Optimism and overestimation: this is how the Netherlands ended up in the autumn wave in a few weeks

Also read: Saying ‘your own fault’ to sick vaccine refusers is not possible

Warning phrases

It is “a critical moment in the pandemic,” said OMT chairman Jaap van Dissel of the Ministry of Health on September 13 in an advice. The cabinet plans to abolish the one and a half meters later in the month. But the OMT is not yet convinced that the much-changing delta variant has become dominant in the summer. International studies show the destruction of vaccines. The vaccination rate is not yet high enough to let go of all measures, the advice says.

Van Dissel outlines three scenarios: in the first change there is nothing at all. In the second, more is possible with a corona certificate – think of concerts where more audiences are allowed to enter and seats are no longer mandatory. The third scenario continues: the one and a half meters will also be deleted.

The third scenario is risky, consisting of the OMT, and could lead to a ‘significant rebound’ in the winter. Reversal of easing must be taken into account. Nevertheless, the third scenario can be followed, writes Van Dissel, under strict conditions. The figures are favorable at the time: the number of positive tests and the hospital occupancy at the moment. The behavioral unit of the RIVM advises against abolishing the one and a half meters: relaxations that have to be reversed later damage confidence in corona policy.

The OMT sees the ‘120 percent scenario’: people have more contact than usual

catching up

The cabinet risk opts for that, most comprehensive scenario, but a few – according to OMT members – important matters. The OMT advised to keep discotheques closed, but the cabinet allows them to open, even though they have to close at midnight. The advice “work at home as much as possible” is replaced by “work at home if possible and in the office if necessary”. The OMT wanted the one and a half meters to remain as advice. Outgoing Prime Minister Mark Rutte and Minister De Jonge call the one and a half meters “a safe distance”, but they do not give clear advice in the cases.

See you again from OMT members, who in the following days already see that people behave when the pandemic is over and even observe catching up behaviour: people go wild now that it is allowed. Within the OMT this is called the “120 percent scenario”, the number of contacts between people is higher than normal due to postponed festivals and weddings that are planned en masse. A typical Dutch phenomenon, says OMT member Andreas Voss, a German. “In other countries, people are a bit more reserved in enjoying their newfound freedom. People still wear masks or keep their distance themselves.”

Enforcement of the measures also leaves something to be desired: from a poll by I&O Research shows that catering establishments do not check the QR code on one in three visits. Municipalities seem to make little: none of the larger municipalities that NRC in an earlier tour, had been fined. In an exceptional case, a catering business was closed. “If we had known beforehand, we would have been different,” says intensivist and OMT member Diederik Gommers.

Fall Rise

At the beginning of October, two weeks after the introduction of the new measures, more Covid patients end up in hospitals. RIVM is talking about “an upcoming fall rise”. But it soon started to wring. Hospitals are catching up on delayed operations, now that new backlogs are threatening to arise. Peter van der Voort, an intensivist at the UMCG in Groningen, will no longer be able to provide all the care on 13 October. Van der Voort hopes that the OMT will meet that week and take future measures before the autumn recess in The Hague begins.

That’s not happening. A week earlier, there was another OMT meeting, in the advice the increase was called ‘a tipping point’, but no new measures are mentioned. “In the RIVM models, the peak in the number of admissions was in January,” says Károly Illy, pediatrician and OMT member. They are not flawless, Illy recognizes, and declared with a lot of strength. “But what else should you base yourself on? It’s the best we have.” De Jonge also looks at the model calculations: in TV show On 1 he says on October 12 that a high peak is not expected in the short term.

The margins and the line

RIVM’s model calculations, says lead modeler Jacco Wallinga, are easy to “overinterpret”: you quickly draw output from the graph that cannot be drawn. Many people look at the line, but minimal and so important are the margins around that large, which indicate how the uncertainties are. Those margins have yielded results in recent months: “The epidemic was first determined by the behavior of the Netherlands,” explains Wallinga. “Now it concerns specific groups: children too young for vaccination, people who do not want to be vaccinated, or for whom the vaccine does not work. It is more difficult to develop in those specific estimates.”

You have to look at the models, says Wallinga. “You can’t say exactly when a wave is coming and how steeply it will receive from a model calculation with such wide margins.” Nevertheless, the basic intake is possible despite the high vaccination coverage.

Cabinet alarmed

As hospital admissions continue, concern in the OMT increases. The cabinet does not intend to make a decision on how to proceed until early November. Part of the OMT thinks this is too late and insists on informal consultation. That will be on Friday, October 22. A number of OMT members believe that new measures for the cabinet should be developed proactively. Diederik Gommers, among others, advocates, but he does not get enough support. “I saw that things were not going well in the ICU.” Gommers believes that the ministry is exaggerating the concern by requiring that the number of IC beds can be expanded to 1,700 this winter. “The idea is: it was possible in March 2020, so it is now possible again. But that is not possible, we have a result personnel problem.”