10/4/2021:
From farmers to the national government, everyone benefits from a well-organised animal health monitoring system. When important signals are received from monitoring, which are a sign of compulsory reportable and compulsory treatment animal diseases, direct contact is sought with the NVWA (Netherlands Food and Consumer Product Safety Authority). When public health may be involved, the Ministry of Public Health, Welfare and Sport (VWS) is also involved swiftly. Three key figures involved in the recent outbreak of the SARS-CoV-2 virus at mink farms explain how these structures work, and demonstrate the strengths of the Dutch system.
Arco van der Spek, Team leader at the Incident and Crisis Centre of the NVWA
“At the NVWA, my team is involved in combating compulsory reportable and compulsory treatment animal diseases. Signals and notifications of suspected disease come directly from the field and from compulsory examination and checks such as those conducted upon import, export and slaughter. The voluntary animal health monitoring conducted by GD is an important supplement to this system. Alongside our regular consultations with GD, we notify one another very quickly in the event of signals. The earlier we are all informed, the better. Many of the parties involved have known each other for years and the lines of communication are short. That trust is extremely important, as is the trust in the monitoring system by the field players. Especially because as a government body, we sometimes have no choice but to enforce very strict measures.
Mink with COVID-19
The significant case of 2020 was of course COVID-19 among mink. After noting clinical problems at a mink farm, the known pathogens could not be found. GD then conducted the PCR test for COVID-19, which proved to be positive. Our team was notified immediately. This was an extremely complicated situation, due to the public health issues involved. It was very useful that the comprehensive consultation structure was already in place. All the parties involved, including the ministries of VWS, and Agriculture, Nature and Food quality (LNV), as well as the National Institute for Public Health and the Environment (RIVM) were already party to the structure. No doubt there will be points for improvement once the cooperation has been evaluated. In the outbreak of COVID-19 in the mink sector, it was sometimes very difficult to share information for example, partly because of the General Data Protection Regulation. We wanted to know quickly which animal handlers had tested positive, but that information is not freely available. However, in general, our monitoring structure worked effectively.
Good structure and cooperation
We lead the way in the Netherlands: from monitoring to combating disease, our structure is well designed. That starts at the front via GD and continues through to our contracted parties who are ready to take action in case of an outbreak, 24 hours a day. Luckily, we were able to examine the mink outbreak in great detail. Thanks to a consortium of research institutes, but also thanks to the cooperation shown by the mink farmers. We were already culling all their animals and on top of that, we wanted to take samples at their farm, that’s quite a big ask. You need to take a respectful attitude to both the animals and the farmers, and to explain everything clearly. Such situations are always dramatic, equally so for our people. However tough such tasks may be, we fortunately often also receive appreciation from the farmers after the event.
One Health
Besides animal health, the ‘One Health’ approach is extremely important. All stakeholders are involved in the Signaleringsoverleg Zoönosen (SO-Z; Zoonoses Signalling Council) in order to monitor signals. While we are on the right track, 2020 also taught us that this One Health cooperation can be improved even further. COVID-19 in mink was a new situation and was not compulsory reportable. It then becomes difficult to take immediate action, and rapid legislation becomes necessary. Being well prepared for new diseases is an essential factor. The procedures need to be already in place, so quick action can be taken.”
Photo 1. Arco van der Spek: “From monitoring to combating disease, our structure is well designed”
Stephanie Wiessenhaan, coordinating policy staff member and Yvonne de Nas, senior policy staff member, department of crisis control and infectious diseases of the Ministry of VWS
This Ministry is responsible for combating infectious diseases in order to protect public health in the Netherlands. Infectious animal diseases are the policy domain of the Ministry of Agriculture, Nature and Food Quality (LNV). Stephanie Wiessenhaan: “The structure for infectious animal diseases is based on that for infectious human diseases. All the same components are included in the zoonoses structure, coordinated by the National Institute for Public Health and the Environment (RIVM).”
Spider in the web: Signaleringsoverleg Zoönosen (SO-Z)
Each month, experts from the human and animal sectors meet in order to assess any possible signals of a zoonotic nature and to take any further steps required. This SO-Z is the first link in the zoonosis structure. Participants include GD, the Netherlands Food and Consumer Product Safety Authority (NVWA), Wageningen Bioveterinary Research, the faculty of Veterinary Medicine and the two aforementioned ministries, while the RIVM chairs the council. Yvonne de Nas: “In the week following the SO-Z meeting, there is further zoonosis consultation with the Ministry of LNV, the RIVM and the NVWA. There, we can discuss other matters at hand and have more time to exchange information.”
Short lines of communication for quick reactions
Wiessenhaan: “At the Ministry of VWS, our information is always provided via the SO-Z. The short lines of communication are standard, in case we need to speed up our response in the meantime. The director of the Centre for Combating Infectious Diseases of the RIVM may be requested by either of the two ministries to organise an Outbreak Management Team for Zoonoses (OMT-Z), for example. Or perhaps a mayor becomes aware that something is wrong.” De Nas: “We always use the information gained from the Dutch monitoring system. If anything occurs in the meantime, we receive the information earlier.”
COVID-19 and farming
De Nas was closely involved in the 2020 outbreak of COVID-19 at mink farms: “We already had regular contact, but I actually spoke to my colleagues at the Ministry of Agriculture more often than those at the Ministry of Public Health last year! The sector itself was also heard, via the Netherlands Fur Breeders Federation and the veterinarians involved. This took place during the Administrative Coordination Meeting. The Ministry of LNV added me to their policy team early in the COVID-19 pandemic, although that was officially not yet necessary at that point. We were still unaware of which animals played a role.” Wiessenhaan adds: “The case concerning the mink last year is the most important so far since the establishment of the SO-Z. An Outbreak Management Team for Zoonosis was also formed. We had of course already scaled up our activities in the past, in response to the Schmallenberg virus for example, but this was unique. The OMT-Z did an excellent job, and the complete structure functions well.”
Drastic
“The outbreak at the mink farms was drastic, particularly for the sector itself. But also for the NVWA, responsible for organising the culling. We spent a great deal of time consulting, and also informing the Dutch Parliament. The Minister for VWS needed to inform Parliament about the mink sector. That was something he never thought he would have to do.” Yvonne de Nas: “What I remember most about the past year is all the hard work. We were working at breakneck speed, and all hands were on deck due to the necessity to take quick action.”
Lessons learned in 2020
Their perspective of the zoonoses structure has not changed fundamentally over the past year. De Nas: “There will always be differences between the animal and the human approaches. We are accustomed to receiving advice from the RIVM, which includes measures to be taken. At the Ministry of LNV, there is a larger gap between risk analysis and risk management.” Wiessenhaan: “Ideally, we would want very precise advice, including the percentage of risk reduction to be achieved per deployed measure, and the exact degree of uncertainty concerned. That would give us the leeway for a policy-based consideration of the measures to be taken. Having worked at length for the Ministry of LNV and in the animal sector, I’m aware that the situations are more easily engineered than in the case of infectious human diseases.”
Roller-coaster
De Nas: “The past year was a massive roller-coaster. A very effective aspect in 2020 was the joint determination of all risks, with input from research parties such as GD. Also effective was the mutual communication by the NVWA and the RIVM. We can take that experience and apply it in case of any other infectious diseases that might develop.”
Photo 2. Yvonne de Nas: “The past year clearly showed that the zoonoses structure works well”