The first week of the second year of the Corona outbreak in the Netherlands has ended. There are nearly 1,900 Covid patients in hospitals, of whom around 550 are in the intensive care unit. 4,000 to 5,000 people test positive for coronavirus every day.
Despite the strict measures, the downward trend in the number of injuries and hospitalizations has stopped. The main explanation for this appears to be the higher infection rate for the British variant and the lesser follow-up of the corona scales.
A conversation about the current situation with Gab Van Dessel, Director of the RIVM’s Center for Infectious Disease Control (CIB), and JACCO and Yinga, the RIVM flagship model.
Estimates of the British variable share, based on random search for mutations, have been very high in the past. How do you explain these big differences between appreciation and reality?
Jacco Wallinga: “We are extrapolating the data from that study, monitoring germs. Every new week, new data are added and we adjust the extrapolation. In the beginning the share of the British variant has grown rapidly. In recent weeks it has grown less rapidly and then the further infection of the British variant is a little more than Previous results We believe that in this week’s data, as samples were analyzed as of February 21st, more than half of the injuries were caused by the British surrogate.
Jaap van Dissel: “You also see these clear differences in the velocity of spread in other countries. The country is not a homogeneous vessel from which you can sample. Suppose the British alternative was introduced in a particular context, for example a student’s home. Spread out. Faster than anywhere else,” For example, due to the specific environment or the behavior of people. “
“In the beginning, you always see such an intermittent development until it reaches an average, as it is now in England. So you have a bias in your sample if there are still regional differences, as is the case in the Netherlands. This type of virus appears in Certain combinations. Within that, the R value could be higher than the national average. As a result, you get this rapid increase in the beginning, then slower then faster. I would expect the same with the South African alternative.
Critics accuse you of knowingly judging the prevalence of the British alternative as negatively as possible in order to make the strict measures more acceptable.
Van Dessel: “Our calculations for the infection of the British variant are low compared to other countries. The UK has four institutes that model and come up with numbers ranging from 30 to 56 per cent of all infections. Germany’s RKI index is 37 per cent, the Social Security index in Denmark is 50 to 74 percent, we’re 28 to 47 percent. Numbers in other countries. “
The R number, which indicates the number of new infections caused by one positive person, rose to 1.14 on February 12. Does this have anything to do with the reopening of primary schools?
Jacco Wallinga: “In the same week, it is also winter and the number of tests is decreasing. Since we count the number of breeds based on the number of people who have tested positive, it appears that this smaller number of people has been infected with a relatively large number of others. If it disappears, it will fall again. I think the explanation is there, but you can’t rule out the possibility that these schools played a role. Using the data from the following weeks, we can better identify cause and effect. R gives more certainty that the winter weather may have caused the increase. If it is about schools, you expect To keep the R high.
So far, RIVM has counted an R every week, ahead of Friday’s Outbreak Management Team meeting. Going forward, a spokesperson for RIVM says, the R number will also be calculated on Monday, the day before the Corona week figures are displayed. It was announced at OMT yesterday that on February 18th, the sum of the R for all variants together was 1.04. This supports Wallinga’s explanation of a high R on February 12th, while noting the effect of winter weather.
Do vaccinations affect the R number and hospitalization yet?
“The number of injections is increasing. The vaccines partially got two injections, but a large number only once and recently. The effectiveness of the vaccine is only complete two weeks after the second injection. So it is very early.” We vaccinated in long-term care facilities and with practitioners, Van Dessel wrote. Public health workers and other care workers providing care for COVID-19. We see fewer infections in these groups. These are the effects of vaccination, but these groups have never appeared in large numbers before. In hospital, so these vaccinations do not lead to fewer hospital admissions. “
Jacco Wallinga: “Most of the admitted patients have not been vaccinated, because they are not already among those eligible for it. I see a clear increase in IC admission, hospitalization is showing a strong weekly prevalence, but the trend is also here to rise.”
Don’t these strict coronavirus measures help?
Van Dessel said, “We have a lot of procedures, but the question is: to what extent are they complied with? From the RIVM’s Behavioral Module And GGDs that are declining. About half of the respondents say they stay home with complaints and 46 percent said they would undergo a complaints examination. These are alarming numbers. Fewer people with virus-like symptoms appear to be tested.
Meanwhile, more people have taken to testing streets in the past two weeks, and the percentage of positive tests has decreased, but it remains around 9 percent. The greater number of tests may be related to the start of the hay fever season. Hay fever causes upper respiratory complaints. More people are also tested as part of source and contact investigation. This makes it very difficult at the present time to determine the relationship between the number of injuries, hospital admissions and admission to the international center. “
What will the coming months look like?
Jacco Wallinga: “Firstly, there were additional measures, now they are more flexible, which makes precisely predicting developments very complicated. The British variable R is much higher than 1. If this alternative takes full control, the epidemic will spread. Better weather could be. It has a beneficial effect, but it is impossible to say how great it is. “
Jaap van Dessel: “About 100,000 people are currently infectious. The R is much higher than 1. So the situation is very vulnerable, as in all countries around us. In Belgium, Italy, France, and to a lesser extent Germany, it is increasing everywhere. The numbers are high. None. A climate in which the virus does not find its way. Look at the outbreak in Manaus in the Amazon region. Even the virus has mainly infected the indigenous tribes there that live abroad. There are two options for containing this virus: an anti-virus agent that eliminates Covid-19 in its infancy and preferably not inhibit the development Immunology and preventive vaccinations. The virus is likely to continue to spreadMaybe in seasons like the flu. By analogy, we can then vaccinate the vulnerable groups against the most common strains of the virus. “