), primary care physician, Dutch College of General Practitioners (NHG), Declaration of Interests
  • Dr Ariene Rietveld MD MSc, medical specialist and trainer in community medicine and infectious disease control, GGD Hart voor Brabant, Declaration of Interests
  • Dr Lisette Romijn MD, primary care physician with an accredited specialisation in diabetes care, senior policy advisor to the Association of Dutch General Practitioners (LHV), Declaration of Interests
  • Prof. Dirk Ruwaard MD PhD, expert on public health and healthcare focusing on chronic care and ageing, professor and chair of the Department of Health Services Research, Maastricht UMC / chair of the Committee on Efficiency in Health Care at the Netherlands Organisation for Health Research and Development (ZonMw), Declaration of Interests
  • Dr Noud Schel MD, physician specialising in international medical advice and risk assessments during outbreaks of infectious disease, KLM Health Services, Declaration of Interests
  • Dr Karin Ellen Veldkamp MD PhD, medical microbiologist, head of infection prevention at Leiden UMC / Network for Acute Care West, Declaration of Interests
  • Prof. Theo Verheij MD PhD, primary care physician, professor of general practice specialising in infectious diseases in primary care, Utrecht UMC, Declaration of Interests
  • Prof. Margreet Vos  MD PhD, clinical microbiologist, infection prevention expert, professor of healthcare-related infections at Erasmus MC / chair of the Hygiene and Infection Prevention working group of the Dutch Society of Medical Microbiology (NVMM-HiP), chair of the European Study Group of Nosocomial Infections for the European Society of Clinical Microbiology and Infectious Diseases (ESGNI-ESCMID), Declaration of Interests
  • Prof. Andreas Voss MD PhD, clinical microbiologist and head of infection control at Canisius Wilhelmina Hospital / professor of infection control specialising in infection prevention and hygiene in hospitals, Radboud UMC / ad-hoc IPC advisor to the Health Emergencies Program of the WHO, Declaration of Interests
  • Dr Toos Waegemaekers MD MSc, medical specialist in community medicine and infectious disease control, GGD Gelderland-Midden / regional medical advisor (RAC) on infectious disease, RIVM *

Participants from RIVM *

  • Dr Susan van den Hof PhD, Head of the Centre for Infectious Disease Epidemiology and Surveillance, RIVM, CIb, EPI 
  • Prof. Jacco Wallinga PhD, chair of Mathematical Modelling of Infectious Diseases at Leiden UMC / head of the Infectious Disease Modelling Unit at RIVM, CIb, EPI
  • Dr Chantal Reusken PhD, virologist, assistant professor of public health virology at Erasmus MC / top expert on virology at the Centre for Infectious Disease Control, RIVM, CIb, IDS 
  • Rob Riesmeijer MSc MPH, Head of the Department of Vaccine Supply and Prevention Programmes, RIVM, DVP
  • Dr Sabine Bantjes MD, medical specialist in infectious disease control, RIVM, CIb, LCI
  • Dr Helma Ruijs MD, medical specialist in infectious disease control, RIVM, CIb, LCI
  • Dr Corien Swaan MD, medical specialist in infectious disease control, RIVM, CIb, LCI
  • Dr Fiona van der Klis PhD, expert on vaccine research, head of the Immunosurveillance Department and project leader of the PIENTER 2 and 3 project and PIENTER Corona, RIVM, CIb
  • Dr Wim van der Hoek PhD, epidemiologist, head of the Department for Respiratory Infections, RIVM, CIb, EPI
  • Dr Nynke Rots PhD, clinical immunologist, RIVM, LCI
  • Prof. Lieke Sanders MD PhD, paediatric infectiologist/immunologist, RIVM
  • Dr Albert-Jan van Hoek PhD, health economist, RIVM, EPI
  • Dr Adam Meijer PhD, virologist, head of the Respiratory Viruses Group, RIVM, IDS
  • Dr Daan Notermans MD PhD, medical microbiologist specialising in antimicrobial resistance and healthcare-associated infections, RIVM, IDS
  • Dr Bettie Voordouw MD PhD MPH, medical microbiologist specialising in virology and vaccinology, RIVM, IDS
  • Peter Molenaar, expert on infection prevention and advisor on infectious disease control, RIVM, LCHV 
  • Dr Albert Vollaard MD, internist-infectiologist, medical advisor on infectious diseases, RIVM, LCI
  • Marieke Timmer MSc, communication advisor, RIVM, CIb, Communication
  • Kevin Kosterman MSc, communication advisor, RIVM, CIb, Communication
  • Harald Wychgel, spokesperson and senior communication consultant, RIVM, Communication
  • Ton Oomen (reporting), infectious disease control consultant, RIVM, CIb, LCI
  • Dr Manon Haverkate PhD (reporting), infectious disease control consultant, RIVM, CIb, LCI
  • Dr Madelief Mollers PhD (reporting), infectious disease control consultant, RIVM, CIb, LCI
  • Imke Schreuder MSc (reporting), infectious disease control consultant, RIVM, CIb, LCI
  • Willemijn Marsman (reporting), infectious disease control consultant, RIVM, CIb, LCI

*Declaration of interests by civil servants in the national government

A civil servant in the national government is bound by rules of conduct in which, by taking an oath or making a promise, he or she swears or promises to comply with these rules. Civil servants are also required to adhere to the standards of integrity.