When we went to the lockdown end of March 2020, I wrote a number of posts advocating for broader use of personal protection means such as face mask. Some of these measures were finally accepted by the government (e.g., in public transport) but I find it insufficient (e.g., no facemask in supermarkets). I have now moved all my posts to this subpage.

April 27. (texts are shown in inverse chronologic order) 

In 2005 we have organised the 6th Liquid Matter Conference at Utrecht University (July 2-5, 2005). I still have a couple of t-shirts from this time. I have now sacrificed one of them to make a couple of new face masks, see the photo. I followed the instructions of https://www.youtube.com/watch?v=pJaVBt8q6g8. It is a perfect solution for those of you who have no sewing machine. 

Will it protect me against coronavirus? Not sure, probably partially. Will it protect the others around me if I have the virus? It will significantly reduce the chance of transmitting the virus to other people according to what the WHO (World Health Organisation) and RIVM (Dutch Royal Institute for Public Health and Environmental Safety) say. So, I take my social responsibility, do you? 

April 16. 

There was a new discussion today in the Dutch parliament. Let me reflect on one statement of Jaap van Dissel, the official Dutch expert in the coronavirus. While answering the question on the use of face masks in Eastern countries, Jaap said literaly "Ik bedoel dit niet grappig, maar in veel Aziatische landen lopen mensen al tijden met mondkapjes en dat heeft daar ook de corona-uitbraak niet kunnen tegenhouden." In plain English, "I don't mean this funny, but in many Asian countries people have been wearing mouth masks for a long time and that has not been able to stop the corona outbreak there." Let us compare then the situation in NL and "Asian countries" (Johns Hopkins Uni data on April 16, 10:00 pm)

As of today in the Netherlands, we have almost 30k registered cases, 3315 deaths, that is 193 dead people per million (not to mention that the number is probably twice as high...). Let us take this number, 193 deaths/million.

In the whole of China there are 3346 deaths, that is 2.3 deaths/million!

Province Hubei, where the problem appeared, counted 3222 deaths, 55 deaths/million, less than in NL!

The rest of China (China minus Hubei), 0.09 deaths per million; their capital Beijing, 0.36 deaths/million! Look in the table below. 

Many politicians say that China is a dictatorship. We cannot accept their measures in the "civilized and democratic" world. Let us look at democratic countries then such as S. Korea, Japan, Taiwan, countries with a comparable density of people. Is it difficult to see that we have 100 times more deaths per million? In other words, these Asian countries did not stop the virus but they did protect their people! 

Is Professor Jaap in a position to analyse a few numbers like this? 

April 8. 

Jaap van Dissel gave a presentation today at the Dutch parliament. My main "anti-highlights":

1. In NL at least 40% of nursing homes for elderly people are infected by the coronavirus. => It is the death sentence for many old people. How is it possible???
2. The main strategy remains: building up the herd immunity. Is it realistic?
3. R0 is not 0.3 as reported by Jaap a week ago but around 1.  

Today I gave this presentation via ZOOM: Coronavirus_8april.pdf

April 6. 

I made a presentation yesterday that I have sent to Prof. Jacco Wallinga from RIVM. Please have a look: Coronavirus_5april.pdf

April 4, morning. 

According to Reuters, "The World Health Organization on Friday said it still believed the use of respirator masks should be focused mainly on medical workers, but opened the door to greater use of homemade masks or other mouth coverings as a way to reduce the spread of the coronavirus." WHO "opened the door", thank God! It is a step in the right direction. But it is a tiny step, far too small to have an effect! We need 100% of people to wear masks! As I said already several times (see below), many people spreading the virus have no or weak symptoms, they are not aware that they are killing elderly people. Please watch this clip: I protect you, you protect me. No masks on sale in the supermarkets/pharmacies? Make them yourself! See my Facebook for more useful links. 

The Netherlands shows some signs of stabilization. Above are two graphs showing the number of deaths per day and the number of patients taken to hospitals. We stopped with the exponential explosion and went to a plateau. The RIVM says that R₀ is now around 0.3. I hope it is true. I hope that next week these numbers will show a clear trend down. Fingers crossed!

The next question is what next (see also my post of April 1 below). We are in the lockdown now. When can we go back to normal life? I think there are a few scenarios possible:

• Stop the quarantine after a few weeks or a couple of months if the number of new cases becomes very low. I am afraid that this can trigger a new explosion followed by a new lockdown if we continue the same policy. 
• Wait until the vaccine is developed and everyone is vaccinated. How long will that take? Will the economy survive? Will we still have money/goods in supermarkets when that happens?
• To my mind, the only reasonable solution is when every one of us uses all possible means to protect themself from other people and to protect other people from themself. 

April 3, morning. 

The WHO leads the “civilized” world along a wrong pass, see the other posts below. The sooner RIVM and Mark Rutte understand this, the more lives can be saved. I feel that I am hitting the wall with no effect. 

There are some signatures of a shift of opinion in the US, please see

• April 3, 4:21 am GMT: https://www.nytimes.com/2020/04/02/world/coronavirus-live-news-updates.html;
• April 3, 1:00 am GMT: https://www.aljazeera.com/news/2020/04/coronavirus-moves-promoting-broader-face-masks-200402214522519.html
• March 27: https://medium.com/@Cancerwarrior/covid-19-why-we-should-all-wear-masks-there-is-new-scientific-rationale-280e08ceee71;

The NOS (Dutch News Agency) showed two headlines at 6:00 in the morning on April 3: Ambassadeur Hoekstra haalt uit naar China and recordaantal doden in VS. It says the "US ambassador in NL Pete Hoekstra shouts on China" and "Record number of death in the US". Hey, guys, why don't you stop pointing into the wrong direction? I can imagine that China manipulates with numbers somehow. For example, like Germany, which only counts deaths as a direct consequence of the coronavirus. If somebody dies of the heart attack induced or promoted by the coronavirus, it is not counted in the 7th column below. However, whatever China does, it CANNOT HIDE THOUSANDS OF DEATHS. Look at yourself and the second headline!

April 2, morning. 

Let us do some sad math with the numbers available at this moment. The US took the lead in this horrible race. According to Gideon Meyerowitz-Katz, an epidemiologist from Sydney, Australia, without having a vaccine, this pandemic will stop in a country where 70% of its population gets sick and subsequently builds up the immune response. With the most optimistic predictions of the fatality rate of 0.5%-1%, this corresponds to 0.35%-0.7% of the population that must die. Taking the average, about 5000 people must die per million. (a note in brackets: in Italy, the fatality rate was yesterday at 11.75% according to Oxford University, but let us hope that the actual number is lower because of the cases that are not registered). Using these numbers, I made a little table below taking a few countries for comparison. 

A note about the accuracy of the numbers: I used the data provided by Johns Hopkins University today and by Wikipedia for the population. The number of actual cases can be very different from the registered cases, shown in the table. The number of deaths can vary by a factor of 2 or 3 depending on how it is counted. My point is that now we are talking about the order of magnitude. My statement is that the actual death numbers in the 7th column cannot be mistaken by more than a factor of ~3. 

Horrible numbers! About 40 million deaths worldwide if we follow the current WHO recommendations and do what we do now. This is 1000 times more than we had up to now! In the US - 1.6 million dead to come, 300 times more than the US current deaths count! In the Netherlands - 70 times more. Italy and Spain have already paid a huge price but the estimate is 20 times more to come. Russia just entered the race and following the scary path of the "civilized world" such as Italy, USA and the Netherlands. I do hope that Russia is still able to learn the lesson from many examples of DONTs. 

What are the DOs then? Look at China! They got a hard blow in the beginning because they were the first when there was no information nor experience with this virus. Despite very tough measures to localize the virus in its capital Wuhan and the whole province, the virus did escape. Let us look at other Chinese provinces then! The situation in Henan province is the worst with ... 22 deaths or 0.2 per million. There are 3 active cases running now, the rest are recovered. Look at their capital, Beijing: the municipality is as large as half of the Netherlands with 21.5 million inhabitants. 8 people died. Eight, man, EIGHT!!!! There are still 150 cases active in Beijing but the situation is under control. I think that in China some people will still die due to coronavirus. But it is going to be only a few rather than thousands or millions! That's why I did not put any numbers in the last column for China.

China is fine and is recovering. They are starting a normal life. This is because all the Chinese have got a special medical treatment called shock therapy. China went through a number of scarry cases such as SARS 17 years ago. The Chinese are apparently "not civilized" as they do not follow the recommendation of the World Health Organisation. In addition to social distancing, every single Chinese uses face masks and other means in public places to protect themself and to protect others around: it needs to work both ways. See my other posts below, I started to repeat myself. 

Just to conclude: Every country has to decide which path to follow. If you want to follow the civilized world, please check the last column in my table. The alternative is to go through shock therapy and to learn how to use protection means properly.  Our governments must help us then. 

Photo: Ramon Espinosa/Associated Press published in the New York Times.

April 1, morning. 

Questions to Mark Rutte and his advisors: (1) Do you have any realistic model for the coming months? How long is it going to take to build up the herd immunity against COVID-19 in NL? (2) How much does the reanimation of a single coronavirus patient cost in the IC unit? Is it more expensive than 10 thousand face masks? 100 thousand? Million? Do you have a number? 

Today is the Fool's Day but it is not a good moment to make jokes. Let us be serious. The hospital statistics in NL gives the first signatures of slowing down. The number of coronavirus patients is still growing but not as fast as it was in the beginning when it was doubling in every 2 days. Thank God and the Netherlanders, who begin to realise how dangerous the crisis is. A thousand lives is an expensive price for the lesson and it still inflates every day with more than 100 per day. I keep my fingers crossed that we shall get down next week and we shall not face the problem of having too few IC beds for too many people who desperately need that to have a chance to survive. 

Hoping for the best, I ask myself what next. Let us assume that the number of cases goes down next week. When can we go back to normal life? Until the last patient dies or recovers? I think it is NOT realistic: the virus will be with us for a very long time if not forever. Until we build up the herd immunity in NL? I think that this is also NOT realistic: it will take many months or even years! My dilettante prediction is that we shall need to open the country before we beat the virus and before we are immune to it. Dear experts, please correct me if I am wrong! I want to see your calculations!

The problem of this pandemic is that on average a sick person passes his infection to about R₀ = 3 people. These 3 infect 9, etc, ... 3¹⁰ = 59 thousand ill people in ten rounds. With an uncontrolled spreading as we had recently, this takes less than 2 months. I think that if the Netherlands get out of the lockdown without learning the lesson, the situation will explode again. We need to bring the R₀ number to less than one. How?

1. Vaccination is not yet available and it will probably take too long to have enough vaccine for everyone.
2. Building the herd immunity won't work in the short term. Let me quote Gideon Meyerowitz-Katz, an epidemiologist from Sydney, Australia: "Until we have a vaccine, anyone talking about herd immunity as a preventative strategy for COVID-19 is simply wrong".
3. Look at China! I don't know whether people in Wuhan have some herd immunity by now, I guess not. But let us look at other provinces! For example, Beijing municipality has 21 million people on 16.4 km2, about half of the Netherlands size. The virus did penetrate to Beijing. 580 confirmed cases of which 8 died and 418 recovered. Did they build herd immunity in Beijing??? I don't think so! In fact, the Chinese had shock therapy, already several times in recent history. They know the secret how to bring R₀ below 1. See below what I think about that.

For comparison: as of today, in NL we have 12595 confirmed cases, 1039 deaths, 250 recovered. Compare this to Beijing numbers quoted above! (data are taken from Johns Hopkins University). So, 250 people are immune now in the Netherlands. Some of the 12595 will die but the majority will survive and contribute to the herd immunity. How many not registered cases do we have by now? 10k, 100k, 1M? Nobody knows. What I do know is what we need to have enough immunity in the country after the lockdown. 2/3 of the population must be immune to make sure that out of R₀ = 3 people, on average 2 are protected. This is 11.6 million people. I think we are yet far below this number. How many of these people must die to build enough immune protection???

Dear Mark Rutte, please think of a better strategy! Arrange protection means to your people. First of all, those who are now exposed (in hospitals, at the supermarkets, and other people of an acute profession). Face masks, in particular! Think of the future of this country! 

An addition written next morning (March 27)

Last evening I watched the NOS journal at 20:00, the Dutch half-an-hour news programme. The vast majority of the reportages were related to the coronavirus crisis. There were many clips filmed on the street, in a shop, in the parliament, in the hospital in Rotterdam with an interview of the man from the intensive care doctor association, from facilities for homeless poor people, people developing coronavirus tests and preparing help packages, see the collage. In none of the reportages, I have seen a single person with a face mask! There were some only in a short clip from New York, none in the Netherlands! Absolute zero, helemaal geen! After this, I am not surprised by seeing the dynamics of the number of people in the intensive care departments (right top image)!

For a comparison: below are screenshots from a reportage from China (Wuhan, the Great Chinese Wall) shown in the NOS journal on March 24. Do you see a single person without a facemask? I don't! What is the current situation with the coronavirus in China and in NL??? Conclusion? 

My wife is working in the hospital although she is not involved in the treatment of coronavirus but cancer patients. Am I sure that none of them beares the virus? Her colleagues? Other people coming to the hospital? Obviously, not! Still, no means for personal protection such as face masks, are provided by the hospital to its employees! Is it understandable? Why people working in supermarkets are not seriously protected in NL? They can easily act as a transmission means and many of them will also become victims of this crisis. Is there anyone taking care of these people involved in the acute service? 

A sufficient number of intensive care beds is crucial at this moment. However, one has to spend efforts to struggle with the actual reason for the scarily growing number of these patients. The government has to provide protection means to ALL people in this country. But, in the meantime, we all must take our SOCIAL RESPONSIBILITY, see below. Only in this way we can slow down the spreading and, hopefully, stop it. 

WE CAN DO IT! Social responsibility against coronavirus (March 26)

The world is threatened by the coronavirus pandemics. Politicians in Europe and the US failed to offer effective protection while the solution is much easier than it seems at this very moment. We all can and must stop it now.

At this moment there are several approaches to the problem. Ten days ago, on March 16, the Dutch prime minister Mark Rutte said that “a total lockdown makes no sense in the Netherlands”. He suggested an alternative approach of a “controlled distribution among groups at least risk”. He has hoped to build the herd immunity in the society, when many young people become insensitive to the virus and, thus, protect the groups at risk. See this website in Dutch, you can use translation tools if you don’t read Dutch.

Now, ten days later, it becomes clear that this strategy does not work. The Netherlands is obviously losing the race and we approach the situation similar to that in Italy and Spain: we might face the deficiency of intensive care beds next week. I keep my fingers crossed that we don’t cross the border when the doctor needs to decide whom to reanimate and whom to let die. The Netherlands is falling more and more into a lockdown, which our prime-minister wanted to avoid.

Our neighbours such as Belgium have enforced a much more stringent lockdown. Will it be more efficient than the Dutch “controlled distribution”? I hope it will on a shorter-term but I am not sure whether the success will be sustainable. If the quarantine measures are released, the virus will start spreading again if there is not enough immunity in society. This might sound depressing while there is an obvious solution to the problem: WE CAN DO IT!

The coronavirus outbreak is dangerous because of the exploding growth of the number of cases. For example, in the US the number of cases grew up 7.5 times within a week, from March 18 to 25! See https://www.worldometers.info/coronavirus/. This happens because, on average, an infected person passes the virus to 2.5-4 new people (the exact number depends on the country and the source on the Internet). We need to bring this number to less than 1 to stop the pandemic. This is possible without a stringent lockdown, look at China!

To achieve this goal, every one of us has to take her/his SOCIAL RESPONSIBILITY. Do not wait until your government solves the problem or the virus ‘dissolves’ somehow. Respect the social distance! Always wear gloves and use facemasks outside your private space. Very carefully wash your hands after touching any surface. If you don’t have face masks, see below (my solution is not safe but it does reduce the passing rate!).

Coronavirus crisis: a dilettant view (March 25)

For far too long we have heard that face masks cannot protect against the coronavirus. The common belief is that one has to build the ‘herd immunity’ when the majority of the population builds immune response after contact with the virus. I don’t want to comment on the moral aspects of this theory. Let us look at the numbers. China shows very promising results. Did they build herd immunity over the whole country? I don’t think so. Look at the latest photos / TV commentaries from China. Did you see a person without a face mask? Is this their secret?

In NL there is not enough protection means even for people working at hospitals! This morning I got a message from our neighbour working at first aid begging for face masks in case one of our neighbours has some of them at home...

I think that we all must protect ourselves to slow down the infection. This morning I spent some time to make a contribution. My mask is not professional and I am not going to donate it to a hospital as it is certainly not virus-proof. But, it might give a contribution even if only 50% of viruses are stopped. 

Why do I find it important? Let us look at the numbers. According to https://www.worldometers.info/, within a week, from March 17 to 24, the number of registered cases in the Netherlands has increased from 1705 to 5506, by 3.23 times. The actual number of infected people is obviously higher but nobody knows by how much. The total number of death rose from 43 to 276, 6.42 times in the same period.

If it continues like this, 3.23*3.23 = 10.4 times in two weeks, 3.23^3 = 33.7 times in 3 weeks, etc for the registered cases. If the death rate growth continues, 6.42*6.42 = 41, 6.42^3 = 265! According to sources on the Internet, each person infected by the coronavirus passes it to 2.5-3 new people on average. This causes the scary effect of the very high spreading rate. We all must reduce this number! If we manage to reduce it to less than 1, the spreading of the disease will quickly decay in a matter of weeks!

World Health Organisation (WHO) says that "if you do not have cough, fever and difficulty breathing ... you do not have to wear masks". It is nonsense! How many people are spreading the virus around before they get the symptoms (or, even not getting sick at all)?  

My suggestion is therefore that everyone has to take his/her responsibility. Take serious precautions! Thoroughly wash your hands after each contact with a surface that might contain the virus. Wear a mask. If you cannot get one, make one yourself. It won't give you 100% protection but:

• it will scare people around you
• it will stop you from touching your own mouth and nose
• it might even stop some of the viruses and will reduce your chance to contribute to the horrible statistics, see above. If we manage to get the passing rate from 2.5-3 to <1, we shall solve the problem together! 

It is the responsibility of each of us. We must, first of all, protect ourselves. By doing that, we shall protect our families and other people around us, our university, the Netherlands, and the rest of the world.