As the summer season comes to an end, the beginning of autumn is a concern for local authorities in the fight against Covid-19. Temperatures will decline and people will stay inside more, which is where most infections occur. Additionally, there are all kinds of other viruses circulating that give similar complaints to corona. Authorities say extensive testing and rapid detection of infections is the best way to keep the corona virus under control, but are we prepared?
The GGDs, the regional Public Health Services in the Netherlands, plays a vital role in this matter. When the number of infections rose again in early August, deputy prime minister Hugo De Jonge insisted that the GGDs were doing well. A day later, the pressure became too high and both the Amsterdam and the Rotterdam offices stopped part of the corona contact tracing. This revealed that the current capacity for testing is still low. Het Parool newspaper reported that De Jonge has requested the GGDs to temporarily stop the upscaling of all test sites for the coronavirus, because the testing laboratories cannot expand their current workload so fast.
FD newspaper states that experts advise to expand the infrastructure of the GGDs and to speed up testing for fall season. However, former GGD director Richard Janssen says the GGDs have long been neglected. “Prevention is not a sexy topic for politicians and the GGDs have been cut back for years, and now they suddenly have to fight the pandemic.”
Additionally, Janssen says the organizational structure of the departments is an obstacle: “There are 25 regional health services, all of which fall under several different municipalities.” It is even more complicated that the administrative responsibility does not lie with the Ministry of Health, Welfare and Sport, but with the safety regions. “This fragmentation makes it complicated to scale up quickly in a crisis situation like this one.” In an interview with FD, Hubert Bruls, chairman of the Safety Council, warns against overloading the GGDs. “We are worried about it. We have been in crisis mode for six months. The GGDs are now being helped by municipal staff, but that will stop. People need to be able to get some rest.”
Bruls is currently not in favour of testing people without symptoms, for example incoming travelers at Schiphol. “The GGDs are already under pressure, so our call is real: let’s ensure tests are available for people with complaints. If people undergo preventive testing, it has consequences for capacity and waiting times.” This was clear in the early September, when test locations were overwhelmed – many people were unable to book a test or had to travel across the Netherlands to get tested.
How much expansion is needed?
AD newspaper reports that the intended upscale of Dutch test capacity is not possible in the short term. However, minister De Jonge hopes the problems will be solved quickly. A deal has been concluded with a lab in Munich, where about 20,000 extra tests per day can be processed by the end of September. That number will eventually rise to about 44,000 in a few months. But in the autumn, as many as 50,000 to 60,000 tests per day may be required to test everyone with corona virus symptoms, so there may be a shortage for some time. De Jonge also wants more cooperation between Dutch labs to better share the workload. The official announcement is that Dutch test capacity will go from 30,000 tests per day now to more than 100,000 in February. Only then, people without complaints can also be tested.
Another solution, according to specialists, is adhering to the German standard for the number of contact investigators, which would mean an extra 4,000 employees. Arnold Bosman, an epidemiologist who has worked for many years at the RIVM, the National Institute for Public Health and Environment, tells FD newspaper the extra people “can research clusters, visit families, try to find out why people do not want to give us details of their contacts or do not want to be quarantined. We can use that kind of knowledge later on.”
Written by Raphael Perachi Vieira