1What is happening now in your country: is the situation stable or are cases increasing, what about clusters and measures?
Since mid-September figures are rising again in The Netherlands and approaching those from March 2020. Also the R value rose from 0.9 up to 1.3, so the second wave is there. Current cases are more often than before younger people aged 20 – 40 years and they appear to be less ill. Nevertheless hospital and intenive care admission are increasing. There are clusters in at least three provinces: North- and South Holland and Groningen. The big cities of Amsterdam, Rotterdam and The Hague have the worst figures. Measures have become more strict several times and since September 29 there is a must for mouthcaps not only in the public transport (which was already obliged since June 1st) but also in busy places in the affected cities. This obligation has been extended 1 day later to include the entire interior public space where the mouthcaps are urgently advised but not compulsary. Theaters etc. are allowed to have only a limited number of visitors, restaurants and cafés have to close early and also have limitations in number of visitors. All sports competitions are even without visitors and at home you may have three guests only.
2Is the policy to do massive PCR tests, in order to find “positive asymptomatics”, effective?
Although massive testing is advocated, there is a rather disappointing shortage of test material. Besides, waiting time at test locations is long, usually more than 48 – 72 hours. Probably this is also the reason why asymptomatics are not being tested. Quick tests are needed urgently and they will be available soon.
3What to advice to protect the most vulnerable people?
The most vulnerable people are advised to be careful and to keep to the general measures already applied since the beginning of the crisis. Social distancing is the most important advise.The nursing homes will most probably not be completely closed for visitors as in the beginning.
4Do you have significant negationist movements against COVID in your country? Do you think that these demonstrations should be permitted?
Yes we do have such a movement, originally called “viruswaanzin”= virus madness”, now renamed “viruswaarheid”= “virus truth”. They organize demonstrations and (mis)use young influencers. According to Dutch law it is not possible to forbid the demonstations, unless there is violence or demolitions.
5What is the reason why lethality now is lower than in spring?
Mainly because younger people are affected. A better understanding of the disease, including better treatment might also be of importance.
6Do you think that a more coordinated European strategy would improve the situation or does each country have to resolve its own problem? (here we can review FAQs 3)
In some aspect a coordinated European strategy might be helpful, especially with respect to traveling and the judgement of areas to be “green, orange or red”.
7What is the situation of children and the return to school. What about the treatment of non-Covid 19 patients (seems to have normalized by now). Is it like this in your country?
All children returned to school already in June and directly after the summer break. For young children there are no limitations and no need to stay home in case of a common cold. For older children the usual measures, such as social distancing etc. are in place. Because of the regular dropout of teachers because of (contact with) corona or burn-out, childen are sent home more often than before and remote digital education is again considered. As far as treatment of non-Covid 19 patients is concerned, this was nearly normalized. However, now with the expectations of new peaks of numbers of Covid 19 patients ahead it is feared that again problems for non-Covid 19 patients may arise. It is tried very hard to avoid that.
8Give scenarios: more lock-down, quarantaine (acceptable for the people?), what about travelling, what about economics. An alternative could be to report what we (and our colleagues) would tell our/their patients or to anybody when we/they are asked this kind of questions.
There is already more lock-down than before (see earlier) and it might be even stricter than that. A total lock-down, however, has never been employed in The Netherlands. Quarantaine is adviced (not compulsory) after air travel and visits to orange or red areas abroad and of course also after a positive test or after contact with a positive person. Unfortunately not everyone is convinced that this is a must, so the measure is not always adhered at. It is emphasized by the government repeatedly that people should adhere to this, but because of an unbalanced policy (no teststreet anymore at the airport, unsufficient test capacity) it is not always easy for the people to understand the urgency of the measure. Travel is very much limited, mainly restricted to the own country and only if safe. Unnecessary travel is advised against. Public transport is, however, fully available - with mouthcaps. The economics, as everywhere, is affected heavily. Mainly the sectors of transport, tourism, theaters/performances/arts, restaurants, hotels etc., sports and many more are dealing with big problems.