A risky game: the Dutch corona strategy

Despite denials, the Dutch government still appears to be pursuing herd immunity in its fight against corona. But protest is stirring.

This is a translation of an article Das riskante Spiel der Niederlande that appeared in the Süddeutsche Zeitung of June 18, 2020.

The coronavirus has affected all European societies. They reacted very differently. For example, while the Greeks acted quickly and firmly, the Swedes apparently overlooked a few obstacles while trying to maneuver through the crisis in a carefree manner. It is less known that the Netherlands also plays a risky game and provides conflicting information about it.

The Dutch opted for an "intelligent" lockdown: more strict than in Sweden, but more relaxed and less "authoritarian" than neighboring countries - and almost without any protest from its citizens. The result is not as bad as in Great Britain or Sweden, but not good either. The mortality rate is almost at the level of Italy.

Like Great Britain and Sweden, the Netherlands is one of the countries that initially focused on the idea of "herd immunity". Its aim is not to contain the virus as much as possible; it is assumed that the healthy part of the population will become infected, while the elderly and people in at-risk groups will be shielded off as much as possible. This is exactly how Dutch Prime Minister Mark Rutte told it on March 16 - the corona crisis had just started - in a television speech: a large part of the population will be infected, that is "the reality". But: as long as there is no vaccine or effective treatment, "we can slow the spread of the virus while building herd immunity in a controlled fashion" in order to build "a sort of protective wall".

Rutte has since contradicted his own speech

The herd immunity theory was already very controversial at the time; the World Health Organization (WHO) warned against it and British Prime Minister Boris Johnson had quit after criticism. And just the weekend before Rutte's speech, an authoritative report from Imperial College London had pointed out the dangerous assumptions and serious risks of the herd immunity hypothesis.

Rutte's chief scientific advisor, Jaap van Dissel, chief virologist at the National Institute for Public Health and the Environment (RIVM), still insisted: 'The idea is: we want the virus to be spread in a controlled manner to those who are least affected, he said directly after Rutte's speech on TV. His colleague Marion Koopmans then confirmed what this strategy would mean for the Netherlands based on the average mortality rate: 40,000 to 80,000 deaths. RIVM did not contradict this.

That the prime minister directly contradicted his own TV speech was hardly noticed by the Dutch public.

Two days later, Rutte, who had found that he was dealing with a delicate topic, made a verbal U-turn. Herd immunity had never been the primary goal, he said in parliament; it can only be a long-term consequence.

That the prime minister directly contradicted his own TV speech was hardly noticed by the Dutch public. Apart from right-wing politicians Thierry Baudet and Geert Wilders, the prime minister was praised by all parties and also complimented by critical media as a 'statesman' and a 'president' - unusual terms in the Netherlands. With regard to 'herd immunity', the government and RIVM were now careful not to use this discredited term. For the rest, the immediate measures against the virus were overall comparable to the approach elsewhere. The government closed shops, restaurants and after some protest also schools and nurseries; it banned public events, and public life came to a stop.

Little testing and tracing

The measures were not exactly strict, rather hesitant and half-hearted. For a long time little testing was done, relatively few people were hired for contact tracing work, and the use of face masks was only advised weeks later than in neighboring countries. And although there were still doubts in Germany, early on in the Netherlands it was decided to ignore the risk of infecting children.

The government's approach suggested that the idea of ​​herd immunity had never left their minds, that they were not so much concerned with effectively fighting the virus, as much as they were about mitigating the effects of its spread. Various public statements support this suspicion.

The spread of the virus cannot be stopped, Ann Vossen, a member of the National Outbreak Management Team (OMT), said in an April talk show. "That is not the intention. We just want it to continue on slowly, with as few problems for the healthcare system as possible (...) If we had wanted to stop the spread completely, we should have gone for a complete lockdown." In mid-May, Sjaak de Gouw, head of the regional health authorities, made similar comments: "The only possible strategy is to allow the virus to slowly land in the Netherlands. That is the strategy we have chosen. If that leads to the buildup of herd immunity, all the better."

"Society is missing a backbone"

This contradiction was hardly discussed in the Dutch media. They have followed the RIVM line more or less uncritically, Van Dissel was portrayed benevolently. There has been no criticism, for example from other virologists. Only on social media did concerned citizens cause commotion from mid-March onward and created platforms such as Containmentnu.nl. They called for consistent strategy in accordance with WHO recommendations ("test, trace, isolate") and cite South Korea or Germany as role models.

Stronks states the Dutch strategy is caused by groupthink.

One of the activists is Jaap Stronks. The 39-year-old politicaly left-leaning and has designed digital campaigns for Greens, Social Democrats and NGOs. He finds the course of van Dissel deadly. He is particularly indignant at the way in which the government and RIVM communicate. In fact, achieving herd immunity has always been part of their strategy without admitting it, he says. He claims they have misled the population. With his concerns he feels 'all alone'; the backbone of society is missing. Stronks states the Dutch strategy is caused by groupthink. Potential critics, for example from academia or from professional associations, are 'co-opted' and are either part of the triangle cabinet-RIVM-OMT, or financially dependent on it.

The Amsterdam health economist Xander Koolman, a government advisor himself, confirms this hypothesis. Scientists in the Netherlands are less independent than in Germany. Anyone wishing to conduct research into the coronavirus must apply for funding from the ZonMw health research organization, which in turn must ask RIVM for an assessment. "None of the virologists or epidemiologists working in the field want to harm their careers."

Stronks and colleagues have not yet reached the opinion pages of major newspapers, but their concerns are now being addressed. Also by political parties. At first they were afraid to break the national consensus that is taking hold in the 'polder land' in times of crisis. Now questions are being asked; most persistently by Lilian Marijnissen, party leader of the socialist party. The RIVM website is still talking about "maximum control" of the virus to "protect vulnerable groups," she recently said in parliament. In addition, Rutte expressly does not state that it aims to minimize infections. "This leads to the feeling that one is striving for herd immunity and wants to allow the virus to spread around."

"There is no Bilderberg-like club"

The prime minister rejected that suspicion. "There is no conspiracy or Bilderberg-like club that says, 'We are now spreading the virus in the Netherlands.'" But why did chief virologist Van Dissel reaffirm the suspicion a few days ago? Herd immunity is 'still 'the only chance, he said in the Volkskrant: 'Because it is a pandemic virus, it is an illusion to think it will go away. And that means you have to build up immunity."

In Sweden, the government's strategy is currently being assessed by an investigation committee under pressure from the opposition. It is not that far in the Netherlands. But that could be worth it.