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Doctor in protective gear taking a nasal swab from a man
Doctor in protective gear taking a nasal swab from a man - Credit: zstockphotos / DepositPhotos - License: DepositPhotos
Health
Coronavirus
Covid-19
Covid-19 test
testing capacity
material shortages
Hugo de Jonge
RIVM
Esther Talboom
Saltro
Jeroen Bos
Star-SHL
Peter Hoppener
Vivent
nursing home
nursing ward
Edwin Boel
healthcare worker
National Coordination Team Diagnostic Chain
Ministry of Public Health Welfare and Sports
Outbreak Management Team
Wednesday, June 10, 2020 - 08:13
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NL could have scaled up coronavirus testing faster, saved lives: report

Despite the government repeatedly saying in debates, briefings, interviews and press conferences that there was insufficient coronavirus testing capacity in the Netherlands due to a lack of materials, laboratories had many more tests than were used in the first two months of the crisis, according to research by Nieuwsuur. If more tests had been done, lives could have been saved, those involved said to the program.

Nieuwsuur asked all 55 RIVM approved laboratories about their coronavirus testing capacity in March and April. More than 30 responded. Data provided by the labs showed that only half of the available tests were used in March, and only 30 percent in April. 

A number of laboratories told Nieuwsuur that they don't understand why they weren't deployed. "I always thought 'use us now'," said Esther Talboom, director of laboratory Saltro in Utrecht. "Because we are there, we are doing tests, we have a logistics network with normally 200 locations and we visit people at home and all vulnerable patients. Give us a role."

Jeroen Bos of the Star-SHL lab in Rotterdam said that he got "stomach ache" watching the press conferences saying that there were not enough tests. "We were approved by the RIVM within a few days and were ready to start. But the numbers fell far short of our expectations. We were able to do more than double the number of tests that we were asked to do," he said. "For me, everyone was ready to run 24/7. It is very annoying that you cannot do the work that is there. 

Healthcare administrators have been confused for months about why more healthcare personnel couldn't be tested while tests were available at laboratories. "This is not hindsight," Peter Hoppener of Noord-Brabant care organization Vivent said to the program. "The capacity of the laboratories was known." According to him, the surprise was not that there were tests available, but that they couldn't be used. "And the fact that corona actually occurs in nursing homes and in community nursing was already known too. And those two things together plus deliberately not testing nursing home staff, I find that scandalous." 

The consequences for healthcare organizations are huge, Hoppener said. Due to little testing, it was often not clear whether a ward or nursing home had an infected resident who needed to be isolated. "If you had done enough tests, you could have nursed people individually. Now you actually condemned a department to corona at such a moment," he said. The lack of testing also put stress on healthcare workers, who were unsure about whether there was corona on their ward, he said. "More testing could have prevented infections in our homes. And thus also deaths." Hoppener eventually bought tests directly from a lab for his own employees. 

Medical microbiologist Edwin Boel, who coordinates the testing capacity in the Netherlands as team leader of the National Coordination Team Diagnostic Chain, was not surprised by Nieuwsuur's findings. "I've seen less testing than there was capacity," he said to the program. "I think that has to do with policy. The experience of a large number of laboratories has consistently been: 'hey, we actually have even more capacity." According to Boel, more testing could have been done at nursing hoes. "And could that have been arranged? Probably yes."

Minister Hugo de Jonge of Public Health told Nieuwsuur in response that testing options were limited in March due to great uncertainty about the supply of sufficient materials. But he called it a "too harsh conclusion" that lives could have been saved if more tests had been done. "You really have to evaluate that calmly when you have enough distance from the past few weeks. I think that these kinds of conclusions cannot be substantiated."

In addition, De Jonge said, the Outbreak Management Team advised to be cautious with tests due to material scarcity. The test policy was scaled up from the end of March, he said, but it remained uncertain whether there was sufficient capacity to expand faster.

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