Jochen Mierau on the corona year
The two biggest mistakes
He only got really mad just once. Just once in the eighteen months that Jochen Mierau shared his views on the government’s pandemic policy from his hometown of Groningen was he unable to shake off the reaction he got.
It wasn’t when someone emailed him saying they’d reserved a room for him in the psychiatric clinic for when the pandemic was over. It also wasn’t when someone told him that ‘we’re coming for everyone, including you’.
No, it was when a government party attempted to silence him and other scientists. ‘We were basically told that they didn’t want us talking about any of this’, he says.
Which party exactly approached him, the scientific director won’t say. Mierau uses the words ‘channels’ and ‘organisations’. ‘That about sums it up, I think.’
More important is the fact that someone was attempting to silence scientific discussion. Sure, the government policy may have been messy, but it’s not like we could have expected an easy solution. That’s fine.
‘But there’s a reason we moved here from East Germany’, says Mierau, who witnessed the fall of the Berlin Wall when he was six years old, after which he moved to Groningen with his parents. His background means he’s aware of how governments can impact scientific discussion, and it’s not always good. What they were trying to do here was wrong.
And so he was mad.
Mierau and his UG colleagues at the Aletta Jacobs School of Public Health (AJSPH), which include virologists, sociologists, psychologists, historians, and more, have had a turbulent year. They’ve been closely following the government’s policy since the beginning of the pandemic. The scientists who’d only two years prior found each other in the multidisciplinary platform the AJSPH aims to be didn’t make any attempts to hide their well-founded opinions.
This isn’t a health crisis, it’s a social crisis
These opinions are partially based on the large-scale Lifelines corona study which studies both the disease and its psychological effects on fifty thousand respondents who live in the north of the Netherlands. Many AJSPH researchers contributed to this study. ‘The knowledge from that study can serve as an important contribution to government policy.’
Both Mierau and virologist Alex Friedrich constantly argued that the government should be testing as much as possible back when this wasn’t an obvious thing to do. They pointed out the importance of a road map so people would know what to expect and when. They argued for policies on a regional level to prevent the entire country going into lockdown during an outbreak.
Historian Rina Knoeff pointed out how people responded to other pandemics, such as the Spanish flu or the plague. It wasn’t much different from how people are acting now. Professor of health law Birgit Toebes argued why forcing people to get vaccinated might be a good idea. ‘This quickly cemented the fact that the corona pandemic isn’t a health crisis. It’s a social crisis that happens to be about health’, says Mierau.
Besides, they did exactly what they’d been hired to do: using their knowledge to aid society. ‘The AJPSH wants to be a network that promotes interaction with society’, says Mierau.
Alex Friedrich ended up with a spot on the Outbreak Management Team. Others, including Mierau, worked behind the scenes, on advisory committees. Was he upset that the government didn’t always follow his good advice? ‘I have a vision’, he says. ‘But politicians have to take other interests into account as well. That’s their job. It’s not up to scientists.’
The discussion needed different voice and more focus. And that, he says, they managed to give it. ‘The ministry was unable to implement their policies in splendid isolation.’
Nevertheless, it would have been nice if the government had just listened every once in a while. Like just after the summer, when students returned en masse and the infection rate rose fast. Especially in student cities. ‘If we’d started a massive testing campaign, we might have prevented a lot of suffering. But we didn’t.
Mass testing could have prevented a lot of suffering
Another thing: he’d been arguing for controlled reopening of society through speed testing. That’s only been current policy for a little while. ‘The Eurovision Song Contest was allowed to have an audience because of speed testing. So did the cup final.’ Wouldn’t it have been better to start doing this back in January or February?
Mierau demurs. ‘Hindsight is 20/20. What if there had been problems with the vaccines? What if we’d been in a similar situation as Japan, where only 5 to 6 percent of the population has been vaccinated? Even now, we’re not sure what’s going to happen in the fall.’
There were only two ‘real’ mistakes made, says Mierau. Two flaws the government should spend some time reflecting on.
The first? They shouldn’t want to do everything themselves. ‘The Ministry of Public Health spent years evolving into a ministry that made policy’, he says. ‘When the pandemic started, they suddenly decided they wanted to actually execute those policies themselves.’
They started focusing on testing infrastructure, and setting up the vaccination campaign themselves. Why didn’t they get someone else to do all that? ‘It led to a host of IT issues, slow upgrades, health workers who were sent home one week when they might be needed again the next week.’
The second mistake is that The Hague ignored the extensive knowledge available to them. ‘The Netherlands is the only country in the world with all its universities in the top 200’, says Mierau. ‘You could argue whether those rankings actually mean anything and to be fair, none of the institutes are in the top 20 or even the top 30, but no other country provides such a high level of education to its students. Why didn’t the government use that strength?’
The universities were sidelined. After a lot of nagging, they were given some extra money. The government practically ignored scientific consensus, which led to dramatic mistakes. ‘They thought there weren’t any asymptomatic infections’, says Mierau. ‘But that’s been the case with other coronaviruses as well. So why would it be different this time? The speed with which they processed this knowledge was much too low.’
Knowledge was processed far too slow
The same thing happened with face masks. Other countries had known for a while that face masks worked, but the Netherlands refused to listen. ‘They said they didn’t have the data yet. But you can never have all the data’, says Mierau. ‘Science works with theories, supported by data. They should have listened to the scientific consensus more.’
This resulted, says Mierau, in the government going into crisis mode, which was characterised by tunnel vision and cognitive dissonance. ‘They thought what people were telling them was just noise, but there’s always noise’, he says. Scientists know how to deal with the noise.
Fortunately, says Mierau, after almost eighteen months, things are going alright. The government seems to have calmed down, and they’re finally thinking about the future.
But he also warns the government. We should learn from this pandemic in order to fight the next one, like the obesity pandemic which is going to be a big problem, since ‘we’re still in the first wave of that one’, or the problems we’ll have once there are too many old people and not enough young ones to take care of them.
The Netherlands needs to work hard to restore people’s trust in the government. This trust is essential to combat any crisis. But because of all the trouble with the earthquakes, the child allowance scandal, q fever, and the recent scandals concerning hexavalent chromium, that trust is shaky. ‘How can you expect citizens to believe you when you have such a spotty track record?’
And after that? They need to create a healthcare system that can evolve, that forces the government to take care of its citizens. There are environmental goals the government needs to meet; why not have healthcare goals? If need be, a judge can force the government to meet them. That’s what benefits people the most. ‘The greatest health benefits of the last century were gained because of prevention’, emphasises Mierau. ‘Vaccination, the invention of the sewer system, labour laws. All these things have nearly doubled life expectancy.’
Mierau has faith that it will happen. That the government won’t look away again. ‘What can I say, I’m an optimist. This crisis has laid bare all the issues in healthcare. We’ll have no choice but to deal with them.’