A year and a half after the start of the corona crisis, the major evaluation of the pandemic has started. A scathing report by a parliamentary committee of inquiry came out in the UK calling the Johnson administration’s corona approach “one of the biggest public health failures” in the country’s history. In the Netherlands, the Dutch Safety Board is expected to submit a first report on the fight against corona early next year, followed by a parliamentary inquiry.
KPMG consultancy is anticipating this with its own interim evaluation of the corona crisis from March 2020 to July 2021. These are the lessons of a year and a half of corona crisis, which will be published this Thursday, KPMG is very critical of the strategy followed by the government and its results.
The consultancy conducted an extensive literature study of public sources and analyzed data available worldwide. More deaths have occurred in the Netherlands, because policy was made based on how many people were in hospital instead of the number of infections, the consultancy says. As a result, action was often taken too late.
Compared to Norway, Denmark and Finland, “it appears that the Netherlands was significantly less able to manage the pandemic in terms of both economic growth and excess mortality,” writes KPMG.
Even more health damage
Further increasing the IC capacity, which the Dutch hospitals tried in vain, would not have been a better strategy in retrospect, according to KPMG. According to the consultancy, “no capacity can cope with the exponential growth of viruses”, and moreover, having more ICU beds available would probably have caused even more damage to health, says doctor and health economist David Ikkersheim of KPMG Health. “If you only intervene when the beds are full, with more capacity this will paradoxically lead to even more damage to health, and is expected to lead to a substantially higher excess mortality.”
According to KPMG, countries that did intervene with more infections scored better
According to KPMG, countries that did intervene when the number of infections rose did much better. Ikkersheim also looked at mortality rates. These are usually difficult to compare, because factors such as climate, population structure and how close people live to each other also have an influence. According to Ikkersheim, they do provide a rough insight into how effective the policy was: in the Netherlands about 24,000 people died more than expected, while countries such as Denmark, Norway and Finland had little or no excess mortality. Those countries went into lockdown earlier and immediately had stricter border controls and quarantine rules.
According to KPMG, countries that have pursued stricter policies have not suffered any additional economic damage. Extra freedom, says Ikkersheim, was ‘a temporary candy’: if the figures rose, restrictive measures had to be taken again. This was also the case in the Netherlands: in the winter a strict lockdown and a curfew were needed to push the numbers. Compared to other European countries, the Netherlands performed ‘reasonably’ in economic terms, partly thanks to the generous support packages. At the same time, the Netherlands recorded a contraction of 0.2 percent, while a number of Scandinavian countries showed growth.
KPMG is surprised in the report about what it calls ‘Dutch exceptionalism’: Dutch policy deviated from what was advised internationally in a number of major decisions. As a result, the precautionary principle was not applied too often.
Ignore WHO advice
That started with ignoring the WHO’s advice to contain. Furthermore, very little testing was done in the Netherlands at first, while the adage of the WHO was ‘test, test, test’. There was also a debate for months about the need for a mask obligation, while many other European countries had already introduced it.
Ikkersheim considers the introduction of the curfew in January 2021 an example of how the precautionary principle was successfully used by the Netherlands. “Then preventive action was taken because of the threat of the British variant. That worked out well and may have prevented ‘code black’. In the next pandemic you have to use this attitude structurally.”
The cabinet regularly used the mantra ‘care over speed’, for example as an argument to start vaccinating later than other European countries. In a pandemic, this is an apparent contradiction, says Ikkersheim. “Doing something not 100 percent right, but quickly, is worth a lot in a crisis.”
During the preparation of the vaccination campaign, the KPMG noticed that there were no good scenarios ready and that various scenarios had not been used. Ikkersheim: “The Netherlands counted on AstraZeneca to come first, with distribution through the general practitioners. It became Pfizer, with a different cooling method, and it suddenly had to go through the GGD. All those things were foreseeable, just look at how the UK has done it.” KPMG concludes that the Netherlands eventually caught up with vaccination and that the current vaccination rate is “above average” high.
KPMG finds it striking that Minister De Jonge complained that his department could not have enough central control over the GGDs and GPs. The current Public Health Act gives the minister far-reaching powers in a pandemic if a disease is given A status. KPMG recommends a good legal analysis ‘to which instruments status A disease offers, and to clarify these where necessary’.
As a lesson for the next pandemic, KPMG also suggests adding foreign expertise to the OMT, because in Europe the OMTs sometimes advised their governments very differently. „Dispute can group think prevent as much as possible.”
A version of this article also appeared in NRC on the morning of October 14, 2021