It is very human, says Jeroen Dijsselbloem in his office with a view over the Lange Voorhout. It is very humane that the Netherlands thought that a major, disruptive pandemic would not take place here. “The last pandemic we had here was a hundred years ago with the Spanish Flu. There were major virus outbreaks in Asia and Africa, but still. And with the swine flu in 2009, great alarms were raised, but it turned out not to be too bad.”
Nevertheless, the Netherlands should have prepared better for a major, long-term health crisis such as a pandemic, concludes the Dutch Safety Board (OVV) in a report published on Wednesday. PvdA member and former Minister of Finance Jeroen Dijsselbloem has chaired it since 2019. According to his OVV, there were plans for outbreaks of infectious diseases, so that the Netherlands thought it was well prepared for a pandemic. But the Netherlands was not: there were no national scenarios for a large-scale pandemic. There was also insufficient central control.
Is it naive to think that a pandemic couldn’t happen here? Do we perhaps suffer from a Western sense of superiority?
“It is difficult to understand why the thought was that corona would stay in Asia. Of course, Wuhan was far away, but Ebola also spread around the world due to globalization. In the beginning, there were more very strong assumptions, while a lot about the virus was still unclear, for example how contamination took place.”
It is also, says Dijsselbloem, about ‘imagination’. Virus fighters found “twenty cases a day” already a lot. They couldn’t imagine at the start of corona that it would go further than that. “You cannot speak as firmly as you have done about a virus that you do not know. That is the lesson for the future. It should have been said: we don’t know this virus, it could be easy, maybe not, but we are making different scenarios.”
Before the corona crisis, the Netherlands scored high in the World Health Organization’s Global Pandemic Preparedness Index. Is it then crazy to think that you are well prepared?
“This shows that such an index is not compiled in depth. The National Coordinator for Security and Counterterrorism (NCTV) released a security analysis in 2019 that mentioned a possible pandemic. Public Health was asked whether the Netherlands was prepared. The answer was yes. But how the Netherlands was prepared was not asked.”
The OVV states that the law gives the Minister of Health too few powers in a pandemic. Was that the biggest problem?
“The law states that the minister is responsible in the event of an outbreak of a serious infectious disease. But his powers are nowhere to be found. We understand that the healthcare landscape is organized in a decentralized way, but that doesn’t work in a crisis. You don’t want to have to make connections when you need them.
“The spread of patients is a good example. Already after the disaster with Turkish Airlines in 2009, the OVV said: arrange that in the event of such a major crisis you can impose patient distribution nationwide, so that you do not have to cancel hospitals if you have hundreds of injured people. The cabinet then said: we will not do that, because it does not fit into our system. In the first corona wave, improvisation was quickly carried out and hospitals were seen to cooperate constructively, but the minister cannot impose it according to the law. That has still not been arranged, it really has to happen now.”
But that is different from the underestimation of the coronavirus. Was the inadequate approach due to that attitude, or to the limited scope that the law gave?
“VWS did not want such a top-down approach. It is a policy department with little knowledge of and experience with implementation. So they improvised and consulted on their own, but the polder model does not relate well to such a crisis. You have to prevent everyone from dropping everything while waiting for the minister’s decision. But in such a crisis, there are many problems that transcend a sector or region, so you need a minister who says: this is how we will do it.”
Is it realistic to expect that from a department that is so used to being mainly concerned with policy?
“It doesn’t have to be the same people. Take Justice and Security as an example: that department combines policy and implementation. That could also be the case at VWS.”
According to Dijsselbloem, the government should think about such questions in order to be better prepared for future crises. “The corona crisis was only one type of crisis, next time food safety or water supply could be endangered by an infection or bacteria. How do we arrange the water supply? Those scenarios need to be worked out. Every virus can be different.”
Central structures were quickly set up with improvisation in the spring of 2020, such as for patient distribution and the purchase of mouth caps. Then the centralization was still successful, right?
“If you look at the starting position of the Netherlands, those improvisations were good and inevitable. But there was no national coordination, there were no structures and powers, nothing had been prepared. Take the testing capacity, for example, that could have been worked out before the pandemic. Talks have been going on for months now, there was too little urgency.
such a letter [van De Jonge] full of judgments, in my time as an OVV-
The OVV hopes that politics will learn lessons. Minister De Jonge was given access and rejected all your conclusions in a long letter. What does that say?
“That letter was special. The inspection is for factual inaccuracies, I have never seen such a letter full of judgments in my time as OVV chairman. We respectfully ignored his opinions. In fact, it didn’t lead to much adjustment either. I can imagine that the ministry thinks: this is hindsight. But it is wisdom. Nor am I in favor of a culture of judgment, but De Jonge’s reaction is the other extreme, namely a blanket under which criticism is stifled. Remove the blanket and see where the scratches are. That is painful, but there is room to improve things and learn lessons. I hope the new minister will do this.”
The new cabinet is easing quickly. What lesson can it draw from this report?
“Now that the measures are being phased out quickly, it is interesting for the House of Representatives to ask whether less favorable scenarios have also been made. Are they being worked out? Keep the uncertainty in the communication, because we don’t know how it will continue, even though there is a lot of reason for optimism at the current stage.”
Read alsoThis NRC analysis on the research report
A version of this article also appeared in NRC on the morning of February 17, 2022