It still exists, the page with coronac figures on the RIVM site. Whoever looked at it last week saw: there is a good wave of deaths. Last January and February 3,200 more people died than RIVM expected on the basis of the population structure. Those extra deaths were practically all the elderly, according to data from the Institute: under the age of 65 ‘only’ 110 people died more than expected, the rest of the so-called ‘overdeld’ came from people over 65. The cause: not the coronavirus, but flu.
The coronavirus is not gone. Last winter there was a huge wave of contamination – even many more people were infected than in the waves during the corona years. This year it is different: there seem to have been so few infections in the winter, the time when airway viruses go around faster. But there was a heavy flu wave. COVID-19, the disease caused by the coronavirus, is now regularly overwhelmed by the flu (from the influenza virus).
After Covid, the public has grown on how serious flu can be
The latter did not escape the media, Susan van den Hof signals, head of epidemiology infectious diseases at the RIVM: “We have received many questions about the recent flu epidemic.” Much more than in 2018, when there was also a serious flu epidemic. “After Covid, the public consciousness has grown how serious flu can be,” says Van den Hof. According to her, it shows that the Coronapandemie “really makes more attention to infectious diseases.”
That attention “should not lead to unnecessary fear,” emphasizes Van den Hof. “It is good that the public realizes that a new pandemic can break out – next week, or in thirty years.” Being ready for such an outbreak is called “pandemic readiness” in policy documents. This readiness means that the government has a good picture of the spread and severity of infectious diseases.
Samples
The RIVM sharpened and supplemented that image during the Coronapandemie. Before Corona it leaned on weekly reports from general practitioners about patients with respiratory complaints. During the pandemic, numerous sources were added, such as the large -scale measurement of virus particles in sewage water, which was limited for that.
These sewerage measurements give a national picture: from every treatment plant (more than three hundred in the country) samples are taken off the water several times a week. The RIVM is investigating how many virus particles that contain. The result is expressed in one hundred billion virus particles per hundred thousand inhabitants. In the week of 17 February – to mention something – that was number 75. During the major wave in December 2023, this virus particle factor lay at 4,343, double the highest peak during the coronacrisis.
This image is supplemented with the so -called Infection radar. For this, around 11,000 people fill in questionnaires about their health every week. With respiratory complaints, most participants do a self -test, where they do cotton swabs (swabs) Getting through their nose or throat. At the RIVM request, a maximum of two hundred randomly chosen people send their bar to the laboratory. Since October 2022, the results have also been included in the InfectionAdar. For example, they show that in the second week of January of this year the number of people with influenza A (flu) was almost three times as large as with Covid.
Such precise observations are thanks to the Coronapandemie, says Van den Hof: “Then suddenly things that could not be done before.” For example, RIVM has long on detailed data about people who were admitted to a hospital with serious airway complaints. “We didn’t manage that at the hospitals for years,” says Van den Hof. “During Covid it succeeded, because everyone saw the need for it.”
The RIVM often had to pull hard to get the information. When testing at the GGDs, RIVM did receive the (positive) reports, but not the corresponding personal data. “We wanted to link that to other data from Statistics Netherlands, for example to see in which groups Covid spread the fastest,” says Van den Hof.
To get permission for this, she had to send 25 letters to just as many GGDs, all of her own lawyer: “Crazy work of course.” Ultimately, this data from the GGDs ended up at Statistics Netherlands via a different route.
Pyramid
Shortly after the extreme wave of contamination in the winter of 2023-2024, some data reports were stopped. The National Coordination Center Patient Spread, which had kept up to which for years how many Covid patients were in the hospitals, has no longer reports hospital figures since April 2024.
In the last figures you could see that the wave of contamination of last winter only caused a small wave of recordings on the IC. Occasionally there is still a corona patient in the IC, but so little that this no longer needs to be registered, says a spokesperson.
The RIVM also no longer receives data from the hospitals. Just like sewerage measurements, vaccination data and general reports, they form a piece of the puzzle that the RIVM has to lay during a pandemic. Van den Hof itself speaks of the ‘surveillance pyramid’, who use epidemiologists in infectious diseases. It is in the point of all people who wear the pathogen – in the lower layer of the pyramid – to the people who die from the disease.
This pyramid not only gives an almost real -time picture of the pandemic, but also makes it possible to make scenarios for the further course. That is, if all layers in the structure are well bricked. And that is not the case, according to Van den Hof, because the hospital figures are missing.
Cut back
Partly that has practical causes. The Netherlands has nearly ninety hospitals, with different IT systems. “The data about recordings often had to be entered manually,” says Van den Hof. That is time -consuming and impossible if you want to constantly follow all serious respiratory infections. “That is why you would like to collect that data automatically from electronic patient records,” she says. “And you also need the results from the laboratory to follow which pathogens take care of the recordings.”
Such wishes are still encountering legal objections, which are the second explanation for the missing data. Due to privacy rules, it is often not permitted to share data in the Netherlands. “In comparison with many other countries, the view of infectious diseases here is not at all bad,” says Van den Hof. “But in the United Kingdom and Scandinavia, for example, data can be simply collected and passed on for public health.”
In some countries, data can simply be collected and passed on for public health
The Netherlands is working on legislation that offers more options for sharing data. “It looks like we will soon get the hospital data,” says Van den Hof. “But not the patient data that you need, for example, to monitor how well vaccines work. This requires that amendment to the law. “
A complication is that the cabinet wants to cut 300 million euros on the pandemic readiness. “The RIVM will have to cut extra,” says Van den Hof. The infection radar may be slimmed down. “But in such a way that we can quickly scale it up again, if a new pandemic breaks out.”
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