Evidence-based effective monitoring and control of Covid-19 after the initial outbreak

The Netherlands, like many countries in the world, is nearing the phase where the social distancing measures that were imposed to control the outbreak of SARS-CoV-2 (the virus that causes Covid-19) will start to be lifted. As there is unlikely to be anything close to herd immunity even in the most affected areas, there is an acute danger that increased mixing of the population when measures are relaxed, as well as importation of cases from outside the Netherlands, can lead to new clusters of cases and a second major outbreak when uncontrolled. Effective monitoring is essential to find new infections, connected to effective protocols for tracing-testing-isolation/quarantine (to be called TTI here) to prevent the new clusters from growing while undetected. The fact that in the Netherlands there will be ongoing within-country transmission when measures start to be relaxed brings additional complications and challenges to monitoring and TTI-response. In addition, given the fact that the Netherlands is an important nation for tourism, trade, collaboration and industry, there is very substantial interaction between our country and all citizens of nations around the globe. This is likely to resume (slowly) when 'normal' international travel and mobility is restored. As the Covid-19-pandemic is out of phase across the globe, with nations at the beginning of their outbreaks and nations nearing the end of their first waves, it is likely that we will experience importation of cases from abroad, by air, train, boat and car. As the world is currently dealing with a unique new public health problem and threat for the coming years, it is unclear what an effective strategy of monitoring and response is and whether existing protocols and effort are sufficient to prevent new major outbreaks in the Netherlands until a suitable vaccine becomes available. The aim of the project is to provide a broad scientific basis for an effective evidence-based system, including uncertainties, of monitoring and TTI response for SARS-CoV-2 that takes into account the characteristics of Covid-19 disease, the status of the outbreak, potential importation of cases, specific risk and core groups, the impact of basic transmission-avoiding measures and human behaviour. This can only be achieved by bringing together a large group of experts from a wide range of quantitative disciplines and medical/public health institutions and organizations and in coordinated concentrated interaction. The scientific results of the project can be used as input for the RIVM/Cib, GGD, NIVEL and other parties within whose remit it lies to give policy advice on monitoring and control and to implement suitable public health measures in response to Covid-19. On top of that, the methods and models developed during the project will be useful for future outbreaks of newly emerging (respiratory) infections.