Corona testing. What happened in the spring

More people could probably have been tested for coronavirus in the first months of the pandemic’s outbreak. Testing equipment was in short supply, but full use was not made of the available laboratory capacity. This investigation by the Netherlands Court of Audit was carried out faster than initially planned as there may be a second corona wave in the autumn. It is one in a series of investigations of the Dutch government’s response to the corona crisis.

Testing capacity under pressure in the spring

Our investigation found that testing capacity came under pressure from several factors in March. Firstly, international suppliers faced a huge surge in international demand and had problems supplying Dutch laboratories. A related problem was that the Ministry of Health, Welfare and Sport (VWS) and the National Institute for Public Health and the Environment (RIVM) initially did not know how much testing capacity was available at laboratories, what testing systems they used and what specific equipment they had in stock or needed. A third factor was that the municipal health services did not have the capacity or financial resources necessary to meet the rapid increase in demand for corona tests and the related track and trace work. There was also a structural problem: the testing system is only as strong as its weakest link. Lack of cotton swabs, for instance, can bring down the entire system.

Our investigation also found that the same 4 problems recurred when testing capacity was scaled up at the end of March. Gaining an understanding of laboratory capacity and stock levels was difficult and time consuming. The laboratory landscape is fragmented and laboratories use a great variety of testing systems and equipment, each having its own supply problems.

Why did we investigate testing capacity?

With a view to a potential second corona wave in the autumn, the Netherlands Court of Audit hopes this investigation will help the government and parliament learn the full lessons of how the testing system could have been improved in the spring. We investigated the factors that frustrated the scaling up of testing capacity and why laboratory capacity went unused in the period between the first measures taken by the Ministry of VWS and the RIVM on the outbreak of the COVID-19 pandemic and 1 June 2020. The investigation was descriptive in nature and did not result in an opinion on the actions of the Minister of VWS, the RIVM or the Outbreak Management Team.

What methods did we use to investigate testing capacity?

To carry out our investigation, we examined data on laboratory capacity and the number of tests performed by the RIVM and the National Diagnostic Chain Coordination Team (LCDK). We also studied relevant documents issued by the Ministry of VWS, the RIVM and the Molecular Diagnostic Task Force. To clarify this information, we held talks with the parties concerned: the Ministry of VWS, the RIVM, members of the Outbreak Management Team, the Molecular Diagnostic Task Force, the LCDK, municipal and regional health services, the government’s special envoy and 22 managers and care professionals from various professional organisations, care institutions and laboratories. In cooperation with the relevant professional organisations, we held a survey among general practitioners, hospitals and other care institutions to identify the problems encountered testing patients, clients and care providers in the period up to 1 June.

Current status

The investigation was published on 23 September 2020.