1. The Netherlands underestimated how serious a pandemic could become
Long before the term covid-19 was coined, the Netherlands had already prepared the scenarios: what to do in case of a virus outbreak? With the current knowledge, we know that those scenarios were inadequate, concludes the OVV.
The preparations focused on tackling ‘flash crises’, in which short and severe intervention is necessary. There were no separate plans for a pandemic that would drag on for years. The Western world has not seen a crisis with the impact of the corona pandemic for so long that the danger of this was not sufficiently felt, the OVV concludes.
Between 2016 and 2019, various parts of the government practiced with a virus outbreak. That helped: government bodies quickly knew what to do with each other during the crisis.
But the exercises were based on regional rather than national crises. The role of the Ministry of Health as national coordinator, which has proved so crucial over the past two years, was therefore not discussed.
The result was a lot of improvisation when there really was a virus outbreak. And improvisation had not been practiced either; one of the things that, according to the OVV, should be different in such exercises.
2. The Dutch healthcare system was not flexible enough
In a healthcare crisis such as this, national cooperation is necessary, for example to spread patients across hospitals. That is difficult in the Netherlands, with its large number of regional healthcare providers that operate autonomously; think of all the different hospitals and GGDs.
Drawing a single national line in this fragmented landscape in the short term turned out to be extremely complicated. Another factor is that the Ministry of Health has limited power. For example, it cannot force hospitals to participate in the distribution of protective equipment. As far as the council is concerned, the ministry should be given more influence in the event of a crisis.
Due to the many parties involved, more and more parties attended national consultations in the first phase of the crisis, which hindered rapid decision-making, the OVV describes. Moreover, at a certain point there were so many ‘coordination structures and decision-making bodies’ that it was no longer clear to civil servants who was responsible for what.
3. The ‘silent disaster’ in the nursing homes was not picked up in time
A ‘silent disaster’ took place in the nursing homes at the beginning of 2020. Sounds from the institutions came through ‘insufficiently’, according to the OVV. This was partly due to the fact that no representative of the nursing home sector was involved in the decision-making in the initial phase. Protective equipment such as face masks were mainly available for hospitals and acute care, not for nursing homes.
‘The crisis approach focused on hospital and IC occupancy; bottlenecks within the nursing home sector were initially underexposed’, according to the OVV. According to the council, this has contributed to the spread of the virus in nursing homes, where large numbers of frail elderly people died.
The branch association for elderly care ActiZ has indicated that it recognizes this picture. This does not apply to Hugo de Jonge, who was still Minister of Health when he was presented with a draft report, according to his attached response. According to him, there was indeed close contact with nursing homes and the fact that less protective equipment went there is mainly due to global scarcity.
4. In all uncertainty, figures provided a basis, resulting in tunnel vision
The directors had to make decisions under enormous pressure while there were great uncertainties about the usefulness of measures, the report repeatedly states. Then it is tempting to be guided by the hard-looking numbers that are available, such as the R number and IC shots.
According to the OVV, this meant that, for example, consequences for the psychological well-being of the vulnerable, which are not easy to capture in figures, were not sufficiently on the radar in the initial phase. The Council is of the opinion that in general too little attention was paid to social interests other than those of healthcare, and that the government did not do its best to gather information about this.
The fact that the OMT recommendations were so important for decision-making contributed to this, because they deal with the medical side of the crisis. According to the OVV, this advisory body was even so influential that it made de facto decisions for the cabinet. Prime Minister Rutte repeatedly indicated that he regarded the OMT recommendations as ‘sacred’. The Council therefore advises that next time social and behavioral scientists are given more input in policy from the start.
De Jonge does not agree with this point either. According to him, there was indeed an eye for other perspectives, for example thanks to advice from the Behavioral Unit of the RIVM and the Temporary Working Group on Social Impact.
5. The cabinet wanted to offer too much hope
Citizens suffered from strict lockdown measures, so the cabinet wanted to offer perspective and hope: just persevere for a while, then we will be freed from this virus. But because of this, the government ‘created its own trap of being held accountable for decisions based on uncertain assumptions’.
The cabinet mirrored citizens too firmly for how the rest of the pandemic would unfold, and was often too positive in this despite uncertainties. As an example, the OVV cites the roadmap for lifting measures presented in May 2020, which was not designed for the rising infection rates from the end of summer 2020. Disappointment followed disappointment, which undermined support for corona policy. .
It is a well-known phenomenon that support for the government’s approach is eroding during a prolonged crisis, but according to the OVV, the government has also contributed to this. For example, OMT chairman Van Dissel stated in 2020 that introducing a mask obligation in public transport, among other things, was a political choice and not a scientific one. According to the OVV, this undermined cabinet policy.