A broader view on containment
How can we help the entire group in the best possible manner? asks Dutch expert
“I usually don’t work this hard, but these days it’s different.” said Christian Hoebe, head of infection prevention at the Dutch National Public Health Institutes (GGD) of South Limburg, The Netherlands. “This is the worst health crisis since the outbreak of the Spanish Flu in 1919,” he said, in an interview with The Limburger, a Dutch newspaper.
Dr. Hoebe has been working extremely long hours for the past few weeks because of his role as a member of the Dutch Outbreak Management Team (OMT), the national group of 20 experts who have been advising the Dutch government regarding the coronavirus crisis under the supervision of RIVM, the National Institute for Public Health and the Environment. (See link for latest update https://www.rivm.nl/en/news/current-information-about-novel-coronavirus-covid-19)
“The group consists of virologists, epidemiologists and infectious disease specialists,” he said. Dr. Hoebe’s role is to view the crisis from the perspective of ‘social medicine.’ He says, “I don’t consider individual patients, but the whole group of patients. How can we help the entire group in the best possible manner?”
How do the 20 members of the team get along? Are everyone’s opinions always aligned? “No, there is sometimes variation in the opinions but in the end, there needs to be a clear uniform advise for the government”.
Dr. Hoebe is proud of his country that government is basing its decisions “on science, on evidence, on facts that we have gathered so far,” he said. “For example, regarding schools: there is simply no evidence yet that children are responsible for spreading this coronavirus.” Nevertheless, Dutch schools were closed under increasing societal pressure a week ago. Dr. Hoebe prefers society to focus on what is truly effective, such as making sure that people who are sick stay home for 14 days, so as not to further spread the virus.
And how would he compare the virus to the yearly flu outbreaks that we have all become accustomed to? “There are definitely similarities, but the main difference is that no one has any immunity to the new virus, whereas with the winter flu, many people have already built up a certain degree of immunity,” he said. “That’s why this new virus is spreading so fast.” However, he pointed out that the disease is very mild in about 80% of infected people.
The Netherlands has chosen a different strategy than most of the rest of the world, relying on herd immunity. “In this model, you allow the virus to spread slowly through the population while trying to maintain control by social abstinence,” he said. Dr. Hoebe predicts that 20 to 50% of the Dutch population will become infected by the Covid-19 virus during the next few months, and most will survive and create antibodies and thus build up immunity that will help protect older, weaker members of society.
However, some critics refer to this strategy as a game of Russian roulette. Dr. Hoebe dismisses the doubters with a convincing argument. “The alternative is a total lock-down. That seems strong and decisive, but it also has its own risks besides the economic fallout. If you institute a lock-down, we emerge from the crisis with no immunity, so the next time the disease comes around, it starts all over again. The alternative is that you institute a lock-down until a vaccine is developed, which in my view will take another year.