What do you think of the extra measures announced by the cabinet last Tuesday?
‘The measures that have been announced are correct. I’ve always believed that ‘hit hard and early(strike hard and early) the only way is to deal with a pandemic. The sooner the better. I hope next time we will move forward sooner. Because this second wave may not be as high as the first in terms of real contamination, but it will take longer. ‘
‘I think it is important to note that we have a positive outlook. We are now dealing with these measures, but if we persist, it will get better. There will probably be a wave of a third and a fourth after this one, but we know better and better what to do. ‘
Why are things going relatively well in the Northern Netherlands?
‘This has three causes: coincidence, policy and behavior. The measures announced on September 28 and October 13 came just too late for other parts of the country, but in time for us. We walked behind the Randstad for three to four weeks. In addition, we started early here with large-scale testing of healthcare workers during the first wave. We still benefit from that now. ‘
What’s against a hard lockdown of two weeks?
‘With the next wave you always pick up where you ended at the previous one. In the summer, the number of infections here had almost fallen to zero. That is now in our favor. We also saw a significant increase in the number of infections in September, but the average age in these cases was low, because mainly students had become infected. As a result, fewer people were admitted to hospital. ‘
Jaap van Dissel (the head of the RIVM and chairman of the Outbreak Management Team – editorial staff) has proposed to the cabinet that a large part of the education should also be locked for two weeks. The cabinet has not adopted that advice, but do you agree?
‘I would be in favor of that, yes. The catch with the virus is that it can spread whenever two people are in contact. By closing schools and universities for two weeks, you break part of the chain. Not only at school, but also in the social behavior around the school. Then the number of infections will go down. ‘
‘But the virus does not distinguish between people. You should actually monitor social life 24 hours a day in order to know where and how to intervene. ‘
So, as far as Friedrich is concerned, everything revolves around making the risk of contamination as small as possible. As far as he is concerned, a short-term lockdown can help: ‘If you talk about months, then that causes problems. But what’s against a hard lockdown of two weeks, as long as we consider it more of a vacation? After all, we are used to such periods with regional differences. ‘
Keep healthcare running safely
But simply letting everyone stay at home for two or three weeks is not enough. Friedrich: ‘Twenty to thirty percent of the people live in a group. It does not matter whether it concerns, for example, a student house, a nursing institution or a temporary stay in a hospital. For the virus in all cases it remains a group of homo sapiens, where it repeatedly jumps from one individual to another and can thus spread indefinitely. So we have to be able to prevent that. ‘
Friedrich keeps saying it: keep healthcare running safely. ‘The biggest risk is that the virus will find its way into the healthcare network. When that happens, the virus spreads very quickly. Healthcare workers and patients cannot stay at home. They must therefore be given maximum protection. A virus that enters a nursing home is not only a danger to the residents. The care workers take it home and can then distribute it further. Or they themselves become infected at home and then take the virus with them to work. Even if they have no complaints themselves yet, ‘Friedrich emphasizes.
He calculates how great the potential danger is: ‘The care network is an accelerator for micro-organisms. About 1.2 million people work in healthcare. At the same time, there are more than three million people in the Netherlands who are seventy years or older. And there are people with a chronic illness. They can all get a serious corona infection. ‘
Other regional, even stricter measures, such as a curfew, are an option for the cabinet. How do you feel about that?
‘You still have to make a distinction between the regions where things are currently going badly. The situation in Twente is different than in Rotterdam. Hospitals in the west are overcrowded, in Twente the number of infections in particular is very high. ‘
In case of a fire, also look at the area around it
It comes down to customization, says Friedrich. Pay particular attention to the scale of the measures that are taken, he says: ‘If a seat of fire breaks out somewhere, look not only at the place itself, but also the area around it. Suppose a source of infection breaks out in Groningen, then you have to take the same measures for the entire north, not just the province. Otherwise it will have little effect. ‘
It is becoming increasingly clear that we should not expect too much from vaccines. How do you see that now?
‘As far as I know, we are working on 201 vaccines worldwide, 45 of which are good candidates. Ten of these can be counted among the leaders. Hopefully they will become available in the short term. Vaccination is an important stone in the mosaic, in addition to other measures such as testing, home quarantine, keeping a sufficient distance and face masks. ‘
But, Friedrich says right away, having a vaccine and actually having everyone vaccinated are two different things. And giving everyone a shot once, you’re not there, he explains: ‘To boost the immune system, you probably need to vaccinate each person twice the first time, three weeks apart. After that, many people will likely need annual vaccinations. In addition, the virus can change. Then you will also have to adjust the vaccine. Just like now with the annual flu shot. ‘
Ira Helsloot (professor of Governance of Safety at Radboud University – editorial staff) said in an interview with de Volkskrant this week that we now spend two million euros to win a year of life of a corona patient. We would never do that with cancer patients, says Helsloot. Does he have a point?
‘I don’t think people who say that have a realistic idea of what a virus epidemic entails. Cancer is not contagious, Covid-19 is. This epidemic will uninhibitedly become a structural disease, a natural disaster that will shut down the entire healthcare infrastructure, if we are not careful. This not only concerns people with corona, but also people who cannot be operated on in a hospital in time after a moped accident, for example. This virus has infected an entire continent in a few months. ‘
More beds and staff need to be added. And there must be a European policy
That is also the reason that Friedrich argues for a change in the health care system: ‘Our current health care system is very efficient, perhaps too efficient and it is not designed for an epidemic. In addition to measures such as prevention, sufficient testing capacity and vaccination, more beds and more staff must be added. That is not a waste of money, because it prevents society from getting stuck. It is ‘systemically important’. You may have more beds than necessary at some point. But you want to avoid having to choose who can and who cannot be treated. ‘
Moreover, Friedrich advocates a joint European policy to combat the corona virus. He doesn’t say it literally, but the bottom line is that the Netherlands cannot afford to follow its own path: ‘If a country chooses to do things differently from the neighboring countries and then loses control over the virus, then that could only be done. if you close the borders. ‘
‘Because you have to prevent yourself from becoming a source of infection for our continent. But closing the borders is impossible and dangerous, given the interdependence between countries. That is why you have to come to a common policy with European poldering. ‘
Also read:
– Break in the trend: North corona figures give hope for the first time in weeks
– Doctor-microbiologist on new measures: ‘We don’t have time to hesitate’
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