Dutch hospitals appeal for new lockdown measures with system ‘gridlocked’

Doctors in region may soon have to decide what care is available to individual patients

The University of Amsterdam. Photograph: Jeroen Jumelet/EPA

The University of Amsterdam. Photograph: Jeroen Jumelet/EPA


Five major hospitals in the Netherlands have appealed for new coronavirus “lockdown-style measures” with immediate effect, warning that they’re on the verge of imposing a “Code Black” – where doctors must decide on the critical care available for each individual patient.

The hospitals – all in the southern province of Limburg – issued a joint statement on Tuesday, warning the caretaker government of premier Mark Rutte in the starkest terms: “We are on course for a breakdown in healthcare and the whole system is gridlocked.”

Code Black means that patients with heart conditions or cancer, for example, cannot assume that intensive care beds will be available if they need them, especially if the current pressure from new coronavirus patients, most of whom are unvaccinated, continues to increase.

The hospitals said that while they expected imminently to become the first province to implement Code Black restrictions locally, “we are unfortunately convinced that several other areas of the Netherlands will follow very soon”.

The Limburg hospital administrators are just the latest medical professionals to go public about the extent of the pressure their staff and resources are facing. Last week, intensive care consultants wrote a hard-hitting open letter to Mr Rutte. Health surgeons have also warned of backlogs.

Changing trends

The scale of the problem was illustrated in the latest figures from the public health institute, RIVM, on Tuesday, which showed the number of new cases over the previous seven days reaching 76,790 – the highest since the second peak last December, when 77,998 new cases were logged.

The figures showed infections rose fastest in school-age children and people in late middle age, a departure from the trend in recent weeks when the virus has spread faster in older age groups.

The number of deaths is also on the increase, reaching 172 in the week to Tuesday, compared with 102 over the previous seven days.

The R number, which measures the rate at which the virus is reproducing, stands at 1.19, unchanged – despite warnings about the current rapid resurgence – since October 25th.

Politically, the pressure is mounting too. While a vaccine booster campaign is not due to start until December with the over-80s, MPs from four parties, plus two independents, have demanded it start within 48 hours given the growing urgency. Pensioners’ lobby groups agree.

Microbiologist Andreas Voss, a member of the government’s expert outbreak management team, commented: “I’m worried that relying on people’s common sense won’t be enough.”

Another indication of the scale of the problem is that while the United States reopened its borders to vaccinated international travellers on Monday, on Tuesday it raised the Dutch risk status to Level 4, the highest, advising Americans: “Do not travel to the Netherlands.”