Level of risk
Each week the coronavirus situation is assessed to see whether it is developing in a positive or negative direction. This assessment is carried out jointly by central government, the municipal health services (GGDs), the National Institute for Public Health and the Environment (RIVM) and the safety regions. The Minister of Health, Welfare and Sport then determines which risk level applies to each region. Do we need to exercise ‘caution’ (level 1), is the situation one of ‘concern’ (level 2) or is the situation ‘serious’ (level 3) or even ‘severe’ (level 4)?
Central government and/or the safety region in question will take appropriate measures based on the risk level. Measures depend on the local situation and may therefore vary from region to region.
What determines a region’s risk level?
A region’s risk level is determined by looking at the situation in that region, in the surrounding regions and in the rest of the country. This is done on the basis of the coronavirus dashboard, RIVM’s weekly report, and assessments by the GGDs and the safety regions. Several aspects are taken into consideration when determining the risk level:
- How quickly is the number of new infections rising?
- Are additional measures needed for vulnerable groups?
- How effective is contact tracing?
- How well are the measures being complied with?
- Is there still sufficient healthcare capacity?
When is a region’s risk level raised to ‘concern’, ‘serious’ or ‘severe’?
- A region’s risk level is in principle raised from ‘caution’ to ‘concern’ if there are more than 50 positive tests per 100,000 inhabitants in one week. This means that the alert value of 7 positive tests per 100,000 inhabitants is exceeded each day.
- A region’s risk level is in principle raised from ‘concern’ to ‘serious’ if there are more than 150 positive test results per 100,000 inhabitants in one week.
- A region’s risk level is in principle raised from ‘serious’ to ‘severe’ if there are more than 250 positive test results per 100,000 inhabitants in one week. If the situation is ‘severe’ in multiple regions, the severest measures then apply to the whole country.
Every Monday RIVM calculates which risk level applies to which region. A more in-depth assessment of the situation in these regions is carried out in the following days. If the situation in a region is one of ‘concern’ or ‘serious’, the Minister of Health, Welfare and Sport (Hugo de Jonge) may decide to assign a higher risk level to that region. The above criteria are intended as a guideline. Even if a region has not yet reached the alert values given above, the risk level may nevertheless be scaled up in light of circumstances and assessments.
When can the risk level in a region be scaled down?
Any decision to scale down the risk level in a region requires careful consideration of not only the number of new infections, but also healthcare capacity. After all, even if the number of new infections falls, the healthcare sector may still be dealing with large numbers of patients recovering from COVID-19. Healthcare professionals must also be given an opportunity to rest. The focus must be on preventing the virus from spreading quickly once more and the healthcare system becoming overburdened.
What do the four risk levels mean?
- Caution. The situation is manageable. The number of new infections is low. Vulnerable groups must remain alert. Contact tracing is largely effective. Measures are being sufficiently complied with and are enforceable. There is sufficient healthcare capacity. Any additional measures are designed to make the existing approach more effective.
- Concern. The situation is moving in a negative direction. The number of new infections is increasing. A tailored approach is needed to protect vulnerable groups. If the situation continues, contact tracing will become ineffective. Measures are not being sufficiently complied with. Pressure on healthcare capacity is increasing. The existing approach needs to be strengthened through additional measures to get the virus under control again and return to a manageable situation.
- Serious. Severe measures are needed to prevent further escalation and return to a manageable situation. The number of new infections is increasing rapidly. An intensive tailored approach is needed to protect vulnerable groups. Contact tracing is no longer effective, making it more difficult to keep track of how the virus is spreading. Measures are not being sufficiently complied with. There is insufficient healthcare capacity. Measures to be taken are designed to prevent regional healthcare from becoming overburdened and to be able to track the spread of the virus again.
- Severe. More severe national measures are needed to prevent further escalation and return to a manageable situation. A very large number of people are infectious and the number of new infections is high. Contact tracing is no longer effective, meaning there is limited insight into how the virus is spreading. Measures are not being sufficiently complied with. Regional healthcare capacity is insufficient and some kinds of regular healthcare have already been scaled down. Measures to be taken are designed to prevent national and regional healthcare from becoming overburdened and to regain maximum control of the virus.