The Dutch public health agency RIVM was aware as early as February 2020 that a coronavirus outbreak could lead to more than 30,000 deaths, according to documents obtained by current affairs show Nieuwsuur.

A newly set up response team warned on February 9 that ‘the impact of an nCoV epidemic meets the classification of a severe or catastrophic threat to national security’, but the potential threat was not made public.

Four days later the RIVM met to draw up a range of possible scenarios if the epidemic in China’s Hubei province spread to Europe.

‘Worst case scenario: six times as bad as seasonal influenza in terms of numbers of deaths,’ it concluded. A severe flu outbreak typically causes around 6,000 deaths.

But the next day the RIVM’s director of infectious disease control, Jaap van Dissel, struck a different tone when he addressed a technical briefing in parliament. ‘Essentially, what is happening in Hubei is comparable on average with the current flu situation in the Netherlands,’ he said.

Van Dissel made no mention of another of the meeting’s recommendations, which was that the health ministry should buy in extra supplies of oxygen and antiviral drugs, including oxygen for people recovering from the virus outside hospital.

‘Very small’ risk

The RIVM responded to people on Twitter who were concerned about tourists from China carrying the virus with the reassurance that there was ‘no need’ to stay away from them because the chance of infection was ‘very small’.

Nee. De kans dat zij besmet zijn met het virus, is zeer klein. Het is niet nodig om mensen uit China te mijden. ^MS

— RIVM (@rivm) February 17, 2020

On February 24, as the first infections were confirmed in Italy, van Dissel told Nieuwsuur that Dutch scientists were focusing on ‘containment’ of the virus – preventing it taking hold – and mitigation measures would be considered if that failed.

But a day earlier an RIVM staff member told colleagues in an email that ‘it seems highly likely that the first infections will soon be in the Netherlands or are already here. And I can speculate about the duration of containment, but I fear it won’t be long because of the high number of imports.’

‘Too complex’

On February 25 a senior member of the RIVM warned that an epidemic would be ‘too complex and too big’ for the government to tackle alone and said: ‘we need to solve it as a society.’

‘We are social people with a need for face-to-face and physical contact, but we will have to limit this and possibly for quite a long time (months instead of weeks),’ he said.

Two days later the first case of coronavirus in the Netherlands was confirmed by the minister for medical care, Bruno Bruins.

The RIVM said in a response to Nieuwsuur that the email exchanges referred to ‘scenarios, not predictions’, adding: ‘When we acquired more knowledge we subsequently revised our advice.’