RIVM: Covid ICU total would hit 4,000 in February without lockdown

RIVM director Jaap van Dissel expected a peak of around 4,260 Covid-19 patients to simultaneously require intensive care treatment in early February if only the evening lockdown would have been extended. That was made clear in the charts the RIVM produced for a presentation Van Dissel gave to Cabinet members this week before the decision was made to put the Netherlands into a new stricter lockdown.

The peak number of patients would be more than double the number of Covid-19 patients in ICUs during the first lockdown. On Saturday, there were fewer than 640 Covid patients from the Netherlands in intensive care.

Van Dissel’s graph showed that the number of Covid-19 patients in regular and intensive care was projected to rise from the current level of 2,375 patients to a peak of 17,500. Such a situation would effectively shut down the hospital system’s ability to provide any regular care, and would seriously hamper emergency care. The “code black” scenario would force hospitals to decide to refuse patients who need hospitalization in favor of others.

Experts, including Van Dissel himself, said there is still a high degree of uncertainty about the effect of the Omicron variant on the number of Covid-19 patients requiring hospital care. Still, even in the best-case scenario, he said an evening lockdown would lead to 3,000 Covid-19 patients requiring intensive care.

With the current lockdown in place, the ICU peak is projected to be reached with anywhere from 900 to 3,000 patients in intensive care, with the model predicting nearly 2,000 as the most accurate estimate. That is still far greater than the current ICU capacity, with around 700 out of the total 1,205 spots reserved for Covid-19 patients. Even with a lockdown starting after Christmas break a peak of about 2,750 Covid-19 patients would be reached.

Around 35 Covid-19 patients are admitted to the ICU every day. That number was expected to increase ten-fold by the beginning of February with only an evening lockdown, according to the RIVM.

The Omicron variant is expected to be the dominant variant in the Netherlands by the new year. "The Outbreak Management Team is concerned about the Omicron variant, which still only accounts for a small part of the infections, but that share will increase very quickly,” Van Dissel said.

Covid-19 vaccines are 75 percent less effective against an infection with the Omicron variant, according to the RIVM. "The immune system actually cannot recognize it well, because the omicron variant takes on a different shape on the outside.” This improves significantly with a booster shot, he said. Health Minister Hugo de Jonge said the lockdown would also buy time to accelerate the booster vaccination campaign and increase immunity.

Van Dissel's model predicting the height of the coronavirus at the beginning of February opens the possibility that the lockdown could be extended past January 14. This could feasibly include stricter measures, like a curfew, and a step-by-step plan to relax restrictions which could take months.