How is RIVMNational Institute for Public Health and the Environment advising the Dutch government about the coronavirus?

In the event of a nation-wide outbreak of infectious disease in the Netherlands, RIVM coordinates efforts to control the disease. This is also the case in the current outbreak of the novel coronavirus. RIVM is working closely with experts and representatives from various organisations. A brief summary of our methods is provided below.

RIVM has guidelines and scenarios in place for the best way to respond to an epidemic, based on scientific insights. These documents are drawn up to ensure that the Netherlands is as prepared as possible for any outbreaks of serious diseases

In the event of an outbreak of a new or rare disease, such as the novel coronavirus, RIVM convenes the Outbreak Management Team (OMT Outbreak Management Team ). This emergency response team brings together specialists from various backgrounds who know a great deal about the disease in question. These specialists discuss the outbreak based on the latest information and knowledge from the scientific community.

The OMT consultations about the outbreak of the novel coronavirus are confidential. After every meeting of the OMT, RIVM drafts an advisory report for the Ministry of Health, Welfare and Sport (VWS)  Ministry of Health, Welfare and Sport. Then the recommendations from the advisory report are discussed in various governmental consultative bodies and by the Ministers. The Cabinet ultimately decides what happens with the recommendations and whether measures are implemented.

Read more about the national advisory role in controlling infectious diseases. RIVM Centre for Infectious Disease Control

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.
This is the approach that we have chosen in the Netherlands. 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 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. RIVM 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.