Free self-tests for contact professions in any case, less wrangling about QR codes, and much more emphasis on ‘basic rules’ such as staying home in case of complaints. OMT advice number 130 can be read as a sample card for a lockdown-free winter. Or is it already too late for that?
1| Also in case of complaints: do a self-test
In case of complaints that indicate corona, go to the test street – and in any case do not do such a clumsy self-test from the supermarket. That was the advice for a long time when it comes to the white corona tests from the store. But like a bolt from the blue, that’s about to change. On closer inspection, the self-tests appear to work fantastically with sniffling and coughing people, the OMT notes in its new letter of advice.
That works out well, says medical microbiologist Jan Kluytmans. ‘Now a teacher who wakes up with a runny nose quickly loses one or two days of class making an appointment at the GGD and waiting for the results. But if he has a home test, he can test himself and if the result is negative, he can say: I’m going to work, if necessary with a mouth cap on.’
The OMT therefore recommends making self-tests ‘available free of charge for at least specific groups’ such as teachers and ‘making use as accessible as possible’. With the caveats: anyone who gets a positive result in the rapid test must still go to the GGD, and anyone who deals with vulnerable people or who is vulnerable themselves should in any case ignore the self-test in the event of complaints.
Behind the miraculous change from ‘no self-test for complaints’ to ‘a self-test for complaints’ lies a number of considerations and developments. Perhaps the most important: a new, thorough study, which shows that self-tests are also correct more than 85 percent of the time for people with complaints. ‘A great outcome’, says research leader Carl Moons (UMC Utrecht), who gave the OMT a preview of the figures.
In addition, the self-tests are more in line with practice. Because 32 percent of people with cold complaints already take a test at home, the figures show. In the meantime, only one in three is tested by the GGD for complaints, the rest do nothing at all in case of complaints.
In such a case, if they had a self-test at home, almost half of the sniffles would also use it, according to new questionnaire research by the RIVM Behavioral Unit. That would reveal more corona cases and, it is hoped, also lead more people to go into isolation at home so as not to infect others.
“I personally think that this is really the way how we should start living with this virus,” says Kluytmans. ‘In the beginning it was a bit strange to say with such a potentially dangerous, notifiable disease: test yourself at home. But now we are in a different phase. The virus causes relatively little damage in immunized individuals. Then it is better to be pragmatic and opt for a course that has more support.’
A little late perhaps, that science is only now coming up with more details about the rapid tests? The reason is that the market is miles ahead of the research, says Moons. The manufacturer is not required to provide detailed figures on how accurately the test works before the sale begins. ‘So they are in the shops and people are already using them, even though not all studies have been done yet,’ says Moons. “That’s weird and annoying, but it’s no different.”
The investigations into the exact figures usually take months, because one has to find enough research participants, take measurements and analyze the results.
2| Stick to THE BASIC RULES
Jaap van Dissel personally seems to have ensured that it was written in capital letters in the OMT advice: good compliance with the basic rules is THE ONLY WAY in which a lockdown or other stricter measures can still be prevented.
And no wonder. Just keeping your distance, staying at home, testing for complaints and adhering to quarantine rules should together remove about 70 percent of the R number, RIVM calculated earlier. The measures ‘ventilating’ and ‘washing hands’ had not even been taken into account.
All the more frustrating that the Netherlands is not very inclined to observe the basic rules, as they are called somewhat biblically. According to the latest figures, barely half stays at home with complaints and only 60 percent keeps a faithful distance from their fellow man. Moreover, the mobility figures do not immediately give the impression of a population that has been taking it easy since last week. ‘The traffic jams were again unprecedentedly long yesterday’, Kluytmans notes. ‘Apparently society no longer takes this very seriously.’
However, the OMT does not get much further than the observation that things are not going well. ‘Our role is to indicate what works and what effective methods are to prevent more severe measures,’ says RIVM spokesperson and OMT spokesman Harald Wychgel when asked. “But when it comes to how exactly to do that? That is a policy consideration.’
“What you hope is that everyone feels co-owner of the covid problem,” Van Dissel said last week, in conversation with this newspaper. ‘And partly that is: monitoring the measures. We are all affected by it, we are all affected by it. And the only consequence, if it turns out to be insufficient, is that we have to put an umbrella of less effective secondary measures over the basic measures, which are also more restrictive for all of us, to cover the leaks.’
For the time being, the OMT is in any case not interested in relaxing the closing times of the catering industry. The catering industry also wants to remain open after eight o’clock in the evening for customers already present, but the OMT does not like it. After all, for the spread of the virus it does not only matter how many people come together somewhere, but also how long they sit next to each other.
3| Let 2G sit for a while
Since July, the QR code has been the main horse on which the cabinet is betting: the panacea that makes the one and a half meters unnecessary, the key that reopens bars, restaurants, event halls and stadiums. And all while the QR code will probably ensure that more people get vaccinated: what more could you want?
But for inveterate QR enthusiasts, the OMT letter comes like a cold shower. QR codes will not save us from the high corona figures, the scientific advisors write sternly. ‘I find it a bit embarrassing that we had to issue advice on 2G and 3G, while we don’t even have the basic measures in order’, confesses Kluytmans. ‘The discussion about 2G or 3G is about reopening society. While we now have to deal with: how do we prevent further closing?’
Corona tickets are therefore never intended as a ‘measure to prevent the spread of virus’ or ‘to combat an epidemic’, emphasizes the OMT. After all, corona passes only protect ‘at the relevant location’. And even then, not even against all infections: there will always be those vaccinated with the virus slipping in.
After which the OMT reluctantly discharged its task: calculating which system of QR codes actually works best, as the cabinet had requested. The result of that calculation is hardly surprising. A stricter 2G system (access only for those who have been vaccinated or cured) prevents more infections and especially more hospital admissions than the current 3G system, which also allows Tested people to enter. And owners of a QR code additional testing for corona will probably stop some infections.
However, a transition to 2G also has major drawbacks, the scientists point out. The system may lead to less compliance with the basic rules, which the experts now consider just as important. People who are not allowed to enter the catering industry with a 2G system could well start organizing their own parties, with all the associated risks.
To make matters worse, the run on the vaccination street, which the cabinet is quietly hoping for, will also not be forthcoming, the experts expect. For example, the Behavioral Unit points out that many vaccine doubters have undoubtedly already had themselves vaccinated after the 3G system was introduced. Moreover, in Germany, after the introduction of the 2G system, there was no significant increase in vaccination coverage.
“An important determinant for whether or not to vaccinate is confidence in corona policy,” says behavioral scientist Marijn de Bruin (RIVM, Radboud UMC). ‘Among unvaccinated people, that trust is already very low. We don’t see how 2G will help with that. You rather expect the opposite.’
That touches on the deeper ethical issue. Is it a good idea to deny unvaccinated a QR code, and thus access to all kinds of public places? ‘I think 2G is quite a strong measure, because you exclude people with it’, says Kluytmans. ‘The Netherlands has always been a place where dissenters had a place. I personally find that an important point.’