These three issues will determine the corona endgame

A boy in Nieuw-Beijerland will receive food in his room in mid-January because he has tested positive for corona and the family is therefore in home quarantine.Statue Arie Kievit

1| The hospitals: no longer overloaded

A tsunami of perhaps more than two thousand IC patients, and against ten thousand ordinary hospital patients. That is the prognosis that OMT chairman Jaap van Dissel had taken to the standing parliamentary committee for Health, Welfare and Sport on Thursday morning. No idea that hospitals can handle such a peak, expected before the end of February.

But wait. The prognosis is, however, too gloomy, said Van Dissel immediately. The calculations are based on the raging infection rate of the omikron variant, but also on the pathogenicity of the delta variant. ‘This prognosis is from two weeks ago’, says Van Dissel. ‘At that time we simply didn’t have a number of key figures for the omikron variant available.’

Those numbers are now available. Such as the number of corona patients who, once in hospital, deteriorate and have to go to IC. There are probably 60 percent less with omikron than with delta, according to UK figures. Out an American analysis, of 70 thousand patient recordsIn the meantime, it has become apparent that patients with omikron are in hospital for a shorter period of time: an average of three and a half days less.

These are all factors that allow the expected tsunami to sink into a solid wave of, roughly estimated, around five thousand hospital patients and less than a thousand IC patients – and that only if everything goes wrong. This means that one of the most important arguments of the corona measures is lost: namely, that there is a threat of a healthcare infarction.

It’s getting exciting. Van Dissel points out that an assumption was also made that in reality turns out to be less favourable: so far far fewer people have had themselves boosted than the 90 percent used by the RIVM. Moreover, it is unclear what will happen if the measures are relaxed further. In the United Kingdom, France and Spain, five times as many corona patients are hospitalized as in the Netherlands, according to Van Dissel. ‘If our hospital admissions were this high, we would have a major problem.’

Moreover, ‘we sometimes forget that healthcare is more than just IC and hospital beds’, says professor of infection prevention and OMT member Andreas Voss when asked. ‘Consider the burden that this phase of the pandemic puts on general practitioners, nursing homes and home care or nursing assistants.’

2| The quarantines: can it be less?

Block on the leg of many families: the home quarantines, if a family member turns out positive.

The current number of 30,000 positive tests per day quickly means that around 120,000 people are removed from society every day for a week, Van Dissel calculated. With far-reaching relaxation of the measures, the number of infections could even rise to 100 thousand per day. Nearly half a million people would then be told to stay at home every day. That would of course disrupt society – are we finally out of lockdown, we are at home again en masse, but in quarantine.

That is why the OMT ‘wants to take a critical look at what is possible’, says Van Dissel. He declined to give details. The rules have already been relaxed recently: people who have been boosted or who recently had corona no longer need to be quarantined. And it will be difficult to stretch the rules even further: then the virus would flare up too much again.

Shorter in self-isolation then, and shorter in quarantine? Annoying. According to a just published British analysis the production of the omikron virus in the throat peaks between day three and day six after infection, after which it decreases only three or four days later. It is therefore risky to stay at home for less than a week, according to London professor Sally Cutler in a comment.

Raising the ‘three infections rule’ in the classroom – with three infections the entire class must be quarantined – is problematic in practice. Once such an outbreak has started, more children will be infected in no time. So where is the limit?

Voss explains how emergency plans are made in healthcare to allow employees who should actually be quarantined or isolated to continue working if too many people drop out due to quarantines and there is no other solution. For example: a cohort of positively tested employees who only work with covid patients. “You have to think about such emergency scenarios now and not when you get into them.”

3| The QR pass: expand or get rid of it?

And then the corona ticket: symbol of exclusion of unvaccinated for one, ideal way to open the catering and cultural sector for the other. Sharpening the QR code to 2G (only for vaccinees and people recovering from infection) will not contain the omikron outbreak, new calculations showed this week.

This is because omikron also infects vaccinated people; of everyone who tested positive this month, 11 percent had already boosted. And as a result, the QR code does not accurately predict who does and does not have the virus among its members. For the politically already heavily controversial QR code, that could be the death blow.

Or not. After all, according to the same calculations, 2G still takes about 10 percent off the R-number. ‘That is certainly not nothing. It is almost the effect of opening the catering industry,” said Van Dissel on Thursday to questions from the SP. In addition, a 2G system saves hospital admissions, according to the report, because unvaccinated people run 17 times as much risk of ending up in hospital if infected and even 33 times as much risk of ending up in the ICU.

That will be a tough job, Van Dissel expects. ‘We would like to interpret it a bit more broadly. I await the exchange of arguments in the OMT.’


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