The Brabant Method

By JAN KLUYTMANS

We have implemented an interesting approach to prevent hospitals to be overwhelmed with #COVID19 cases in The Netherlands. This may be useful for others to consider. It is based on spreading of the burden of disease for hospitalized cases over larger areas.

As we have observed in China and Italy, COVID-19 often present in hotspots while other areas are affected less severe. In The Netherlands the first case was found on February 29 in the Province of Brabant (2.5 million inhabitants). On March 15 we had 24 people who had died from COVID on a National level and 21 originated from Brabant. Hospitals in this area were seeing an increasing amount of cases and prepared for larger numbers.

Based on a mathematical model that estimated the number of infected people based on recent deaths it was anticipated that the number of cases would soon be too high for the local hospital and especially the ICU’s.

Other parts of the country were still experiencing few cases and it was decided to transport patients (Both COVID and other diseases) from the hospitals in Brabant to other parts of the country.

This has been a very effective way to spread the burden of disease and at present all hospitals of the country are still fully in control despite a huge increase in the number of patients in the affected areas.

Although we are still in the middle of the storm and we are not sure how this will proceed, we can say that without this approach the local problems would have been at the edge of the hospitals capacity. We believe this strategy is worth considering elsewhere.

Jan Kluytmans is Professor of Epidemiology and Healthcare Associated Infectious disease at UMC Utrecht.

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