Policy responses for Netherlands - HSRM


Policy responses for Netherlands

1.3 Isolation and quarantine

As the Netherlands relaxes physical distancing measures after the first (targeted) lockdown in spring 2020 (see Sections 1.1 and 1.2), the following isolation measures have been emphasized to keep the coronavirus under control:
• People have to stay at home when they have mild symptoms of a cold (sneezing, running nose, sore throat or a body temperature up to 380 Celsius)
• When people have a fever or difficulty with breathing, family members should go into self-isolation as well
• People should avoid crowded spaces in all circumstances. 
• As of 1 June 2020, all citizens that have symptoms can be tested. Individuals who test positive are requested to self-isolate, and contact tracing will be conducted.

Contacts of positively tested persons include individuals who have interacted with the infected person up to two days before the first symptoms appeared or, for asymptomatic infections, before the testing occurred. These contacts should do the following:
• People from the same household should self-isolate up to 14 days after the last contact with the infected person. They should be available for contact with the Public Health Service at any time and they can go out again only after approval from the Public Health Service. 
• Close contacts (persons with whom the infected person had more than 15 minutes contact within 1.5 meters) are requested to work at home, to not use public transportation or receive visitors up to 14 days after the last contact with the infected person and to keep 1.5 meters distance when outside. Children under the age of 12 can go to school and sports facilities. These people shall be tested as soon as possible when they develop symptoms. The Public Health Service will contact them at day 7 and day 14. Close contacts should take care of good hygiene measures (for sneezing, coughing and washing hands).
• Other contacts (people who have been more than 15 minutes in the same room as the infected person) are advised to keep the 1.5-meter physical distancing rule, good hygiene measures and to stay at home and get a test when developing symptoms. (https://lci.rivm.nl/COVID-19-bco).
• Since 18 August, the duration of self-isolation is shortened to 10 days and since 1 December, after a self-isolation duration of 5 days people can have a test. If the test is negative, they may come out of quarantine.

People returning from holidays abroad from areas with outbreaks are requested to go into voluntary self-isolation for 14 days (10 days as of 18 August, 2020)  upon return to the Netherlands.

The government does not expect (in August 2020) that the second wave of the virus will require a total lock down of the Netherlands. Instead, the application of local measures are anticipated, such as temporarily closing a factory, a restaurant or a nursing home in the case of an outbreak.

The Minister of Health informed Parliament on 16 July 2020 that a national closure of nursing homes for all visitors probably will not happen again. The national closure led to loneliness among nursing home residents and family members were in emotional distress that they could not visit their loved one in the last days of their lives. Going forward, the nursing home can decide on isolation measures.

Since 3 February, individuals with suspected and confirmed cases are advised to go in self-isolation for 14 days. Family members of suspected cases who do not have health complaints are allowed to leave the house, but visitors are not allowed (except for members of the public health services). Isolated persons have to check their body temperature with a personal thermometer twice a day, after which the thermometer is disinfected with 70% alcohol and the patient washes his/her hands. A case manager of the Public Health Services checks on the situation daily. If the condition worsens or symptoms are developing, the isolated person has to contact the GP or the Public Health Services. The physician of the Public Health Services decides whether self-isolation is still appropriate or whether the patient has to be isolated in a hospital.

People who are sneezing, coughing, have a running nose or a fever over 38⁰C and who have been in contact with a confirmed case or have been in a region with many cases should stay at home.
In the beginning of March, two hospitals stopped admission and visitors as a result of having identified cases in their facility that were already admitted before they were tested positively for COVID-19.

In the Netherlands, everyone who has symptoms of a cold should stay at home. If a household member has a fever, all other household members should stay at home as well for 14 days (10 days since 18 August, 2020) after the infected patient went into isolation. Family members are allowed to go outside in certain cases, for instance, grocery shopping, but should avoid bodily contact and keep distance from other people.

The GP should only be contacted by phone when symptoms become severe. Advice on when to call the GP is given on www.thuisarts.nl. Confirmed cases outside the hospital should stay at home until they are 24 hours symptom free. Non-symptomatic family members who are also health care workers can still go to work.

Since 24 March 2020, all family members of an individual with a fever should stay at home until the whole family is 24 hours free of symptoms.

At a press conference on 2 April 2020, the Prime Minister and his Cabinet urgently asked all travellers coming from the US or from countries with no remaining commercial flights to Dutch airports to go into voluntary self-isolation for 14 days. (https://nos.nl/artikel/2329186-nederlanders-veertien-dagen-in-thuisquarantaine-na-terugkeer-uit-vs.html).