Ernst Kuipers is usually a gastrointestinal and liver cancer specialist, but has recently become chairman of the hastily designed national coordination center for corona care. He must ensure that the Netherlands has enough IC capacity to provide each patient with a place, if necessary on the other side of the country. How does he work and how does he estimate the current situation?

"We have a good handle on the situation at the moment," says Kuipers, while he adds with a laugh: "And I say that while I am late for this appointment."

Kuipers, who is also chairman of the board of Erasmus MC in Rotterdam, is referring to the expansion of IC capacity in Dutch hospitals to 2,400 beds, the so-called upscaling phase. Hospitals achieve this through mutual cooperation, the addition of available equipment and the optimal deployment of staff from other departments.

As chairman of the national coordination center, Kuipers keeps an eye on the patient distribution and capacity of Dutch hospitals. The center is built up in the empty study center of Erasmus MC.



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Plans are made in peace

The vaults of the Rotterdam hospital are not at all hectic. Several rooms are classified as small classrooms and large papers on the walls display coronavirus data in the Netherlands.

In a corner of the center, some soldiers are talking to each other. Of course they observe the rules and keep all 1.5 meters away from others. They have served on missions in Iraq and Afghanistan and have experience of acting quickly in these types of crises.

The soldiers help Kuipers with his work, watch how the coordination center works and intervene if something goes wrong during the process, says the professor while he arrives almost half an hour later than agreed. He was briefly talking to Minister Hugo de Jonge of Health, Welfare and Sport (VWS) by telephone.

"We really looked at how Defense does that when they are on a mission," explains Kuipers. "Strangely enough at the moment the same comparison. Defense has helped us a lot with how we should do it."



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Kuipers looks no further than 2,400 IC beds

Defense tries to provide help wherever possible during the corona crisis. Defense not only assists Kuipers and the coordination center, but also assists with the delivery of extra respiratory equipment. Those machines are needed to expand the IC departments across the country.

Before the number of corona patients on ICs increased sharply, hospitals in the Netherlands had a total of 1,150 IC beds. This must be expanded to 2,400 beds next weekend under Kuipers' watchful eye.

According to Kuipers, there are no corona patients on about five hundred of the beds. These places are intended for patients who need urgent help, but who are not infected with the coronavirus. He does not want to have it on his conscience that there is no place on the ICs for people with diseases other than COVID-19.

"Think of victims of a serious accident or people who suffer from heart failure. You can't stop that for a while. Because then you pick up the net afterwards and it turns out that you have saved corona patients, but also lost others."

The chairman of the national coordination center is jointly responsible for the capacity in the ICU departments in hospitals. However, he does not want to go into the question of what happens if those 2,400 beds prove to be insufficient and we enter a crisis phase. "We are now concentrating on that 2,400. Of course we are thinking behind the scenes about the chance that the curve will not flatten anyway."

"You have to think about all kinds of different options," he nevertheless lifts a corner of the veil. "Can we still grow further? Or, based on all the knowledge we now have, can we better triage patients (determine who comes into intensive care and who doesn't, ed.)? When the first patients came here, we only had data from China and a little bit of information from Northern Italy. Meanwhile, we know what the disease is exactly. This means that you can better predict who really benefits from an IC withdrawal and who does not. "



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No prediction about peak in intensive care

When asked how long he thinks the coordination center in Rotterdam is needed, Kuipers responds diplomatically: "As long as it is necessary for this crisis. I hope it will go quickly."

It was previously outlined that the peak in the number of patients in intensive care will be reached in late May. But Kuipers does not want to venture such a prediction now. "Let's take it first per day. But it's very simple: we are seeing an increase in the number of patients admitted and it is expected that this will continue in the coming week."

"At the time of admission, they are generally here for at least four weeks," continues the doctor, who is a specialist in stomach, colon and liver cancer. "If the number of patients continues to rise and they have been here for four weeks, calculate how long that will take."

Kuipers takes the time to explain his story, but a spokesman has interrupted him several times because he has to go to the next appointment. He is actually already fifteen minutes late for it. Despite the calm that the director radiates, these are hectic times.

Whether the professor himself is afraid of the virus? "No, but I am aware of it. We have seen that it is really a contagious virus and that it can make people seriously ill. Well, that is something we are used to in the hospital, but that is what I mean not tough at all. I come into contact with many people, so I am very aware that I could get infected. But at the moment I have no complaints. "

See also: Why the ICs are already filling up, but the real peak will only follow in time

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The coronavirus in short

  • The coronavirus mainly spreads from person to person via sneezing and cough drops. The chance of becoming infected through surfaces such as door handles is small. This chance decreases if you wash your hands often.
  • You can considerably reduce the chance of spreading by keeping at least 1.5 meters away from others.
  • An infected person infects two to three others on average. Precautions are necessary to contain this.
  • The vast majority of patients have mild (flu-like) complaints.
  • Almost all deaths involve the elderly or other vulnerable persons, such as heart, lung or diabetes patients. If everyone complies with the measures, this reduces their risks.
  • Read here what precautions you should take.