There he sits, remarkably relaxed behind his desk in his office at RIVM, as if nothing special had happened in the past two and a half years. The storm has passed, the OMT has been dissolved, the fight against corona has moved into calmer waters.
And so that battle is once again being fought from the Center for Infectious Disease Control, where Jaap van Dissel is director, by a ‘covid-19 response team’ that reviews the latest figures and developments on a weekly basis. There are less than fifty corona patients in intensive care. Not nothing, but a number that has been more or less constant for months.
Can we already say: fire master?
‘Well, to that extent I can agree that we have actually not had any measures at all other than the basic rules for quite some time: testing for complaints and isolation if the outcome is positive. We are now at a level that is very low compared to before. We see in the Netherlands, but also in other European countries, that it is really declining.
‘At the same time, of course, it’s not gone. It will be more exciting in the near future. The weather changes, the seasonal influence goes from minus to plus. People come back from vacation. So we’ll have to see in the near future.’
Until now, many assumed that there would surely be a new variant, as has happened every six months until now. But we’ve been dealing with omikron alone for three-quarters of a year now. Is that a sign that the virus has become stable?
‘That’s just looking at coffee grounds, I can’t predict it either. The critical period is yet to come, in the fall. It also depends on what is happening abroad. Those variants have always come from somewhere, of course.’
Suppose it stays with omikron, do we then rely on our first corona winter without all kinds of extra measures?
‘What is in any case remarkable is that we have seen a number of significant peaks in omikron, without this immediately leading to very high numbers of hospital and IC admissions or overload of care. If that is the picture that will continue in the coming months, then I would say: that is not very unfavourable.
‘And of course we are going to offer a repeat booster, hopefully with the renewed vaccine that also contains the omikron component. Of course you also expect that to have an effect, certainly on serious illness and hospital admissions.’
At the same time, an atmosphere has arisen of: omikron is nothing. While the variant in the United States, for example, caused more corona deaths than the alpha and the delta wave. In your view, is the ministry doing enough to make people aware: omikron is not that innocent, it is mainly due to vaccination that we are now in calmer waters?
He improves: ‘Through vaccination and a previous infection. But you’re right: what we see now is mainly the protective effect of immunity.’
Well, that immunity gradually decreases.
‘Yes, that’s why we give the repeat vaccination. If your question is whether enough communication is used… It strikes me how many commercials I have seen and heard lately: corona is not over. And then the call to get vaccinated has yet to come. Whether it is sufficient remains to be seen. You want to make the percentage that will get the jab as high as possible.’
Last summer there were more corona patients in hospital in the Netherlands than in previous corona summers. Doesn’t that mean we are doing too little against corona?
‘The hospital patients in these waves are the very oldest… But your question is of course justified. But that is ultimately a political choice. If you have the proposal: I actually want to have the lowest possible circulation of the virus, then you will have to drastically reduce the number of contacts, or reduce the chance of transmission. And that means: additional measures. That is of course a policy choice.’
Are there other ways too? Take ventilation. Belgium has just made CO2 meters mandatory in all kinds of places. In our case, the ministry has made money available for CO2 meters in the classroom, but that’s it. Why is this possible in Belgium, but not here?
‘I think corona has drawn attention to: better thinking about healthy indoor spaces. What are its characteristics and how can you influence that? That is important, not only for corona, but also for a lot of other respiratory infections.
‘But of course it shouldn’t just focus on CO2 meters. Again, you have to deal with a lot of factors here. Just think of the placement of those meters in relation to doors and windows, you name it. Creating healthy indoor spaces is an important discussion that simply needs to be continued.’
Another thing that Van Dissel will be dealing with this autumn is the evaluations. Two reports from the Dutch Safety Board and a parliamentary inquiry are in the pipeline. In addition, a modest amount of professional literature is emerging on the question of what side effects the measures themselves had. After all, learning disabilities in children, delayed treatment of patients and bankruptcy of companies are all factors that can cause health damage.
But beware, Van Dissel immediately emphasizes when you ask about it: don’t make the mistake of thinking that nothing would have happened without measures. The virus had struck harder, healthcare had become overloaded, people would take measures themselves. ‘If there is a serious illness outside, you can think as a person: I don’t want my family to get it, I stay at home. You saw that in the first phase. The shops were not closed, yet the net effect of the virus spreading was that there were far fewer people on the shopping street.’
Will the RIVM actually weigh up: what have the corona measures yielded and cost in terms of health?
‘Of course we are only partly on the economic side, but other parts of RIVM are. So yes, this kind of research happens. And not only at RIVM, but also more broadly through universities and international institutions such as the Organization for Economic Cooperation and Development, the OECD.’
Do you think it is conceivable that this could lead to: the remedy was worse than the disease, the measures cost more health than they delivered?
‘That is, of course, a very complex question. And unfortunately, the answer is also complex. What did we send to? Those were hospital and IC admissions. But is it true that we have not seen any IC tax at all? Well, no: up to twelve hundred patients. We really went to the edge, while we managed to prevent an important part of the infections with those severe measures. If you’d let it go completely, you’d be way past it.’
On the other side of the equation is also health damage that is not immediately visible. For example, failing to complete an education can quickly translate to poorer health later in life.
‘You’ll have to figure all that out. The obvious thing to do is to make comparisons with other countries. But they quickly get lost in the details. Sweden is often mentioned as an example, where it would all be very different, with fewer measures. While… When I talk to my Swedish colleague, he says: I don’t see much difference. Only in Sweden people adhered much more to all kinds of voluntary suggestions.’
Something else that comes up in the evaluations is your independence from the government. The cabinet immediately said: the advice of the OMT is sacred. A public administration expert I spoke to said: wrong, that way you give science too much of a political role. Can you follow that?
‘Yes, I can certainly follow that analysis. Of course, there is always a danger that lurks. And of which I can only say: we have to keep tight roles in that. I believe that we have also done so in our OMT recommendations. I’m not about policy, I don’t want that at all.’
The OMT could also have advised: listen, we do not want to become a player, keep our distance from matters such as press conferences and deliberations in the Catshuis.
‘I really don’t agree with you. The fact that you are often seen as a consultant in The Hague does not mean that you will sit on the chair, let alone sit on someone else’s lap. When I look at the countries around me, from Belgium to England, my colleagues always took part in the press conferences there. We have done very little.’
Perhaps those other countries were also wrong. You literally pull science onto the political stage.
‘That is something that could possibly come from the evaluations, but I think it would be wrong if we threw an advice over the fence in The Hague and then ran away. Dialogue is necessary. The jargon is different, you have to explain. I think this is just part of the role. Don’t narrow it down and say: you should do this. But broaden and indicate: these are the possibilities and consequences. And the choices that people then make are not up to us.’
The parliamentary committee of inquiry includes Pepijn van Houwelingen (FvD), who called the corona policy ‘the biggest scam ever’ and speculated that the committee could develop into a ‘tribunal’. How do you relate to that?
‘I am positive about it. You are right to say that this is something that has had a tremendous impact, not only in terms of morbidity and mortality, but also socio-economically. It makes sense that you put that under the magnifying glass. I have no problem with that at all, I’m actually looking forward to it. I’m going to experience it.’
You are 65. After two insane corona years, don’t you feel like: time to do something else?
‘You mean: stop earlier? Well, then I wouldn’t go to work with energy and pleasure. And no, I don’t have that at all.’