Just take a test to see if you have COVID-19, if you feel sick? It is not quite that simple. Read more about who is eligible for a test and why, and what role RIVMNational Institute for Public Health and the Environment plays.

Not all the information on our website has been updated according to the press conference on 27 May. We will update our information as soon as possible.

Who will be tested?

The testing policy in the Netherlands focuses on the following groups of people.

People in risk groups have a higher risk of severe illness from COVID-19. These people can be tested if they develop symptoms, and if confirmation of whether or not they have COVID-19 is important to determine the correct treatment or care. This applies to people aged 70 years and older; and adults aged 18 years and older with underlying health conditions. ( See page on Risk groups).

When testing healthcare workers, the factors that are taken into account include the health of the employees, the risk of infecting patients or clients, and the limited availability of personal protection equipment (PPE). More details are provided on our website for professionals (only in Dutch). A healthcare worker who has had symptoms of COVID-19 (coughing and/or a nasal cold and/or fever), and who provides direct care to a patient or client and cannot be missed, can be tested. Healthcare workers who have intensive contact with elderly or physically vulnerable patients have priority.

The test policy was expanded as of 18 May 2020 to include informal carers, volunteers working in palliative care, and care providers funded by a personal budget (PGB).  Additional tests can also be arranged for visitors to the 25 nursing homes that have been participating in the Visiting Scheme pilot project since 11 May. The Ministry of Health, Welfare and Sport (VWS) has provided guidance (in Dutch).

On 11 May, the Netherlands reopened its primary schools, special education schools and childcare. Although children do not seem to play a major role in the spread of the novel coronavirus, it is important to closely monitor the effect of relaxing the measures.

By providing low-threshold access to testing for these teachers and staff, if they have mild symptoms that could indicate a coronavirus infection, it will be possible to detect an increase in the spread of the novel coronavirus at an early stage. If necessary, additional measures can be taken to limit the spread of the virus.

In the context of relaxing the measures for schools and childcare facilities, children will also be closely monitored if there are indications that suggest a local cluster of infections.

Please note: People who have severe symptoms (high fever and/or shortness of breath) or are considered higher-risk because of other (serious) underlying conditions should contact their GP or specialist directly for diagnostics and treatment, as is customary in the event of (serious) illness. This is separate from the testing policy for schools and childcare facilities.

Testing policy for employees in primary education, special education and childcare

Employees who have had symptoms of coronavirus infection (coughing and/or a nasal cold and/or a fever) for at least 24 hours must stay home and notify their employer that they are ill.

The testing policy applies to:

  • Employees in primary education, special education, childcare facilities (including medical nurseries), after-school childcare facilities, and host parents who have professional contact with groups of children;
  • People who are professionally involved in transporting groups of children to and from primary education, special education and/or childcare facilities.

 An employee who has symptoms of coughing and/or a nasal cold and/or fever, and who is listed above, may be tested. Testing is coordinated by the Municipal Public Health Service (GGD) in each region (see https://ggdghor.nl/thema/testen-covid-19). The employee contacts the company doctor, who contacts the GGD to arrange registration for the test. If there is no company doctor (such as for host parents), the employee can contact the GGD infectious disease control department directly. Until the results of the test are known, the employee must stay at home. In the case of a host parent, he or she will not receive any children or other adults in their home while awaiting the test result.

  • If the test is negative, the employee can return to work, taking general hygiene measures into account.
  • If the test is positive, the employee must stay at home for at least 7 days and recuperate from the illness. After that period, if the symptoms have been completely gone for at least 24 hours, the employee may return to work.

COVID-19 is a notifiable disease under the Public Health Act. The laboratory that detects the infection will report it to the Municipal Public Health Service (GGD). In all patients with a confirmed coronavirus infection, the GGD investigates the source and traces the contacts. To do so, the GGD asks the patient exactly who they had contact with during the infectious period and, if necessary, takes measures to prevent further spread. People in the same household as a COVID-19 patient should remain in home quarantine for up to 14 days after their last contact with the patient. That is because they may still become ill up to 14 days after the last contact. The exact measures that need to be taken at the school or childcare facility will depend on the circumstances, and are determined by the GGD. The GGD will contact the school or childcare organisation.

Testing policy for children aged 0 to 12 years old in primary education, special education and childcare

It is customary for schools and childcare organisations to report outbreaks of infectious diseases to the GGD infectious disease control department. Within the framework of Article 26 of the Public Health Act, the school manager or location manager reports the occurrence of an unusual number of cases of a disease that is presumed to be infectious. This also applies to (possible) coronavirus infections. The definition of an ‘unusual number of cases’ has been set at 3 or more.

Children aged 0 to 12 years who have symptoms that could indicate coronavirus (nasal cold and/or cough and/or fever) should stay at home until they are symptom-free for 24 hours. Parents report their child’s illness to the school and/or childcare organisation, which registers the report.

In case of coronavirus (or suspected coronavirus), the school and/or childcare organisation will notify the GGD infectious disease control department if there are 3 or more children in a class who have had symptoms of a nasal cold and/or cough and/or fever. If necessary, the school or childcare organisation can also contact the GGD if a child continues to have symptoms for an extended period, and is therefore not allowed to come to school or the childcare centre. The GGD will then launch an investigation and, if necessary – with the parents’ consent – administer tests.

  • If the test is negative, the child can go back to school or childcare.
  • If the test is positive, the child must stay at home and recuperate for at least 7 days. If the symptoms are completely gone for at least 24 hours after that period, the child can go back to school or childcare.

In all children with a confirmed coronavirus infection, the GGD investigates the source and traces the contacts. To do so, the GGD asks the parents exactly who the child had contact with during the infectious period and, if necessary, takes measures to prevent further spread. Family members of a child with COVID-19 should remain in home quarantine for up to 14 days after the last contact with the patient. That is because they may still become ill up to 14 days after the last contact. Any other measures that need to be taken at the school or childcare facility will depend on the circumstances, and are determined by the GGD. The GGD will contact the school or childcare organisation.

From 11 May, people with contact professions can also have themselves tested easily if they have symptoms that could indicate COVID-19. 

If you work in a contact profession, it is possible to be tested easily for COVID-19. That means health problems such as a nasal cold, coughing, shortness of breath or fever. Testing can be arranged in consultation with the company doctor, municipal public health service (GGD) or your GP. A person with symptoms should stay at home from when the symptoms start until the test result is known. If you test positive, you should stay at home for at least 7 days to recuperate. After that period, if you are symptom-free for at least 24 hours, you can go back to work. The GGD will contact you to discuss the measures that apply to you and the other people in your household to prevent the further spread of the virus.

From 18 May, public transport employees who have direct contact with clients can have themselves tested  if they have symptoms that could indicate COVID-19.
That means health problems such as a nasal cold, coughing, shortness of breath or fever. Testing can be arranged in consultation with the company doctor, municipal public health service (GGD) or your GP. A person with symptoms should stay at home from when the symptoms start until the test result is known. If you test positive, you should stay at home for at least 7 days to recuperate. After that period, if you are symptom-free for at least 24 hours, you can go back to work. The GGD will contact you to discuss the measures that apply to you and the other people in your household to prevent the further spread of the virus.
 

From 18 May, law enforcement personnel working in enforcement and supervision (police, special investigating officers, employees of the Custodial Institutions Agency (DJI), and RNM border police) can have themselves tested easily if they have symptoms that could indicate COVID-19.

That means health problems such as a nasal cold, coughing, shortness of breath or fever. Testing can be arranged in consultation with the company doctor, municipal public health service (GGD) or your GP. A person with symptoms should stay at home from when the symptoms start until the test result is known. If you test positive, you should stay at home for at least 7 days to recuperate. After that period, if you are symptom-free for at least 24 hours, you can go back to work. The GGD will contact you to discuss the measures that apply to you and the other people in your household to prevent the further spread of the virus.

RIVM guidelines

RIVMNational Institute for Public Health and the Environment draws up guidelines for when a person will be tested, in order to determine if you are currently infected with the novel coronavirus. There needs to be a reason to administer the test. There is a huge demand for tests worldwide, and the testing capacity that is available should be used as wisely as possible. The Municipal Public Health Services (GGDs) and hospitals administer the tests.

The quality of the tests being offered is monitored closely. It is not currently possible to request a test to determine whether you were previously infected. These tests are currently only being done to a limited extent, as part of research on the spread of the virus in the Netherlands. Right now, RIVM is investigating which antibody test gives the most reliable result. RIVM is also investigating whether the presence of antibodies also means that you can no longer get the virus, and that you can no longer become ill from it. People with mild symptoms may have fewer antibodies, which would mean that they are not fully protected against the virus.
 

Two types of tests

There are two types of tests. One test determines if someone currently has the novel coronavirus, and the other determines if someone has had the novel coronavirus in the past.

Test to determine if you are infected now

Polymerase chain reaction (PCR) test
Most commonly used test that detects whether the genetic material (RNA ribonucleic acid ) of the virus is present in the nasal or oral cavity. A smear is taken from the nose and throat with a cotton swab.

Test to determine if you have been infected

Serological test
Test to determine if there are antibodies against the novel coronavirus in your blood. This test involves taking a blood sample. So far, none of the rapid diagnostic tests examined are suitable for diagnosis in individual patients or for home use.

Evaluating tests

RIVMNational Institute for Public Health and the Environment is one of the organisations involved in evaluating polymerase chain reaction (PCR) testing and serological testing. We are often asked whether test methods that have been submitted are in fact suitable for diagnostics. RIVM will not be providing information on the status of requests to evaluate and validate tests. In recent weeks, many different tests have been submitted and evaluated by RIVM, and some have been validated.

The standard PCR test, which takes about 6 to 8 hours, is the most commonly used test in various laboratories in the Netherlands. Rapid PCR tests have recently been used that give results within an hour. However, these tests are primarily intended for situations where rapid diagnosis is absolutely vital. For example, if someone has to be treated in hospital for heart failure or organ transplant. These types of tests are not intended to be used in test lanes for general COVID-19 diagnostics.

Various tests are also available for serological testing. These tests are intended to see if people are producing antibodies against the novel coronavirus. There are also tests that detect the presence of virus proteins. These tests are used for research at a population level to see whether people in the Netherlands are building up immunity against the virus. There are also all sorts of serological rapid diagnostic tests. So far, none of these rapid diagnostic tests examined by RIVM are suitable for diagnostics in individual patients or for home use. For that reason, RIVM is cautious about processing requests for evaluation of rapid diagnostic tests.

Testing capacity

When operating at full capacity, the Netherlands can handle about 17,500 tests per day. If necessary, the labs can increase testing capacity to about 29,000 tests per day. Testing capacity depends on people and resources. Materials are needed to perform the test, such as cotton swabs, packaging materials and personal protective equipment for the workers taking the samples. Materials are also needed for the analysis in the lab: fluids, filters and components in the analysis equipment, as well as the devices themselves. And people are needed: people to administer the tests, transport them to the lab, analyse them in the lab, and communicate the results. In short: when we refer to testing capacity, we are talking about many different aspects. By testing according to careful guidelines, we are ensuring that sufficient facilities are available to use these resources efficiently. The Dutch testing policy is based on advice from the Outbreak Management Team.   

Developing alternatives

RIVM is also working with national and international laboratories to find possible options to supplement the current tests. Besides the current polymerase chain reaction (PCR) tests, which detect the genetic material of the virus, we are also looking at other types of tests. One type is antigen tests, which detect the presence of virus proteins; another type is serological tests, which detect the presence of antibodies in the blood. By using these tests, for example in combination with the current test, more people can be tested to find out whether they have (or have had) the novel coronavirus.

Frequently Asked Questions

Questions

Can I use a rapid diagnostic test to test myself?

RIVMNational Institute for Public Health and the Environment is researching COVID-19 rapid diagnostic tests that are being offered for home use or by third parties at a specific location. These are not self-tests, but rapid diagnostic tests (‘sneltesten’ in Dutch). So far, the quality of these rapid tests has been insufficient to test on individual patients or to use at home.  The results are not reliable. Users may become unnecessarily worried, or they may be wrongly reassured. The Health and Youth Care Inspectorate (IGJ) has also published a report about this. Tests that can be used at home to check whether you are infected with a disease are prohibited if they have not first been assessed by a notified body.  More info at IGJ. The World Health Organization also discourages the use of rapid diagnostic tests.

Which people will be tested?

Patients from vulnerable groups will be tested if it considered important for their treatment or care.

Also, patients with symptoms of a coronavirus infection will be tested if they become so ill that they require hospitalisation.

Healthcare workers, such as GPs, nursing home employees, and home care workers, will also be tested if they have symptoms that indicate a coronavirus infection and are essential in providing healthcare.

From 11 May, people working in a contact profession can also have themselves tested if they have symptoms that could indicate the novel coronavirus.

From 18 May, the testing policy was expanded to include informal carers, volunteers working in palliative care, and care providers funded by a personal budget (PGB).  Additional tests can also be arranged for visitors to the 25 nursing homes that have been participating in the Visiting Scheme pilot project since 11 May.   From June on, it will be possible to test everyone in the Netherlands who has symptoms that could indicate the novel coronavirus. If the test shows that you are infected with the novel coronavirus, the Municipal Public Health Service (GGD) will carry out intensive source and contact tracing.

When will someone be tested? 

If people have symptoms that could indicate COVID-19, they should stay home until they have no symptoms for at least 24 hours. The doctor or GP can determine whether a test contributes to a patient’s treatment or care. If possible, the GP can test the patient himself or consult with the Municipal Public Health Service (GGD). Healthcare workers with symptoms that could indicate the novel coronavirus can be tested by the GGD. The GGD will follow the RIVM guidelines.

Are alternative testing methods being investigated?

All around the world, there is a shortage of certain laboratory materials needed for the test. For that reason, RIVM is working with national and international laboratories to find different testing methods that require other laboratory materials. Besides the current polymerase chain reaction (PCR) tests, which detect the genetic material (ribonucleic acid, RNA) of the virus, we are also looking at other types of tests. These are tests that detect the presence of virus proteins (antigen tests). We are also looking at tests that detect the presence of antibodies in the blood (serological tests). With the help of these tests, for example in combination with the current test, we may be able to test more people to find out if they have (or have had) the coronavirus.

Can I have a test to see if I have already had the virus and if I have antibodies against the novel coronavirus?

No, people are already being tested to a limited extent as part of research into the spread of the virus in the Netherlands. Right now, RIVM is investigating which antibody test gives the most reliable result. We discourage people from having their blood tested for the presence of antibodies against the novel coronavirus. This can give a feeling of false security. RIVM is currently investigating whether the presence of antibodies also means that you can no longer get the virus, and that you can no longer become ill from it. People with mild symptoms may have fewer antibodies, which would mean that they are not fully protected against the virus.