Coronavirus: why so many people die in Belgium


Grand Place in Brussels


A man and his dog are the only visitors in a normally occupied Grand Place in the center of Brussels

Belgium is the most affected country in the world with regard to the coronavirus mortality rate.

This rate, unlike the total number of deaths, is a measure of the number of deaths relative to the size of the population.

President Donald Trump recently highlighted a graph, showing Belgium at the top and the United States in seventh place, due to the number of deaths relative to the size of the population.

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He suggested that the United States was managing the pandemic more effectively.

Belgium has 11.5 million inhabitants. This means that 66 out of 100,000 people died from Covid-19. In the United States, with a population of around 330 million, that’s 19 in 100,000, according to data from Johns Hopkins University.

But these figures are “false comparisons” that have been “abused”, argues Professor Steven Van Gucht, Belgian virologist and government spokesperson.

“This is the difference between public health science and political motivation,” he says. “It is purely inspired by showing how well you are doing and it is wrong. We actually report more correctly. “

What is different in Belgium?

Belgian officials say they count in a way that no other country in the world currently does: count deaths in hospitals and care homes, but including deaths in suspected, unconfirmed care homes , like the cases of Covid-19.

According to the latest official figures from Belgium, 53% of 7,703 deaths occurred in nursing homes.

Some 16% of deaths in nursing homes have tested positive for the coronavirus. The others are suspected.

This means that more than 3,500 deaths have been reported to be caused by Covid-19, but have not been confirmed.

How it works?

“It is based on the doctor’s assessment, usually taking into account the presence of the coronavirus in the same nursing home,” said Professor Van Gucht.

“For example: if you have one or two confirmed cases, then the week after you have had 10 deaths in the same house on the basis of similar symptoms. “

Prof Steven Van Gucht

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They are not laboratory tested, but it is reasonable to assume that they are also related to Covid-19

Prime Minister Sophie Wilmès recently suggested that Belgium could overestimate the actual number of cases.

However, Professor Van Gucht says the actual number of deaths may be even higher than what they report, as he thinks they may still miss a few cases.

Is it fair to count?

Another factor is that many more people place their loved ones in nursing homes than elsewhere in Europe.

Only the Netherlands and Luxembourg have a higher nursing home occupancy rate compared to their population.

Long-term care in Europe

Over 65 years cared for per 1,000 people

The authorities also recognize that mistakes were made at the start: poor preparation left nursing home staff without personal protective equipment (PPE). This allowed the virus to spread quickly, with a devastating effect.

Now all staff in retirement homes are receiving masks and protective clothing, and hospital nurses and soldiers have been brought in to help.

Epidemiologists say they have found a “remarkable” finding in nursing homes that about 10% of residents have been asymptomatic carriers of the virus and have developed immunity. Small comfort, but of significant scientific value.

How long has Belgium been locked out?

Since March 18, all non-essential activities have been closed and, with the exception of rescuers, people have been asked to stay at home.

Purchases are limited to one person per family. You can leave the house for medical reasons, to walk the dog, or for an hour of exercise with the immediate family or another person, while maintaining a social distance of at least 1.5 m (5 feet).

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Signs on the border of Belgium with the Netherlands

Belgian police imposed the lock, using drones in the parks and fines for anyone who violates the rules of social distancing.

Checkpoints have been set up at the borders with Luxembourg, France and the Netherlands, allowing only border residents or those with an urgent reason to enter Belgium.

Some cyclists have been fined after touring the Netherlands, then arrested by Belgian police on their return.

Neighbors with different locks

All non-food stores were also closed, causing a strange incident in the nearby towns of Baarle Hertog and Baarle Nassau, where the border line crosses a low-cost store called Zeemans.

The Dutch half of the store is open, but the Belgian half has been registered, as customers have been unable to access the men’s clothing section.

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A border crosses it: half of Baarle is in Belgium, part in the Netherlands

Contrary to Belgian policy, the Netherlands has what Prime Minister Mark Rutte has described as a “smart lock”, with florists, hardware stores, bakeries, clothing and toy stores remaining open.

There have been fewer deaths in the Netherlands, despite a larger population. But unlike Belgium, the Netherlands does not count suspected deaths of Covid-19 in nursing homes.

I asked the head of the Belgian Covid-19 task force, Minister Philippe De Backer, if he believed that the Belgian containment method was more effective than the more relaxed Dutch and Swedish approaches.

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Media captionPhilip De Backer says Sweden’s more relaxed approach cannot be compared to Belgium’s foreclosure

He told me that the Swedes were known to follow government advice, when it was “a little more difficult in a country like Belgium”. However, he was “impressed by the way the Belgians handled the crisis”.

What happens next?

Belgium will gradually lift its lock, in four phases. Starting Monday, fabric stores are open so people can buy materials to make their own masks. Masks will be mandatory in public transport.

Sport will also be allowed, although a maximum of two people can play together.

All other stores will open from Monday, May 11. Schools will resume on May 18, with a maximum of 10 students per class.

Cafes, restaurants and some tourist attractions will open after June 8, if there has been no second peak in the cases. Travel abroad can also be authorized in early June.

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How does Belgium test?

Tests for Covid-19 are performed on 10 to 20,000 people per day, primarily for emergency workers.

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Although the number of people admitted to hospital has stabilized, it remains fairly high

The task force also completed screening of 210,000 residents and employees of nursing homes, discovering that 10% of people are infected. There are more than 500 nursing homes and about half have experienced an epidemic.

Antibody tests to detect if people have had the virus will begin in mid-May.

Will Belgium use tracking applications?

Not in the short term. The head of the working group, Philippe De Backer, tells me that this is not “feasible” at the moment, so they will focus on the laborious manual tracing system.

“When people are positive, it activates a call center, and our staff ask who they have been in contact with, and they will be contacted and may have to isolate themselves. “

De Backer said that using an app requires at least 60% of the nation to participate voluntarily and he believes that is not realistic at the moment.

“I have seen reports in Austria, where it is around 9-10%. So that means you have to do 90% of the tracking some other way, “he said.

As Belgium gradually lifts its restrictions, 2,000 so-called “corona detectives” are hired to find people who have been in contact with confirmed or suspected Covid-19 patients.

What has Belgium learned?

Belgian scientists have started to examine lessons that can be learned, including an analysis of why three cities had the highest concentration of cases: Charleroi to the south, and Hasselt and Sint-Truiden to the east.


As Belgium decides to gradually lift its lockout, concern will move to a second peak later in the year

Early indications suggest that local carnivals with large gatherings of people in March may have contributed, as well as areas where second generation Italian populations are high. In the case of Charleroi, experts study whether the spread was linked to problems of poverty and deprivation.

Belgian hospitals have so far been able to cope with the epidemic, with an occupancy rate of 42%, but some hospitals in Brussels have been overwhelmed and have had to move patients elsewhere.

As imprisonment ends slowly, September is a concern for officials, as Professor Van Gucht points out.

“When all the schools are reopened after the summer, it is then that the virus may spread again quickly. It’s then that I’m most afraid, with the arrival of winter too. “


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