Dutch public health policy during the COVID-19 pandemic of the first half of 2020. Answers to questions on public health activities January–June 2020

The authorities’ first responses were the classification of COVID-19 as Group A-disease in the sense of the Law on Public Health, scaling up of regular crisis control structures, installation of an Outbreak Management Team OMT and a “National Operational Team-Corona”. COVID-surveillance is done by the RIVM (National Public Health Institute), and is based on data from Municipal Public Health Services (GGDs) supplemented with additional (inter)national sources. The OMT is the main advisory body regarding preventive measures and includes experts from relevant medical specialisms. Organisations of medical professionals gave separate advices. Sanctions to preventive measures can be fines and closure of accommodations. Initially, 80% of the population trusted the government’s messages and “intelligent lockdown” strategy. The Prime Minister’s addresses to the people were highly appreciated. However, at slow-down of the outbreak (May-June) society’s trust crumbled (“quarantine-fatigue”). The initial testing policy was very restricted and contrary to WHO’s adagium “Test, test, test!”. In June the Minister of Health announced that a capacity of 30.000 tests per day was achieved, to be scaled up to 70.000. The crises management’s primary concern was to increase the (ICU-)bed capacity and was achieved by transforming regular wards into COVID-care, setting-up external “Corona-wards” in hotels, and regional, interregional and crossborder spreading of COVID-patients. This focus on ICU-bed capacity was criticized, as half of the death cases and extreme equipment shortages occurred in other sectors (nursing homes, homecare, homes for the elderly, psychiatry, mental handicaps). Transformation of hospital wards also led to waiting lists for non-COVID care. End of June the government presented a step-by-step easing of the lockdown in which a fine-tuned epidemiological surveillance dashboard and the continuation of economical support for the economic sector are the backbones.