The national GGD must hire more people as soon as possible to increase the capacity of the crucial source and contact research into new corona infections. Temporary deployment of the army does not rule out Minister Hugo de Jonge (Public Health, CDA). “In this way we hope to get more people available in a short time to carry out the research, and thus to strengthen this indispensable link in the fight against corona,” said De Jonge in a written statement on Friday evening.
The minister is thus responding to news that the GGD regions of Amsterdam and Rotterdam-Rijnmond will stop informing ‘close contacts’ of all persons infected with the corona virus. Because of the increasing number of infections in the regions and the increasing number of contacts, the source and contact research would otherwise no longer be sustained, they say.
In future, an infected person in these regions must inform his or her close contacts – 15 minutes of contact within a meter and a half – about contamination risks. The adjustment of the source and contact investigation is temporary and came about in consultation with the RIVM, the two GGD regions write in Friday’s press releases. GGD employees still hold a conversation with the infected person to find out the source of the infection. But informing close contacts is then the responsibility of this ‘index patient’ himself.
The decision of the two GGDs to limit the contact investigation led to a lot of criticism, including from PvdA party chairman Lodewijk Asscher. He wrote on Twitter: “This really cannot be. The cabinet must come to the aid of the GGD. Fast.”
RIVM: ‘not desirable’
Placing the responsibility on infected people to inform their contacts is “not desirable”, says a spokesman for the RIVM. “You want to keep the best possible view of the virus.” Although it is not so, she says “that the GGDs let go of everything.” Infections in high-risk groups or high-risk situations – such as people who work in healthcare or were present at an event where no one and a half meters distance could be kept – are still called by the GGD.
Limiting the contact investigation places more responsibility on a society that is less and less adhering to the cabinet’s corona measures. “The question is whether people will inform their contacts,” says the RIVM spokesperson. The GGD regions want to contact all contacts themselves as soon as possible. “The fact remains that you get less insight into the virus,” says the RIVM spokesperson. “You shouldn’t want that, but we all caused that.”
The reduced compliance with the rules of conduct, such as keeping sufficient distance, is also the reason, according to Minister De Jonge and the GGD regions, to limit the contact investigation. On the one hand, this led to an unexpected increase in the number of infections in Rotterdam and Amsterdam. On the other hand, infected persons have much more close contacts to call after because of not keeping their distance. Infected people with more than fifty of these contacts are not uncommon, writes the GGD Amsterdam.
“It is a logical next step with the increasing number of infections,” says Saskia Baas, director of Public Health at the GGD Rotterdam. “We focus on risk groups and high-risk situations. We use our capacity most effectively with this new method. ”
De Jonge has asked the GGD to accelerate the implementation of the national upscaling plan. The GGDs can currently start six hundred investigations every day, the minister wrote in a letter to the Lower House on Friday. The limits of that capacity are already in sight, with an average of around four hundred new infections per day – with peaks rising.
The GGDs can make use of a national pool of researchers if their own capacity is insufficient. Nine of the 25 GGD regions are currently doing this. De Jonge wants this group of ‘flying keeps’ to be increased more quickly and to double in size to 1,100 full-time jobs within two weeks, “and a further doubling in that period after that”.
Any new infected person must be reached within 24 hours for a source and contact investigation. The contacts of persons are advised to have themselves tested for the corona virus in case of complaints. The goal is to break through infection chains, by reaching new sources of infection faster.
With a view to the autumn – when even more infections are expected – the GGD regions are also busy scaling up their capacity for source and contact research. GGD Rotterdam-Rijnmond and GGD Amsterdam also want to more than double the number of employees in the short term.
“And at the same time, the GGD cannot do it alone,” writes De Jonge. Without observance of the behavioral measures by the rest of the Netherlands, mopping with the tap will remain open, the national GGD warned earlier this week. De Jonge: “We will have to rediscover the discipline to adhere to the basic rules and the GGD if possible. to continue to do their important work well. ”
A version of this article also appeared in NRC Handelsblad of 8 August 2020
A version of this article also appeared in nrc.next on August 8, 2020