Second wave, second lockdown: not-so-intelligent
Daily Covid-19 infections in Europe have overtaken the US, but it's hard to follow the good example in Germany.
Bars, cafes and restaurants are closed in the Netherlands except for take-aways. A 9pm curfew in Paris and other cities has grounded a third of the French population until dawn. England’s elected mayors of northern regions are in open rebellion against government orders to force local lockdowns rather than a nationwide “circuit breaker”.
The daily rolling average rate of new infections in Europe last week topped 78,000, as the long-anticipated second wave - de tweede golf - spread faster even than in the US. The Netherlands - where authorities imposed a new “half-lockdown” from October 15th for at least four weeks - is high on a list of 17 countries labeled ‘red or predominantly red’ by the European Centre for Disease Prevention and Control, an EU agency.
Germans are said to be more likely to follow instructions. Dutch prefer to discuss, then do whatever they decide for themselves
Red signals a daily infection rate over the past 14 days of 150 cases or higher per 100,000 inhabitants. Where the first lockdown, in March, was labelled an “intelligent lockdown” by Dutch ministers, that flattering terminology now looks naïve. Under the new half-lockdown, no more than three visitors to a private home are permitted in any 24-hour period. Selling alcohol after 8pm is prohibited.
During the past three weeks, patients awaiting scheduled care in Dutch hospitals have been moved outside regions worst-affected by the coronavirus. The Landelijk Coördinatiecentrum Patiënten Spreiding (LCPS), national patient coordination centre, has not ruled out relocating patients to Germany, reported De Telegraaf - niet uitgesloten dat er binnenkort verplaatsingen naar Duitsland zullen plaatsvinden - as happened in the first lockdown.
Football, melody and smut
At the root of these problems is the thorny, evergreen issue of compliance. Public appetite for official advice has waned. First came the first lockdown, noted Theodor Holman, columnist for Het Parool. Next came a dashboard - dashboard in Dutch - of colour-coded risks and warnings. Then on the evening of October 13, prime minister Mark Rutte announced a new roadmap. Its first stop? The half-lockdown.
Government messaging is a mess, inferred Holman. The same charge is levelled elsewhere, not least in the UK where a new three-tier warning system has added to doubts over the government’s credibility. Holman set to untangling the mixed metaphors in the Hague with a satirical zeal that borders on licentious (I’ve looked this word up in translation: losbandig, ongebonden - meaning debauched, dissolute, untramelled by convention or principle in sexual matters. As we’ll find out.)
Holman’s column starts in the sanguine tones of a question-and-answer dialogue with an unnamed government insider. The demographics of Covid-19’s spread have been described in terms of a football team. Every player is different, runs the analogy: a sick mid-fielder May be rushed to hospital, while the goalkeeper at the back remains asymptomatic.
He mistakes the symbol of a hammer in an official document for the outline of a penis doodled in the margin of the page
Metaphors become muddled when official statements are compared to the keys on a piano, each sounding a different chord. This musical-sporting contraption - a hybrid of football pitch and piano - may seem a difficult concept, but the idea serves as a test for government guidance. If the melody sounds wrong - vals, then the messages aren’t working - Geeft de piano nu een vals melodietje, dan is de communicatie niet goed.
Like a schoolboy sniggering over his biology text book, Holman (born in 1953) looks for impudent questions. Official statements are becoming a kind of virility test for politicians. Insiders vet every new proposal, to check if the measure has balls - eerst wordt er getoetst of de maatregel ballen heeft. Such discussions are for internal use only - voor intern gebruik, but the blushes of embarrassment are starting to show.
Accidentally-on-purpose, Holman is confused by the symbol of a hammer in a government plan, an emblem for action perhaps. Its shape resembles a penis doodled in the margin. The organ is none other than the prime minister’s, confirms his interlocutor. With every good measure, the penis goes up a little - Bij elke goede maatregel van de minister-president gaat de penis…ietsje omhoog. Or down - of omlaag.
And that, surely, is sufficient: our cue to ignore such puerile opinion and look for relief elsewhere.
Why Germany did better (to date)
The exception to Europe’s rising second wave is Germany, where clarity seems to prevail. Conventional wisdom is that while Dutch authorities were busy trying to stop hospitals from becoming overburdened, Germany focused instead on taking steps to curb actual infections. This much seems to hold true, wrote Anne Marie Juli, a researcher, in NRC. But cultural differences take the rap too.
Germans are said to be more compliant and hence likely to follow instructions. Dutch typically prefer to discuss a problem before doing whatever they ultimately decide for themselves is right - een Duitser doet klakkeloos wat hem wordt opgedragen, een Nederlander gaat in discussie en doet vooral wat hem/haar goeddunkt.
Attempts to explain the pandemic in terms of national stereotypes is comforting, concedes Juli. But wrong. Mulling national caricatures has diverted real criticism of actual policies, she argues. And the consequences are stark: total fatalities in tiny Netherlands, population 17 million, may soon exceed those in big Germany. Juli cites data suggesting a plausible, unreported death toll from Covid-19 in the Netherlands of more than 10,000. That would be on a par with Germany, population 81 million.
One in six Dutch people say they will not abide by new corona-rules, compared with one in 13 during the first lockdown
The successful ingredients of Germany’s response are not in dispute. Berlin saw the rapid spread of Covid-19 across Italy in February, scrambled to roll out mass testing (including at airports), closed borders, then imposed and policed strict quarantines. By August, Chancellor Merkel, never knowingly mistaken for a drama queen, had warned of the greatest challenge to Europe since World War II.
For all their vigilance, the fable of native compliance is misleading. While Germany sought prevention rather than containment, its response to Covid-19 owes much to an often delicate convergence of centralised knowledge with localised know-how. Rather than impose rules from the centre, Chancellor Merkel worked in her technocratic way to build a consensus with federal leaders on practical lessons learned from the ground up.
Widespread resistance to facemasks, for example, yielded to empirical evidence of low infection in North Rhine-Westphalia, the first state to require wearing of masks in public. Hot spots of Covid-19 were tracked, traced and isolated. Data from 16 federal states - each with autonomy over health services - is crunched into daily Situation Reports published by the Robert Koch Institute, a national public health agency tasked with disease control.
Juli points to a stark contrast with the Netherlands, where the separation of scientific advice from political responsibility has blurred. When criticised in parliament, Dutch politicians routinely cite the National Institute for Public Health and the Environment (RIVM) - verwijst de regering bij kritiek vanuit het parlement regelmatig naar het RIVM, which in turn throws the issue of responsibility back to the politicians - dat omgekeerd wijst op de verantwoordelijkheid van de politiek.
Mutual deference between scientists and politicians has become the new normal in government and parliament - steeds maatgevend lijken voor regering en parlement. Frustrated by Dutch indecision, Juli admires the Berlin government for both hearing the science and still answering for political decisions to parliament. Even if true, Juli seems to miss the collaborative approach from Merkel, whose authority reflects her ability to chivvy, influence and nurture devolved decision-making at the state level. Her professional background as a chemisst helps with that.
It’s easy to overstate their reputation for efficiency, but Germans’ readiness to learn from their peers is useful too. Most have followed the guidance and kept faith with institutions. Not that they have much alternative: violations of German corona-rules incur heavy fines, with potential prison terms of up to two years. The relative lack of coercion in the Netherlands feels benign, but as national caricatures go, the Dutch attachment to protracted discussion is accurate enough. As well as an individualistic tendency, ultimately, to decide for oneself.
In this light, reactions from the Netherlands in both the public and private spheres, do start to look, well, pretty Dutch. Even as she refuses comforting stereotypes, Juli points accusingly at an apparent resistance in The Hague to changing course. Dutch politicians insist on heeding advice from RIVM as if sacred - heilig, despite a number of recent failures in the science - ondanks een aantal ernstige missers. Why this unearned deference, she laments rhetorically? We can only guess - Het blijft overigens gissen waarom.
Dissidents and exceptions
Better answers may be found closer to home. From early March, when the Dutch government prioritised testing for Covid-19 for severe cases only, the University Medical Centre in Groningen set up a universal testing facility staffed by medical students. An important regional hub for medical care, UMCG screened all of its 15,000 employees, and others from the north of the country. Anyone who tested positive, or had traveled outside the region, was told to self-quarantine.
The prime mover behind this dissenting, innovation step was Professor Alex Friedrich, virologist. “They said that diagnostics is interesting for statistics but not important for the fight against the disease. There I strongly disagree,” Friedrich told the Irish Times in April. During those early weeks of the pandemic, the seasonal death rate doubled in the worst-hit region of North Brabant, while deaths in Groningen were just four percent higher than previously. Six months on, Groningen’s official death toll from Covid-19 stood at 23, from 4,122 infections to date. This compares with 6,736 deaths nationally, from 220,000 infections.
Generalised testing is now, in principle, uncontroversial: a measure widely recognised as crucial to any track-and-trace system. From the onset of the pandemic, “Test, test, test” has been the standard advice from the World Health Organisation to national governments.
Social media is awash with contradictions: you are either an anxiety rabbit, egotist, the bravest boy in the classroom or virus mad
Yet mass screening remains rare outside Germany. A critique of the Dutch corona-rules, seen through the lens of the German process, would surely point to this as a significant failure. Friedrich’s screening regime at UMCG should have served as an important example. The ingredients for a Germany-style process were available in Groningen: harvesting experience from devolved authorities, learning with the regions, crunching the data from a peer group to determine the best practice. Instead, the lessons were missed by policy-makers in the Hague.
Not that anyone, anywhere can point to a clean bill of health. No European country is rated by the ECDC (which also tracks the UK, Norway, Iceland and Liechtenstein) as ‘entirely green’, the threshold of a fortnightly reporting rate of less than 25 cases per 100,000 below which EU member states agree to waive all travel restrictions.
Writing in Het Parool, Amsterdam district councillors Fenna Ulichki (West) and Maarten Poorter (Oost) warn that adherence to government guidelines has waned. A survey commissioned by EenVandaag, a television news programme, found that one in six people will not abide by the corona-rules. This reflects a sharp fall in public confidence and solidarity compared with the first lockdown, when the figure was about one in 13.
What, then, do the councillors counsel? Compulsory screening, perhaps, or more vigilant reporting of new infections? None of that. They worry that comparing infection rates between Amsterdam’s seven districts is polarising. Social media is awash with contradictions and reproaches: you are an anxiety rabbit, an egotist, the bravest boy in the classroom or virus mad - je bent een angsthaas, een egoïst, het braafste jongetje van de klas of viruswaanzinnig.
The spirit of human connection and solidarity of the early days is in jeopardy. Yet the rules are the same, still simple. If everyone will just wash their hands, stay at home when sick, and observe the 1.5 meter social distancing rules, other restrictions are superfluous - zijn andere beperkende maatregelen niet nodig.
Blaming others won’t help, the councillors argue, and may even fuel the pandemic. Next to anxiety over the famous R-rate, the reproduction number of the virus - het reproductiegetal van het virus, de R, the counsellors are worried too by another statistical co-efficient of their own invention: the R-rate of social polarization - ook over het reproductiegetal van de polarisatie.