Five questions about five years of COVID-19  Chantal Rovers and Aura Timen on the lessons for the future

10 March 2025

It’s been five years since the COVID-19 pandemic broke out in the Netherlands, resulting in a heavy disease burden, many deaths, and lockdowns. Where do we stand now, five years later? Professor of Outbreaks of Infectious Diseases Chantal Rovers and Professor of Primary and Community Care Aura Timen, during the pandemic working at RIVM at the time, answer five questions about five years of COVID-19. 

What lessons from the pandemic have we taken to heart?

We gained a lot of knowledge during the coronavirus pandemic. Chantal Rovers, an internist-infectiologist and professor of Infectious Disease Outbreaks, led the action teams for healthcare and vaccination and treated patients at Radboudumc. She recalls, 'The national distribution of patients through the Dutch Patient Distribution System started quickly. During the first outbreak in March 2020, I drove on an empty highway to Radboudumc past Bernhoven, the hospital in Uden, which was overwhelmed with COVID-19 patients. The only traffic was ambulances transporting patients from Bernhoven to hospitals in the north. This distribution allowed us to make the best use of available capacity. We’ve also benefited from this system in new crises, such as in 2021 during the evacuation of the Venlo hospital due to a looming flood.' 

Professor Aura Timen, who worked at RIVM as Head of National Coordination for Infectious Disease Control and as scientific secretary of the OMT, also sees improvements: 'At the RIVM, we now have the National Function for Pandemic Infectious Disease Control (LFI), responsible for scaling up and providing materials during a pandemic, such as for mass testing, vaccination, and contact tracing. This was a major shortcoming at the start of the crisis. Also, the EU is now working more closely on pandemic control, for example, through the HERA organization.' 

Hospitals are also providing more care remotely today. 'We had less experience with this before the pandemic,' says Rovers. Additionally, GGD has invested in knowledge retention. Large-scale projects like RAPIDE have been launched to develop and test scenarios and care models to organize regular healthcare more flexibly and resiliently during crises. Timen adds, 'More collaboration between hospitals, primary care, and the GGD is crucial, and the Integrated Care Agreement (IZA) also provides opportunities for this.' 

In what ways are we worse off than five years ago?

Chantal Rovers explains: 'We now have fewer ICU beds than five years ago due to less staff and the push for more efficient healthcare. This makes sense for affordable healthcare and an aging population, but it also makes us more vulnerable if we suddenly need many beds. We also see that vaccine willingness in society has decreased over the past few years, partly due to misinformation. This is a concerning development.' Timen agrees: 'Trust in institutions is declining. We haven’t succeeded in sufficiently addressing vaccine doubts. A key lesson is that we need to build more understanding by connecting more with society, especially regarding the need for potential measures.' 

Timen also advocates for better integration of scientific research. At the beginning of the pandemic, much of the research was done individually by researchers or hospitals. A better infrastructure for gathering both data and research findings could help address clinical questions about causes, treatments, or at-risk groups. 'In the UK, much information within the NHS system came together automatically. This allowed them to quickly identify new variants and who was susceptible to them. We can learn a lot from that system.' 

What impact do (inter)national political decisions have?

In 2024, the Dutch government announced plans to cut €300 million from pandemic preparedness. Rovers sees this as a major setback: 'The Dutch Safety Board has published three reports with recommendations, which require investments that society must be willing to make. With these proposed cuts, the GGD will have less capacity and will struggle to retain knowledge.' Timen adds: 'Collaborations will almost grind to a halt, while we need to seek and strengthen connections in public health.' 

International political decisions can also have far-reaching consequences. The US has withdrawn from the World Health Organization (WHO) and is no longer sharing knowledge or data. Moreover, Robert F. Kennedy has been appointed Secretary of Health, someone who openly questions the effectiveness of vaccines without scientific evidence. Timen warns: 'The consequences of these political developments are yet to be seen, but you can imagine that we’ll have less control over potential new virus outbreaks. In the US, the H5N1 virus, which causes avian flu, has jumped from birds to cows. This outbreak has not been contained, and with a few mutations, the virus could also jump to humans. This is a concerning development, and we can’t foresee the consequences if America doesn’t share information.' 

What is the risk of a new pandemic?

Both Timen and Rovers foresee another pandemic. However, it’s impossible to say if it will happen tomorrow, in ten years, or twenty. Timen notes: 'We face several risk factors that increase the chance of a quicker outbreak. The decline in vaccination willingness, more misinformation, the proposed cuts to public health, and the US withdrawal from the WHO all contribute. This also raises the risk of the return of diseases we almost eradicated, like measles. Just last month, a child in the US died from measles, and we could also expect the return of polio.' 

Rovers agrees: 'Pandemics will likely follow each other more quickly. The global population is growing, which leads to more animals being displaced from their natural habitats. This increases the risk of viruses jumping from animals to humans. Climate change is also causing disease-carrying insects to move to places where they couldn’t survive before. We’re making it easier for outbreaks to happen, and I think we’re not fully realizing this. During COVID-19, we experienced how small the world is. A virus that broke out in Wuhan, China, took only a few weeks to spread across the globe.' 

Are we adequately prepared for a new pandemic?

The COVID-19 pandemic exposed vulnerabilities in the healthcare system. Timen: 'Collaboration between hospitals, general practitioners, long-term care, and public health is still suboptimal, and a weak link in pandemic preparedness. We also notice that the events of the pandemic are fading from our collective memory, which undermines proper preparation.' Rovers concludes: 'If the cuts to Dutch public healthcare go through, we’ll quickly return to pre-COVID preparedness levels. Adding to the concerning international developments, we are not sufficiently prepared for another major outbreak.' 

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