Netherlands could be dealing with coronavirus pandemic for over 2 years: report

It may well take more than two years for the Netherlands to find its way out of the coronavirus pandemic, according to the most promising 'exit strategy' a team of around 40 epidemiologists, psychologists, mathematicians, and modelers from all over the country could come up with, NRC reports. 

The good news is that there is a way out, professor of infectious disease modeling Sake de Vlas and Luc Coffeng of Erasmus MC, part of this team, said to NRC. But Coffeng added: "I saw the first results and I thought: holy fuck, that timeline." According to their model, the day that all coronavirus restrictions in the Netherlands are lifted is over two years away. 

The team of 40 scientists considered various ways of dealing with the Covid-19 pandemic, also looking at studies and plans from universities and hospitals and politicians around the world. According to Coffeng and De Vlas, a geographical model is a promising exit strategy for the Netherlands.

This would mean dividing the Netherlands into 10 regions with the same number of inhabitants, they explained to the newspaper. Impose strict measures on all these regions, but 'release' the disease in one region. Open up the intensive care capacity throughout the Netherlands to the sick people in the exposed area. Once the peak passed in that area, and there is sufficient immunity there, 'release' the second region and expose it to the virus. All this while protecting vulnerable people in exposed areas as much as possible.

In this model's 'normal' scenario, it will take over 800 days before all measures can be lifted. In the 'positive' scenario, if effective medicine against the coronavirus can be found, the duration can be shortened almost by half. The scientists deliberately did not take account of a vaccine being found. In over 40 years, there's still no vaccine for HIV, they pointed out. So finding a vaccine is not a certainty. 

De Vlas and Coffeng added that this nation-wide experiment involves a number of impossible dilemmas. For example, who chooses which region to expose first and last? And how do you keep people from different regions apart for so long? And is it ethical to deliberately expose people to a potentially deadly virus? "We are not saying that it must be this way. That is up to politicians and society. We only give schools of thought for how it could theoretically be done."

Health sociologist Johan Mackenbach, who is not involved in this team and has not been asked for his opinion on the long-term approach, told NRC that not only the Covid-19 mortality rate should be considered, but also the side effects. And it is time to start thinking about this, he said to the newspaper. "If we need such an 'intelligent lockdown' for another six to twelve months, the first question should be: what are we left with?" A damaged economy, damaged 'normal' healthcare, children who fell behind in their school work at home, unemployment. "We cannot presume that the prevention of deaths is paramount."

According to Makenbach, there are two main issues in dealing with the coronavirus. The first is to what extent this disease, which mainly affects the elderly, should be allowed to damage younger generations who are losing their jobs and falling behind in education, he said. And the second is to what extent the virus and measures against it should be allowed to further increase inequality. Socio-economically vulnerable people are more likely to become seriously ill, and also most disproportionately affected by drastic anti-coronavirus measures, Makenbach said. 

"How we're going to get out of this is about economics, about behavior, about public health, about ethics. And no one has a ready-made answer," Makenbach said to the newspaper.