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Safety board criticises inflexible Dutch response to coronavirus

The Dutch government’s plan to contain coronavirus focused for too long on short-term health goals, the national safety board has said in its final report.

Lockdowns and other pandemic control measures were imposed and released in response to the threat to the healthcare system, particularly intensive care units.

In the last part of its three-stage assessment of the government’s response, the Dutch safety board (OVV) said the government should adopt a more flexible approach to future crises and communicate its reasons better to the public.

During the two and a half year period from March 2020 to September 2022 the situation evolved from a healthcare emergency to a broader social crisis, but the cabinet’s basic priorities never changed, the OVV commented.

It criticised the fact that the health minister was put in charge of decision making throughout. That meant the effects of school closures on young people, post-covid syndrome and social isolation were downplayed after the initial acute phase.

The wider consequences for healthcare, with operations and treatments for conditions such as cancer postponed to keep beds open for coronavirus patients, were also neglected, the OVV said.

Broad social crisis

In the early weeks of the pandemic the then health minister, Hugo de Jonge, had to scramble to increase intensive care capacity to 1,350 beds as hospitals struggled to cope with the early wave of infections.

During the second wave, starting in October 2021 intensive care managers again sounded the alarm, but occupancy peaked at just over 800 and has not risen above 650 since.

“When the crisis developed into a broad social crisis, there was not always sufficient scope to give equal consideration to other parties, with the result that the long-term effects of the crisis did not get enough attention,” the OVV commented.

The third part of its assessment into the pandemic response looked back over the whole 30-month period, as well as making recommendations for future national crises.

The board’s first report, covering the first six months of the pandemic, said the Netherlands was ill-prepared for a large-scale outbreak, leading to a “silent disaster” in nursing homes because of the focus on hospitals and the lack of protective equipment.

The second report criticised the vaccination programme for being poorly planned, with family doctors expected to manage the process. The Netherlands was the last country in Europe to start immunising its population and only caught up once it established a nationwide network of vaccination centres.

Regular assessments

“The OVV found that the cabinet – looking at the recommendations of the three reports – should take measures in the short term to ensure it is better prepared for future long-term crises,” chairman Chris van Dam said.

The board said the government should carry out regular assessments “to check if the course they have chosen is still the right one as the crisis goes on and continuously decide if the aims need to be adjusted.”

Another point of criticism was the sharing of patient information, which was hampered by differing views of privacy laws. Van Dam said the Netherlands appeared to have been more constrained by privacy concerns than other countries where similar rules apply.

“The argument about exchanging data between the GGD [health board network] and the CBS statistics agency went on for six months in the middle of a crisis,” he said.

“It seems as if risk aversion dominates the issue of privacy in this country, but arguments about the protection of personal privacy must not be a hindrance. We need to make real progress in this area, something that other countries with the same regulations appear to be better at doing.”

Van Dam said the board would summarise its recommendations in a letter to the cabinet and parliament, partly to help MPs decide whether a public inquiry should be held into the pandemic.