We now almost have 8 cases. Familymembers of the first two cases turned out to be infected. The youngest child of the Amsterdam woman did NOT go to Italy so it most have gotten the virus from her mother. 

In Delft a 23 year old woman became the 7th case-travelhistory Italy. In Rotterdam someone tested positive for the first covid19-test-waiting for the result of the second test. 

Looking at how cases explode in Italy we know the numbers in the Netherlands also will go up "like a rocket". Still no schoolclosures etc. (proberbly already late for that-usually done after the spread instead of before).

Latest news is 10 cases-Amsterdam=3 Tilburg=3 (both mother, father and child) the four newest cases is Delft 23yo female student, 2 other cases related to Tilburg (1 male and 1 female) and a woman that was accepted in Gorinchem Hospital than transported to Rotterdam were was found out she had (a severe IC ?) case of Covid19. The Gorinchem hospital now is in lock-down to find out if others are contaminated. So in the Netherlands 2 children, 5 women and 3 men have Covid19.

Average age may be below 40. No new cases in the Netherlands from the (southern) Dutch German border-eventhough in Germany cases go up. 

DJ -Trump blaming Europe ([url]https://en.wikipedia.org/wiki/Schengen_Area[/url]) for the US outbreak of covid19 will even further worsen US-EU relations. No travel between the US and EU is welcome-the US may have become the biggest problem in dealing with covid19 by lack of testing. (The EU together did do tens of thousends of tests-still not enough). KLM, Lufthansa etc will be hit hard by the US travel ban.

-Good article on how the Dutch CDC-RIVM made the situation much worse. We already had a shortage of health care workers-lack of testing in time infected several hospitals and staff even before any major spread of covid19 ! Do trade unions have to call for a national strike ?

[url]https://www.irishtimes.com/news/world/europe/how-dutch-false-sense-of-security-helped-coronavirus-spread-1.4199027[/url]

The position of Dutch authorities was that only people with symptoms could transmit coronavirus. It was repeated by the government, national and local health authorities, justifying a cascade of decisions that allowed the  https://www.irishtimes.com/topics/topics-7.1213540?article=true&tag_location=Netherlands" style='color: rgb(35, 81, 122); text-decoration: none; -webkit-tap-highlight-color: transparent; outline: none !important; font-family: Georgia, "Times New Roman", Times, serif; font-size: 16.8px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255);'>Netherlands  to keep up a “business as usual” attitude even as the virus exponentially spread.

The problem was, it was wrong. As early as February 21st, Chinese doctors published a case of apparent asymptomatic transmission; German doctors wrote to the New England Journal of Medicine on March 5th to warn of a case near Munich. The World Health Organisation advises transmission without symptoms is possible.

Despite this the Dutch government and health authorities stuck to looser quarantine advice than other European countries up to the time of publishing, telling people who had travelled from  https://www.irishtimes.com/topics/topics-7.1213540?article=true&tag_location=China" style="color: rgb(35, 81, 122); text-decoration: none; -webkit-tap-highlight-color: transparent; outline: none !important; - China , outbreak spots in  https://www.irishtimes.com/topics/topics-7.1213540?article=true&tag_location=Italy" style="color: rgb(35, 81, 122); text-decoration: none; -webkit-tap-highlight-color: transparent; outline: none !important; - Italy , and  https://www.irishtimes.com/topics/topics-7.1213540?article=true&tag_location=Iran" style="color: rgb(35, 81, 122); text-decoration: none; -webkit-tap-highlight-color: transparent; outline: none !important; - Iran , that they need only self-quarantine if experiencing symptoms.

As well as being underpinned by a flawed assumption, the advice relies on people knowing whether they have symptoms or not. This is questionable:  https://www.irishtimes.com/topics/topics-7.1213540?article=true&tag_person=Chris+Higgins" style="color: rgb(35, 81, 122); text-decoration: none; -webkit-tap-highlight-color: transparent; outline: none !important; - Chris Higgins , a GP in  https://www.irishtimes.com/topics/topics-7.1213540?article=true&tag_location=Australia" style="color: rgb(35, 81, 122); text-decoration: none; -webkit-tap-highlight-color: transparent; outline: none !important; - Australia , provoked an outcry after treating 70 patients while he had what he thought was the tail end of a mild cold, before he tested positive for Covid-19.

It’s also in stark contrast to the approach in the countries most successful at containing the virus, such as  https://www.irishtimes.com/topics/topics-7.1213540?article=true&tag_location=Taiwan" style="color: rgb(35, 81, 122); text-decoration: none; -webkit-tap-highlight-color: transparent; outline: none !important; - Taiwan and  https://www.irishtimes.com/topics/topics-7.1213540?article=true&tag_location=Singapore" style="color: rgb(35, 81, 122); text-decoration: none; -webkit-tap-highlight-color: transparent; outline: none !important; - Singapore , where authorities drew on their experience of the Sars outbreak to implement strict travel checks and preventative quarantine before even registering a first confirmed case.

Individual freedoms

The case of the Netherlands shows how a flawed belief about transmission filtered down throughout society, enabling the virus to spread. It also makes for a grand experiment in what happens when a country takes a relaxed approach to the virus, placing the maintenance of normality, personal responsibility and individual freedoms first.

It also makes for a grand experiment in what happens when a country takes a relaxed approach to the virus, placing the maintenance of normality, personal responsibility and individual freedoms first.

Great article DutchJosh - thank you!  I think most countries of the world (and 'most' individual people within each of those countries honestly) have been doing the same thing - taking the relaxed approach.  It will come back to bite us - the question now is...how hard will the bite be? 

Newbie1A-Finally even the Dutch CDC begin to see cases doubling-Italy scenario only a week/10 days away. Wuhan was closed with 400 cases-the Dutch government is not even willing to close schools with over 600 cases....

Mid April 40.000 cases 400 deaths for NL-4 days later 80.000 cases 800 death from the virus-and many more who could be saved if we had a government that did its job. 

People are stopping to send their children to school etc-due to mismanagement. And the Durch stocks had the second worst day ever...

from [url] https://nos.nl/liveblog/2326799-evenementen-met-100-bezoekers-afgelast-kabinet-roept-op-tot-thuiswerken.html - https://nos.nl/liveblog/2326799-evenementen-met-100-bezoekers-afgelast-kabinet-roept-op-tot-thuiswerken.html [/url]

Strong criticism by microbiologists at RIVM
If the Netherlands does not immediately pursue its efforts to curb the number of corona infections, the consequences will be incalculable. The Dutch Association for Medical Microbiology writes this to RIVM today, after the announcement of additional measures across the country. The doctors state that failure to act now will ultimately lead to more damage. "Only drastic measures in the initial phase can limit the risk for citizens."

The doctors have studied data of the virus from other sources and conclude that information on the RIVM site is "seriously behind and incomplete". They accuse RIVM of not testing sufficiently for corona contacts.

How about you, DJ, are you safe?

Thank you for asking Techno-I'm quite safe-for the moment. People in my surroundings need medication-this has to come from China (processed in Germany) and there should be enough in store at farmacies. 

In a worse case scenario this crisis may last longer that two months. Sheltering in place during a heatwave is "no fun". due to lots of rain we have some flooding in the south of the country-things like that are now extra unwelcome !

The lack of government may create panic. You are all safe in Scotland ? 

From [url]https://www.moonofalabama.org/2020/03/coronavirus-the-hidden-cases-why-we-must-shutdown-everything-and-do-it-now-.html[/url]; (With "Yes Minister"clip)

Our dear leaders are following the https://www.youtube.com/watch?v=nSXIetP5iak" style="color: rgb(153, 51, 0); text-decoration: underline; - four stage strategy (vid):

In stage one we say "Nothing is going to happen".
Stage two we say something may be going to happen but we should do nothing about it.
Stage three: We say maybe we should do something about it but there is nothing we can do.
Stage four: We say maybe there was something that could have been done but it is too late now.

Just stay safe DJ - prayers for you and your loved ones to come through this unscathed, with flying colors

Thank you Newbie1A- I notice the things in Canada are not going much better than in the Netherlands. At least your PM-Trudeau-is "getting to know" the risks of covid19. 

[url]https://www.youtube.com/watch?v=8Hlf4SDdRgc[/url] Paul Beckwith-another Canadian-is doing a great job in not only climate change but also-in this video-on why soap destroys the outer-fat-layer of the corona-virus. 

Here in the Netherlands stronger measures against the corona-virus is getting "the new normal". Eventhough the government/RIVM (Dutch CDC) still is not getting children can spread the virus without getting ill-so no "official" schoolclosures-lots of schools do close. (The excuse is that teachers have a cold-do not know what it is-lack of testing-do not want to spread it to other teachers, parents etc.) 

Also much less trafic, measures in public transport-mostly because people work at home, companies (often international oriented) know better than this ....... government. (The UK is even worse-there the idea is to "sit it out")

In the schooldiscussion Belgium is closing schools but ask them to take care of children that otherwise would end up at grandparents-since both parents work. Education would go via public television/internet. The difference between the Dutch and Belgian approach is not that big in practice. 

This "government" does not want public gatherings of over 100 persons (schools are above that but the idea is that you do not have 100 pupils in one classroom)-some churches neglect that "rule". Since it is no "law" mayors may now end up closing churches, mosqs etc. 

There is also a "friendly panic" in the supermarkets-extra christmassales. Toiletpaper and soap, canned food are most wanted. Since a lot of the products are made in the Netherlands supermarkets can deal with this extra demand. Sometimes have to close to fill up the shelves-get new deliveries. Pay by card-not cash is supposed to help slow down the spread. 

(The Netherlands is second largest agriculture exporter after the US-since export may be getting more difficult extra home demand is welcome. Supermarkets in the Netherlands often have also shops in Belgium/Flanders. Their basic companies [url]https://en.wikipedia.org/wiki/Ahold_Delhaize[/url] for example also own "Food Lion" , "Giant Food (Stores)" etc in the US. [url]https://en.wikipedia.org/wiki/Ahold_Delhaize#United_States[/url] in fact Dutch companies may even own all of the shopping centers-just to illustrate that a run on supermarkets in the Netherlands is not a problem-YET !!!)

In the Dutch press more and more awareness of the critical situation. From correspondents in Italy, China asking why the Netherlands did not read what they were reporting to medical staff-going for "code red" in North Brabant province-with 40% of the Dutch cases. 

From that press [url]https://www.gelderlander.nl/buitenland/verontruste-topdokters-slaan-alarm-alle-landen-moeten-in-totale-lockdown-er-is-geen-tijd-meer~ac8264b3/[/url] translation;

Distressed top doctors sound the alarm: "All countries have to go into total lockdown, there is no more time!"
If Europe does not take an example from countries such as China or South Korea in the short term, the chaos the corona virus will unleash can no longer be seen. Renowned doctors warn about this today in an open letter to colleagues from other countries. "Time is our common enemy, because the virus spreads very quickly and is very deadly."

DJ-Two links via google translate

[url]https://nos.nl/artikel/2327139-coronavirus-minder-nieuwe-besmettingen-en-scholen-mogelijk-toch-dicht.html[/url] 

190 new patients were reported Friday afternoon. According to RIVM, the decrease is the result of the changed test policy. Since Thursday, people with mild complaints are no longer tested because there is a national measure to stay at home with the first complaints.

Schools closed or not?
It seems that the cabinet is reversing the decision to keep schools open. Talks are planned for the next day with educational organizations and also with hospitals, RIVM and the Federation of Medical Specialists (FMS). In The Hague, account is taken of the fact that it will still be decided to close the schools.

The FMS, which represents some 22,000 specialists and institutions, called on the cabinet to close the schools last day. The specialists are concerned that children and young people may actually spread the coronavirus.

The doctors are also concerned about the supply of mouth masks and corona tests. Some of the supporters only have enough for a day or two.

[url]https://www.gelderlander.nl/binnenland/40-a-50-nederlandse-coronapatienten-op-intensive-cares-meer-dan-de-helft-is-onder-de-vijftig~a058aad2/[/url]

Today, between forty and fifty corona patients are in critical condition on Dutch intensive care units. “More than half of those patients are under fifty years old. It also includes young people. "That says chairman of the Dutch Association for Intensive Care (NVIC) Diederik Gommers, in an interview with this site.

The professor of intensive care medicine, who himself heads the IC of Rotterdam's Erasmus MC, emphasizes that it is not only the elderly who are affected by the corona virus. ,, What has mainly made the news is that older people die faster. This is about 2.5 percent of the entire population, while about 15 percent of the elderly die. But more than half of those patients are under fifty years old. It also includes young people. "
-

A 16-year-old boy from Breda is infected with the coronavirus and is currently in the intensive care unit of the Erasmus MC-Sophia Children's Hospital. His family calls on the whole of the Netherlands: "Wake up and take this virus seriously."

The IC specialist also says that admissions to intensive care because of the Covid-19 virus can take weeks. ,, In Erasmus there are two patients who have been on respiration for three weeks now. All other patients on the intensive care unit are shorter. "

Dutch doctors have also been informed about patients from Lombardy, Italy, who confirm data that young and relatively healthy people are also affected by the corona virus. ,, The youngest intubated Covid-19 patient is a girl of 16 years old. Two children with Covid-19 were admitted to the pediatric IC for observation, but did not require additional therapy, "the information circulated among Dutch physicians states. The first patient in that Italian region to receive a ventilator was ventilated for eighteen days, while he was relatively healthy. "It was a 38-year-old, otherwise very healthy man, who ran marathons for this."

Main risk factor for obesity

The average age of all covid-19 ic patients in Lombardy, Italy, was 70 years, according to which "the main risk factor for ic uptake is obesity". According to that information, the transmission of corona from mother to unborn children "does not seem to take place." ,, This is based on three positively tested mothers (all incidentally complaint-free) who gave birth to a child which tested negative for covid-19. The same was observed in China, "according to the information distributed to Dutch specialists based on the Italian region.

Thanks DJ,,

Great to know what's happening in another part of Europe.

Are they panic buying there? 

Or is it quiet orderly

Carbon20-Yes there is some panic buying here-mostly friendly-extra X-mas sales. Since we are distributing goods all over the world there is no shortage of most goods -except face mask, PPE etc for hospitals (we get that from China most-but since China is willing to export those goods-even giving it for free-there is hope). 

The good thing is people realize that something serious might be on its way. There is a public reaction. (The bad thing is we finally get better weather-spring-people sitting on terraces of still open restaurants and cafe's like nothing is happening. 

I expect the government to close schools, restaurants this week-unless they are totally blind for what is happening in Italy and Spain. 

When I look at the numbers cases per milion-Denmark, Norway must be in crisis by now. It is very silent from there (maybe EdwinSM knows more). 

Economic institutions expected economic growth for the NL to be 1.4% at the beginning of this year-beginning of this month (or so) they expected a drop of 0,5 % due to China corona crisis (but did not expect it here) now the prospect is severe economic fall back. 

But since we had a trade surplus we have 90 billion in reserve to deal with the crisis...

A bit of good news was hidden in the last report, that is the bit about the virus not transferring from mother to baby, based on three cases of positive mothers giving birth - this also seems to back up the information from China.

I understand the need to change the testing criteria, but I wonder how long after the out break do we start getting good statistics on how widely this spread (and therefore how low the CFR is).  I realise that at this stage medical research into total numbers of population with anti-bodies, might not be high priority as this is moving too fast.

On february 27 we had our first case-on march 15 schools, restaurants, sportclubs etc. have to close. Restaurants got the message at 5.30 in the afternoon they had to close at 6.00 hrs-so in half an hour,

The cabinet/PM did get a lot of criticism when he told the public -just a few days ago-they had to work at home-but send their children to school-it simply did not make much sense. 

Now telling restaurants they had to close within half an hour gives me (DJ) the impression politics-the "leadership" is panicking. 

Dentists stop working-only open for emergency-since working in ones mouth can bring the dentist in contact with the virus-to much risk/shortage of masks ?

Of course we went over the 1000 cases mark-sunday, with 8 more deaths. Proberbly the 368 new deaths-in just one day-in Italy may have given the final shock. 

The bad thing is of corse it is al much to late-every day of delay in an exponential phase results in more damage in the nearby future.

(Delay 1 day =5 time as much problems at day 10, 2 days=50 times as much problems, 3 days=500 times as much -such a kind of scenario. The UK and US "are lost"-face very severe damage)

Of course here on Avian Flu Talk-forum we all knew this scenario would come one day-we hoped it never would happen. 

For today I expect chaos in the supermarkets-less friendly/panic. People will start realizing we may be in a sort of lock down for months. 

Economicly-we are heading towards a global depression-proberbly far worse than the 1929 one. (Still here in the Netherlands a reduction of economy by 10% would bring us at the economic level of the 1980's).

Globally countries like the Netherlands-centers of distribution (due to ports, geo-position, infrastructure) may have lots of goods in storage. Other countries may be in a worse situation. 

Our healthcare is not able to deal with this kind of pandemic-in any country. Germany did close it borders with France, Switserland, Austria, Luxemburg, Denmark-I think Poland did close its border with Germany....from a containment view it is much to late. 

We are in the beginning of a major storm that will last for the coming months....

Prime Minister Rutte said in a direct speech that the coronavirus is among us and will remain with us for the time being. There is no easy way out, the reality is that a large part of the Dutch people will become infected in the near future, he said in his speech to the Dutch people.

It can take months to build group immunity. Until then, we must do everything we can to protect the most vulnerable people.

Many people feel that we are on a rollercoaster, which is getting faster and faster. The measures are unprecedented, says Rutte. He emphasized that expert advice is leading in these measures. The only sensible way is to use scientific knowledge and facts.

Flatten peak in spread
According to Rutte, the government chooses to control the virus as much as possible and to level off the peak in its spread. With this approach, we ensure that care can continue to cope.

If the virus went wild out of control, the health care system would be completely overrun. Vulnerable elderly and other patients could not be helped.

One of the scenarios is that our country will be locked. But that would take a very long time, and it would not yet give any certainty. As long as there is no vaccine, the virus will continue to spread around the world like a wave and not skip our country, says Rutte. That is why the cabinet has not opted for a lockdown.

He ended with a call: "We have to do it with 17 million people. Together with 17 million people, we will overcome this." Pay attention to each other. I count on you."

DJ-The good thing about the PM speech  [url]https://www.rijksoverheid.nl/documenten/toespraken/2020/03/16/tv-toespraak-van-minister-president-mark-rutte[/url] in Dutch ) is that is getting clear what the basic idea is-the bad thing the idea is wrong. 

Three scenarios: (In the PM speech)

1 controlled spread

2 let the virus do its way

3 lock down for over 1 year

DJ-In my opinion looking at Italy, Spain, China "controlled spread to create herd immunity" is a nice theory but China showed a total lock down might have worked when it was set in progress in time. 

One commentator reminded the public just one week ago the message was to stop shaking hands. Since then all other rules were put in action that first were claimed to be not needed.

DJ-There were stories about secondary infection-the numbers in the Netherlands go up fast. We are just a few days away from the Italy scenario-the PM/cabinet AND RIVM (Dutch CDC) seem to be blind for that.  The idea that only elderly will be severe effected is wrong !

With very limited testing the number of mild/asymptomatic cases is unknown. It is a big gamble to go for herd immunity on that basis,

A lock down for over a year may be needed due to little action when action was needed.  We will have to change the way we live....

[url] https://www.zerohedge.com/markets/half-america-will-get-sick-here-what-goldman-told-1500-clients-its-sunday-conference-call - https://www.zerohedge.com/markets/half-america-will-get-sick-here-what-goldman-told-1500-clients-its-sunday-conference-call [/url]

DJ, thanks again for your excellent reporting!  You are the eyes and ears of AFT into the heart of Europe, and we appreciate it. 

Be safe, Chuck

CRS, DrPH thank you. What is your idea of the "Dutch approach" ? A "controlled outbreak" because we can not stop it ? 

What does this story [url]https://www.thailandmedical.news/news/breaking-new-research-indicates-sars-cov-2-coronavirus-is-indeed-mutating-into-various-strains-that-have-specific-preference-of-attacking-human-host-[/url] mean for the global outbreak-will there be lots of variations of Covid19-with possible reinfections all the time ? 

The Dutch cabinet-I expect-will change its ways within one week-go for lock down when the number of infected further goes exponential-4000 cases in NL by the end of this week ? 

Are we expected to accept half the population becoming infected with over 500.000 deaths in one year ? Summer is not stopping this outbreak if that was the idea...

The Dutch-way goes against the (new) WHO guideline to test every possible covid19 case and contact.

In my opinion politics-worldwide-are lost in dealing with this pandemic because science seems to be lost for the moment....

[url]https://www.gelderlander.nl/binnenland/who-kritisch-nederland-vaar-niet-blind-op-groepsimmuniteit~a99537fa/[/url]

(DJ-google translate)

WHO critical: The Netherlands, do not blindly focus on group immunity
The Netherlands should not blindly assume that group immunity will arise for the Covid-19 virus. World Health Organization warns about this. The organization also states that our country and other European countries must continue to test intensively for Covid-19. RIVM states: we do what is necessary.
-

"Testing is the key to controlling the virus," said Hans Kluge, European Director of WHO on Tuesday at a news conference. His boss, Tedros Adhanom Ghebreyesus said earlier that he has a simple message to all countries. "Test, test, test."
-

It seems to be going the other way in the Netherlands. Patients who can get sick at home are no longer tested, and the family of the infected patients is no longer checked as standard for a while. The same applies to the staff of a number of hospitals.

Strategy
That is not the right strategy, says Kluge. Testing and the detection and isolation of (potentially) infected people are still at the top of the package of measures to combat the virus. This will be followed by increasing the capacity in health care to accommodate the expected flow of patients and promoting social distancing among the population.

Hospitals in the Netherlands previously indicated that test capacity in the Netherlands is limited. The WHO recognizes that some European countries are struggling with this and pledges to make every effort to ensure that these deficits are remedied.
-

Unwise
The Dutch policy to slowly build group immunity, by allowing the coronavirus to spread slowly, as it were, is unwise according to the WHO, the health arm of the United Nations. According to experts from the organization, there is no evidence yet that this group immunity is caused by this virus. "That is why it is not the right time for us to focus on that now," said Dorit Nitzan, Health Crisis Coordinator. "We need to know more about it first. It is a new virus, it has only been around for 12 weeks in the human race. Now we have to focus on those very basic precautions. "
-

Richard Pebody, who is responsible for the containment of contamination as a team leader at WHO Europe, says a set of measures is needed. ,, So both finding and isolating infections, and contact research, and increasing capacity in hospitals, and social distancing. People are now talking about group immunity, but we have to suppress the virus, that is now a priority. Flatten the curve! ”

RIVM is confident that group immunity will eventually occur. But that does not mean that the virus should continue to spread, says Aura Timen, head of the National Coordination Center for Infectious Disease Control at RIVM. “We also fight the virus, we even go further than other countries. We ask everyone to stay at home as much as possible, but we don't lock the entire country. You may have to keep that up for a year. And if you relax it, the peat fire will flare up again. ” About the allegedly restrictive test policy, Timen says: “We apply the WHO policy in a Dutch context. A lot is being tested: about a thousand a day in recent days, at numerous laboratories in the country. We test at hospital admissions. We also have monitoring stations throughout the country, which we started seven weeks ago. And we will use the infection radar to gauge the population. I think the WHO mainly addresses countries where there is not yet a clear picture of the virus. "In addition, Timen argues, much more testing does not mean that the virus becomes less" dangerous. "

[url]https://nltimes.nl/2020/03/18/temporary-lock-possibility-yet-necessary-dutch-pm-says-covid-19[/url]

Prime Minister Mark Rutte is keeping the possibility open to temporarily halt public life in the Netherlands completely in the fight against the coronavirus. But, as the country's care capacity is still sufficient, such a lock down is not yet necessary, he said to NOS in response to criticism on the  https://nltimes.nl/2020/03/16/coronavirus-full-text-prime-minister-ruttes-national-address-english" style="text-decoration: none; color: rgb(153, 5, 0); - Dutch policy to strive for "herd immunity" against Covid-19.

Some critics say that the " https://nltimes.nl/2020/03/17/around-60-nl-residents-must-get-covid-19-herd-immunity-health-institute" style="text-decoration: none; color: rgb(153, 5, 0); - herd immunity " approach is risky and could lead to many deaths, according to NOS. Other critics point out that other countries like France opted for a lock down approach. Belgium also took a step towards lock down on Tuesday evening.

But according to Rutte, there is not much of a difference between the Netherlands' approach and that of other countries. "We don't have a different strategy. This is the strategy that the whole world is following," he said. According to Rutte, the capacity of ICUs is the decisive factor in all countries' decision making. France and Belgium are locking down their countries because their ICUs are filled up. "That is also conceivable here, but we don't have to do that now," he said to the broadcaster.

Rutte added that a complete lockdown until a vaccine is available, is off the cards. "I don't think we're going to say to people: you can't go outside and that could take a year or maybe longer. Because it can take that long before there is a corona vaccine," he said.

[url]https://nltimes.nl/2020/03/17/travel-anywhere-except-emergencies-dutch-government[/url]

The Dutch government issued a far-reaching cautionary statement on Tuesday telling the country's residents to avoid traveling outside the Netherlands at all costs. The warning, released by the Ministry of Foreign Affairs, was because of the rapid speed with which new restrictions were being introduced by the national government and governments abroad.

"Holiday trips abroad are not recommended," the Ministry continued. "If you have travel plans, consider whether this trip is really necessary. Postpone or cancel the trip whenever possible."

Those who were already abroad when the government updated its travel advice were told to work with their travel provider to return at the earliest date possible. Anyone not able to depart for the Netherlands should work with their travel provider to secure shelter.

[url]https://nltimes.nl/2020/03/17/mps-praise-dutch-pms-covid-19-speech[/url]

rime Minister Mark Rutte could count on praise from both opposition and coalition parties for his https://nltimes.nl/2020/03/16/im-counting-dutch-pm-asks-country-unite-fight-coronavirus" style='text-decoration: none; color: rgb(153, 5, 0); font-family: "Open Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255);'> address to the nation on Monday . In his speech, the Prime Minister warned that coronavirus Covid-19 will be in the Netherlands for some time, and called on Netherlands residents to face this difficult time together.

Dutch Josh, I spend probably too much time ruminating about this....would it be better for each of us to catch the SARS-CoV2 virus now, at the beginning of the epidemic, and gamble that there would be adequate hospital capacity & ventilator support to live through the illness, or better to dodge the virus as long as possible?  We would also be gambling that we would land a "mild" case of illness. 

At my age, I vote "dodge the virus," but patients who catch COVID-19 at the earliest stage of the outbreak may actually be at an advantage.  Most of society would experience a mild disease which would confer immunity, so it would nearly be like being vaccinated.  If enough of the population were infected and survived, this would help to shield the vulnerable in the population, not unlike "ring vaccination" used to control smallpox. 

Of course, even the young can be infected and actively shed the disease, so this strategy would be highly risky.  However, gathering the young and exposing them en masse might be a strategy that could be used in very poor countries with limited healthcare infrastructure. 

I hope you are safe and well in the Netherlands, my friend! 

I Am waiting to see if China has really dodged a bullet.....

I think that the minute China starts to relax 

It will take off again.

CRS, DrPH-even with a lockdown our healthcare system would get to breakingpoint very fast. Due to spending cuts there are 250.000 vacancies in (health)care. Old people are supposed to stay at home "almost till they drop". There is a severe shortage of masks (China just gave Dutch healthcare tens of thousends of masks etc). PPE's etc. 

On that bases only lockdown is a acceptable choice. 

(I will update with numbers in a second post)

CRS, DrPH wrote: Dutch Josh, I spend probably too much time ruminating about this....would it be better for each of us to catch the SARS-CoV2 virus now, at the beginning of the epidemic, and gamble that there would be adequate hospital capacity & ventilator support to live through the illness, or better to dodge the virus as long as possible?  We would also be gambling that we would land a "mild" case of illness.  At my age, I vote "dodge the virus," but patients who catch COVID-19 at the earliest stage of the outbreak may actually be at an advantage.  Most of society would experience a mild disease which would confer immunity, so it would nearly be like being vaccinated.  If enough of the population were infected and survived, this would help to shield the vulnerable in the population, not unlike "ring vaccination" used to control smallpox.  Of course, even the young can be infected and actively shed the disease, so this strategy would be highly risky.  However, gathering the young and exposing them en masse might be a strategy that could be used in very poor countries with limited healthcare infrastructure.  I hope you are safe and well in the Netherlands, my friend!

That is a brilliant idea...mandatory separations in countries based on age...

Separate the young from the old/weakened....then deliberately expose the young, let it burn out (there will be casualties), let them do all the work such as food production, delivery, essential services, at a distance. How to enact, logistically? Households, apartments, streets, blocks, neighborhoods get separated by age. No one under 50 or with health conditions allowed in/out, for example. 

This would require extremely visionary leadership. 

I'm thinking of a country I have some ties to, Colombia. Their health care system is fairly minimal, with high urban density. How to get this to the decision makers around the world? WHO? They seem so incompetent they couldn't lead anyone out of cardboard box. 

This popped out at me from above - does Mr. Rutte not understand the time delay between exposure and ICU overload?  To me it's basic math, and the understanding of the long/slow climb then 'hockey stick' turn upwards of this is essential knowledge for governments...does he 'not get it'?  If he doesn't understand it's scary, and if he does understand and choses to do 'nothing' - that's kind of even scarier!

Prime Minister Mark Rutte is keeping the possibility open to temporarily halt public life in the Netherlands completely in the fight against the coronavirus. But, as the country's care capacity is still sufficient, such a lock down is not yet necessary, he said to NOS in response to criticism on the  https://nltimes.nl/2020/03/16/coronavirus-full-text-prime-minister-ruttes-national-address-english" style="color: rgb(153, 5, 0); font-family: Verdana,Arial,Helvetica,sans-serif; font-size: 12px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 1.4; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px; - Dutch policy to strive for "herd immunity"  against Covid-19.

Newbie1A-maybe our PM did get the point that-with any scenario-there will be a lot of fatalities. CRS, DrPH -Peak Prosperity (PP)[url]https://www.youtube.com/watch?v=tmhsNdW24BM[/url] has a good video on the question of strategy. 

If you can not avoid a major disaster is there some wisdom in trying to delay it-yes proberbly. Are there means for delaying it-yes sveral-from closing of schools-or not to only telling the people most vulnarable to stay indoors-selfisolate.

In a debate in parliament our healthminister collapsed due to exhaustion. I am willing to believe they weigh all the different options-and all those options mean lots of lives lost-there are no miracle options.

Our politicians/cabinet underlines there is no major difference between how most countries deal withis crisis. I think the main difference might be timing of measures. 

(I will try to come back on numbers-[url]https://www.worldometers.info/coronavirus/[/url] has lots of info-for lots of questions. NL has a high number of fatalities-already-in comparison with Germany, Austria-that both have more cases-per-million-how come ?)

From P.P. :

The more we learn about the coronavirus, the more nefarious it becomes. Most public efforts to are focused on detecting those with symptoms, like a fever. But new research shows that the majority of covid-19 carriers (50%-75%) are asymptomatic. So you're much more likely to get infected by someone who looks and feels fine. To date it looked like only the elderly and immunocompromised were at risk of serious complications. Well, that assumption is changing. European doctors are reporting a concerning number of younger, healthy people getting sick, too. Similarly, it was assumed that the virus didn't thrive in heat and humidity. Hopes in the northern hemisphere have been pinned on the nearing arrival of Spring. Well, new data shows that this may be false hope. And as government response plans become clearer, the math shows that most of them will be too insufficient to "Flatten The Curve" much and prevent national health care systems from being overwhelmed. Combined, most of what we're learning now reinforces the conclusion that many, many people will become infected; the virus will be with us a long time; and the economic legacy will be massive and painful.

Another story on the debate:

Best known virologist Belgium: The Netherlands will come back from this
The best-known virologist in Belgium, Marc van Ranst, is extremely critical of the corona policy of the Netherlands. On Flemish Radio 1 he said that the Netherlands will come back.

"They still have less than 50 deaths, but they are getting close to that. 100 deaths and all this policy changes. And at that moment it will be too late, or very late, to take the same measures as Belgium now Certainly when there are images of healthcare that it can not handle, people who have to be in the hallway, a lot of people on the ventilator, the call for those measures will become very large. "

In Belgium, a ban on gathering has been in effect since noon. All non-essential shops are closed and only a limited number of people are allowed to enter supermarkets.

DJ-We had our first case in the Netherlands feb-27. At present  (march 19 10hrs CET) 2051 cases-58 deaths.  Info (a.o.) from:[url]https://www.worldometers.info/coronavirus/[/url], [url]https://www.rivm.nl/en/news/current-information-about-novel-coronavirus-covid-19[/url]

When you look at numbers per million: Netherlands (NL) has 120 per million (pm). Germany (DE) has 147pm, Italy (IT) has 591 pm. 

(I wanted to compare those numbers backward-mmmmm-does not work country pm)

[url]https://www.worldometers.info/coronavirus/country/italy/[/url] and [url] https://www.worldometers.info/coronavirus/country/germany/ - https://www.worldometers.info/coronavirus/country/germany/ [/url]

Italy (IT) had first 3 cases (c) feb 15 at that time Germany (DE) had 16 cases NL=0 (d=deaths)

feb15 IT 3c DE 16c NL0c

feb27 IT 655c /17d DE 48c NL1c 

march(ma)2 IT 2036c/52d  DE 165c NL 18c

ma4 IT 3089c/107d DE 262c NL 38c  (ratio IT 28.8 (3089:107=) increase  (inc-c) IT 4636:3089=1.5 DE 2.6 NL 3.4

inc-d IT 1.8 

ma6 IT 4636c/197d DE 670c NL 128c/1d (ratio IT 23.5 NL 128 inc-c IT 1.6 DE 1.5 NL 2.1

inc-d IT 1.8 NL 3

ma8 IT 7375c/366d DE 1040c NL 265c/3d ratio IT 20.1 NL 88.3 inc-c IT

ma10 IT 8514c/631d DE 1565c/2d NL 382c/4d (ratio IT 13.5 DE 782.5 NL 95.5

ma12 IT 12839c/1016d DE 2745c/6d NL 614c/5d (ratio IT 12.6 DE 457.5 NL 122.8

ma14 IT 17750c/1441d DE 4599c/9d NL959c/12d (ratio IT 12.3 DE 511 NL 79.9

ma16 IT 23073c/2158d DE 7272c/17d NL 1413c/24d (ratio IT 10.7 DE 427.8 NL 58.9

ma18 IT 28710c/2978d DE 12327c/28d NL 2051c/58d (ratio IT 9.6 DE 440.3 NL 35.4

(with these numbers one can compare the outbreaks in IT-DE-NL and make some projections)

DJ-I may be continuing the calculations in "the dungeon" on this site. Germany-our eastern neighbour-seems to be doing much better in keeping serious cases/deaths down. How ? Maybe better testing ? Picking up early cases, contact tracing-so able to limit damage in a very early stage ?????

On this map [url]https://www.rivm.nl/coronavirus-kaart-van-nederland-per-gemeente[/url] one can see most cases are concentrated in SE part of the NL.  [url]https://en.wikipedia.org/wiki/Carnival[/url] is the main reason for that. One can also see some relation with the [url] https://en.wikipedia.org/wiki/Bible_Belt_(Netherlands) - https://en.wikipedia.org/wiki/Bible_Belt_(Netherlands) [/url] orthodox protestant christians-although most churches stopped major activities. 

The army is helping to transport cases from the southern part of the country to other area's were there is still room in ICU.

We had nice-but cold and windy- weather so lots of people went to forrests, parks, beaches. Since 50/60% of the shops are-still- open in the Netherlands also people from Germany and Belgium came over. The Belgian-Dutch border is now closed for that kind of visits. (Also lots of Dutch get their gas across the border because it is cheaper there. The Belgian border now closed for that.)

The Netherlands is getting Chinese help (from China air transport companies, Huawei-most likely also AliBaba/Aliexpres) in the form of masks. 

A Dutch company making [url]https://en.wikipedia.org/wiki/Chloroquine[/url] is under police surveilance. Dutch doctors are using (a.o.) this medication-without much succes and lots of side effect-on the severe Covid19 cases. The Dutch CDC (RIVM) hopes to see this coming week the results of less shacking hands, working from home aproach-otherwise we will get more strict rules. 

Another Dutch company is making 50 ventilators per week, people from restaurants that lost their jobs can get temporary positions in hospitals. Other companies-that used to work for restaurants-sell their products via the internet to consumers. 

DJ-My impression is that most Dutch people do not get how serious the situation is. Closing of gyms was not an invitation to organize your own group work-out in a park. Shops still open are not meant for fun-shopping (lots of supermarkets etc. do want people to get there essentials individualy-so not all of the family in the supermarket.) After a fall of numbers in public transport better weather did see a rise again of people on fun-trips. 

The Dutch approach-much critizised by most of the rest of Europe-of "controlled spread"to get herd-immunity is on its way to become a disaster. Our PM Rutte may not be the right person to get the message over (he is way to friendly, always smiling).

Some links;

[url]https://nltimes.nl/2020/03/22/total-coronavirus-cases-quadruple-week-4204-death-toll-reaches-179[/url],

[url]https://nltimes.nl/2020/03/22/nl-alert-urgently-warns-people-stay-home-crowds-flock-popular-areas[/url],

[url] https://www.facebook.com/NOSinEnglish/?__tn__=kC-R&eid=ARAQayCaSmxqSJlsiafqSGpARuLjgDNq4pA41XofoWyJwrF5mmLwggrbcTAKnGveTPyTRGdv64Qz_7xv&hc_ref=ARSsPj7DotjvJErICnCxeLMdEiaIx19I97VYHcPrdxzYsoOepsYQy5gFzrvimXSGSkM&fref=nf - https://www.facebook.com/NOSinEnglish/?__tn__=kC-R&eid=ARAQayCaSmxqSJlsiafqSGpARuLjgDNq4pA41XofoWyJwrF5mmLwggrbcTAKnGveTPyTRGdv64Qz_7xv&hc_ref=ARSsPj7DotjvJErICnCxeLMdEiaIx19I97VYHcPrdxzYsoOepsYQy5gFzrvimXSGSkM&fref=nf [/url]

[url]https://nltimes.nl/2020/03/24/mayors-pleased-clear-rules-new-covid-19-measures[/url]

DJ-A lot of criticism on why some rules last till june 1, other rules april 6-but maybe longer-barbers are "adviced" to stop their job (because you can not work from a distance unless you have very long arms)-children (till what age ?) can still play outside (because they do not spread the virus ????) [url]https://nltimes.nl/2020/03/24/secondary-schools-unions-call-exams-scrapped[/url] de facto most schools had to make this decision themselve. Another new "rule"is supposed to have not more than three visitors in your house-if you have more "police could invade your house" police already claiming they will not do so. 

[url]https://nltimes.nl/2020/03/24/philips-step-equipment-production-fight-coronavirus[/url] Problem for the Netherlands-the production is in Pittsburgh PA-USA-the US may not allow export. 

[url]https://nltimes.nl/2020/03/24/virologist-condemns-netherlands-slow-covid-19-testing[/url] DJ-How do you know how far "herd immunity" is when you do not test ? In Groningen they tested 1000 hospital workers-50 of them had the corona-virus. 

(The WHO advises "testing, testing, testingRoche a main manufacterer of the tests claims there are not enough tests. Can others produce more tests ?)

[url]https://nltimes.nl/2020/03/24/amsterdam-hospital-building-large-corona-care-unit[/url]

[url] https://nltimes.nl/2020/03/23/covid-19-vaccine-developed-leiden-wont-tested-nl-report - https://nltimes.nl/2020/03/23/covid-19-vaccine-developed-leiden-wont-tested-nl-report [/url]

Since Germany has 34 ICU's per 100.000 people-NL has 7 per 100.000 there are now talks of transporting cases from NL to the borderarea, Aachen, Kleve, Münster. Germany also welcoming patients from Italy, France. [url]https://nltimes.nl/2020/03/27/118-coronavirus-patients-admitted-icus-netherlands[/url] getting close to its limits.

[url]https://www.rivm.nl/en/coronavirus-map-netherlands-per-municipality[/url] spread most in SE and bibble-belt. 

DJ-At present in Dutch news;

-some 600.000 facemasks (part of 1.300.000 masks) bought from China are not good-do not provide enough protection. 

-Since spending cuts on care for the elderly many old people with healthissues still live by themselves. Familymembers are expected to take some care-but they run in difficulties when they get sick themselves. Professional care (also lots of spending cuts) hase lots of health issues themselves (the outcome will be a lot of people with healthissues will be in the colatteral deaths statistics). People in health institutions are supposed to stay indoors and can not get visitors (for weeks, months)

-still a lot of shops are open but most people do not go there (supermarkets do-it-yourself shops, farmacies excluded)

[url]https://nltimes.nl/2020/03/26/coronavirus-impact-netherlands-bracing-deep-recession-94-unemployment[/url]

The coronavirus will definitely cause a recession in the Netherlands, according to a report central planning office CPB released on Thursday. The CPB calculated four scenarios depending on how long the measures to curb the spread of Covid-19 will remain in place, and all four scenarios resulted in a recession. In the best case scenario, the Dutch economy will shrink 1.2 percent this year, in the worst case it will shrink 7.7 percent. In three of the four scenarios, the shrink will be greater than in the 2008/2009 financial crisis, CPB said.

"Corona is primarily a health crisis. Measures to contain the spread of the virus are necessary, but it is clear that they have a profound impact on the economy," CPB director Pieter Hasekamp said. "At the same time, much is still uncertain. We do not yet know how long the current measures will remain in force, nor do we know the exact impact on the economy, because such measures have never been seen before." Which is why the CPB worked out four scenarios. 

[url]https://nltimes.nl/2020/03/27/dutch-security-services-warned-consequences-pandemic-years-report[/url]

Security services in the Netherlands have been warning about the dangers of a pandemic like the coronavirus since 2016. In reports by the national coordinator for counterterrorism and security NCTV, the security services warned that the Netherlands does not have enough ICU beds, among other things, NRC reports based on its own research. It seems little was done with this advice.

Last year's National Security Strategy, a policy document on which the government bases its security plans, also paid attention to preparing for a pandemic. "The risk of an outbreak of a (serious) infectious disease such as an influenza pandemic remains real," the newspaper quoted from the document. It advised the government to implement "policy at a strategic level" to be prepared for this.

Despite being warned about the dangers of a pandemic in NCTV safety analyses since 2016, written in collaboration with experts from health institute RIVM, research center TNO, and intelligence and security service AIVD, little seem to have been done to actually prepare. "Our preparations for a pandemic has been mainly symbolic," Ira Helsloot, professor of security governance, said to the newspaper. "Plans have been written for it, but we were not prepared in a material sense."

[url]https://nltimes.nl/2020/03/28/arrival-covid-19-nl-earlier-thought-study-reveals[/url];

The Covid-19 disease was already being transmitted among health care workers in Noord-Brabant from as early as Feb. 19, new research reveals—indicating that transmission was occurring over a week before the first case was officially recorded in the Netherlands late last month.

According to a  https://www.medrxiv.org/content/10.1101/2020.03.23.20041913v1.full.pdf" style="text-decoration: none; color: rgb(153, 5, 0); - survey published Friday by a joint team of Dutch researchers, as many as 86 health care workers in two Noord-Brabant hospitals were infected with severe acute respiratory syndrome coronavirus 2, more commonly referred to simply as "coronavirus," from late February and into early March. Of these, eight were apparently showing symptoms of the coronavirus disease  https://nltimes.nl/2020/03/25/nls-first-covid-19-patient-recovered-back-work" style="text-decoration: none; color: rgb(153, 5, 0); - before the case of Joost Boons , the official "patient zero," was  https://nltimes.nl/2020/02/27/coronavirus-netherlands-first-positive-case-covid-19-reported" style="text-decoration: none; color: rgb(153, 5, 0); - reported by health authorities on Feb. 27 .

While the 86 infected health care workers were indeed a small sample (6.4 percent) of the total sample taken of hospital employees; the findings do nevertheless represent a “relatively high prevalence of mild clinical presentations that may go undetected,” the researchers write.

DJ-The Dutch CDC/RIVM keeps optimistic over the outcome of their (lack of) policy. Looking at Italy, China I do not see any reason for that optimism. Also hospitals and GP's give another perspective. Of the infected Dutch cases close to 10% are HCW.

[url]https://www.rivm.nl/en/news/current-information-about-novel-coronavirus-covid-19[/url];

28-03-2020 | 14:00 hr

Overview of the numbers

• The total number of confirmed cases: 9762 (+1159)
• The total number of confirmed cases who are or were admitted to hospital: 2954 (+454)
• The total number of reported deaths: 639 (+93)

Explanation

As seen yesterday, the number of reported new hospital admissions and Intensive Care admissions appears to be increasing less rapidly. The number of reported deceased COVID-19 patients is lower than yesterday. Because not all patients can be reported immediately, the reported numbers may differ slightly from the actual situation.

The number of reported hospital admissions and the number of reported deaths from COVID-19 is increasing less rapidly than would have been expected without measures in place. If this trend continues, we can conclude in a couple of days whether the measures are working.

The province with the most confirmed cases is still Noord-Brabant with a total of 2748 persons. However, the number of new hospital admissions in this province is decreasing. Subsequently, the most confirmed cases were reported in Zuid-Holland (1508) and Noord-Holland (1401). In the province of Zuid-Holland, the number of hospital admissions of confirmed cases is rising faster than in other provinces. The provinces of Friesland and Drenthe are still the provinces with the fewest infections, 96 and 98 confirmed cases, respectively.

[url] https://www.rivm.nl/en/coronavirus-map-netherlands-per-municipality - https://www.rivm.nl/en/coronavirus-map-netherlands-per-municipality [/url]

Not a lot of good news there DJ - make sure you stay safe!!!

The only thing that might be possible with the 600k masks - they may not be good event to prevent catching virus, but are they good enough for people coming into an ER or clininc or doctor to wear 'in case' they have it and prevent spread???  Just a hopeful thought if they can serve a purpose...

Newbie1A-the problem with the masks was that they did not cover enough of the face-left openings on the side. The masks were already distributed to hospitals (could cover 1 month of need for masks in NL)-but they saw the problem. (Could be a wrong size ? May be returned to the Chinese company and be replaced by "perfect fit ones"?)

According to Paul Beckwith cases in Canada are exploding-stay safe !

DJ-On feb 27-a little over a month ago-we had our first Covid19 case in the Netherlands. [url]https://www.rivm.nl/en/current-information-about-novel-coronavirus-covid-19[/url] The number of tested cases is now over 13.000-the real numbers both in cases and deaths will be several times higher. [url]https://nltimes.nl/2020/04/02/life-expectancy-likely-fall-due-coronavirus-experts-say[/url]

(Life expectancy in NL is among the highest in the world [url]https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy[/url] (UNDP-list) [url]https://www.cbs.nl/en-gb/news/2016/53/life-expectancy-gap-between-dutch-women-and-women-elsewhere-in-europe-widening[/url]-quality of life is a different story)

DJ-[url]https://nltimes.nl/2020/04/01/covid-19-curve-flattening-lockdown-unnecessary-says-health-agency[/url]

Allthough I am very critical on politics for the moment the Dutch government may be doing the best they can;

-increase testing (from 4000 per day to 20.000 or something like that

-increase ICU capacity from 1150 to 2400-3000

-working with Germany that still has room in ICU

-there is an "intelligent lockdown" (with streets most empty but people can go out-for this moment this brings the R0 to 0.3 claims the RIVM/dutch CDC)

[url]https://nltimes.nl/2020/03/31/coronavirus-schools-shut-businesses-remain-closed-april-28[/url]

"It should not have to be this way" goes for NL as well-lot more action earlier (february) could have stopped this outbreak.

Most bordercrossings are still open-we expect (but not welcome) tourists from Germany, Belgium for Easter-may have to close borders then. 

Supermarkets, DIY-shops were overrun-there is a shortage of jog-saw-puzzles-but no shortage of medication.

The ICU's are stretched to their limits but the number of infected HCW remain low. Elderly are not free to move-in some houses for people with needs there are Covid19 outbreaks-it is far from perfect. Comparing the NL situation-we have a lot of deaths-with other EU countries we are "somewere in the middle ranks"-comparing with the US the EU is doing so much better ! (Again it does not have to be this way !!!)

A lot of shops may go bankrupt-other shops sell via the internet, restaurants become take-aways. There will be an increase of unemployment-but also of new jobs doing old things in a new way.

Hi DJ thanks for the update

Is your government helping the people laid off because of this, 

Our government supporting us all here with $750.00 a week for all wage earners

For at least 3 months possibly 6

DJ- You really shouldn't rely on all those propaganda rags to form your opinions....

The world’s #top10 #coronavirus #covid18 deaths per 1 million people countries. 1. #Italy 218 2. #Spain 201 3. #Belgium 87 4. #Netherlands 68 5. #France 62 6. #Switzerland 56 7. #Luxembourg 46 8. #Iran 36 9. #Uk 35 10. #Sweden 24 ?. #USA 15 ?. #Finland 3 ?. #China 2

[url]https://nltimes.nl/2020/04/02/anti-coronavirus-measures-likely-remain-months-virologists-say[/url] DJ-This will be a "job" for up to two years ? 

ksc-[url]https://www.worldometers.info/coronavirus/[/url] has also a list of deaths per millions-I try to base my opinions as good as possible on facts.

carbon20-Our government is paying companies up to 90% of salary costs if they do not fire their workers (still KLM did end contracts for several thousends of employees). Of course otherwise those who do lose their job would get unemployment benefit. 

[url]https://nltimes.nl/2020/03/16/coronavirus-full-text-prime-minister-ruttes-national-address-english[/url] DJ in practice there may be difficulties with burocracy-but the Dutch government is willing to go far to ensure everyone does get an income. (One problem is that a lot of Dutch live across the border in Belgium, Germany but work here-wich country should do what ? Also self-employed with no stabile income-do you use last years tax-info ?)

So what facts led you to form this opinion?

"-comparing with the US the EU is doing so much better !  "

ksc-the picture I am getting is that in the US;

-a lot of people when they fall ill is they lose income, job, insurance and sometimes housing

-Health care is not public but for profit

-First indications give me the impression HCW run more risks of getting infected in the US than in most of the EU

(due to more PPE available in most EU, stronger rules and trade unions)

-Although in some parts of the EU there are a lot of older-at higher risk-people obesity etc. seems to be a bigger problem in the US

ksc-Blaming China is not helping in stopping the spread of Covid19-stopping flights/travel is. 

Also Mr Pence said that the USA was following the path of Italy, which currently has the worst situation in Europe.  So by simple logic, the European average must be less than that of Italy. and therefore on average will do better than the USA [although that is hard to emotionally accept given how bad parts of Europe are now].

I think Mr Pence should get credit for not watering down the situation his country is facing.

ksc-the picture I am getting is that in the US; You're not getting an accurate picture

-a lot of people when they fall ill is they lose income, job, insurance and sometimes housing wrong

-Health care is not public but for profit wrong

-First indications give me the impression HCW run more risks of getting infected in the US than in most of the EU wrong

(due to more PPE available in most EU, stronger rules and trade unions) wrong

-Although in some parts of the EU there are a lot of older-at higher risk-people obesity etc. seems to be a bigger problem in the US maybe

ksc-Blaming China is not helping in stopping the spread of Covid19-stopping flights/travel is. already done

This might help you understand...

"The reason that drugs and medical systems can be so cheap in the world is because they are so expensive in America. If companies recover all costs of research and development from America then sales in other countries can be done on a marginal profit basis.

Let me put this into perspective for you... In 2017 the world spent $7.79 trillion on healthcare, the U.S. made up $3.3 trillion of that. Which, in case you are wondering, is 42.67%. We are not consuming 42.67% of the world's healthcare, we are paying for other's consumption.

Now let me also put that into perspective for you... If America refused to pay any more than Canada per capita for healthcare costs the world would lose $1.25 trillion from the system. Which is way more than all the profit in the entire world's healthcare system in fact, it would be roughly equivalent to all the profit in the entire world's health care system from suppliers to providers plus about 50% -70% of all doctor salaries (that is every doctor in the entire world taking a 50% to 70% paycut just so the system could maintain the level of care that it currently does and America could pay what Canada pays). If that seems preposterous... congratulations you now understand how massive this problem is. How does this happen?

It is a function of product development costs. It takes about a billion dollars to bring a drug to market. Suppose that a company estimates that the world wide dosage for this drug is 100 million doses (let's ignore the time value). The drug then needs to sell for $10 per dose worldwide to break even, but many countries refuse to pay that. However, suppose that Americans are willing to pay $100 per dose and they will use 10 million doses. That means that all of the development costs are covered by Americans so any contribution margin (price - cost of producing one pill) that comes from other countries is profitable."

ksc-it would be nice if you have a source/link

[url]https://www.theguardian.com/world/2020/mar/13/european-countries-take-radical-steps-to-combat-coronavirus[/url]

Indeed the US is spending a lot of money on healhcare but that does not mean;

-healthcare for all

-money well spent/most effective

-China, Germany and India not being very major players 

[url] https://www.zerohedge.com/health/shocking-footage-bodies-piled-manhattan-hospital - https://www.zerohedge.com/health/shocking-footage-bodies-piled-manhattan-hospital [/url]

Hopefully, the worldwide boycott of chinese products will start gaining traction. They can partner up North Korea when the missiles start flying...

https://www.theatlantic.com/ideas/archive/2020/03/china-trolling-world-and-avoiding-blame/608332/ - https://www.theatlantic.com/ideas/archive/2020/03/china-trolling-world-and-avoiding-blame/608332/

You are right ksc, but not entirely.  America's money also makes drug company executives rich.  On the rare occasion an American is given medical aid here, they start out astonished at the assumption we will give aid even if you can't pay for it and go on to be even more amazed when they find out how little we do pay for it.

Because our government pays ALL medical bills, it really buys in bulk!  This means they can drive a    very    hard bargain. 

The NHS is short of money, as is every health system on the planet, but has an internal body called NICE (National Institute for Clinical Excellence) and they bargain for every pill.  If something is extortionate they simply won't buy it.  NICE is not thought of as nice, but it is very effective.  Thanks in part to them, it all remains free at the point of need.

We also have several charities that do research and their goals are different from those of big pharma.  They look for cures.  Big pharma really wants treatments - then the patient must pay for longer!  The charities also get government funding and lottery money on top of their donations.

I paid national insurance for decades.  I don't have to pay it any more.  It gives me a pension and lifelong health insurance and also paid dole money if I needed it.  It used to cost me about £30 a week.  I don't know what it is these days, but probably double that now.  That one payment covers all three for life.

In addition to saving us a fortune, compared to our American cousins, infectious diseases (not just covid, but HIV, TB Hepatitis etc.) spread less quickly as all are treated and our medical staff get their jobs as a calling, not an act of desperation to put food on the table.  About 15 years ago a friend of mine was contemplating going to the states to rejuvenate her career.  She decided to swat up for the exam to be a nurse in the USA.  She sat several online 'mock' exams to practice.  I have no medical training but sat one out of curiosity - I got a distinction, hubby tried it and got a 100% perfect score.  As it happens she did not go as she found out how hard life there can be.  I don't think I could pass one of our own nurse exams.

[url]https://nltimes.nl/2020/04/02/coronavirus-deaths-top-1300-nurses-alarmed-icu-staff-shortages[/url]

It may get hard to get more than 2400 ICU's in NL-due to shortages of staff. Also medication to keep patients sleeping for longer time-2-3 weeks-may become a problem.

Dutch watercompanies are warning for [url]https://en.wikipedia.org/wiki/Legionella[/url] now that sportfacilities, restaurants are not used for a longer time. 

[url]https://www.rivm.nl/en/current-information-about-novel-coronavirus-covid-19[/url]; Techno-we also have a "NICE" here in NL -National Intensive Care Evaluation

Explanation

Hospital admissions for 625 patients were reported today. 166 deaths were reported. Not all of the hospital admissions or deaths occurred within the last 24 hours.

The ‘ https://www.rivm.nl/actuele-informatie-over-coronavirus/data" style="box-sizing: border-box; color: rgb(1, 104, 155); text-decoration: underline; background-color: transparent; - coronavirus data ’ report includes a graph showing the number of hospital admissions by reporting day and deaths per day of death. Due to delays in reporting, these figures may change per day.

It seems as though the initial effects of the measures can be seen. The number of patients admitted to hospital and the number of deceased patients reported in the Netherlands are increasing less rapidly than would have been expected without measures in place.

RIVM National Institute for Public Health and the Environment   is receiving information on the outbreak of the novel coronavirus from multiple sources. The daily data reports from the National Intensive Care Evaluation (NICE) Foundation are now also included in the reports on coronavirus data in the Netherlands (only in Dutch). These figures are updated constantly by the NICE Foundation. For that reason, the figures in this report have a slight delay compared to the real-time situation.

Since not all COVID-19 patients are tested, the actual numbers in the Netherlands are higher than the numbers stated here.

ksc wrote: So what facts led you to form this opinion? "-comparing with the US the EU is doing so much better !  "

Heavens, are you another American looking to take offense? Another American who can find an insult in any sentence? Seriously you guys need to get over yourselves and enter into a discussion rather than shutting it down with your misplaced sense of national pride. It's not appropriate here.

I'm not taking offense at all, just amazed at the ignorance shown by citizens of other countries concerning the USA. It's actually humorous, especially since I was born in the UK and have family living in Europe.....

ksc-With the rule-nationwide-you have to wear masks in the US the US is taking a major step forward. The EU is not doing that allover the EU.

Also "sense of community" may be better in the US-lots of volunteers willing to help in a crisis-nationwide. In the EU borders often still are barriers-interest of most stop at the border of their own country. 

Maybe I put my criticism of the US to "black-and-white"-some more nuances may be welcomed. With criticsm (based on what I read/learn from Moon of Alabama, Zero Hedge, Peak Prosperity-all US sites or this one [url]https://halturnerradioshow.com/index.php/en/[/url] behind paywall shortages food, medication in US)  I hope to help push for changes.

[url]https://www.zerohedge.com/economics/here-comes-next-crisis-30-all-mortgages-will-default-biggest-wave-delinquencies-history[/url]-this is not only a US problem. But the US is supposed to be "the richest nation" in the world. It should do better in public healthcare, housing etc. We are all-in many ways-in "the same boat".

(By the way "Yankee" comes from Jan-Kees -Dutch names when New York was Nieuw Amsterdam-the US has "Dutch roots" in my opinion)

DJ-With so much bad news from around the globe things look "reasonable" in NL;

-ICU are being stretched-but many German hospitals are willing to take IC patients from NL (problem is more in duration-staff may be working very hard for the coming 4-6 weeks) [url] https://nltimes.nl/2020/04/06/early-optimism-icu-assoc-says-covid-19-figures - https://nltimes.nl/2020/04/06/early-optimism-icu-assoc-says-covid-19-figures [/url]

-One "person" between 25-29 died of Covid19, several others have died yonger than 50-in all cases comorbidities

[url]https://www.rivm.nl/en/current-information-about-novel-coronavirus-covid-19[/url];

Among the deceased patients, three were between 25 - 50 years of age. They all had serious underlying health conditions.

-Germany may close border with NL today (goods, essential workers excluded)-there is some criticism on that; [url] https://nltimes.nl/2020/04/06/germany-declares-nl-international-risk-area-covid-19-borders-close - https://nltimes.nl/2020/04/06/germany-declares-nl-international-risk-area-covid-19-borders-close [/url]

  -why now-it is rather late, Easter-weekend as an excuse ? [url] https://nltimes.nl/2020/04/06/warm-sunny-weather-give-way-clouds-showers-easter-approaches - https://nltimes.nl/2020/04/06/warm-sunny-weather-give-way-clouds-showers-easter-approaches [/url]

  -why all of the border while most cases in NL are in the south and west, some regions in the north still have no cases (!), also in Germany spread is very uneven-Northrhein-Westphalia has a lot of cases, also limited numbers in northern Germany

   -People see it as conservative CSU getting its way-closure of border for political reasons

-Insurance companies are not renewing/giving new credit-insurances for shops in the NL so they may run into difficulties buying goods

https://ourworldindata.org/grapher/covid-confirmed-cases-per-million-since-1-per-million?country=ITA+NLD+ESP+USA - https://ourworldindata.org/grapher/covid-confirmed-cases-per-million-since-1-per-million?country=ITA+NLD+ESP+USA  

Looks like Italy, Netherlands, Spain and US are one the same curve.

ksc-thanks for that link, from [url]https://www.worldometers.info/coronavirus/[/url] more and more testing in most western countries. 

[url]https://www.worldometers.info/coronavirus/country/us/[/url], [url]https://www.worldometers.info/coronavirus/country/italy/[/url]

[url]https://www.worldometers.info/coronavirus/country/spain/[/url] and [url]https://www.worldometers.info/coronavirus/country/netherlands/[/url] have lots of data for comparison 

-the Dutch (and Belgian) border with Germany will get more controls but not close [url]https://en.wikipedia.org/wiki/North_Rhine-Westphalia[/url] wants the borders to remain as open as possible

-For NL at least till april 28 a lockdown-with some room to move (shopping, fresh air) is-more or less-working. 

DJ-The Dutch CDC is telling the R0-on average-is under 1 in NL-but still smaller outbreaks do happen. In 1/3 (900) of the 2500 care centers for elderly there is Covid19-the peak is flattening but far from over. 

[url]https://nltimes.nl/2020/04/08/coronavirus-biggest-humanitarian-disaster-since-wwii-red-cross[/url], [url]https://nltimes.nl/2020/04/08/govt-plan-use-apps-track-covid-19-raises-privacy-concerns[/url] DJ-one of the concerns is police checking via apps how many people are in your house etc. Is there an "exit-strategy" for the use of thes apps or will they be used long term ? 

[url]https://nltimes.nl/2020/04/08/coronavirus-new-normal-attention-needed-regular-healthcare-lcps-chair[/url],  [url]https://nltimes.nl/2020/04/08/29-year-old-youngest-yet-die-covid-19-brother-31-icu[/url]

DJ-More and more realism-this Corona-crisis is lasting for years. Economic damage is major-our economy will loose at least 10%.

Since we are "not an island" developments around the globe will effect events in NL. Economic pressure can bring a rise in cases. 

DJ-There is a severe shortage in PPE, face masks etc. for care centers in NL [url]https://nltimes.nl/2020/04/10/healthcare-workers-veluwe-quitting-lack-protective-gear-fear-covid-19-infection[/url] since also rules are not always clear, staff sometimes switch jobs often-[url]https://nltimes.nl/2020/04/09/half-residents-rotterdam-dementia-care-home-died-coronavirus-report[/url] this cen be the outcome. 

Most old, people in need, are not allowed to get outside the care center (some do have (roof)gardens, balconies etc) or to get visitors. In practice sometimes partners get seperated-only contact via window, phone, internet. 

The borders between NL and Germany, Belgium are "open" for goods and essential travel [url]https://nltimes.nl/2020/04/10/german-police-randomly-check-dutch-border[/url] . Quite a lot of people live on one side of the border, work on the other side-urban area's may cross borders-with supermarkets etc 'on the other side"-a strict closure of the border brings problems. 

[url]https://www.rivm.nl/en/novel-coronavirus-covid-19/current-information-about-novel-coronavirus-covid-19[/url] Over a 100 German hospitals are willing to accept Dutch patients-our ICU system is (very) close to the max-we would not be able to give the needed care without Germany. [url]https://nltimes.nl/2020/04/08/first-drop-covid-19-patients-treated-icu-since-pandemic-began[/url]

DJ- The "Euro-crisis" is not over yet [url]https://nltimes.nl/2020/04/10/europe-commits-eu500-billion-coronavirus-support-package-sensible-solidary-dutch-fm-says[/url] (DJ-Italy, Spain, Greece etc. see the Euro damaging their economies-while rich Euro-countries NL, Germany, Austria, Finland are not willing to give up their benefits. In interest-rates that would cost them billions they fear-but putting those cost/rates on the poor Euro-states (already also dealing with most of the refugees) is-in my opinion-also not reasonable, durable. There once were talks on N-(North)Euro and S-(South) Euro-but that would not solve problems for countries in between like France-let alone new-possible-Euro-countries like Poland.)

[url]https://nltimes.nl/2020/04/09/zero-chance-life-will-return-normal-apr-28-dutch-pm-schools-talks-reopen[/url] DJ-Some estimates 800.000 to 900.000 jobs lost due to Coronicrisis. Tourism was a main source of income-should hotels transform to studenthousing ? The transportsector move to home-delivery of groceries ? KLM staff instead of working in aircraft work in healthcare ? 

The Netherlands are supposed to be very flexible-able to see new oppertunities and chances. The internet already was a major competitor for shops-in-the-street-Covid19 speeds up that proces. There were over 250.000 vacencies in care, a shortage of teachers-there is a shortage of affordable housing. (Lots of offices now have turned into houses-sometimes they started as a house-become office for decades-now turn back to appartments...)

The not-that-strict lockdown in NL may be working better than strict lockdowns in other countries. [url]https://www.worldometers.info/coronavirus/country/netherlands/[/url] There is shortage of tests, masks etc. but there is also new production of those in NL. 

DJ-Some news (with Dutch links) [url]https://www.gelderlander.nl/ede/rioleringen-raken-verstopt-door-ontsmettingsdoekjes-zelfs-mondmaskers-spoelen-mensen-door~aed227ad/[/url] The Dutch sewage system is facing more problems due to all kind of materials being dumped in the toilets-from facemasks, kitchenpaper, to dipers since small children do not go to kindergarten etc. It takes two persons to clean up the mess-they have to wear PPE since they can not keep a distance of the prescribed 1,5 meter. 

[url]https://www.gelderlander.nl/nijmegen/trouwambtenaar-noemt-huwelijk-met-dertig-mensen-onverantwoord-en-krijgt-ontslag~a1d993f3/[/url] A civil servant for mariages lost her job after critizizing there are still 30 people alowed at mariages (and funerals etc)-it contradicts the other rules of no more than 3 persons (or a household) getting together. "For a wedding you need the persons getting married, two witnesses and a civil servant. "

[url]https://www.gelderlander.nl/binnenland/weer-branden-in-zendmasten-telecomaanbieders-gaan-uit-van-5g-terreur~a7d9485e/[/url]

Several 5G-telecom mast have been set on fire. Some people see a link between 5G and Covid19. The police see these attacks as terrorism and attacks at vital infrastructure. 

Links in English;

[url]https://nltimes.nl/2020/04/10/nl-acquisition-production-masks-happened-slowly-report[/url] Dutch manufacterors could have started production of PPE, masks etc. weeks earlier if the government did order earlier. (DJ-The NL exported PPE etc to China in february-the government did not see this pandemic coming eventhough they were warned-in early february there were already cases in the EU !!!). Also carecenters for the elderly (etc) have severe shortage of PPE-killing hundreds of people-the government denied the problem !

[url]https://nltimes.nl/2020/04/11/large-majority-icu-patients-suffer-long-term-consequences-visit[/url]

Also in Dutch press-keeping elderly alone in carecenters, without visitors, social distancing, can cost lives (and decrease quality of live) soon. 

DJ-Dutch politics first had the idea of a "controled break out"-herd immunity would protect the most vulnarable, others would not get severly ill....the main problem was to protect ICU/healthcare from being overrun. Most likely the hope was warmer weather would slow down the spread. In the balancing act keeping the economy going was maybe more important than saving lives. Still the view seems to be to go back to the "old way of living" with international travel, traffic jams, etc. In my (DJ) opinion that view is unrealistic-politics is slowly getting there. This covid19 will have effects for a longer period-so we should prepare for a "new normal". 

There is growing concern that this easter (by the way that name comes from Ishtar [url]https://en.wikipedia.org/wiki/Inanna[/url]) may cause a second wave. Allthough airtravel is now 10% of normal flights from New York see no controls, people are "advised" to limit contacts. In their first comments the Dutch PM gave the impression young people would not be effected by Covid19-(based on RIVM non sense !). Since then he learned better but the story put younger people at the wrong foot. 

Testing is limited, severe shortages of PPE, unclear rules, still international travel  and nice-summer like-weather all form the bases for a second wave we will see end of April, early May...

DJ-Tomorrow the Dutch cabinet will inform the nation on plans and restrictions after april 28. What to expect ?

-Maybe barbers, dentists can reopen under the restriction of limiting contacts (so only on appointment, most likely with PPE/masks, desinfection, a screen at a reception, pay-by-card etc.)

-I do expect restaurants, gyms etc. will have to stay closed. At best some rules will be discussed on what bases they may reopen. (A lot of these kind of businessess will wait for tomorrows news and then may decide to go for bankruptcy)

-No visiting for the old in carecenters-maybe till june 1 ? (Maybe in the north of the NL were there are less cases there will be more room for other rules)

-[url]https://www.zerohedge.com/technology/covid-19-smartphone-surveillance-and-state[/url] there has been a lot of discussion on the use of smartphone-apps to help against Covid19. Seven companies had a chance to present their products. Experts are not very happy with the results-so this will take more time.

(DJ-I am against mandatory using of apps-there is still a large group that does not have the (right) smartphone-specialy with elderly. Also using drones etc. proberbly will be seen as government mistrusting their own people. There is a "social contract" of trust. People mostly doing the best they can in social distancing, staying informed/educated. Most people are willing to accept-for the time being-stricter rules when the government is willing to provide income for those now without an income.)

-[url]https://nltimes.nl/2020/04/20/adjusting-public-transit-social-distancing-society-will-cost-eu12-billion-report[/url] DJ-The number of people using public transport now is about ten percent of normal. To create social distancing in public transport will be a challange-it also will not make that kind of transport cheaper. It is expected people will go for e-bikes.

[url]https://www.youtube.com/watch?v=hxGRiipfuCI[/url] in Dutch-the (7 persons) Outbreak Management Team advises the government on what measures will do. They are doing that on bases of  their professional knowledge-but as a person (so not as a representative of the hospital or company they work for). It is politics that have to make the rules. 

-[url]https://nltimes.nl/2020/04/20/elderly-coronavirus-patients-transferred-icu-less-report[/url] DJ-The number of ICU patients has been dropping for some days now. But part of the story is elderly (70+) may go to ICU less. 

[url]https://www.at5.nl/artikelen/201429/hans-was-kerngezond-maar-overleed-aan-corona-ik-ben-gebroken[/url] A story from Amsterdam. A 62 y/o man died-after a very active sporting life. His wife and his mother (97) also were ill. But they both recovered. 

For intubation the man was brought in coma-but suffered 4 strokes-so he never woke up again....

DJ-Just had the PM/CDC-RIVM press conference on Covid19-

Main point was keeping healthcare functioning so very limited room. For schools NL watched what Scandinavia was doing-further there have been talks between PM Rutte and Angela Merkel-Germany-because we face the same questions-more or less in a same phase. 

[url]https://nltimes.nl/2020/04/21/netherlands-will-open-primary-schools-may-lockdown-measures-continue[/url]

Prime Minister Mark Rutte confirmed on Tuesday that primary schools will reopen after the May vacation period, weeks after they were ordered closed to help contain the spread of coronavirus. The schools were part of five points Rutte wanted to make on behalf of his Cabinet just one week before the first coronavirus social distancing measures were set to expire.

He also discussed the extension of a ban on most organized sports and close-contact businesses through May 20, and the cancellation of all large events through September 1, including professional football, which effectively ends the Eredivisie's 2019-2020 season.

-

Joined by the head of public health agency RIVM, Jaap van Dissel, Rutte repeated what the country's health leaders have been saying for a week: That the number of Covid-19 patients in intensive care and the reduction of new patients with coronavirus in hospitals are both positive signs. However, "the pressure on healthcare is still enormous," he said.

Both men expressed concern for healthcare workers, and said that they have to get a break and a chance to recover before any more rules may be relaxed. "For months, these people are already working shifts of twelve hours a day; They need time to recover."

-

He continued, "One person's freedom should not be at the expense of another's health."

Rutte also suggested that testing for coronavirus would be expanded to include teachers and school staff, with the schools reopening their doors. The Dutch leader said that the he felt the decision will make life easier for parents.

"Few children have been reported with infections, the disease display was mild and the transmission of children to parents appeared to be limited," Van Dissel said. Of the 34 thousand people in the Netherlands who have tested positive for the virus, 124 are under the age of 14, of which 47 were treated in a hospital.

He also said that there were no clusters of children who tested positive for the virus. "Children are underrepresented in the number of illnesses. We see that elsewhere in the world."

-

Children up to age 12 are also allowed to begin playing team sports again starting on April 28. Those from 12 to 18 years of age may play sports or exercise, but only at a distance of 1.5 meters from each other. Still, the prime minister urged people to "use their common sense", and not crowd up alongside sports fields, and to shower at home.

"Individual sports, such as running and cycling, can and should still be done for everyone," he said.

-

The initial plan from the government to cancel all large events was supposed to be in effect up through the end of May, however that was extended to September 1 on Tuesday. The decision largely matches advice from many mayors in the country, and provides more clarity for some of the biggest Dutch festivals which had complained they were in the dark and did not know how to proceed with their ticket-holders, performers, sponsors, and insurance firms.

-

While hairdressers and beauticians had put effort into creating a protocol to return to their work, that effort was in vain for the time being. Barbers, masseuses, sex workers and other close-contact professions will still have to stay closed, Rutte affirmed. 

"We are not yet safe. There is no vaccine. People who get the virus may have to call on the hospital. The pressure [on hospitals] is still enormous and must really decrease first," Rutte said.

Other businesses, where workers and visitors can keep 1.5 meters away from each other, can continue to stay open.

There was also talk earlier Tuesday of a possibility to allow people to again visit loved ones resident in care facilities. However, the Cabinet decided against permitting this.

"As difficult as it is to not allow visits to nursing homes, we must protect our elderly. We do this, knowing that it is very difficult," Rutte said.

-

The team of experts could not reach a consensus on whether high-contact businesses should be allowed to reopen. The hesitancy here had to do with lack of knowledge on exactly how contagious the coronavirus is before a patient starts showing symptoms, and the shortage of protective gear. For example, this week  https://nltimes.nl/2020/04/21/hairdressers-present-plan-reopen-social-distancing-society" style='text-decoration: none; color: rgb(153, 5, 0); font-family: "Open Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255);'>hairdressers submitted a protocol  containing measures they will take in order to safely reopen. These largely involved wearing masks and gloves. This will increase the already high demand for protective gear.

[url]https://nltimes.nl/2020/04/26/mink-found-infected-covid-19-two-dutch-fur-farms-areas-now-closed-public[/url] ;

"Human to animal contamination is possible, but the impact of this mink contamination on human health is currently negligible. Human to human contamination is the driving force behind the current coronavirus pandemic," the ministry said.

"There is currently no reason to believe that the virus spreads in these mink farms in any other way than it does between humans," the ministry said. All Dutch mink farmers, veterinarians, and researchers will be required to report any respiratory problems or increased mortality in mink.

The ministry wants more research to be done to determine if the virus spreads the same way among livestock as it does among humans. "While it is not expected that the virus will spread over longer distances, air and dust samples are also taken in the vicinity of the company as a precaution," the ministry said.

[url]https://nltimes.nl/2020/04/26/customers-angered-klm-refusal-give-cash-refunds-tickets-eu-discuss-issue[/url] ;

KLM has confirmed that they will not be issuing refunds for travelers who have booked flight tickets with a departure date prior to May 31, the airline told NL Times. This comes amid a spate of customer complaints against the airline from passengers who said their financial situations means they need the cash back for their cancelled flights, requests which they said have fallen on deaf ears at the airline's customer service department.

In place of a refund, passengers are being offered vouchers equal in value to the cost of the original ticket. The vouchers are valid for one year and can be used in exchange for future flights with KLM and its partners, including Air France, Delta Airlines or Virgin Atlantic. Alternatively, affected travelers can opt to adjust the date of their travels, or change their destination entirely, both free of charge.

Vouchers which go unused may be exchanged for cash after the 12-month period runs out, the airline said.

-

However, many customers believe that the vouchers are insufficient, and that KLM has not done an adequate job of communicating with its aggrieved customers. "I understand it is important to support companies during the crisis," said Eindhoven-based Susannah Letouze.

She spent 800 euros to fly to Washington D.C. last month, but fearing the contagious virus, and with countries racing to change their entry policies, she paid KLM an extra 100 euros to move the flight to May. That flight was later cancelled by the airline. She was offered KLM's voucher instead, and said the airline told her the conditions involved.

"I explained that it is not good enough. They pushed me to fill in a dispute via the website." she told NL Times. Since then, they have not replied to her concerns over using the voucher.

"It’s not my place to help bail out KLM," she said.

[url]https://nltimes.nl/2020/04/28/coronavirus-crisis-increasing-inequality-netherlands-society-professor-says[/url] ;

About a fifth of Dutch people lost a big part of their income since the outbreak of the coronavirus crisis. Another group is saving more money now that restaurants are closed and holidays are being canceled. The crisis is widening the gap between these two groups, Oscar Gelderblom, professor of financial history in Utrecht, said to the Telegraaf. Vulnerable families are being hit hardest.

According to Gelderblom, there are worrying parallels between this crisis and the great depression in the 1930s. "There is a big difference in vulnerability between people with a big and small purse. The people who were able to build up a buffer will survive the crisis. If you don't have that, you can do nothing but spend less. Then there is only money for the basic necessities in life," he said to the newspaper.

[url]https://nltimes.nl/2020/04/28/organized-crime-hindered-coronavirus-crisis-rotterdam-police-chief-says[/url] ;

While the coronavirus crisis brought massive parts of society to a halt, organized crime continues unhindered. There is no visible reduction in the amount of trafficked drugs discovered in Rotterdam, and a first batch of cocaine has already been found in a shipment of medical supplies that was shipped to the United Kingdom, according to Rotterdam police chief Fred Westerbeke. "Criminals adapt very quickly," he said to AD.

Over the past six week, over 40 people were arrested at the port of Rotterdam on suspicion of being so-called "retrievers" - people who get themselves locked into the port in order to remove drugs from containers and smuggle it off site. According to Westerbeke, their presence shows the continuity of the drug trade.

Westerbeke doesn't think lockdown diminished the demand for drug in many countries, he said to the newspaper. "The use will be less, but I don't believe there was a halving." 

Increased controls on the borders, due to measures in place to curb the spread of the coronavirus, did make drug distribution more difficult. But according to the Rotterdam police chief, criminals just switched back to old smuggling routes, or invented other methods of moving their product.

Drug dealers themselves are also having a harder time. With everyone stuck at home, there is not only fewer customers on the street, but more people watching out their window. They are therefore gathering in places where there are crowds, such as the parking lots of supermarkets or hardware stores, Westerbeke said

[url] https://www.rivm.nl/en/novel-coronavirus-covid-19/what-are-we-doing-in-the-netherlands-in-response-to-the-coronavirus - https://www.rivm.nl/en/novel-coronavirus-covid-19/what-are-we-doing-in-the-netherlands-in-response-to-the-coronavirus [/url]

About the first point of some losing income, and others finding they have more money now they cannot spend it...

I was talking to some family in London who are fortunate in that they have kept their jobs and are working from home.  They all commented that they now have more money than ever because they are not having to pay out for the very expensive communing costs.  On the down-side more is being spent of food - for one family this was because there was a local M&S that was pleasant to go to, rather than a hour+ wait in queue to get into one of the big box stores.

I guess we will see much more pressure for firms to allow more working from home than they did before.  Along the same lines, some of the rural communities in Finland want to keep up tele-schooling in some form as the long distances make transport cost very high (the worst case was where over 10% of the education budget in a community went on transporting children to and from school).

EdwinSM, I hope (and expect) working, study from home will become a new normal. Here in NL we have a major online supermarket [url]https://join.picnic.app/?_ga=2.140400051.1678489304.1588574530-92380823.1584174098[/url] (also already selling in Germany (?)) Other major supermarkets have now also become internet-supermarkets bringing groceries at your doorstep (some used to bring it to your kitchen-may even help those in need to store it-social distancing has stopped that service. Now they park it at your front door-ring the doorbell-step away-so you can get your shopping.) Drugstores also send their goods for free when you order for over 20€.

Here in local (Arnhem) news-this weekend police ended a party with over 40 people in a house.[url] https://www.gelderlander.nl/arnhem/politie-maakt-einde-aan-illegaal-feest-met-veertig-personen-in-arnhem~ab75a165/[/url] link in Dutch In Velp (suburb) a group of Polish migrant workers was found to be infected with Covid19. Over 28 of them now placed in quarantine on a rivercruiseship in Arnhem-harbour. [url]https://www.gelderlander.nl/arnhem/tientallen-buitenlandse-arbeiders-in-isolatie-op-arnhems-cruiseschip-na-coronauitbraak~aabe55e3/[/url] Link in Dutch

[url]https://nltimes.nl/2020/05/04/third-teachers-worried-schools-reopening[/url] DJ-I would not be surprised if NL followed Germany and schools may reopen in september. 

[url]https://nltimes.nl/2020/05/03/many-international-train-passengers-required-wear-masks-monday[/url] and [url]https://nltimes.nl/2020/05/02/make-face-masks-mandatory-public-transport-urges-advisory-group[/url] DJ-Since public transport and social distancing do not mix very well: A Public transport in urban area's only for longer distances B Since cars use so much space-use of cars further restricted to create more room for people walking or riding a bike. (C. More government money needed to keep "privatized" (often now in foreign state-public transport companies hands) public transport running.)

[url]https://nltimes.nl/2020/05/04/mayor-calls-adam-residents-responsibility-adhere-coronavirus-measures-hoping-relaxation[/url] and [url]https://nltimes.nl/2020/05/02/dutch-take-streets-raising-concerns-around-sprawling[/url] DJ-More shops reopen/need to reopen or face banktruptcy=more people on the street. There are limits on NPI/(even "intelligent" lockdowns (with more room to go outside). 

If there would be a second wave (and I expect there will be several waves) both NPI and healthcare may become problematic. A lot of HCW are getting exhausted (or infected in care centers-shortage of PPE). Still very limited testing so underreporting. [url]https://nltimes.nl/2020/05/01/nurses-caregivers-mentally-exhausted-feel-pressured-work-unprotected[/url]

Government aid programm is far from perfect [url]https://nltimes.nl/2020/04/29/students-financial-trouble-unions-call-aid[/url]. Forcing some restaurants, cafe's etc. to "become creative" (You can book a hotel-eat at a restaurant without even staying in the hotel-hotels are excluded from some rules). 

[url]https://nltimes.nl/2020/04/28/coronavirus-crisis-increasing-inequality-netherlands-society-professor-says[/url] DJ-Just like in most other countries less well educated have lesser income, health, housing-face more problems when children are supposed to "study at home". (DJ-They smoke more-so if nicotine means less ACE2 receptors they may have a bit more protection than non-smokers-on the other hand life-expectency for the poor is sometimes 12 years less than for the rich. In poor area's (the study was in Amsterdam) babies dying at birth is at third world level. 

DJ-Outlook-the spread of Covid19 is not even in the NL. The south and west have more cases-but cases per million are the highets in the south-risk of further spread is major in the big cities (Amsterdam, Rotterdam, The Hague, Utrecht) in the west. The government has put a lot of costs for unemployment and care on [url]https://nltimes.nl/2020/04/30/coronavirus-pushing-municipalities-financial-trouble-report[/url] they now face banktruptcy. 

There is NO exit strategy. Call for "apps" to slow down the spread are not very welcome. On a voluntary basis over 60% may cooperate but so far the government has not showed they know what they are doing. Shortage of PPE and testing goes on-even with an airlift from China and increased production in our country (Here in Arnhem refugees will produce 100.000 masks per day in a social-work project [url]https://www.gelderlander.nl/arnhem/vluchtelingen-in-arnhem-aan-de-slag-met-productie-100-000-mondmaskers-per-dag~acd44c93/[/url] link in Dutch).  There is need for perspective-a lot of companies can do without income for three months but may not survive six months. Even open shops now see an income of less than 50% of normal. [url]https://www.gelderlander.nl/nijmegen/horecabaas-met-veertien-kroegen-in-arnhem-en-nijmegen-1-juni-open-of-meer-steun-anders-actie~a5b62f79/[/url] link in Dutch-Owner of 14 cafe's will reopen june 1 unless he gets more help. 

The picture I get NL is doing "above average" but as a major spill in international trade "pain" is on its way. (Oil and gas are an important part of NL trade. Global demand for all products may be falling. NL is second largest agriculture exporter (after US) in the world-a lot of it may go to China. Flower export collapsed. )

[url]https://www.buitink-technology.com/uk/industry/sanitarian-transparent-separation-panels/?cat=7898[/url] Extreme light weight screens may be used in offices, schools, gyms etc. New technics for social distancing society. 

PS-google translate is a great help for articles in Dutch. 

[url]https://nltimes.nl/2020/05/06/coronavirus-restrictions-ease-spring-summer-testing-widely-available[/url]

Schools reopening step-by-step from may 11. DJ-There is still limited knowledge of how Covid19 may effect children. Since the belief is they do not get infected or ill-very limited testing. [url]https://nltimes.nl/2020/05/06/roadmap-reopen-netherlands-unveiled-economic-assistance-planned[/url] In the balancing act-the other choice would end most bussinesses in the NL. 

[url]https://nltimes.nl/2020/05/06/face-coverings-public-transit-hairdressers-terraces-open-soon-reports[/url], [url]https://nltimes.nl/2020/05/07/ns-scraps-group-discounts-bans-bikes-trains-prepares-travelers[/url], [url]https://nltimes.nl/2020/05/07/social-distancing-two-thirds-dutch-notice-others-getting-close[/url]

DJ-The outcome may be that in the NL the most vulnarable will seek self-isolation with very limited help from authorities. The "gamble" is R0 will stay below 1-if cases rise more restrictions. The idea is there will be more testing-but so far the number of tests per million in NL is at the same level as that of countries like Peru. [url]https://www.worldometers.info/coronavirus/[/url]

[url]https://www.worldometers.info/coronavirus/country/netherlands/[/url] Reporting of cases is far from optimum. There is an uptick every tuesday since then the weekend numbers come in. Very likely there is major undereporting. 

[url]https://www.rivm.nl/en/novel-coronavirus-covid-19/current-information-about-novel-coronavirus-covid-19[/url] looking at the map still the old pattern of most cases in the South-East. 

DJ-We have to do with this-limited testing, limited statistics, very limited PPE, Do-it-yourself masks in public. Our economy/industrial production will decrease 7,5% Q1-EU average =9%. Maybe this is the best scenario ? NL now at place 16 in worldometers list-a week ago at place 10. But we may be doing it "a little bit less worse" than some other countries not that much better.

A lot of people doing "vital jobs" get minimum wage in NL (10€ p/h). We have minimum wages since 1968-then it was enough to pay for a family-now it covers only 42% of the costs-corrected for inflation-it then covered. Trade Unions want better minimum wages (it would be nice if they also discussed maximum wages. Politics now discussing support for KLM-Dutch airlines. They do not want taxmoney for bonusses, buy-backs and high saleries for the overpaid. It is a good thing they are at least somehow thinking of what role aviation has to play in future. Why tax on gas-for-cars but not for kerosin-for-planes ? AVT etc on airliners. 

DJ Although the official numbers in NL have been going down [url]https://www.worldometers.info/coronavirus/country/netherlands/[/url] there are still problems both in testing and PPE in lots of carecenters. 

[url]https://nltimes.nl/2020/05/11/schools-hairdressers-reopen-nl-eases-coronavirus-lockdown[/url] In my opinion "we" have to be very carefull. In Germany the R0 now has moved above 1-a "slow spread". 

A cynical view could be that support for NPI/lockdown is decreasing so a certain increase in cases may provide new support for NPI. I hope that is not the basic idea. Both Dutch and German virologists warn for a second wave (although that is the job of epidemiologists). [url]https://nltimes.nl/2020/05/09/second-coronavirus-wave-horizon-experts-warn[/url]

In other Dutch news;

[url]https://nltimes.nl/2020/05/09/ancient-volcano-discovered-dutch-seafloor[/url]

and [url]https://nltimes.nl/2020/05/10/three-n-s-americans-arrested-eu10-million-crystal-meth-bust[/url] A 37 y/o US, 29 y/o Mexico and 19 y/o Columbia man were arrested in a crystal meth bust-not far from Arnhem-production meant for Eastern Europe. 

From [url]https://www.gelderlander.nl/arnhem/rijnstate-en-philips-gaan-coronapatient-volgen-met-slimme-pleister-vol-sensoren~a9e69c01/[/url] via google translate;

Rijnstate and Philips will follow a corona patient with a smart plaster full of sensors

ARNHEM - Rijnstate Arnhem Hospital will monitor corona patients after discharge from the hospital. It will do this, among other things, with smart plasters full of sensors. They measure and pass on a person's heart rate, blood pressure and temperature.

To this end, the hospital is working together with Philips, healthcare provider DrieGasthuizenGroep in Arnhem and the regional general practitioner organization Onze Huisartsen, which is active in Arnhem, the Betuwe and the Liemers. Corona patients can be monitored remotely by combining measurements with portable sensors and questionnaires, says Wim van Harten, chairman of the board of Rijnstate. Through measurements of vital functions by portable sensors on the patients' bodies, doctors assess which corona patients need (additional) care. The test with sensors was previously announced, now it is being used for the corona patients. More complete picture These patients are located outside the walls of the hospital, for example in a care facility of Drie GasthuizenGroep or at home. "This solution gives the treating specialist at Rijnstate or the general practitioner a more complete picture of the patient's health situation," explains Van Harten.

The sensor measures heart rate and respiratory rate. These measured values and the results of the automated follow-up questionnaires are displayed in a dashboard. In this way, Rijnstate has an overview of any trend change in the patient's health situation and healthcare providers can act accordingly, according to Van Harten.

More remote care
One of the objectives is to prevent the further spread of the coronavirus. At the same time, the approach must ensure that the hospital can resume non-corona care. “It is important that we can continue to provide care for all patients who need it, even in times of crisis. Our innovations come in handy here, ”says Henk Valk, CEO Philips Benelux.

Rijnstate is working on the clinic of the future together with Philips. In addition, hospital doctors are increasingly providing remote care.

Acceleration of digital care
The pilot for tracking corona patients started this month. Essential parts of this program are scientifically evaluated in collaboration with the University of Twente. “We want to realize innovations that are tangible. So using science and research that matters in practice, ”says Van Harten van Rijnstate.

Because of the corona outbreak, both the hospital and Philips see the need to accelerate the digitization of care.

Now THAT is smart!

[url]https://nltimes.nl/2020/05/15/slump-dutch-gdp-plunges-17-5-years-quarterly-growth[/url]

[url]https://nltimes.nl/2020/05/15/dutch-coronavirus-medicine-ready-6-months[/url]

[url]https://nltimes.nl/2020/05/15/dutch-find-coronavirus-antibodies-first-dog-3-cats-risk-mink-farms[/url]

[url]https://www.gelderlander.nl/binnenland/brabant-steunt-onderzoek-naar-luchtvervuiling-signalen-te-alarmerend-om-af-te-wachten~a64bfcc6/[/url] google translate;

Brabant supports research into air pollution: "Signals too alarming to wait"
Brabant probably allocates tons for research into air pollution. The investment has everything to do with a possible link between polluted air and the high number of corona victims in the province. In the east of Brabant in particular, the virus strikes mercilessly hard and air quality is affected, partly due to traffic, industry and intensive livestock farming.

The new, hard political contradictions went overboard on Friday evening to enable research into air pollution in Brabant. Only the PVV voted against the proposal to invest in RIVM measuring points that map air quality. The measuring points cost about a ton each to build, estimates Hagar Roijackers, GroenLinks leader in Brabant.

Roijackers is one of the driving forces behind the new research. It is still unknown how many measuring points will be added to the province, where they will be located and when. The new provincial government will start working on the assignment. Roijackers wants six measuring points. "But two is also an improvement."

"Should something happen now"
RIVM is already investigating whether air pollution contributes to the number of corona victims. A broad coalition of experts and interest groups urges the institute to hasten that research, especially now that international studies are already showing links. Brabant politics also supports this research, which may take years.

The province does not want to wait patiently for the results. "We believe that something should be done now, the signals from residents, doctors and experts are too alarming to wait," said Janneke van Kessel, D66. "We must act now and develop a concrete step-by-step plan to structurally improve air quality in Brabant."

Maarten Everling (SP) also believes that Brabant should not sit still, pending the research results. “It is striking to see that especially in East Brabant, where there is a lot of cattle, more people are sick and die from corona. I don't have hard evidence for a connection, but it is at least striking. It needs to be investigated. ” Everling also says, "We've been arguing for a long time to reduce livestock, this is an additional argument

"Really inappropriate"
Hans Smolders of the Forum for Democracy thinks it is "really inappropriate to associate corona with air pollution for political gain", as the SP said he does. "Just wait for the investigations first. And don't abuse it, ”says the party's nestor, who has officially joined the new provincial government since Friday.

Brabant and Limburg together account for almost 40 percent of the Dutch corona deaths, while 20 percent of the Dutch live in these provinces. GroenLinks, D66, SP, PvdA and Party for the Animals initially wanted to enforce that the province not only measures air quality, but also reduces emissions of nitrogen, particulate matter and ammonia. This could be done through stricter licensing and enforcement. However, the parties waived this after consultation on Friday, to ensure that the other part of their proposal would reach the finish line.

[url]https://nltimes.nl/2020/05/21/gelderland-slaughterhouse-closed-45-coronavirus-diagnoses[/url] and [url]https://www.dutchnews.nl/news/2020/05/dutch-meat-processing-plant-closed-as-45-workers-test-positive-for-covid-19/[/url] (DJ-Arnhem is the capital city of Gelderland-in the east of NL)

[url]https://nltimes.nl/2020/05/20/13-netherlands-deaths-covid-19-related[/url], [url]https://nltimes.nl/2020/05/21/forced-quarantine-possibility-governments-new-coronavirus-policy[/url]

[url]https://time.com/5836599/rem-koolhaas-architecture-coronavirus/[/url]

DJ-In NL the number of cases has dropped-but there is trend of new cases showing up more in the larger cities, Amsterdam, Rotterdam, The Hague (Den Haag) the main ourbreak center up till recent was in the South East of NL. 

With summer weather [url]https://nltimes.nl/2020/05/21/warmest-day-week-temps-28oc-expected[/url] and slowly less restrictions [url]https://nltimes.nl/2020/05/19/dutch-pm-unveils-relaxed-coronavirus-measures-june-15[/url] the number of infections may go up again. 

Also possibly more news on Covid19 in minks, ferrets, rabbits, cats etc. in NL the coming weeks.

DJ-In NL elderly in care centers have been under a two month lockdown-they were not allowed to go outside-no visitors. From today they can only get 1 visitor-1 hour-per day-and it has to be the same visitor every day. 

[url]https://www.gelderlander.nl/nijmegen/keiharde-kritiek-op-corona-aanpak-ze-hebben-alleen-doden-en-ic-bedden-geteld-alsof-dat-het-enige-is-dat-er-toe-doet~a8de9ac0/[/url]; google translate

Harsh criticism of corona approach: "They only counted dead and ic beds, as if that's all that matters"

Health minister Hugo de Jonge accuses him of "raising false expectations", virologists of "indiscretion". “They only counted dead and IC beds. As if that is the only thing that matters. "" Professor of geriatric medicine Marcel Olde Rikkert is cracking down on how the Netherlands has handled the virus so far, its elderly, and the younger generations.

The effect of the coronavirus on the elderly has not been studied. Too much has been led by some military command of ministers, IC doctors and virologists who paid too little attention to other interests. And it shows an "unprecedented lack of realism" if you really think that in the near future there will be a corona vaccine that adequately protects everyone.

Marcel Olde Rikkert has long kept his mouth outward. "But," says the professor of geriatric medicine at Radboud University Nijmegen, "there is no reason to continue to use panic scrutiny, no reason to continue to feed the story" we are in crisis. " There is now an opportunity to learn from each other. "

Two degrees lower
And he wants to contribute to the dialogue. Because many things should have been different. As with the elderly. The knowledge about that target group built up in years suddenly seemed to no longer exist. For example, it was standardly assumed that people could only have corona had a minimum fever of 38 degrees. While the standard body temperature for a very elderly person is one or sometimes even two degrees lower than for a younger person. And with an older person with 37 degrees you can sometimes speak of a relevant temperature increase.


Result: it was recognized too late that a lot of corona did occur in the elderly in nursing homes, for example. People are therefore treated later and protected later. And when a high mortality arose, there was a kind of panic reaction: they were locked, visitors are no longer possible.

In itself Olde Rikkert understands such reactions. “In the beginning there was really chaos. In chaos it is very important that you take a clear measure and it can not always be nuanced. That is not a problem at all, but you need to make adjustments quickly. "

You quickly fail large groups of people
But that has not been done, according to Olde Rikkert, caused by the "chain of command" that addressed the problem with the coronavirus. ,,, They only counted dead and IC beds. As if that's all that matters. But you quickly fall short of large groups of people by mastering only one discipline, in this case letting the hospitals, intensive care, take the lead. "

He failed to look at what could be learned abroad. “You saw in Italy that a lot of people did not survive and in the care homes there were hot spots for the virus. Then you can also start thinking: this can also affect us and what do we do with our concentrations of elderly people in nursing homes? Due to the dominance of the chain of command that was aimed at intensive care, this was looked at far too late. "

And there is still insufficient attention, says Olde Rikkert. ,, Especially when you realize that there is so much mortality in the elderly, that in people aged 80 and older the death percentages rise to 30, 40 percent, then you also have to think: how are we going to arrange this properly with palliative care? How do we ensure that the people who are admitted do not die in isolation? How do we ensure that people who are not allowed to receive visitors do not become socially isolated? "

Marcel Olde Rikkert
Olde Rikkert thinks that this has not been sufficiently looked at. ,, In a kind of military organization in which the crisis has been tackled, people often don't listen very well. Then it is very difficult to get through to the captains and make it clear: what I see here could really be better. Really, I am convinced that everyone had the intention to do it as well as possible. But there is little sensitivity to what seems to be something out of the sight of the storm. "We must ensure that the IC remains upright," that was the goal. But of course that can never be the goal. The aim is to provide good care and to fit what you encounter in practice.

Counting dead is easy, and then mortality seems to be the only thing that matters in this period. While you also have to look at effects on quality of life, quality of dying: you also have to consider the final phase of life. You are very narrow if you are only talking about the numbers that die and do not ask yourself: how is that going? Are the people well prepared, has there been enough dialogue, are they not lonely, does the family know how to deal with it? I think, also globally, we have unfortunately often been too short-sighted. Everyone has stepped into the heroism of the disaster, especially considering that death counter. "

No timely concern
For example, the observation of general practice that there was a decreasing demand from patients about other problems was not heard. Now figures from excess mortality show that thousands of people may have died because they did not go to the doctor with, for example, heart complaints. "About two hundred thousand heart patients in the Netherlands did not receive timely care as a result of the corona outbreak," said the Dutch Association of Cardiology last week. "This leads to premature death and loss of quality of life for tens of thousands of cardiovascular patients."

Olde Rikkert: "Those signals were there much earlier." But what he says is missing is intelligent leadership. “Intelligence is using as many different insights as possible and making the best choice together. Intelligence is not one person or a very select group continuously mandated to decide everything. "

You are suddenly the boss
While there has been too much reliance on experts who do not properly estimate the complexity of the pandemic. “Those experts don't have a crystal ball either. But don't sufficiently realize that they should be more modest. That is not in them and there are also all kinds of temptations that make modesty difficult: you are suddenly in charge, are in the spotlight, the research money is for the bragging rights ... That is a dynamic that we have not realized. "

And that may bother us now. “Look at the dynamics of the money. A jar of honey has been placed outside, which means that people in corona research are now perhaps doing in a thousand places worldwide. That is not sensible, for the most part does not become good scientific research: too small, too quickly twisted together. The history of virus vaccines teaches us that it is very difficult to realize an effective vaccine. For example, we have so far not been able to make influenza vaccine that is sufficiently effective for the elderly, for example.

That we can only organize events again when there is a vaccine, as Hugo de Jonge says, is ventilating something that is not realistic, it is arousing the wrong expectations. If you have a desire to protect vulnerable groups, you have to realize that it will not work soon. Certainly not if you allow too much small-scale research, while it requires large studies, the association of people, the collection of expertise. It requires scientists who step over their own shadow, who do not necessarily want to do their own research. But that approach is difficult for us. And it becomes even more difficult if we let ourselves be rushed by the public opinion that asks for fast quickly quickly. "

Fear of electoral loss
Olde Rikkert understands that it goes like this. "In politics, of course, there is fear of electoral loss, of hassle in the Chamber, of populist parties that shout" you are going to let people die. "" But the "narrow view" does not do justice to the elderly.

“It turns out to be very difficult for people who are not in elderly care to realize that people do not fear death themselves. If you are used to fighting death, if that is your daily activity in politics or health care, it is difficult to recognize that the question being asked is another. That the patient may not mind dying, but is concerned about the way. "


“The most intelligent general rule for aging better and healthily is to keep moving, both socially and physically. And what do we do with our so-called intelligent lockdown? We are going to limit the room for maneuver very much. That is an intervention that you know will cause a lot of damage, both in a physical and social sense. You see the condition of people deteriorate, you see the muscle strength decreases, you see the appetite decreases. People become more vulnerable precisely because of the intervention. The well-being of the frail elderly is the most important thing to keep in mind. And what is happening now is what you shouldn't want. As long as you keep denying that ... "

Not forbidden for a moment
He calls the experiments in the nursing homes, where some visitors are spared, "too slow".

“In the Radboud university medical center, our geriatrics department has never banned older people from receiving visitors. However, it is limited to one known person per day and strict precautions. I do not see why you cannot work in the nursing home with the same measures. I would say: talk to hospitals, share their experiences, how they have protected their elderly. But anyone who claims that the pandemic made all specialties work well together ... That is what the people who pull the cart say, but they do not see that there is also a large group that is not involved at all. "

Olde Rikkert calls for a short breather. “Look at what happened to us, and look at what you can now learn from what is happening together. Then you are more effective than now. And realize that we are now in control, but that new cases are constantly being added. That is also part of life. People get sick and die. But we can also learn to see how it goes. "

DJ-A lot of cases/deaths in NL are related to care centers. [url]https://nltimes.nl/2020/05/25/nursing-homes-using-sub-par-mouth-masks-large-scale-report[/url] And then there are several problems;

-lack of testing, sometimes people with healthissues are told to come to work/shortage of staff

-lack of PPE, out-of-date masks, sometimes just dusk-masks are used for a long time

-some carecenters have airco's limited possibility to open windows

Under these circumstances one has to question if the used policies were realy meant to protect the people that lived inside those centers or just "act like politics is doing something usefull". In most countries the policies in care centers did not prevent cases/deaths being above what one may expect based on statistics. 

If lockdowns were meant to save those people with vulnarabilities the policy failed. In many places lock downs did reduce the R0, saved the ICU-capacity from being overrun. 

[url]https://nltimes.nl/2020/05/25/147-employees-gelderland-slaughterhouse-tested-positive-coronavirus[/url] DJ-We knew that meat-production was high risk-why was there no action earlier ? How can it be a lot of workers are untraceable ? [url]https://nltimes.nl/2020/05/24/emergency-covid-hospitals-rotterdam-maastricht-rushed-nobody-pay[/url]

[url]https://www.dutchnews.nl/news/2020/05/frugal-four-including-the-netherlands-present-eu-recover-plan/[/url] DJ-We are still in the early stages of this pandemic. Why there is no plan on what bussinesses have a future and what do have no future-a lot of money will go to companies that only will delay their bankruptcy.

Black Lives Matter-also in NL !

[url]https://nltimes.nl/2020/06/02/adam-mayor-criticized-massive-anti-racism-protest-potential-super-spreading-event[/url] and [url]https://nltimes.nl/2020/06/02/calls-anti-racism-protesters-self-quarantine-unnecessary-says-virologist-adam-mayor[/url], [url]https://nltimes.nl/2020/06/02/hague-discussion-organizers-tuesday-black-lives-matter-protest[/url]

[url]https://www.dutchnews.nl/news/2020/06/amsterdam-mayor-under-fire-for-not-intervening-at-anti-racism-demo/[/url]

Minks

[url]https://www.dutchnews.nl/news/2020/06/coronavirus-found-on-more-mink-farms-taking-total-to-eight/[/url] (DJ-In earlier reporting the story was one farm had 50 people working there-if that would be an average 400 workers would have been exposed). There is an illnes in Dutch hedgehogs in the area were also the minks are kept. More on hedgehogs in general-and by eating everything their vulnarabilty [url]https://www.wildlifeonline.me.uk/animals/article/european-hedgehog-mortality-parasites-diseases[/url] It does not have to be Covid19-may be coincidental this "strange disease in hedgehogs"is in the same area. 

Religion

[url]https://nltimes.nl/2020/06/01/second-hague-mosque-closes-coronavirus-outbreak[/url], (There are still limits to the number of people allowed in a church, mosque or synagoge-also no choirs/group-singing)

Public transport

[url]https://nltimes.nl/2020/06/01/mouth-masks-compulsory-public-transit-today[/url] (From june 1 also restaurants are allowed to go to 40% of their capacity-social distancing, only on reservation etc.)

History

[url] https://www.dutchnews.nl/features/2020/05/leiden-400-commemorates-the-journey-of-the-pilgrim-fathers/ - https://www.dutchnews.nl/features/2020/05/leiden-400-commemorates-the-journey-of-the-pilgrim-fathers/ [/url]

DJ-Good development [url]https://nltimes.nl/2020/06/05/dutch-governments-coronavirus-dashboard-launched[/url] also regional info [url]https://coronadashboard.rijksoverheid.nl/regio?regio=VR07[/url].. 

More testing is more (positive) cases [url]https://www.dutchnews.nl/news/2020/06/positive-coronavirus-test-total-shoots-up-as-testing-is-expanded/[/url]

[url]https://www.rivm.nl/en/news/corona-crisis-has-limited-impact-on-infant-participation-in-national-immunisation-programme[/url]

[url]https://www.dutchnews.nl/news/2020/06/doctors-find-link-between-covid-19-complications-and-lack-of-vitamin-k/[/url]

[url]https://nltimes.nl/2020/06/05/government-may-step-rescue-hema-report[/url]

[url] https://www.dutchnews.nl/news/2020/06/encourage-working-and-studying-at-home-post-covid-19-think-tank-says/ - https://www.dutchnews.nl/news/2020/06/encourage-working-and-studying-at-home-post-covid-19-think-tank-says/ [/url]

Non corona-news;

[url]https://www.dutchnews.nl/news/2020/06/ruttes-recognition-of-systemic-problem-of-racism-is-a-watershed-moment/[/url] and [url]https://nltimes.nl/2020/06/05/dutch-pm-now-thinks-differently-blackface-zwarte-piet[/url] (DJ-Here in NL we have "Sinterklaas" [url]https://en.wikipedia.org/wiki/Sinterklaas[/url] on december 5. This "Sint"has black (colored) helpers (sometimes in slave like dresses/with slave rings). It come up in the 19th century-before that it was seen as "catholic" lot of protestants were/are against it for that reason. Now the "black helper" Zwarte Piet (Black Pete) is seen as racist-eventhough a lot of Dutch did not have racist intentions with it. A compromise coming up is "roetveeg Piet"-a white person with some black soot from the chimney. In the US Sinterklaas became Santa Claus. The origins of Sinterklaas (with helpers, rendeers etc) goes to Wodan or [url]https://en.wikipedia.org/wiki/Odin[/url] the timing has to do with winter turning/longest night.)

[url] https://nltimes.nl/2020/06/05/anti-racism-protests-utrecht-nijmegen-enschede-today - https://nltimes.nl/2020/06/05/anti-racism-protests-utrecht-nijmegen-enschede-today [/url]

DJ - I know you follow Peak Prosperity really heavily - do you remember the episode about how to develop 'gold standard testing' and how none of those protocals were followed for this virus?

Ever since watching that I take all test results with a grain of salt (for better or worse) as I don't really feel they have any idea what they are actually testing for - is the test even finding c19 specifically or just any coronavirus or ….   

I'm not doctor - but that video has seriously made me question test results.   

Newbie1A-I am also not a doctor-I do think testing for antibodies may be a bit more reliable-but even there one has to ask what it does mean. Do antibodies provide immunity (for all present strains of Covid 19) and for how long (a moth or two would completely change the picture. Make those test almost pointless-but the best may be antibodies only provide some protection for a matter of years. Maybe someone with more medical knowledge could answer that issue ? In a cold-causing corona infection how long does immunity last ?)

Some news from NL; 

[url]https://nltimes.nl/2020/06/06/new-covid-19-law-will-keep-emergency-restrictions-longer-leak-reveals[/url] For now there has not been that much of a discussion on the need for certain measurers. Trade Unions would like to include a right to work-from-home if possible. Also more growing resentment against "locking people up" in care centers for months while reopening restaurants, travel for most others. 

[url]https://nltimes.nl/2020/06/06/culling-mink-covid-19-fears-begins-activists-lose-court-hearing-thousands-put[/url] Dutch newspapers mention culling at ten, maybe 11 farms-so the number of infected farms would have grown (but stayed out of the news). I can not find-yet-news on hedgehogs, cats being infected/spreading-yet. 

[url]https://www.dutchnews.nl/news/2020/06/farmers-call-for-more-scope-to-bring-in-non-eu-seasonal-workers/[/url] A few fruit processing workplaces did see an outbreak last week.[url]https://nltimes.nl/2020/06/06/coronavirus-outbreak-gelderland-fruit-firms-11-employees-infected[/url] Just like in the meat"industry"-a lot of (some illegal-so cheap-in NL) foreign workers in crowded houses, sharing overcrowded busses and working close together.  [url]https://nltimes.nl/2020/04/21/fewer-people-eating-meat-daily-vegetarians[/url] DJ-Eating less meat will become a global trend-and at least for some part decrease healthrisks. 

[url]https://nltimes.nl/2020/06/04/dutch-ambassador-nigeria-leaked-confidential-info-shell-report[/url] DJ "corruption Dutch style". 

[url]https://nltimes.nl/2020/06/12/coronavirus-infections-verge-rising-disease-modeller[/url]  ;

The coronavirus reproduction rate - the number of people a coronavirus patient infects - in the Netherlands is slowly rising to above one, according to Jacco Wallinga, the top infectious diseases modeller at public health agency RIVM. He said in an interview with newspaper Trouw that he worries the virus will flare up again. 

In the first month of the coronavirus outbreak in the Netherlands the reproduction factor was about two and the number of infections doubled every four days. Lockdown measures implemented in mid-March brought that number down to below one, which means that on average someone with an active infection passed it on to less than one other person allowing the number of new patients to decrease.

As the lockdown measures relaxed, the government took into account that the infection rate would increase again. But the discipline to stick to physical distancing measures that are still in place is also deteriorating, Wallinga said. "People do not stick to the basic rules," he said. "I hope that with the source and contact investigation of the GGDs we can get the [infection rate] back down," he added.

"If not, I see the number of infections and hospital admissions increasing again this summer."

The government's data-driven https://nltimes.nl/2020/06/05/dutch-governments-coronavirus-dashboard-launched" style="text-decoration: none; color: rgb(153, 5, 0); - coronavirus dashboard will sound the alarm if any one of three things happen: if more than ten new coronavirus patients are admitted to ICU for three consecutive days; if more than 40 new patients are hospitalized; or if the infection rate rises above one. It is the government that decides what to do when that alarm sounds.

Timely action is necessary, Wallinga said. The number of infections is low now, so the Netherlands can cope with a reproduction rate above one for a while. "But we saw in march that the peak was yet to come when the lockdown had already started. We cannot let a resurgence take its course."

[url]https://www.dutchnews.nl/news/2020/06/coronavirus-takes-a-shocking-toll-on-health-patient-survey/[/url] ;

People who have been infected with coronavisrus but were not admitted to hospital are struggling with severe effects on their health months after first falling ill, a survey by the respiratory disease organisation Longfonds has shown. Some 95% of the 1,600 respondents, of whom 91% were not admitted to hospital and 43% were never officially diagnosed, said they have trouble with normal day to day activities three months after being infected. Persisting symptoms include tiredness, shortness of breath, headaches, muscle pain and heart palpitations. The average age of the respondents is 53. Most of the respondents, some 85%, said they had no health problems before the infection. That number dropped to 6%, with almost half of the respondents unable to resume physical activities like sport. Longfonds spokesman Michael Rutgers said the results are shocking. ‘This is a large group of corona patients who are sitting at home and who really need help. They are in a terrible state. (..) Six in 10 people even have trouble walking. These are normal, healthy people who are now wondering if they will ever be well again.’

[url] https://nltimes.nl/2020/06/12/shocking-nearly-recovered-covid-19-health-issues-months-later - https://nltimes.nl/2020/06/12/shocking-nearly-recovered-covid-19-health-issues-months-later [/url]

[url]https://nltimes.nl/2020/06/12/coronavirus-must-push-health-insurance-premiums-higher-green-party[/url] ; 

Health insurance premiums must not rise as a result of the coronavirus crisis, according to GroenLinks. The green party is submitting an emergency law to prevent the bill for this crisis ending up being paid by citizens. According to the party, big business can cover this bill by scrapping  https://nltimes.nl/2019/09/17/budget-day-leaks-know-far" style="text-decoration: none; color: rgb(153, 5, 0); - plans to lower profit tax , RTL Nieuws reports.

The coronavirus crisis had a massive impact on healthcare providers. Hospitals had to incur many extra costs while regular, income bringing care was brought ot a near halt. Other healthcare providers like dentists and physiotherapists also lost turnover. Health insurers https://nltimes.nl/2020/04/22/insurers-jump-aid-hospitals-facing-financial-trouble-due-covid-19-crisis" style="text-decoration: none; color: rgb(153, 5, 0); -  helped compensate for the missed income .

According to healthcare economist Wim Groot, Netherlands residents can expect to see that reflected in their health insurance premiums. He expects that annual premiums will be an average of 150 euros higher next year, he said in the Zorgvisie magazine. 

not good DJ....

Not good at all.....

take care....

I agree carbon20-not good. Worse even no discussion on what to do. Airtravel will use facemasks and AC-filters-but economy goes for safety. 

[url]https://nltimes.nl/2020/06/12/survey-shows-22-washing-hands-toilet-use-covid-19-deaths-tops-6050[/url] There is a lot of denial here as well. 

Old people in care centers are not allowed to go outside since March 20-while there were no test available for care workers-at least that was the political story. Testing facilities claim there was room for testing. HCW in care centers were told to do their job-even with some healthissues-did infect lots of patients (that also often did not get tested-so not in the Covid statistics). 

We are on the same road as some US states-support for NPI is very limited. Those most vulnarable must take care for themselves...

Far from herd immunity

"BBC Live News" wrote: Since 1 June, everyone in the Netherlands with suspected Covid-19 symptoms has had the right to get tested. Between 1 and 15 June, more than 113,800 tests were conducted at the GGD (local health authority) sites and 1.7% showed up positive.

DJ-Testing in NL has been a problem for all of this outbreak-untill recent there was a shortage in testing. Last week we came to the point there was more testing capacity then people who wanted/needed to be tested. Often people believe they have a cold-not Covid19-so why testing. 

[url]https://www.dutchnews.nl/news/2020/06/mass-covid-19-testing-identifies-sharp-region-differences/[/url] Some regions did have a problem-first SE NL carnaval related-also winter holliday was linked to carnaval-so lots of imported cases from Austria, Northern Italy. Second was most the major cities, The Hague, Amsterdam-with more international travel. 

The Northern NL was hardly effected by Covid19-some church-going regions did see outbreaks. 

[url]https://nltimes.nl/2020/06/16/05-children-12-tested-positive-covid-19-death-toll-6070[/url] We did see lots of restrictions lifted-with that the R0 moving dangerously close to 1 again. The outlook will be some restrictions may get in action again/lifting will be delayed.

Since NL is far from an island-we need international travel-there is a high vulnarability there still. Also the mink-infections at-at least 15 farms-with over 600.000 minks culled-remains a problem.

[url]https://www.dutchnews.nl/news/2020/06/the-hague-mayor-bans-anti-coronavirus-rules-demonstration/[/url] leads to [url]https://nltimes.nl/2020/06/21/clashes-police-protest-covid-restrictions-covid-19-death-toll-6090[/url] 

DJ-There were all kind of groups-most of them peacefull. Some of them think Covid19 is non-sense, some of them protest against emergency laws-limiting basic freedoms. Than a bunch of football/soccer hooligans showed up "to fight with the police". 

DJ There is fierce opposition, protests against Dutch measures to deal with Covid19. Another protest-with possibly 50.000 protesters is expexted sunday june28 in The Hague. I do not agree with most of what they say or do-I think we have to take the virus very serious-but I want to understand their view. [url]https://www.dutchnews.nl/news/2020/06/three-more-corona-deaths-rivm-to-move-to-weekly-reports/[/url] The protests again are banned-but the behaviour and thinking behind it can not be banned. You need better communication not more police to deal with these kind of protests. 

From [url]https://viruswaanzin.nl/over-ons/[/url] virus lunacy/about us; 

Who are we? Willem Engel has made a scientific career as a Bio-Pharmaceutical scientist after graduating from Leiden University in 2001. [1] In 2008 he left the world of science. Since then he teaches dance in his own studio DA Dance Studio in Rotterdam. Mr. Jeroen S. Pols graduated in 2003 with a specialization in criminal law. Since then he has mainly conducted administrative and civil proceedings. For the past 17 years, he has litigated against governments that are not so keen on laws and regulations. The numerous procedures surrounding the RIECs have regularly attracted attention in recent years. The focus of the procedures is on the illegality of the integrated approach, whereby the cooperating authorities structurally override laws and regulations and violate civil rights. What do we want? We fight for the preservation of a democratic constitutional state in which our children also have the opportunity to develop freely and to live a life with their own convictions and opinions. These freedoms and fundamental rights have been increasingly jeopardized in the past decade. We see the COVID-19 crisis as a quantum leap in this worrying development. We believe that conducting legal proceedings against governments is an effective tool in this battle. We have noticed that many judges try to do their job well, but unfortunately the judiciary is also not insensitive to the increasing influence of the government. Being right does not mean being right. However, we believe that litigation is still an effective means. Why? Our lack of critical questions from parliament, regulators and the media hides our policymakers time and again behind inconsistent and unmotivated statements. This is not possible in court. The government will have to defend itself substantively on all arguments we have put forward. And this is of great importance in the COVID-19 case: even if our claims are rejected, she is forced to account for the first time for the content of her policy. And with that, we believe that this battle ultimately leads to victory inside or outside the courtroom.

[url]https://www.volkskrant.nl/nieuws-achtergrond/op-de-dag-dat-het-rivm-nul-doden-meldde-stierf-verpleegkundige-boy-ettema-aan-corona~bf67bcd7/[/url] google translate;

POSTUUM BOY ETTEMA (1978-2020) On the day RIVM reported zero deaths, nurse Boy Ettema died of corona

Boy Ettema, a surgery nurse who worked in the Covid department, was healthy, cycled a lot, was not overweight and was only 42 years old. However, he died of corona on the first day that RIVM reported zero deaths. Thomas Borst and Maud Effting5 July 2020, 5:02 PM For RIVM it was a question of statistics, of simply adding up all reports. And they never came that day. But for Boys' family, the RIVM statement came as a blow to the face. It felt as if the death of Boy, a surgery nurse who had worked in the hospital's covid ward for many weeks, was ignored. As if he didn't matter. It was the reason that Boy's brother called Thomas de Volkskrant. Because the ice-cold statistic with those zero kills - that's the big story. But there is also another reality. Boy Ettema is the youngest healthcare provider in the Netherlands who died of corona at the age of 42 - a total of thirteen died. He was healthy, cycled a lot, was not overweight and did not smoke, his girlfriend said.

It is mid-May when the surgery nurse returns home from his covid service at St. Antonius Hospital in Nieuwegein in the evening. That day he helped a critically ill patient who had unexpectedly coughed in his face. He felt something in between his glasses and mouth mask.

"I have the idea," he said anxiously to his girlfriend, who is also a nurse, "that I was infected today."

At home they have been kept apart for weeks. They don't meet anyone and she does the shopping. Boy warns everyone to watch out. "Even if they arrange things differently at work, please stay at home," he tells his brother.

Two days later, he wakes up on a Tuesday with a high fever and headache. He sees flashes before his eyes. The stuffiness doesn't start until a few days later. "I'm deathly ill," Boy says to his brother Thomas. "But don't worry too much. It will be fine.'

His brother Thomas had previously asked him if he would do those covid services. "It has to be done," Boy replied. He felt it his duty to contribute. He sends cheerful photos of himself in a corona dress to his friends and family.


That nice brother
Boy Ettema is a striking appearance in the surgery department of the St. Antonius Hospital. His laughter is loud, he talks a lot and makes contact with patients quickly. Sometimes they ask specifically for "that nice brother". If there is a difficult patient, Boy is put on it. At home he is cheerful, gentle and caring, says his girlfriend Lizahn (31), whom he proposed to him last March and with whom he was engaged. Boy doesn't care about money, stuff or status; he prefers to spend time with nature, with friends, reading newspapers and books, doing fun things. He is concerned about inequality in the world. At the age of 35, he studied nursing after studying sociology. It turned out to be a golden move. He wanted to mean something to others, his brother says.

He is at home for days, where he is getting sicker. His girlfriend Lizahn calls the GP post three times. "I said Boy was getting exhausted," she says. "But the doctor brushed us off and said, well, he still speaks full sentences. We could come to a fever of more than 41 degrees. I felt we weren't taken seriously because Boy was still young. "

On day eight, Boy says, "This is really not good."

Within fifteen minutes they drive urgently to his own hospital, where Lizahn can see him that day. "I'm scared," says Boy, lying in bed panting. It's all he can say. His blood still contains 80 percent oxygen.


Lizahn: "He knew exactly how it could go. He should have taken so many people to the morgue himself. His greatest fear was the IC. "

The following night she is woken up at half past four with his telephone number. In the picture is a nurse. "It really is no longer with Boy," he says. "We have to intubate him now."

Then she sees Boy lying there, gasping for breath. He says he loves her. And that he is afraid. He has to cry, but it only makes him more anxious. Lizahn can say just a little before the nurse says the phone. Lizahn drives to the hospital as fast as she can, but when she arrives, he is already asleep.

This isn't really happening, Lizahn thinks. She feels that he can walk around the corner laughing any moment.

His brother Thomas arrives without being able to say anything to his brother.

Heart lung machine
The nurse is in his own intensive care unit for sixteen days, while his lung pictures get worse and his family hardly sleeps anymore. Doctors and nurses at the ICU skip breaks, work longer, do everything for their colleagues. Lizahn and her family receive extra visiting hours. It always seems to go better, but he always gets a backlash. "I thought a thousand times he was going to make it, and a thousand times he would die," says brother Thomas. Because his lungs can't make it, he is put on the heart-lung machine, where the blood gets oxygen outside the body and blood thinners are needed.


It is June 22 when Lizahn receives a call from an IC doctor at a quarter to five in the morning. "He said it was a good idea that I would come and asked if I wanted to call his parents and brother," she said. "Then I knew: this is wrong. I've worked here long enough to know that. "

That night Boy had a massive cerebral hemorrhage with major brain damage as a result. He doesn't respond to anything anymore. The doctor says that the state of his brain can no longer be reconciled with life. There are tears in his eyes. That morning he struggled to enter the department, he says. Lizahn drops through her legs when she hears that. "This just can't be true," she says.

"Then you know," says his brother Thomas, "that your brother is dying."

It is three o'clock in the afternoon when the doctor switches off the heart lung machine and the other devices in the presence of family and friends. In the room, someone plays Guns N 'Roses on the guitar: Boy was a fan of punk and hard rock.

While his girlfriend Lizahn is holding him, his heart beats for another two minutes. In the room it becomes very quiet. Nurses cry in the hallway. Afterwards, Lizahn barely manages to leave him.

Boy's motto was memento mori - remember to die. "He was always aware," says his brother Thomas, "that life could just be over."

The next morning, Boy's father reads the news. "Zero corona deaths for the first time," it says.

It is sad....  I can see the emotional problem with the delay in updating statistics, especially if the health department trumpted the idea of zero deaths.

But it seems to be a hard concept to grasp that what is published is a trailing (ie after the time) indicator.  We saw a lot of this on this site at the beginning of the pandemic with people arguing that because the numbers were low "it was not bad", not realising that they had to wait for the statistics to catch up with the reality.

Very moving story Josh, thank you for sharing.

DJ-[url]https://www.rivm.nl/en/novel-coronavirus-covid-19/current-information[/url] The way they bring the info needs a translation: we may be at the start of a second wave in the Netherlands. Schools are closing-people going away for trips-most in NL but there are even "lover-meetings" in Aruba. Persons from the EU and US can meet there-and of course a relationship between persons with a mixed EU-US background is "complicated" these days. 

Still-if it is on me-there would be travelrestrictions worldwide. The major problem is no strict rules so problems are not being solved. 

From the Dutch CDC/RIVM: 

14-07-2020 | 14:00 PM

Weekly COVID-19 update: 8-14 July 2020

534 new COVID-19 infections were reported over the past week. Hospital admissions for 16 patients due to COVID-19 were reported (current or previous). 8 deaths were reported. Not all of the reported hospital admissions or deaths occurred within the last week. Some patients are reported later. For this reason, the figures are often supplemented with previous reports that had not yet been included.

In the past week, the number of reports of COVID-19 infections increased with 102 compared to the previous week. At that time, 432 new COVID-19 infections were reported.

Since 1 June, anyone with symptoms can get tested. However, it is possible that not all people with COVID-19 infections will request a test. The actual numbers in the Netherlands are therefore probably higher than the numbers stated here.

Minor local outbreaks

Throughout the country a number of small local outbreaks (clusters) with infections are visible. These small clusters of three or more infections are now more visible because the number of infections is considerably lower than in the months March to May. Usually we find these clusters in the household- and family setting. In addition, local outbreaks are also visible in, for example, businesses, nursing homes, student homes or sports clubs.

With the easing of the restrictions and the holiday season approaching, international travel traffic is also picking up again. As of this week, the travel history will be included in the  https://www.rivm.nl/documenten/wekelijkse-update-epidemiologische-situatie-covid-19-in-nederland" style="box-sizing: border-box; color: rgb(1, 104, 155); text-decoration: underline; background-color: transparent; - weekly epidemiological report (in Dutch).

(the map gives an indication of how Covid19 did spread) 

[url]https://nltimes.nl/2020/07/14/new-covid-19-report-shows-8-deaths-16-hospitalizations-69-test-positive-travel[/url], [url]https://nltimes.nl/2020/07/14/mayors-prepping-second-covid-19-wave-necessarily-nationwide-lockdown[/url] and [url]https://nltimes.nl/2020/07/14/netherlands-still-pushing-eu8-billion-fossil-fuel-industry-annually-environmental[/url] 

[url]https://www.dutchnews.nl/news/2020/07/prinsjesdag-festivities-cancelled-for-the-first-time-since-1904/[/url]

PP; case, case, cluster, cluster, boom-we seem to be in the cluster, cluster phase

DJ-From [url]https://www.worldometers.info/coronavirus/country/netherlands/[/url] how numbers are creeping up again-wonder when some "authority" will say something more usefull then that the numbers are "not alarming". Playing stupid, closing their eyes-experts showed their expertise in getting us into a pandemic in february. They will do that again without losing their job ? 

(last week new NL tested cases with july 14-15 a mix of counting=average 60)

july 20 185

july 19 144

july 18 127

july 17 103

july 16  99

july 15 106

july 14  53

[url]https://www.dutchnews.nl/news/2020/07/coronavirus-daily-infections-rise-while-concerns-raise-about-accuracy-of-dashboard/[/url];

Daily coronavirus infections have risen by the highest daily amount in a month, while some researchers raised concerns that the official ‘coronavirus dashboard’ is not registering all instances. On Monday, the RIVM reported 185 new positive tests, on Sunday there were 144 while on Saturday there were 127, reports NOS. Andreas Voss, a professor of infection prevention at Radboud teaching hospital in Nijmegen, and member of the Outbreak Management Team, told NPO Radio that the rise was ‘to be expected after relaxing the lockdown’ and predicted more hospital admissions in four or five weeks. However, Marino van Zelst, a student at Tilburg University, told the NRC that he believes 264 too few infections have been measured this month by the dashboard. The paper reports that this dashboard is judged a crucial weapon by the government to measure how far to continue relaxing controls – or whether to impose new ones. Van Zelst claimed that the problems were related to corrections of previous faults in the numbers. A spokesperson for the RIVM confirmed that there are corrections of the numbers, but told the paper that the number of positive tests reported depended above all on people’s willingness to get the test. Last week, the RIVM reported that more than eight in 10 Dutch people with cold symptoms are not requesting a corona test, although a fifth are staying home.

DJ-Things could go fast in NL [url]https://www.ad.nl/binnenland/vrees-voor-enkele-honderden-coronabesmettingen-na-uitbraak-in-cafe-hillegom~adcc3073/?referrer=https://www.gelderlander.nl/binnenland/live-ggd-directeur-vreest-honderden-besmettingen-hillegom-trump-vindt-mondkapje-nu-patriottisch~af1dcac6/[/url] google translate/part;

The local outbreak of the coronavirus in Hillegom in South Holland has become much larger than initially thought. The 23 people who contracted the coronavirus in a local cafe may have infected "several hundred" others. Director Sjaak de Gouw of the GGD Hollands Midden fears this. He calls it "disturbing". He said that today in the radio program News and Co.

All residents of the site who tested positive for Covid-19 have investigated the GGD where they have been. Café De Kleine Beurs emerged as a common source. They also check with whom they have had contact in recent days. ,, That turned out to be disturbing. A number of people continued to work with minor complaints, ”says De Gouw. ,, That is in our genes, that we are not faint and just start working with a nose ratio or cough. But in this case it means that these people have many close contacts. Because if people have been to work and interacted with other people there, we must all follow those people. And then you are soon talking about a multiple of those 23. "

DJ-Today another 163 new tested cases in NL. R0=1.29, 19 new hospitalizations, 7 new tested deaths in 1 week. With many people on holliday that will return with various forms of Covid19. Putting the economy first-by the government-gives the same results in NL as in the rest of the world-a disaster !

[url]https://nltimes.nl/2020/07/21/covid-19-rise-sign-possible-second-wave-wake-call-says-expert[/url];

News of an  https://nltimes.nl/2020/07/21/nearly-thousand-test-positive-covid-19-big-increase-last-week" style="text-decoration: none; color: rgb(153, 5, 0); - alarming increase in the number of SARS-CoV-2 infections in the Netherlands must serve as a reminder to people to remain cautious and vigilant, said Aura Timen, the head of the Center for Infectious Disease Control. She said her team feared people have become too cavalier and were ignoring the prevailing advice, including maintaining a safe physical distance of at least 1.5 meters from others.

She noted the "significant increase" in every benchmark which measures the spread of the novel coronavirus responsible for respiratory illness Covid-19. It includes the near doubling of positive tests for the virus recorded last week, the rise in the percentage of people getting a positive result out of all those who were tested, and the rise in the basic reproduction number of the virus to 1.29, which means that every 100 infected patients will likely pass the virus on to 129 others.

"If this continues, we can lose control of the virus. This is a wake-up call: we cannot go on like this," she told broadcaster NOS on Tuesday. She said that if the situation continues to deteriorate, the risk of a second wave of infections becomes more likely.

Just last week a milestone was reached with the  https://nltimes.nl/2020/07/17/fewer-90-covid-19-patients-dutch-hospitals-lowest-since-early-march" style="text-decoration: none; color: rgb(153, 5, 0); - fewest number of Covid-19 patients in hospital since early March. However, on Tuesday public health agency RIVM said SARS-CoV-2 was now spreading at its worst rate since March 12, which  https://nltimes.nl/2020/03/25/dutch-coronavirus-infection-rate-declining-health-officials-icu-peak-expected-may" style="text-decoration: none; color: rgb(153, 5, 0); - led to a sharp spike in hospitalizations for Covid-19 and a subsequent increase in deaths linked to the disease.

"We have all reduced the virus by following the measures well," Timen told the broadcaster. "We have to get back to that behavior," she continued. "People now have a sense of freedom and want to catch up on parties," a decision which has consequences. "Our concern is that the measures are no longer being observed."

She said people have to continue to adhere to the advice from the RIVM by first remaining strict about keeping a 1.5-meter physical distance from people. This includes staying home as much as possible. They also have to wash their hands frequently, sneeze or cough into their elbow, and use disposable tissues. At the onset of symptoms like a fever, cold or flu, people must call the municipal health service GGD to schedule a test for an active SARS-CoV-2 infection.

DJ-Of course NO mention of international (air) travel, government reopening to "safe the economy". If things go wrong blame the citizens...

[url]https://nltimes.nl/2020/07/21/nearly-thousand-test-positive-covid-19-big-increase-last-week[/url] and [url]https://nltimes.nl/2020/07/21/nl-residents-say-work-home-video-calls-stay[/url] DJ-There is no law giving workers a right to work from home if possible. Again politics keeps on failing ! [url]https://www.dutchnews.nl/news/2020/07/wake-up-call-as-coronavirus-cases-in-netherlands-almost-double-in-a-week/[/url] and [url]https://www.rivm.nl/en/news/number-of-covid-19-infections-is-increasing[/url] A major rise in the age group of 20 to 40 y/o. (DJ- if tested cases doubled most likely the untested number of cases did go up even more. Certainly if only 12% of people with symptoms did go for a test. Another form of testing is needed to get a view on how widespread (40-50% without symptoms) Covid19 realy is. Not very likely RIVM/government will go for that kind of testing.

DJ-Some links on Dutch corona-news; 

[url]https://innovationorigins.com/british-scientists-also-see-a-link-between-covid-19-and-particulate-matter-in-dutch-province-of-brabant/[/url]

[url]https://innovationorigins.com/dutch-university-hospital-radboudumc-finds-genetic-mutation-tlr7-as-a-cause-for-corona/[/url]

[url]https://innovationorigins.com/this-is-how-sars-cov-2-shuts-down-our-immune-system/[/url]

[url]https://innovationorigins.com/update-this-is-how-the-sars-cov-2-virus-spreads-through-indoor-air/[/url]

[url]https://nltimes.nl/2020/07/27/long-distance-relationships-exempt-dutch-entry-ban-starting-today[/url]

[url]https://nltimes.nl/2020/07/27/blood-donors-wanted-coronavirus-medicine[/url]

[url]https://nltimes.nl/2020/07/26/majority-dutch-want-face-masks-mandatory-public[/url] but [url]https://nltimes.nl/2020/07/26/virologist-face-masks-will-help-people-still-keep-distance[/url] 

[url]https://www.dutchnews.nl/news/2020/07/catering-firms-likely-to-shed-a-quarter-of-staff-as-coronavirus-measures-bite/[/url]

[url]https://www.dutchnews.nl/news/2020/07/positive-coronavirus-tests-reach-seven-week-high-but-hospital-admissions-are-down/[/url]

The number of new coronavirus cases in the Netherlands rose by 214 on Sunday – the highest daily increase since June 7, according to new official figures. There has been a slight upward trend in the number of new infections in the Netherlands in recent days, and requests for tests have been rising at a rate of around 1,000 a day, website Nu.nl reported at the weekend. At the same time, the number of people being treated in hospital for coronavirus fell to 67 on Sunday, with a further 16 people in intensive care. This is the lowest number of coronavirus hospital patients in recent months. Testing Local health boards have been ramping up testing facilities because of the increase in demand and to try to ensure people get the results within 48 hours. On Friday, officials planned in a record 20,553 test appointments, a spokesman for the national health board GGD-GHOR told Nu.nl. There have been complaints in some areas about long waits for tests and again for the results.

DJ-Latest update from the Dutch CDC-RIVM [url]https://www.rivm.nl/en/novel-coronavirus-covid-19/current-information[/url] 

28-07-2020 | 14:30 PM

Weekly COVID-19 update: 22-28 July 2020

1,329 new COVID-19 infections were reported over the past week. That is 342 more than the number of confirmed cases reported last week and 795 more than the week before that. Hospital admissions (current or previous) due to COVID-19 were reported during the past week for 23 patients. That is 4 more than last week. 

9 deaths of laboratory-confirmed COVID-19 patients were reported, 2 more than the week before. 

The number of new people who tested positive in the Netherlands continues to increase. In the GGD test lanes, the number of tests increased by almost 23,000 compared to the previous week. The percentage of positive tests remained the same as a week earlier: 1.0%. Just like last week, the reproduction number is above 1.  See the news item: https://www.rivm.nl/en/news/number-of-covid-19-infections-continues-to-increase" style="box-sizing: border-box; color: rgb(1, 104, 155); text-decoration: underline; background-color: transparent; - Number of COVID-19 infections continues to increase

[url]https://www.rivm.nl/en/news/number-of-covid-19-infections-continues-to-increase[/url]

The virus continues to spread in the Netherlands. The reproduction number (R) indicates how many other people are infected on average by one person who has the novel coronavirus. The reproduction number is 1.40. This means that 100 people who are infected with the novel coronavirus will collectively infect another 140 people.

Although the number is slightly higher than the 1.29 reported last week, the upper limit of the bandwidth has hardly changed. This indicates that the situation has not changed much over the past week. 

There are regional differences in the number of confirmed cases (see figure 1). This is also visible in the total number of tests performed in the test lanes per 100,000 inhabitants and the percentage of positive tests per region. (see https://www.rivm.nl/documenten/wekelijkse-update-epidemiologische-situatie-covid-19-in-nederland" style="box-sizing: border-box; color: rgb(1, 104, 155); text-decoration: underline; background-color: transparent; - epidemiological report - only in Dutch )  The provinces of South Holland and North Holland in particular show an increase in the number of confirmed cases. The number of new infections remains stable and low in the provinces of Friesland, Groningen, Drenthe and Flevoland.

In addition to an increase in the number of infections, there is also a shift in age structure. In recent weeks, we have seen a stronger increase among younger age groups than among older age groups.

DJ-The conservative cabinet has been succesfull in increasing Covid-19 in NL by reopening almost everything and not stopping international airtravel. No doubt "our"PM Rutte will keep blaming a lack of handwashing as the main reason for the present exponential growth in most of the NL (only the north and east of NL doing reasonable-still-increase here is on its way...) 

[url]https://www.rivm.nl/en/novel-coronavirus-covid-19/current-information[/url] ;

04-08-2020 | 14:30 PM

Weekly COVID-19 update: 29 July - 4 Aug 2020

2,588  new COVID-19 infections were reported over the past week. That is 1,259  more than the number of confirmed cases reported last week and 795 more than the week before that. Hospital admissions (current or previous) due to COVID-19 were reported during the past week for 44 patients. That is 21 more than last week. 

6 deaths of laboratory-confirmed COVID-19 patients were reported, 3 less than the week before. 

The number of new people who tested positive in the Netherlands has almost doubled compared to the previous week. Approximately 10,000 fewer people have been tested in the GGD test lanes in the past week compared to the week before that. The percentage of positive tests in the Netherlands increased this week from 1.1% in the week of 20 July to 2.3% in the week of 27 July. Just as last week, the reproduction number is above 1. See the news item https://www.rivm.nl/en/news/number-of-confirmed-covid-19-infections-almost-doubled-last-week" style="box-sizing: border-box; color: rgb(1, 104, 155); text-decoration: underline; background-color: transparent; -  Number of confirmed COVID-19 infections almost doubled last week .

[url]https://www.rivm.nl/en/news/number-of-confirmed-covid-19-infections-almost-doubled-last-week[/url]

Percentage of positive tests doubled in the past week, fewer people tested 

Between 27 July and 2 August, the number of people tested at the GGD test sites was just over 100,000*, a decrease of about 10,000 people tested compared to the previous week. The test results are now known for just under 100,000 people. The percentage of positive tests in the GGD test lanes more than doubled, rising from 1.1% in the week of 20 July to 2.3% in the week of 27 July. The percentage of positive tests was higher than last week in almost all regions; the highest percentage (3%-7%) was seen in the GGD regions of Rotterdam-Rijnmond, Amsterdam, West-Brabant, and Haaglanden. These are also the regions where most of the known clusters are located, and where a relatively large number of people were tested because they were a close contact of a person with a confirmed COVID-19 infection. 

One-quarter of the people who tested positive are in the age group of 20-29 years old. However, half of the people who tested positive and have been hospitalised are 60 years or older.
Hospital admissions (current or previous) due to COVID-19 were reported during the past week for 44 patients. That is 21 more than last week. 

*Source: GGD-GHOR

Reproduction number R

The reproduction number (R) indicates how many other people are infected on average by one person who has the novel coronavirus. The reproduction number is 1.20. This means that 100 people who are infected with the novel coronavirus will collectively infect another 120 people. Although the number is lower than the 1.40 reported last week, the bandwidth has hardly changed. The confidence interval is still entirely above 1. 

Number of infection clusters rises to 242

There are currently 242 known active COVID-19 clusters in the Netherlands. This represents an increase of 109 clusters of three or more related infections compared to the previous week. Over the past week, the average size of these clusters was 5.7 people (range: 3-37). The GGD is using source and contract tracing to try to identify where each infected person contracted the novel coronavirus. The source of most infections is still within the home; this is the case in 52.8% of all clusters. Most of the other infections are the result of contact with other family members, friends, at parties, in the workplace or other leisure activities such as cafés, restaurants or sports clubs. In 70% of the infection clusters, the source has not yet been registered; this figure is higher than last week due to delays in registration as a result of the large number of reports in a number of regions. 

Source and contact tracing

The results of source and contact tracing are now available up to week 30 (13 July to 26 July). Among the close contacts identified in that 14-day monitoring period, 344 COVID-19 infections were identified (8.4% of all close contacts). The percentage of contacts that were infected varied between household members and other close contacts. In the monitoring period from 13 July to 26 July, 13.0% of the household members turned out to be infected with the novel coronavirus. 5.6% of the other close contacts were infected.

Other viruses active in the Netherlands 

Samples are being taken from a sample set of people with flu-like symptoms or other acute respiratory symptoms who go to a GP. These samples are taken by GPs from practices that are testing stations for the primary care database maintained by the Netherlands Institute for Health Services Research (NIVEL).  RIVM National Institute for Public Health and the Environment   then tests those samples for five viruses: the influenza virus, the RS virus, the rhinovirus, the enterovirus, and SARS-CoV-2 (the novel coronavirus). From late January to mid-March, the influenza virus was frequently detected. From March to early May, a positive test for viruses at the testing stations primarily detected the novel coronavirus. From 11 May to 27 July, the rhinovirus was the virus found most frequently in the samples. (see figure 2). It is possible that people who tested negative may still have other viruses, since the tests only cover a limited number of viruses. As of this week, this report will be included in the https://www.rivm.nl/documenten/wekelijkse-update-epidemiologische-situatie-covid-19-in-nederland" style="box-sizing: border-box; color: rgb(1, 104, 155); text-decoration: underline; background-color: transparent; -  epidemiological report .

I think we are seeing virus fatigue......

Governments have set a timeline..... 

IE,

how long can we afford lock down say 6 months......

After that we have to open up,

 come what may, because economies crash.....

Im finding it all very interesting.....

And a

Tad worrisome.....

Take care all..... 😷😜

DJ-Facemasks would go against the constitution, quarantining people from high risk countries only on a voluntary basis....how you are going to fight a pandemic this way ? 

In combination with utter stupidity of "experts" from the RIVM that "do not see proof facemasks offer protection", "young people do not get ill from the virus etc...  

Of course stupidity is not only a Dutch problem, but we do have a history of largest legionella, Q-fever outbreaks in the world. Over 20% of Dutch mink farms have Covid19-and still no real action.

Dutch Josh wrote: DJ-Facemasks would go against the constitution,

Going back in time there were many arguments against wearing seat belts in cars, but over time they have become acceptable.