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Coronavirus: Why Dutch lockdown may be a high-risk strategy

  By Anna Holligan BBC News, The Hague
    * 5 April 2020

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  Related Topics
    * [72]Coronavirus pandemic

  Tram in The Hague Image copyright Anna Holligan Image caption Trams are
  all but empty, but under the Dutch lockdown not everything is shut

  The Netherlands has tried to adopt an "intelligent lockdown", but the
  infection is spreading rapidly and it has one of the world's highest
  mortality rates from the pandemic.

  The Dutch have also been accused of failing to show solidarity with
  countries in southern Europe hit hardest by coronavirus.

  So what are the Dutch trying to achieve and how has stricken Italy
  reacted?

What is an 'intelligent lockdown'?

  The Dutch are among the few who began by openly embracing the
  contentious idea of group or herd immunity. It's an approach
  characterised by one Dutch global health expert as cold and calculated.

  Having shunned the stricter measures of neighbouring states the
  government has pursued an "intelligent" or "targeted" lockdown. It
  wants to cushion the social, economic and psychological costs of social
  isolation and make the eventual return to normality more manageable.
  Image caption Bakeries may still be operating but the beaches are all
  but deserted

  My local florist, ironmonger, delicatessen, bakery and toy store are
  still serving customers. Posters on the door and sticky tape on the
  floor encourage people to give each other space. Staff at the tills
  wear surgical gloves.

  Only those businesses that require touching, like hairdressers,
  beauticians and red light brothels, have been forced to cease trading.

  Schools, nurseries and universities are closed until at least 28 April.
  Image caption Children's daycare centres are largely closed except for
  workers in key professions

  Bars, restaurants and cannabis cafes are shut, although they seem to be
  doing a roaring trade in takeaways.

  "We think we're cool-headed," explained Dr Louise van Schaik of the
  Clingendael Institute of International Relations. "We don't want to
  overreact, to lock up everybody in their houses. And it's easier to
  keep the generations apart here, because grandpa and grandma don't live
  at home with their children."
  [p0866gdr.jpg]
  Media playback is unsupported on your device
  Media captionDutch PM tells nation not to shake hands – then does

  People have been advised to stay at home, but you can go out if you are
  unable to work from home, or have to grab groceries or fresh air, as
  long as you maintain 1.5m (5ft) social distance.

  It helps that the Dutch appear to be broadly compliant. One survey
  suggested 99% of people kept their distance and 93% stayed at home as
  much as possible.

  Prime Minister Mark Rutte described the Netherlands as a "grown-up
  country". "What I hear around me, is that people are glad that they are
  treated as adults, not as children," he said on Friday.

  Sometimes this lockdown feels invisible. Cities may be quieter, but
  children still clamber on climbing frames and teenagers cycle
  side-by-side.

How Dutch went beyond UK on herd immunity

  When the UK's chief scientific adviser revealed a plan to develop a
  broad immunity across the population, within days researchers revealed
  it could claim a quarter of a million lives, and the UK changed course.

  Allowing a deadly virus to spread through society to create a level of
  immunity implicitly means accepting people will die.
  [p08720v7.jpg]
  Media playback is unsupported on your device
  Media captionDutch health minister Bruno Bruins collapsed in parliament
  because he was so exhausted by dealing with the crisis

  It was initially embraced by the Dutch government too, but then rapidly
  repackaged as a useful by-product rather than the main goal.
    * [73]UK changes course amid death toll fears
    * [74]Coronavirus outbreak eats into EU unity
    * [75]Capital by capital, coronavirus shuts Europe down
    * [76]Lockdown, what lockdown? Sweden's unusual response

  In a televised speech to the nation on 16 March, [77]Mr Rutte outlined
  his approach.

  "We can delay the spread of the virus and at the same time build up
  population immunity in a controlled manner," he said.
  Dutch PM Mark Rutte on 16 March
  Dutch government

  The bigger the group that acquires immunity, the smaller the chance
  that the virus can make the leap to vulnerable older people or people
  with underlying health issues

    Mark Rutte
    Dutch Prime Minister, 16 March 2020

  "We have to realise that it can take months or even longer to build up
  group immunity and during that time we need to shield people at greater
  risk as much as possible."

  Prof Claes de Vreese of the University of Amsterdam believes the UK
  government did not have measures in place for such a policy. "It left
  people dangling and feeling like they were part of a bizarre social
  experiment," he says.

Can it work?

  Dutch public health agency RIVM has launched a study to see how far
  antibodies created when people are exposed remain effective in
  preventing re-infection.

  "It's kind of like creating your own internal vaccine, by being exposed
  to it and then letting your body generate those antibodies naturally,
  to turn into a vaccination which doesn't yet exist," Prof Aura Timen
  from the RIVM told the BBC.

  She stressed they were still doing all they could to slow the pace of
  transmission of Covid-19 to "flatten that curve".

Covid-19 fatalities in Netherlands

  Deaths reported 16 March to 4 April
  Source: RIVM

  The problem is that the number of deaths in the Netherlands seems
  relatively high for a population of 17.2 million.

  "We have a good reporting system for people who have become infected,
  who have been hospitalised, but also for death," explains Prof Timen.

Reality sets in as deaths rise

  The Netherlands is now scrambling to increase its hospital capacity,
  with the peak of the crisis anticipated in two weeks and deaths as high
  as 175 in one 24-hour period. Some 1,650 people have died since the
  crisis began and over 6,600 have been admitted to hospital.

  Some patients have been transferred to Germany to free up beds and the
  Ahoy Rotterdam concert hall, which was supposed to host Eurovision
  2020, is to become an emergency facility.

  There are plans to quadruple the number of tests and healthcare workers
  not directly involved in treating coronavirus patients will also be
  screened.

  But there have been setbacks too.

  When a million masks shipped in from China were deemed faulty, the
  government had to order an urgent recall.
  Image copyright Laurie Schram Image caption Artist Laurie Schram at
  Space Fantastic is running a team of volunteers sewing masks

  There is a shortage of personal protective equipment (PPE), so students
  in Delft are working on transforming swimming snorkels into surgical
  masks and local artist Space Fantastic is collecting fabric donations
  and running a legion of volunteers frantically sewing masks for those
  on the front line.

How the Dutch enraged the Italians

  The Dutch are largely pro-European, so when a letter by prominent
  Italians to a German paper condemned them for a "lack of ethics and
  solidarity in every respect", the words stung.
  Image copyright Twitter Image caption The Italian letter published in a
  German paper condemned a lack of Dutch solidarity and ethics

  The Netherlands and Germany led opposition to easing the debt burden on
  southern states through the issuing of "coronabonds".

  Both countries pay more into the EU than they get out, but this
  "scroogy", arrogant Dutch approach was destined to backfire, says
  global health lecturer Remco van de Pas of Maastricht University.

  What's more, it is seen as self-defeating.

  "If the whole south collapses, the rich north ceases to exist," as
  Dutch National Bank ex-president Nout Wellink put it bluntly.

  The Dutch rely on other EU countries buying their exports, says Prof
  Claes de Vreese.

  "We have a shared interest bouncing out of it in economic terms in a
  way that keeps the union and the euro in a strong place."

  Then came an admission from the Dutch finance minister. Yes, the
  Netherlands' initial response lacked empathy.
  Dutch finance minister Wopke Hoekstra
  Getty Images

  We were not empathetic enough, to the point that it has raised
  resistance. We did not succeed in conveying what it is we want to do

    Wopke Hoekstra
    Dutch finance minister

  Prime Minister Rutte proposed an EU emergency fund to cover the
  immediate medical costs of the crisis, with contributions from the
  member states. "It would not serve as a loan or guarantee, but as a
  gift to those in need."

  Their hand was forced.

  "The Dutch have benefited tremendously from the European Union, its
  open labour, market and mobility," Dr Van de Pas told me.

  But the idea of an intelligent lockdown, driven by evidence and
  numbers, is very different from the stricter approach in neighbouring
  Belgium, where fatalities have also been high.

  For Dr Van de Pas it's a cold and calculated Dutch approach, that can
  perhaps only work in an individualistic society used to a
  non-interventionist medical culture, from cradle to grave.

  While herd immunity, modified as it is, may eventually dampen the
  effects of the epidemic, it has to be accepted by a substantial part of
  the population.

  The worry is that the Dutch approach may be based more on aspiration
  than actual intelligence, and that the Netherlands' "intelligent
  lockdown" does not make the country immune.
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Related Topics

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    * [85]Netherlands

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117. https://www.bbc.com/news/world/middle_east
118. https://www.bbc.com/news/world/us_and_canada
119. https://www.bbc.com/news/world/us_and_canada
120. https://www.bbc.com/news/uk
121. https://www.bbc.com/news/uk
122. https://www.bbc.com/news/england
123. https://www.bbc.com/news/northern_ireland
124. https://www.bbc.com/news/scotland
125. https://www.bbc.com/news/wales
126. https://www.bbc.com/news/politics
127. https://www.bbc.com/news/business
128. https://www.bbc.com/news/business
129. https://www.bbc.com/news/business/market-data
130. https://www.bbc.com/news/business-38507481
131. https://www.bbc.com/news/business/companies
132. https://www.bbc.com/news/business-22434141
133. https://www.bbc.com/news/business-11428889
134. https://www.bbc.com/news/business-45489065
135. https://www.bbc.com/news/business-12686570
136. https://www.bbc.com/news/business/economy
137. https://www.bbc.com/news/technology
138. https://www.bbc.com/news/science_and_environment
139. https://www.bbc.com/news/stories
140. https://www.bbc.com/news/entertainment_and_arts
141. https://www.bbc.com/news/health
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143. https://www.bbc.com/realitycheck
144. https://www.bbc.com/news/world_radio_and_tv
145. https://www.bbc.com/news/newsbeat
146. https://www.bbc.com/news/special_reports
147. https://www.bbc.com/news/explainers
148. https://www.bbc.com/news/the_reporters
149. https://www.bbc.com/news/have_your_say
150. https://www.bbc.co.uk/news/10628994
151. https://www.bbc.co.uk/news/help-50068132
152. https://www.bbc.co.uk/news/10628323
153. https://www.bbc.co.uk/news/20039682
154. https://www.bbc.co.uk/
155. https://www.bbc.co.uk/news
156. https://www.bbc.co.uk/sport
157. https://www.bbc.co.uk/weather
158. https://www.bbc.co.uk/iplayer
159. https://www.bbc.co.uk/sounds
160. https://www.bbc.co.uk/cbbc
161. https://www.bbc.co.uk/cbeebies
162. https://www.bbc.co.uk/food
163. https://www.bbc.co.uk/bitesize
164. https://www.bbc.co.uk/arts
165. https://www.bbc.co.uk/taster
166. https://www.bbc.co.uk/news/localnews
167. https://www.bbc.co.uk/bbcthree
168. https://www.bbc.co.uk/usingthebbc/terms/
169. https://www.bbc.co.uk/aboutthebbc
170. https://www.bbc.co.uk/usingthebbc/privacy/
171. https://www.bbc.co.uk/usingthebbc/cookies/
172. https://www.bbc.co.uk/accessibility/
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174. https://www.bbc.co.uk/contact
175. https://www.bbc.co.uk/bbcnewsletter
176. https://www.bbc.co.uk/help/web/links/

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179. https://www.bbc.com/news/av/world-europe-51820520/coronavirus-dutch-pm-tells-nation-not-to-shake-hands-then-does
180. https://www.bbc.com/news/health-52145140
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183. https://www.bbc.com/news/technology-52169444
184. https://www.bbc.com/news/av/science-environment-52070786/how-to-make-an-igloo
185. https://www.bbc.com/reel/video/p086wjwk/the-surprising-psychology-behind-mastering-a-new-skill
186. https://www.bbc.com/news/business-52130592
187. https://www.bbc.com/news/in-pictures-52155029
188. https://www.bbc.com/news/world-latin-america-52109982

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