In their last press conference on corona policy, more than a week before the elections, outgoing Prime Minister Rutte and Minister Hugo de Jonge dropped some hard conditions for relaxation of the measures. In the words from De Jonge: “if it is possible to keep the R-number around 1 and if it is possible to not overburden the hospitals much more, then further relaxation will be possible around Easter”.
Suddenly, ‘the R’, the number that indicates how many people are infected by one infected person, no longer had to drop well below 1. And the number of hospital admissions could even rise slightly without any relaxation being jeopardized.
How does Jaap van Dissel, the government’s most important adviser on viruses, view those statements?
And what do Van Dissel and RIVM chief model Jacco Wallinga think of the criticism from the scientific community of the alleged lack of transparency about the calculation models used?
On Tuesday it appeared that the R has increased slightly to 1.06, hospital admissions and IC admissions are going up again. Do you agree with Rutte and De Jonge’s analysis that relaxation is possible with an R of around 1 and possibly slightly more hospital admissions?
Van Dissel: “A number of circumstances have been mentioned, which have also been suggested earlier in the OMT, which are actually an indication of the epidemiology. Whether we still meet these will become clear in the OMT meeting (yesterday, ed.). if the R-value is below 1 or if we expect that R to fall below 1, then of course there is a completely different situation than when that R is above 1. We know exactly how that turns out if we use new calculations by Jacco and his group. “
In the OMT meeting on Friday, March 19, it was announced that the R-value has risen to 1.13.
What role does the increasing number of infections play?
Van Dissel: “It is complicated to interpret the numbers without further ado. We have people who are tested because of complaints and some of whom are positive. We have people who are tested on the fifth day of their quarantine, but have no complaints. There has been a significant increase in the number of children being tested. Children test positive less often, but they do contribute to the total number of tests and also the number of positive tests. So the shift in the number of tests and the percentage of positive tests ask for more explanation than just establishing that the line is going up. “
Don’t those extra infections necessarily translate one-on-one into extra hospital admissions?
Van Dissel: “That is one of the elements that requires interpretation. There is a certain dynamic in the relationship between tests, positive reports and hospital admissions, which reflects, among other things, that more young people are being tested. Another factor is that some GPs provide more care at home. fits in with the aim to treat more patients at home for longer, also with oxygen and medication. All of this influences the burden on hospital care. “
Are the signal values that indicate when easing is possible then outdated?
Van Dissel: “It is more that you constantly have to give a good interpretation of the epidemiology. You cannot immediately interpret the numbers at first sight. There is a story behind the numbers.”
Scientists, for example public health economist Jochen Mierau and modeler infectious disease control Sake de Vlas, criticize RIVM’s lack of transparency about the modeling that is so decisive for government policy. How do you view this?
Jacco Wallinga: “Op our website describes which models we use, where our research has been published, where the code and where the data can be found, and what we are still working on, so I don’t understand that very well. Of course people can always say: it is not enough. But then you also have to indicate what else we need to do and why. “
“Three weeks ago I called Sake de Vlas for an hour and showed him the website. And Jaap van Dissel also gives an extensive explanation every two weeks in his briefings in the House of Representatives. To be honest, I do not know whether those scientists those who criticize us have shown their research results to others every two weeks. “
Sake de Vlas recently stated during a webinar that it is desirable to use more calculation models for estimates.
Wallinga: “That is indeed the case. We use several models. And the information about them is on our site. The strength of the modeling is that it is so close to the current hospital data. At patient level. There is a limitation of transparency. Of course we cannot share that patient data due to privacy provisions. Moreover, the data is not ours, but belongs to the NICE Foundation. “
“For people who want to see if we are doing our work properly, the data without the privacy-sensitive information is available as open data of the RIVM and the type of model we use on the website. Finally, I would also like a lot more publishing about our work, but we are in crisis. We are constantly being asked questions from the ministry to which they want immediate answers. As a result, we actually do not have time to produce those scientific publications now. If we were to work on this now, the timeliness of the advice would be jeopardized. And in a crisis that timeliness is most important. “
Do you work with modellers in other countries?
Van Dissel: “Every so often, visitations are carried out by an international group of top experts. Jacco’s group happened to have such an audit quite recently on all aspects of their work, the quality, the transparency, the applicability, everything. And on that they have whole scored well. Furthermore, we are not the only ones working with models and estimates. This happens in all countries. Broadly speaking, this results in the same estimates and uncertainty margins everywhere. “
Wallinga: “There is a European modeling network in which all kinds of groups, such as ours, work together and develop models together. There is therefore mutual control, colleagues check each other’s work, also at an international level. We are not just messing around.”
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