Criticism of corona approach: “They only kill and ICU beds counted ‘

Professor of geriatric medicine Marcel Olde Rikkert crack hard nuts about how the Netherlands has dealt so far with the virus, are older and younger generations. “They only kill and ICU beds counted. As if that is all that matters. “

Has not looked at the effect of the coronavirus in the elderly. Too much is country led by a sort of military command of Ministers, ICU doctors and virologists who had little regard for other interests. And it shows “unprecedented realism little ‘if you really think there is a vaccine against corona foreseeable future that protects everyone adequately.

Marcel Olde Rikkert held outwardly long his mouth. “But,” says the professor of geriatric medicine at Radboud University Nijmegen, “there is no reason to continue to apply even to the panicked urgency, 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 there are many things had done differently. As with the elderly. The knowledge accumulated in years of that audience suddenly seemed no longer to exist. So standard was that people kept only possible corona could have if they had at least 38 degrees fever. While the core body temperature at an aged one or even two degrees lower than a younger person. And you’re in an older by 37 degrees so sometimes you talk about a relevant temperature.

Result: too late is recognized that there is still a lot corona occurred among the elderly in nursing homes for example. People are therefore protected discussed later and later. And then there was a high mortality rate, there was a kind of panic reaction: they were thrown locked visit is not possible.On himself understands Olde Rikkert such reactions do. “In the beginning there was real chaos. In the chaos, it is very important that you have a clear measure affects and can not always nuanced. That’s no problem, but then you have to adjust quickly. ”

You do large groups of people quickly too short

But that is not done, according Olde Rikkert caused by the ‘command’ that the issue has been addressed with the coronavirus. “They only kill and ICU beds counted. As if that is all that matters. But you do large groups of people to quickly deficit by one discipline master, in this case hospitals, intensive care leading to his. ”

Which failed to see what there was to learn abroad. “You saw in Italy that many people did not survive and the homes were hotbeds of the virus. Then you can start thinking: this can take us and what we do with our concentration of elderly in nursing homes? The dominance of the command structure aimed at intensive care is much too late to look. ”

And even there is not enough attention, says Olde Rikkert. “Especially when you realize that there is so much mortality in the elderly, which in people 80 and older increase the death rate to 30, 40 percent, then you also need to consider how we are going to arrange with good palliative care? How do we ensure that people who are not included isolated die? How do we ensure that people who may not receive a visit not become socially isolated? ”

Really better

There is insufficient looked, says Olde Rikkert. “In a sort of military organization in which the crisis is handled is often not listened. Then it is difficult to penetrate the captains and to make clear what I see here is really better. Really, I am sure that everyone had the intention to do it as well as possible. But there is little sensitivity to that which appears to be in the eye of the storm. “We must ensure that this case remains intact ‘, that had become the target. But that goal can not be natural. The aim is to provide good care and appropriate to what you encounter in practice. ”

“Killing counting is easy, and it seems like death is the only thing that matters in this period. While you should look at effects on quality of life, quality of dying: you should also take into account the final phase of life. You are very narrow busy when you’re just about the numbers who die and not wonder: how does that work? Are people well prepared, there has been enough dialogue, they are not alone, the family knows how to cope? We are, I think, even global, unfortunately often spent short sighted. Everyone has gone to the heroism of the disaster, mainly killing counter taken into consideration. ”

No timely care

Thus the survey of general practice was that there was a decrease in demand not heard in patients on other issues. Now, according to figures on deaths that may have been thousands of people died because they have not gone to the doctor with heart problems. “About 200,000 heart patients in the Netherlands due to the corona outbreak enjoyed no timely care,” stated the Dutch Society of Cardiology last week. “This leads to tens of thousands of heart patients to premature death and loss of quality of life.”

Olde Rikkert: “The signs were there much earlier.” But where it has failed to according to him, is intelligent leadership. “Intelligence is to use as many different views and there the best choice to make together. Intelligence is not a person or a select few continue to give the mandate to decide anything. ”

You’re the boss suddenly

While there is much too long leaned on experts who do not fully appreciate the complexity of the pandemic. “The experts have no glass bulb. But realize themselves enough that they should be more modest. That is not in them and there are all kinds of temptations that make modesty difficult: you are the boss of a sudden, in the spotlight, the research money is up for grabs. This is a dynamic that we have not realized. ”

And which we now possible bothering. “Look at the dynamics of the money. There is a honey pot put out, so people are now working globally perhaps a thousand places with corona research. That’s not wise, the majority is not a good research: too small, too fast twisted together. The history surrounding virus vaccines teaches us that to realize it is very difficult an effective vaccine. It is our example so far completely failed to make for example an influenza vaccine that is effective enough for the elderly. ”

“We again only to organize events as there is a vaccine, such as Hugo de Jonge says, venting something that’s not realistic, it is awakening false expectations. If you have the desire to protect vulnerable groups, you have to realize that it will not happen quickly. Especially if you allow too many small-scale research, while asking for major studies, to unite people, gathering expertise. It requires scientists about their own shadow over steps, do not want to necessarily own research. But that approach is difficult for us. And gets harder as we get rushed by the public opinion that demands fast-fast-fast. ”

Fear of electoral loss

Olde Rikkert understands that it goes. “In politics, of course, fear of electoral loss, hassle in the Chamber, for populist parties calling” you let people die. ” But the “narrow view” does not do justice to the elderly, he says.

“It appears very difficult for people who do not care for the elderly are to realize that people do not like to stir the dead themselves. If you are used to fight against death, if your daily activity in the politics of health care, it is difficult to recognize that the question raised is another. That the patient might not mind dying, but it is concerned about the way. ”

“The most intelligent general rule be for better and healthy aging is to keep moving, both socially and physically. And what do we do with our so-called intelligent lockdown? We are going to maneuver very limit. This is a procedure that you know which is cause much damage, both physical and social sense. You see deteriorate the condition of people, you see reduced muscle strength, you see reduce appetite. People are more vulnerable, especially through the intervention. The well-being of the frail elderly is the most important thing you have to maintain. And what is happening now, is that you just would not want to. ”

No banned single moment

The experiments in nursing homes, where sparsely again visit what is allowed, he calls “too slow.”

“In the Radboud University Nijmegen Medical Center on our geriatric ward no time prohibited that older people could receive visitors. It is limited to one person per day known and strict precautions. I do not see why you can not in the nursing home to work on the same measures. I would say go talking to hospitals, swap out what their experiences, how they protected their elders. The people who pull the cart say the pandemic all specialties did well together, but do not see that there is a large group involved not at all. ”

Olde Rikkert calls for a brief respite. “Look what happened to us, and look at what you now can learn together what is happening. Then you’re effectively doing now. And realize that we are now in control, but there always be new cases. That is also a part of life. People get sick and die. But we can also learn to see how that goes. “

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