Coronavirus: What the Netherlands tells the UK about 'Freedom Day'

Covid cases in the Netherlands had fallen steadily to just 35 infections per million people per day by the time it adopted its 'Step Four' measures (for comparison, the UK is currently recording 515 per million per day, but this is already accelerating rapidly).

From the end of June, life in the Netherlands returned to semi-normality.

Dutch PM Mark Rutte

There were no limits on the number of people who could gather in homes or share a table in pubs and restaurants.

Mandatory face coverings were scrapped, except in situations where people were sharing crowded and potentially poorly-ventilated spaces such as public transport.

A ban on the sale of alcohol after 10pm was lifted and curfews on hospitality and leisure venues' opening hours abandoned.

Cinemas, concerts halls, shops, bars, restaurants, stadiums and nightclubs could open their doors with limited mitigations.

READ MORE: What more can - and should - we do to boost vaccine uptake in young people?

In the case of restaurants, for example, seating had to be spaced 1.5 metres (5ft) apart.

In venues where people moved around - such as shops and museums - capacity was capped at one person per five metres squared, unless the Coronavirus Entry Pass system was adopted, in which case venues could open at full capacity without distancing or masks.

This domestic 'passport' system was mainly adopted by nightclubs and larger events spaces where revellers were permitted entry only if they had proof of vaccination, a pre-admission negative test, or proof of having had Covid.

Infections have risen rapidly in the Netherlands and are now almost equal to the UK

It didn't take long for the party to sour, however.

In the space of just two weeks, the Netherlands' virus rate surged seven-fold.

Nightclubs and discos were shut down, the entry pass system suspended, music festivals and other large public events banned until August 14, trading curfews reimposed, and the public urged to limit gatherings in their homes to small numbers with physical distancing - even if people are fully vaccinated.

As of July 14 its infection rate had practically caught up with the UK, with 490 cases per million people per day against the UK's 515.

On Monday, Dutch Prime Minister Mark Rutte conceded that the government had eased restrictions too quickly.

"What we thought was possible turned out to be wrong in practice," he said. "We made a miscalculation, we are disappointed about it and we apologise."

READ MORE: Warning as quarter of under-30s hospitalised with Covid develop complications

The Netherlands is a cautionary tale of how rushing back to too much freedom, too soon, can spectacularly backfire.

By the time it opened up on June 26, only a third of its population had been fully vaccinated and the Delta variant was in the ascendency (it had gone from making up around 10% of Dutch cases on June 14 to 38% by June 28).

We know that people previously infected with non-Delta strains are susceptible to reinfection with this new variant, and that people who have had a single vaccine dose are only 33% less likely to contract symptomatic Delta-Covid than those who are unvaccinated.

Around 43% of the Netherlands total population is fully vaccinated compared to just over half of the UK's total population

When the Netherlands threw open the doors of its bars and nightclubs without restrictions, it invited Delta to the party as well - and now its health system will have to cope with the hangover.

So far the number of patients in hospital remains low (around 119 compared to a peak of more than 3,300 in March last year) but those numbers will rise as infections picked up over the last few weeks feed through into hospitals.

As in Britain, overall admissions will probably remain lower than during previous waves due to vaccination, and a larger share of the patients will be unvaccinated young people.

READ MORE: Vaccinating children - is it too risky? Or too dangerous not to?

But that does not mean the impact should be dismissed.

On the basis of Scotland figures, roughly 1.5-2% of people aged 20 to 39 who test positive for Covid after developing symptoms are ending up in hospital (the real translation of infection-to-hospitalisation is likely to be lower once you take into account asymptomatic infections, however).

Between June 9 and July 6, a total of 357 people aged 20 to 39 were admitted to hospitals in Scotland with Covid.

Covid hospital admissions, Scotland

According to a new study, published in the Lancet on Friday with significant input from researchers at Edinburgh University, 27% of 19-29 year olds and 37% of 30-39 year olds hospitalised with Covid - even those with no pre-existing health issues - suffer complications ranging from kidney and liver problems to neurological and cardiovascular damage, in some cases long-term.

That research was based on patients treated between January and August last year, long before the Delta variant emerged and which separate UK studies have shown doubles the probability of being hospitalised with Covid.

Professor Calum Semple, chief investigator on the Lancet study and a Scottish virologist who sits on the UK's SAGE and NERVTAG expert bodies, said the work "contradicts current narratives that Covid-19 is only dangerous in people with existing co-morbidities and the elderly".

Professor Calum Semple

Focusing solely on deaths is also "likely to underestimate the true impact" of the disease on health and care services long-term, said co-author Aya Riad, "particularly in younger people who are more likely to survive severe Covid".

For now, cases in Scotland are high but levelling off with nearly 54% of the total population fully vaccinated and a slower, more cautious reopening underway.

There is every chance that England's Dutch-style 'Freedom Day', with its "bonfire of restrictions" from facemasks to social distancing and long-awaited nightclub reopenings, will be getting reined in by the time Scotland reaches 'Beyond Zero' on August 9.

"Living with the virus" should mean accepting basic mitigations to manage it, at least while the vaccine rollout continues.

Embracing "freedom" just because we wish the pandemic were over already is a strategy doomed to fail.