Measures take too great a toll

The threat of the ‘British’ variant has made the cabinet decide to introduce stricter corona measures. Fortunately, the number of new Covid-19 patients in intensive care is gradually decreasing. Now that the crisis has persisted for so long, we wonder aloud whether all the negative consequences of the measures are still in proportion to the intended health benefits.

The starting point of cabinet policy is solidarity with the weakest in our society. However, measures to prevent the virus from spreading are taking an increasing toll. Non-urgent regular care is postponed, so that people with cancer, people waiting for transplants or other patients sometimes die prematurely. There are many primary and secondary school pupils who are seriously lagging behind. Shops, cafes, restaurants and hairdressing salons are all closed. Many entrepreneurs will not ‘survive’ this crisis. The number of people living in poverty is increasing and the gap between rich and poor is growing.

Present and future generations will have to pay the bill for all the financial support packages we are now concluding. And let’s not talk about future (financial) challenges, such as fighting the climate crisis. All of this has a strong negative impact on the health of our society as a whole. The total package of measures is no longer in proportion to the intended health gain.

Full recovery difficult to achieve

Our direct perspective is of course intensive care. We have the impression that neither the Dutch population nor politicians are well informed about what goes on in hospitals.

Until now, only a small portion of our population (less than 8,000 patients) with severe consequences of Covid-19 has been admitted to ICU, thanks to the measures and our current selection policy. We would prefer to record our days with a camera: the treatment in the IC is very drastic and often takes a long time (at least two to three weeks). Less than half of all people over 75 with Covid-19 survive that stay.

Full recovery is often not feasible because many of our Covid patients have severe comorbidity, such as obesity, high blood pressure and / or diabetes, all risk factors for a serious Covid-19 infection. In addition, half of all our ex-IC patients have significant residual complaints after admission.

We are in crisis, but what is this crisis really asking of us? What decisions do we want and need to make? Which choices can be justified in the short as well as the long term? Which measures are proportional to the health and well-being of the individual and society as a whole? At the moment, we are probably more affected by our approach to the Covid-19 crisis, with a strict lockdown, than by the virus itself.

We advocate relaxing a number of measures that have a major impact on the well-being of our population, while accepting that more people will die as a result of corona.

Also read this interview: ‘Nobody has the right to live as long as possible’

You can think of lifting the ban on meeting in the open air, at a distance, in small groups, for example to play sports and to meet each other. If a few measures let go means that more people become infected, become ill and hospitals fill up, then a more selective IC admission policy is needed.

Accept more deaths

We like to think along. This means: having a conversation with and about patients with a low chance of survival and an expected long hospital stay. For example, a 75-year-old patient with diabetes who is no longer able to climb the stairs at home has a predetermined low chance of survival, let alone a good recovery. This also applies to a 69-year-old patient with morbid obesity and a previous cerebral infarction, which meant that he or she already had to be helped at home with washing and dressing.

The dilemmas of this unprecedented crisis must be clear to the population: either we keep the strict measures and protect the ‘entire’ population against the virus – with all the social consequences that entails – or we let go of some of the measures and accept that more people will die from Covid-19 in the short term.

Of course, every individual consideration is and remains a diabolical dilemma. But avoiding the conversation about this is detrimental to both Covid patients and our society.

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