Dutch health officials explain Brazilian variant, Janssen vaccine, and cabinet's reopening plan
All relevant numbers in terms of the coronavirus crisis are still high and the new, probably even more contagious Brazilian P1 corona variant is in the process of establishing itself in the Netherlands. But it was also the week of moderate optimism in which national health agency RIVM boss Jaap van Dissel said that the peak in the number of infections should have been reached by now, the number of hospital and IC admissions had stopped rising, and the cabinet presented a plan for reopening the country.
National broadcaster NOS spoke about that moderate optimism, the Brazilian corona variant, and the ongoing vaccination activity with Jaap van Dissel, director of the Center for Infectious Disease Control (CIB) at the RIVM, and Jacco Wallinga, chief modeler of the RIVM. These were the main points in the interview:
Wallinga explains that the difference in infectivity between the so-called British variant and the Brazilian P1 variant is not far apart different. The Brazilian variant is estimated to be 49 percent more contagious than the classic variant. In the British variant, this was 33 percent. This explains why the Brazilian variant appears to be spreading more slowly, despite its supposed higher infectivity.
He also said that it was not certain that the Brazilian variant would eventually replace the British variant. "The Brazilian variant seems about 16 percent more contagious than the British one. But the numbers are still very small, and we are actually not so sure whether the Brazilian variant is that much more contagious," said Wallinga. The key point is thus to establish whether the P1 variant is truly more contagious.
In relation to the fear that the vaccines may work less well against the Brazilian P1 variant, Wallinga said that "our prognosis assumes that the Brazilian variant behaves in the same way as other variants. That is why the increase is going so slowly. We still have to see whether the Brazilian variant can really infect so many more people who are already immune. "
The latest advice from the Outbreak Management Team (OMT) ends with a remarkable passage on the importance of speed in vaccination. It states that that the evaluations by the European Medicine Agency (EMA) of possible side effects of the vaccines from AstraZeneca and Janssen take far too long and delay the vaccinations too much.
Jaap Van Dissel responds that this was not what the OMT intended. He explains that communicating the possible side effects of a drug between different EU countries is the priority. "Europe has created the EMA and in particular the PRAC, the European Adverse Reaction Assessor, to use all the expertise available across Europe to identify possible side effects. We are actually making an appeal to improve that process. Everyone would benefit from that. "
Van Dissel thus argues that it would be wise to listen to EMA and PRAC expertise. "We suspect that countries are willing to listen to the EMA, but there must be a mechanism by which you can get advice very quickly," he said. Van Dissel also cautioned that it is mainly the delay that causes countries to make their own decisions. "This applies to the Netherlands, but also to Denmark, Germany, or England. I can well imagine that it comes across as confusing. I think we would benefit a lot from making more use of the European fora. And faster. "
Van Dissel pointed out that the seriousness of the side effects discovered in the AstraZeneca and the possible side effects of the Janssen vaccine need to be determined by the Medicines Evaluation Board and the Health Council. "Such an assessment depends on the balance between the efficacy and the risk of possible side effects in certain age groups, but also of circumstances such as the availability of alternatives." He also added that this might lead countries to take different approaches.
The cabinet announced a roadmap to slowly reopen the country, which will include frequent reviews of the data. According to Van Dissel, this numbers-driven approach is desirable.
Wallinga added that it appears that the country has reached a peak in coronavirus infections and hospital admission. "The highest number of reports of infections is on March 27, the highest number of hospital admissions on March 29, and the highest number of ICU admissions on April 2. It looks like we have reached a plateau or a peak, but we can only be sure when a decline sets in," he explains. Until then, there is "little room" for a rapid reopening of the country.