Cabinet neglected nursing homes in first phase of Covid causing "silent disaster": Safety Board

The Cabinet paid too little attention to nursing homes in the first phase of the coronavirus pandemic, resulting in "serious" consequences for their vulnerable elderly residents, the Dutch Safety Board (OVV) said in its first report on the Netherlands' handling of the coronavirus pandemic. According to the OVV, a "silent disaster" happened in nursing homes.

This first report spans the period from when the pandemic hit the Netherlands in end-February 2020 to September that year. In that period, half of the coronavirus deaths happened in nursing homes, according to NU.nl.

The government focused too much on hospitals and insufficiently listened to concerns from nursing homes, the OVV said. During the initial phase of the pandemic, protective gear like face masks were only given to hospitals and acute care. Nursing home staff had to do without.

When the seriousness of the situation in nursing homes finally dawned on the Cabinet, it imposed a visitor ban. "This had a major social and psychological impact, due to loneliness and because family members could not always say goodbye to their loved ones," said the OVV.

The Netherlands unprepared for prolonged crisis

The Netherlands was not well prepared for a prolonged national health crisis, the OVV concluded. Improvements to the crisis approach are necessary, according to the OVV. "There is a lot of room for improvement," said OVV chairman Jeroen Dijsselbloem. The Netherlands turned out to be vulnerable, he said.

The Cabinet took too little account of the uncertainty surrounding the coronavirus, especially in the first months.

The OVV also said that RIVM boss Jaap van Dissel's presence on almost all crisis teams caused a kind of tunnel vision, in which the Cabinet only looked at the infectious disease side of the crisis. And that Van Dissel's public doubts about the efficacy of face masks undermined trust in the Covid-19 policy when the government decided to make masks mandatory in 2020.

Improvements

Elaborate more scenarios, learn to improvise better, and identify vulnerable groups quickly. These are a few of the measures the government can take to be better prepared for the next "society-disrupting crisis," the OVV said. The Council wrote that "some restraint" is required, as the crisis is not over yet and follow-up investigations are still ongoing. Nevertheless, the researchers already see various possibilities for improving the handling of protracted crises. All recommendations in this regard are addressed to the Cabinet.

Dealing with uncertainties is a vital overarching point. The OVV advised the Cabinet to strengthen the preparation for crises "by working out scenarios with the conceivable consequences and the way in which these can be dealt with." The next step is to determine the "state of readiness."

The government can, for example, develop improvisation skills through practice. The Cabinet must also include the use of data in advice and decisions. "This way, you provide the best possible up-to-date picture of the course of the crisis and into the implementation and effectiveness of the measures."

The OVV believes the Minister of Health should be given more powers during health crises to "tackle problems effectively." This Minister must be able to give "directly binding instructions."

The advice also needs to be improved, according to the OVV. It recommends that in addition to short-term advice, the Cabinet should also give long-term advice "parallel and separately."

The OVV will do a total of three investigations into the Dutch government's handling of the coronavirus pandemic. The second part will focus on September 2020 to July 2021. That report will publish sometime in the summer.