The Netherlands is ill-prepared for another serious wave of COVID-19 in the autumn, the government's plans are too unclear, the time to develop new ones is too long, and valuable time is wasted. If the coronavirus makes a comeback, a new lockdown will emerge this fall or winter. This is the obvious conclusion of a round of interviews with hospital directors, virologists and scientists by Dutch media NOS.
Taking the necessary measures, such as re-fulfilling the obligation to wear a mask and maintaining a distance of one and a half meters, is also a form of blockade, which the Cabinet believes is also a realistic scenario that may emerge. This is remarkable because the basic principle of the latest cabinet plan is to prevent a re-lockdown and to keep society open even during the recovery of the virus.
Today, the Second House of the Netherlands is discussing long-term coronavirus policy, but according to experts, there is too little discussion about preparations for another wave of coronavirus this autumn.
David Jongen, president of Zuyderland-ziekenhuis, a hospital in the south of the Netherlands and vice president of the Dutch Hospital Association, said: "Everyone seems to be asleep, it's a bit like burying their head in the sand. His words also represented the concerns of other hospital presidents.
Fewer hospital staff and intensive care beds
The biggest problem remains the shortage of health care personnel. Before the pandemic, the shortage of manpower was already serious, and in the two years of the epidemic, many nurses have stopped working. On top of that, the absenteeism rate of nursing staff who remain is also twice as high as it was before the covid-19 crisis.
According to Joke Dieperink, a member of the board of directors of the Dutch Association of Critical Care Professionals V&VN-IC and a nurse in intensive care, the government has done little to address the issue. "We now have to work in intensive care with fewer colleagues than we did at the beginning of the pandemic," Dipellinck said. I'm really worried because I don't know if this will work on. In the next wave of the epidemic, more colleagues may disappear and stop working. ”
The pressure of staff shortages remains high
It is in the area of staff shortage that the government's Ministry of Health seems to have abandoned efforts to address it ahead of schedule. The Ministry of Health's Pandemic Preparedness Policy Agenda dated 14 April states: "Given shortages in healthcare and other sectors, it is unrealistic to have a further increase in the number of healthcare workers in the coming years." ”
André Knottnerus, the former chairman of the government's Policy Science Committee (WRR), said there appeared to be no signs of the government committing to the issue. "Of course you want to hear: it's hard to find employees, but we're doing everything we can to do it."
Mark Kramer, the successor to Health Minister Koubers and chairman of the Netherlands' National Coordination Centre for Patient Distribution, is concerned about whether hospitals can cope with another strong wave of COVID-19 that could emerge this fall and winter. "Many healthcare workers have not yet recovered, absenteeism rates are still high, and people are stressed to work."
Kramer stressed that it's not just about hospitals, "We're facing a chain of care. So, in addition to hospitals, family doctor positions, family doctor clinics, nursing homes, home care, and mental health care, if one link in the chain falls off in the wave of the outbreak, the rest of the chain could also collapse. Because there is a blockage in the patient flow, there is a risk that the entire chain will fall off. ”
Concerns about the emergence of new variant viruses
It is uncertain whether a new, heavier variant of the coronavirus will emerge and lead to an overburdened health care. According to virologists who have spoken to NOS, the situation may not be so bad. However, they warn that the past two years have only been more disappointing, and even with the emergence of a less pathogenic coronavirus, it could still lead to the collapse of the care system due to the simultaneous emergence of outbreaks of influenza and RS viruses.
Therefore, as WRR advocated last September, all situations must be taken into account in order to prepare for new setbacks.
At the time, such information seemed anachronistic, and after a good summer and the completion of a large number of vaccinations, few believed that the virus would be revived, let alone a new blockade.
A month later, new measures were needed, and Dutch politics and society then discussed 2G measures during the crisis.
Ask the government to speak honestly
This is imminent again.
Epidemiologist Frits Rosendaal believes that Minister Koopers should be honest. "As they did in Denmark, they have developed the predicted scenario and communicated clearly: what measures we will take if this happens." Let everyone know this, and then you can have an open debate about it. In this way, you will not panic because of what situation has emerged, new measures will be re-introduced, surprise or anger society, and you will not have to debate society again. ”
Experts urged an open debate now, with those involved demanding that Cabinet policies be honest, clear and decisive.
"I know the cabinet is now mainly busy with other matters such as the war in Ukraine, rising inflation, budget issues and climate issues," Notnarus said. But as citizens, governments can be expected to deal with multiple crises at the same time. Because for a crisis, every day of waiting is important. ”
To complete this article, NOS spoke with 20 people in the field, including 10 hospital directors, 2 health economists, nurse representatives in intensive care, virologists, authors of important WRR reports, the Association of Critical Care Physicians and the National Center for Patient Distribution.
The European Centers for Disease Control and Prevention believes that there will be another wave of outbreaks in the summer
The EcDC, the European Centre for Disease Control and Prevention, predicts that variants of the new Omicron virus, BA.4 and BA.5, could lead to an increase in hospitalizations and intensive care in the coming weeks and months, with a new wave of outbreaks emerging in the summer.
The center has positioned the new variant as a worrisome variant. After these variants of the virus dominated South Africa, they continued to advance in Europe. In Portugal, IT is estimated that BA.5 will dominate around May 22.
These strains have now also been confirmed to be found in the Netherlands. In Amsterdam, the percentage of BA.4 and BA.5 infections rose from 0.7% to 8% in three weeks. Chantal Bleeker, an internal epidemiologist at Nijmegen University Hospital, said: "The pathogenicity of these new strains is not considered to be more serious than the previous Omiljung variant. However, if the number of COVID-19 cases increases significantly, as in previous waves, it will always lead to more hospitalizations and more COVID-19 patients. ”
So it's time to make plans, Brick said, "We shouldn't talk about COVID-19 strategies until autumn arrives, it's too late." It's unlikely that we'll have another wave of the summer and we're wasting precious time. For example, why aren't we now starting to study ventilation and the use of carbon dioxide meters in schools and healthcare facilities? ”
Brick is also concerned about the fact that there are fewer tests and studies of mutations, "We do need to pay better attention to viral infections and the emergence of new variants." The Dutch expert group OMT has also previously made such recommendations, for example, by expanding the family doctor's site or creating a portal where people can report positive results on self-tests. Brick believes it's still important to get a reinforcing needle.
Bert Niesters, a virologist at the University Medical Center Groningen, said: "This booster needle is still effective in preventing serious illness, hospitalization and death. We were fortunate that the initial vaccination against the virus was also effective against the Omiljung variant, as evidenced by the Israeli data. Pharmacists are said to be working on a new vaccine mixture that works better against variants, but so far, I haven't seen any results. ”
Still, Nesters isn't very worried about another wave of the summer. "Is it about people who end up being hospitalized with the Aumechjong virus? I know that the large number of infections in Africa is indeed worrying, but vaccination rates there are still low. However, we have been vaccinated here, and many of us have been infected with the virus at one time. So, we were reasonably protected. ”
However, another expert, Brick, disagrees: "If you have the variant BA.1, it doesn't mean you're well protected from BA.4 or BA.5, especially if you haven't been vaccinated in any way." ”