Interview | GGD director Sjaak de Gouw looks back on the first corona wave: 'We have to prepare much better'

On February 27 of this year, about five months ago, the Netherlands had its first official corona infection. Where there used to be room for Dutch carefreeness - 'We are a down-to-earth people,' said Prime Minister Rutte - it did not take long before daily life changed dramatically here too due to the virus.

Now, more than fifty thousand corona infections have passed, we can cautiously look back on the first wave of the virus. Issuemakers did this in a conversation with Sjaak de Gouw. As public health director of the GGD, he became one of the most important faces of virus control. We spoke to him about the consequences of the pandemic for the healthcare system, being prepared for a new outbreak, ethical issues and his new role as a public figure. 'My wife could check the TV guide to see what time I would be home.'

We have recently seen a lot of analysis of the consequences of the pandemic for society. All sectors have had to quickly rearrange priorities, healthcare is probably the best example of this. But what does this pandemic mean in the long term for the design of the Dutch healthcare system?

'In any case, we must prepare ourselves much better for such disasters. We are now faced with abrupt shortages – not only in terms of ICU beds, but also protective equipment and testing capacity. That had very serious consequences. But in addition to preventing scarcity, more fundamental changes to the system must also be considered, such as: E-health and prevention.'

Why do you think that is important? Is the current design of the healthcare system no longer sustainable?

'That is very questionable, especially given the current staff shortage and the changing demographic composition of the population. If we continue at this rate, healthcare costs will eventually account for 40 percent of GDP. That is not feasible. But we have not even begun to see what that new system should look like. You also see that historically we have grown in a certain model. From illness to care, and now we see a movement towards healthy behavior. As medical professionals, your role is increasingly to keep people healthy, rather than to make them better.'

The importance of medical professionals for society has become extra clear during the corona crisis. Do you think this will also have real consequences?

I find this new appreciation very fascinating. I find it difficult to estimate exactly what it will mean. We have deregulated a large part of our vital infrastructure, so I think there will now be a major revaluation. There are a number of things that keep society running, and the question is whether we have sufficiently safeguarded them.'

Comments on the corona approach not only referred to healthcare costs, but also compared the interests of public health and the economy. Opinion makers as Jort Kelder suggested that the economy is underrepresented in that balance. Do you understand that comment?

'It's very cynical in a way, but it is an important theme. The current crisis measures were taken to prevent Italian situations, but I understand that the social disadvantages are subject to discussion. I certainly predict more ethical issues with those costs in mind, including at an international level. The Netherlands can support it, but other countries sometimes absolutely cannot.'

Do you expect the pandemic to lead to lasting behavioral changes? Are shaking hands and kissing on New Year's Day a thing of the past?

'There has been a lot of emphasis on fighting corona together, but I wonder whether people will quickly fall back into old patterns. If it's nice in the pub, and you just don't fit in anymore – Do you stay outside?'