watch live hereThe Netherlands was not well prepared for the corona crisis. The preparations were substandard, the Ministry of Health had not practiced scenarios for a major pandemic. In addition, visibility of the virus was poor at the beginning due to ‘a limited testing policy’, because by no means everyone could be tested.
Tobias den Hartog, Niels Klaassen
Latest update:
10:40
That is what the Dutch Safety Board (OVV) concluded today in her first report on tackling the coronavirus crisis.
“The government thought it was prepared, but they were not,” said Jeroen Dijsselbloem, chairman of the Dutch Safety Board at a press conference. “There were exercises and scenarios, but not for such a long-term crisis. “In practice, a Minister of Health does not have the powers to manage healthcare institutions or GGDs. So the government had to rely on improvisation. There were scenarios for a pandemic, but they had not been worked out or prepared.”
The OVV writes that the ‘crisis structure and crisis communication’ proved to be insufficient. “Stakeholders in all sectors worked hard and under difficult circumstances. The efforts of many do not alter the fact that improvements in the crisis approach are possible and necessary.”
According to Dijsselbloem, ‘The Netherlands appeared to be vulnerable’. “That is due to the way in which the government has set up the care and crisis structure: it turned out to be insufficient for the nature and size of the crisis.” The council of the decentralized healthcare system: in times of crisis, the Minister of Health must be given the power to enforce measures.
According to the OVV, there was a lack of knowledge about the virus and the limited testing policy provided insufficient insight into the spread of the virus in this first period. In addition, signals about social effects such as loneliness remained ‘for a long time underexposed in advice and decision-making’.
The OVV report is the first of three parts, this time the period March 2020 to September 2020, i.e. the start of the pandemic for the Netherlands, is examined.
Advice
According to the OVV, it was logical that the cabinet relied on the advice of the OMT, but as a result, the attention during the first wave of contamination was ‘very strongly focused on the hospitals’. Little attention was paid to other consequences of the corona crisis. The crisis had unprecedented consequences for nursing homes, but also for education, the cultural sector and small and medium-sized enterprises. Those effects turned the health crisis into a social crisis as well.”
About the ‘silent disaster’ in nursing homes, Dijsselbloem says: “About half of the deaths involved residents of nursing homes.” They came too late on the political radar, due to a lack of protective equipment, the elderly had to stay in nursing homes for months without visitors.
Dijsselbloem calls it ‘most distressing’ that residents and staff in nursing homes ‘have received insufficient attention’. For example, quarantine was imposed on large groups of residents because there were too few protective equipment. “That is very distressing.”
The OVV also emphasizes that the OMT and the cabinet focused too closely on the situation in hospitals, so that ‘a silent disaster’ could take place in nursing homes, with many deaths and ultimately a ban on visiting relatives. “As a result, the mental suffering is enormous.”
The crisis organization was stuck ‘on combating the virus’, the OVV concludes: “As a result, there is too little attention for long-term effects and social impact.” But more and more parties are joining the consultations, which makes ‘decisive decisions’ difficult. But informal consultations in Catshuis and Torentje make it unclear where the real decisions are made. As a result of these consultations, ‘checks and balances’ that normally apply to decisions disappear.
The Dutch Safety Board concludes that the cabinet could have ‘improved the effectiveness of the crisis approach by looking more and further ahead’ and by ‘obtaining broader advice than just about the effects of the virus on acute care’.
Communication
Government communications have also been criticized. Some groups in society were not reached by the crisis approach or the corona aid and did not feel heard, says the OVV. The council also criticized the government’s firmness. “With less certainty, but by clearly stating what is or is not known about the course of the crisis, the government can prevent unrealistic expectations among the public.”
The corona press conferences and communication campaigns work well in the first phase of the pandemic, but then resistance to the approach becomes increasingly visible and communication “does not match well with the increasing number of people suffering psychologically, socially and financially” from the crisis.
It is also salient that the OVV implicitly warns against the danger of the double cap of, for example, Jaap van Dissel, who is an advisor as chairman of the OMT, but also leads infectious disease control at RIVM and attends informal consultations in Catshuis. and the Turret. “Everyone has to stick to their own role. Directors are decision makers, experts are advisors.”
Dijsselbloem warns against potential mixing of roles of the OMT, where the experts sometimes already included practical-logistical considerations in their scientific analysis, such as the lack of face masks. That should not happen to the experts, says Dijsselbloem: “For example, factors such as scarcity of capacity were already incorporated in the OMT advice, uncertainties and risks that were discussed at the OMT, did not reach politicians sufficiently.”
The OVV also notes that Van Dissel has ‘undermined’ the public’s confidence in the government’s corona policy by openly doubting the usefulness of face masks. Van Dissel initially thought that face masks could lead to a false sense of safety, because people would become more lax with other precautions. When the cabinet made it mandatory to wear face masks in 2020, first in public transport and later in public spaces, he called it a political choice and not a scientific choice. “Through these statements, government policy was undermined by advisers from the same government,” said the OVV.
classes
The OVV advises the cabinet to practice on such crises much more often, and much more data must also be taken into account from the start, including ‘less hard data’: so not only IC figures, but also welfare graphs. This broadens the view and prevents medical tunnel vision, the OVV outlines. “And it reduces the risk that vulnerable groups are left out of the picture.”
The OVV now recommends a two-track approach: a crisis team must consider and advise on acute measures, another organization must focus on the longer term, so that longer-term effects outside of healthcare are automatically taken into account. Dijsselbloem: “Apparently such a scenario did not fit our imagination.”
context
The government has already taken note of the report. A response from the then minister Hugo de Jonge (Public Health) shows that he believes that the OVV paid too little attention to the context in which it operated. According to the cabinet, the ‘coherence between certain subjects’ has been lost from sight in the report. According to De Jonge, it was unavoidable that the research looked at individual sub-topics, but the overall context did not come into focus as a result. For example, general corona measures were also taken to protect vulnerable people living in nursing homes. “This also sheds a different light on the conclusion that the situation in nursing homes received insufficient attention, not to mention the fact that the visit ban was decided early in the crisis, one of the most drastic measures during the entire corona crisis.”
Dijsselbloem says that De Jonge’s reaction is ‘striking’. ,,Yes, there has been hard work, by many people, by everyone. But there must be a willingness to look back. It often doesn’t get any better from the defense. This letter stood out. There was something wrong in it. Everyone can find what they want, but we see: is this correct. In the end, the criticism from us has stood.”
Second part
The second sub-report is expected around the summer. This focuses on the period from September 2020 to July 2021. There will also be a third study, into the period after July 2021.
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