Microbiologists: We should have tested more vulnerable groups


“More testing would certainly have mattered,” says professor of microbiology Bert Niesters of the UMCG in Groningen. “It has been neglected to test more among frail elderly in nursing homes.”

While the World Health Organization called for as many tests as possible in mid-March, the Dutch government chose to limit the test policy at that time. Only hospital staff and patients at risk were tested from then on. The government feared a shortage of test materials.

‘Capacity not used’

Why Niesters has not scaled up earlier is a mystery, “because I have a lot of overcapacity, the entire pandemic for a long time. We have capacity for 1000 tests per day. I only get about 100. That is 10 percent. There are simply no monsters coming in. ”

In the laboratory of the Catharina Wilhelmina Hospital in Nijmegen it has never been really busy in recent months. “At its peak, it only ran at 40 percent of its capacity,” said Professor of Infection Prevention Andreas Voss. “It was sometimes difficult to get test material, but there was always enough.” Voss thinks that no laboratory has been at full capacity.

Guidelines too strict

In mid-April, less than 50 percent of the capacity was used in the UMC Utrecht laboratory. This has now risen to 70 percent, says professor of microbiology Marc Bonten of the UMC Utrecht. He believes that the unused capacity could have been used to test more healthcare workers more quickly.

At the end of March, Minister De Jonge of Health announced that the test capacity would go to 17,500 tests per day. The RIVM figures also show that this capacity has not been used at all. Most tests were taken in mid-April, well over 6,800 per day, far below the available space.

“The guidelines for those who could be tested were perhaps too strict and could have been expanded much faster,” says Professor Voss. He has the idea that it was mainly the GGD: that it had insufficient capacity. And that the influx did not really get going as a result. According to Voss, the Netherlands is known anyway for a cautious policy when it comes to testing.

Tossed in the ring too soon

In addition to testing, it is important to do source and contact research on people who have tested positive. But from March 12, 2020, the contact investigation no longer had priority, according to a guideline from the RIVM.

“I was surprised that the Netherlands threw in the towel so quickly,” said Xander Koolman, health economist at the VU. “I saw it as a step backwards.”

‘We should have opted for testing and contact research right away’

Since then, the GGD’s contact investigation has mainly been limited to vulnerable groups. The reason was that the number of infections rose so fast that the 250 GGD employees in charge of the source and contact research could no longer cope.

“It would have been better if we had immediately opted for testing, contact research and closing airports. So we would try to aggressively work out the virus in society in an aggressive way. Of course, that would never be entirely successful, but then our economy would have been less damaged. The consequences are really disastrous, “says Koolman.

Test anyone with complaints

From next Monday, anyone with complaints can get tested at a GGD. With a positive test, a source and contact investigation is started. Important, said Minister De Jonge of Medical Care earlier this week. “Because this way we can quickly see where the virus flares up again and we can immediately stop it.”

Response of the Ministry of Health

“Demand for testing ended up lower than previously estimated. But there was great uncertainty about how many people would sign up for a test when expanding the target groups.

It was also necessary to avoid a lack of testing capacity for the number of target groups eligible for a test.

In addition, much had to be organized behind the scenes, such as setting up a single national IT system for the test results.

At the start of the large-scale outbreak, source and contact research was not fully possible in some regions. Many GGDs have continued with this, possibly in an adapted form.

In addition, the hygiene measures, staying at home as much as possible, have significantly reduced the number of infections by social distancing. ”

You can read the entire response from the ministry here.

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