Judicious application of testing To control the novel coronavirus, it is important to use our available test capacity and resources wisely. This is important so that enough tests can be administered, both now and in the long term. Laboratory material is not available in sufficient quantities for certain specific steps in the test procedure. This is an international problem and is not limited to the Netherlands. Dutch testing policy To ensure that we will continue to be able to carry out tests in the long term, not everyone in the Netherlands who has symptoms is being tested. Tests can be administered in the following situations: Patients in hospital may be tested because confirmation is important for the protection of other patients in that hospital and for the hospital staff. Patients in hospital (especially in intensive care) may also be tested because confirmation is important for their course of treatment. In care facilities that house vulnerable patients, such as residential facilities for the elderly and the disabled, the first few patients with symptoms are now being tested. This will make it possible to determine whether the virus is present in the care facility. Based on the results, measures for the whole ward will follow. Approximately 40 GP practices in the Netherlands (the ‘testing stations’ designated by Nivel Netherlands Institute for Health Services Research ) are taking part in a study of flu-like symptoms in their patients.  The aim is to see how often these symptoms occur and which viruses are causing these symptoms. Since early February, this study has also included testing for the novel coronavirus.    The Dutch testing policy is based on advice from the Outbreak Management Team. This is a group of experts associated with various medical institutions and professional associations, under the direction of RIVM, which advises the government on the measures to control the novel coronavirus. Testing capacity will be expanded in the coming weeks. As that happens, the testing policy can also be extended to others.  In the new testing policy, priority will be given to care workers (who are showing symptoms) who work with vulnerable patients and/or are essential to continuity of care. Patients with an increased risk of developing a severe case of the disease will also be tested sooner. The new testing policy will be laid down in the LCI  National Coordination Centre for Communicable Disease Control guideline for COVID-19 and will be phased in from 6 April. Differences by region There are regional differences in how the coronavirus is spreading within the Netherlands. As a result, there are also differences in testing capacity between certain areas in the Netherlands. When giving general advice, the experts always look at the national overview. Developing alternatives All around the world, there is a shortage of certain laboratory materials needed for the test procedure. For that reason, RIVM is working with national and international laboratories to find alternatives to current test procedures that require other laboratory materials. Besides the current PCR polymerase chain reaction tests, which detect the genetic material of the virus, we are also looking at other types of tests. One type is antigen tests, which show the presence of virus proteins. Another type is serological tests, which show the presence of antibodies in the blood. By using these tests, for example in combination with the current test, more people can be tested whether they have (or had) the coronavirus. 

What is RIVM National Institute for Public Health and the Environment (RIVM) doing to monitor the outbreak of the novel coronavirus in the Netherlands? RIVM publishes daily updates on the number of patients with COVID-19 in the Netherlands. These are the confirmed cases that Municipal Public Health Services (GGDs) are required to report to us. We know that the number of people who actually have the virus is higher. This is because not everyone who may be infected is tested for the virus. Read more about the testing policy: Policy on testing for novel coronavirus disease (COVID-19) in the Netherlands. Knowledge and research Naturally, we are also monitoring and mapping the outbreak of the coronavirus in other ways. We do so by collecting and analysing data. This page presents some of the activities that we are doing to monitor the outbreak. If you would like to know more about how we are using the figures on the coronavirus, watch the video (in Dutch). Data from laboratories in the Netherlands Since 9 March 2020, some 40 laboratories in the Netherlands have been tracking how many people they are testing for the virus that causes COVID-19 and how many people tested positive. RIVM has asked them to report positive tests on a daily basis. These figures also offer an impression of the virus outbreak in the Netherlands. The number of people who test positive is lower than the number of confirmed cases in the RIVM daily update. This is because not all laboratories are reporting on a daily basis (yet). Netherlands Institute for Health Services Research (Nivel) testing stations Nivel is working with RIVM on screening for people with flu-like symptoms. Working together, they are running tests at 40 General Practitioner (GP) practices to see how often these symptoms occur and which viruses are causing these symptoms. Since early February, this study has also included testing for the novel coronavirus.  Records of admissions to hospitals and to intensive care (ICU intensive care units ) The National Intensive Care Evaluation (NICE) Foundation is also sending data to RIVM, reporting on the number of patients in the Dutch intensive care units (ICUs) with COVID-19. The Dutch ICUs have been recording these figures since late February. RIVM includes the data in the daily update (link). There may be a delay of a few days before the data is provided. This is due to how busy the hospitals are. Research on families and young people RIVM is carrying out research among families in the Netherlands where someone has contracted the novel coronavirus. We want to find out more about the course of the disease. The aim is to gather more information about how long symptoms last, how long it takes to recover, and how people build up immunity to the virus. In addition, we want to know if children also pass the virus on to others. Research is taking place in various provinces across the Netherlands, among a hundred families with coronavirus patients.  Once there is confirmation that someone is infected, a nurse visits the family as soon as possible. Nose, throat and blood samples are collected. The family then keeps track of their symptoms for a month. If a family member becomes ill, we take samples again and see if this person also has COVID-19. In any case, we take samples from the whole family two more times: 2-3 weeks and 4-6 weeks after the first home visit. The results will be processed six weeks after all the families have had their first home visit. Research on antibodies against the novel coronavirus Working with Sanquin, the organisation that runs the Dutch blood banks, RIVM is looking into the extent to which people in the Netherlands have antibodies against the new coronavirus in their blood. If there are antibodies in people’s blood, it means they have already had the virus. Sanquin is conducting an initial test to see whether these antibodies are present in the blood supply. RIVM is assessing the test in order to confirm the results. Large-scale study on immunity (and herd immunity) RIVM will be carrying out a large-scale study on immunity to the novel coronavirus. This multi-year study will continuously provide information that is needed to control the outbreak of the novel coronavirus. We are going to invite 6,000 people from all over the country to take part. These people are between the ages of 2 and 92 years old. The people that we are inviting to take part are already participating in a long-term study on protection against infectious diseases (known as the PIENTER study). By conducting this study, we want to gain insight into how immunity develops in different age groups. RIVM would also like to know how people remain immune.