Hard lockdown, school closure should be considered, says ICU leader Gommers

In ten days' time, the intensive care units will be at “Code Black”, with hospitals forced to decide which patients they can help, and who must be turned away, said Diederik Gommers during a Tuesday evening committee meeting of Tweede Kamer members. As such, the Outbreak Management Team and political leaders in the Netherlands need to quickly consider a harsher set of measures to slow the extremely high number of coronavirus infections recently reported on a daily basis. This could include a hard lockdown starting next week, with the prospect of shutting down schools.

With infections spreading quickly among primary school students and their parents, ”everything is on the table,” sources close to the Cabinet told newspaper AD. Members of the Cabinet will meet with RIVM leader Jaap van Dissel to discuss the situation in detail on Wednesday. Following that, a full meeting of the OMT will take place, more discussions will be held with the prime minister, and then a press conference will be organized to announce any changes. No dates have been determined.

"I think there is now momentum to enact tough measures and to do so as soon as possible," he told a committee meeting of Tweede Kamer members. The intensivist is the head of intensive care at Erasmus Medical Center, and the chair of the Dutch Association for Intensive Care.

Now is really the last moment to act, Gommers said. It will be extremely difficult to get the situation under control if that Code Black scenario is reached. He said that 650 intensive care beds can be made available for Covid-19 patients. Figures from the LCPS showed there are 2,540 patients in hospitals with Covid-19, including 488 in intensive care. “At 651 you are at Code Black,” he stated.

Gommers was invited to the meeting to update MPs about the proposed 2G coronavirus access pass policy. Before that can be considered, he said everyone must first undertake stricter measures. Otherwise, the Cabinet will be much too late with restrictions "to prevent the heart stopping in healthcare by the end of next week.”

Caretaker Health Minister Hugo de Jonge stated on Monday that the country is still "very far away" from a Code Black in the hospital system. Ernst Kuipers of the National Network Acute Care (LNAZ) and the head of the Erasmus Medical Center also said at the time that he did not expect this scenario to occur in the coming days or weeks.

Nevertheless, the number of coronavirus patients ending up in hospitals is continuing to rise. This is not expected to end in the coming days. Because of this, Gommers asked his colleagues from the Outbreak Management Team if they can meet earlier than planned, "tomorrow instead of Friday". He wants to quickly issue advise on strict measures, "because we cannot get into Code Black while the country is still open for business. That is not possible."

People cannot still be out shopping and visiting bars if there is a sudden, unexpected shortage of manpower to make more spaces available in the ICU system, Gommers said.

"The outflow of personnel has been so great that we have much less flexibility, and that we have a much reduced ICU capacity," explained Gommers. "So the beds are there, the ventilators are there, the monitors are there, but we are missing the nurses." Therefore, intensive care cannot scale up as it did during the first wave of infections.