Understanding Belgium’s high death toll

By Javier Albisu

Brussels, Apr 22 (efe-epa).- With a population of 11.4 million people and more than 5,000 Covid-19 deaths, Belgium tops the table globally of deaths per capita, exceeding both Italy and Spain.

The country has recorded 549 deaths for every million people.

This surpasses other European hotspots like Spain (452), Italy (408), France (310) or the United States (128) where President

Donald Trump made a point of highlighting the Belgian fatality rate.

But there are reasons for this discrepancy in figures, the main one being that Belgium does not account for coronavirus deaths like most countries do and if it did the rate would drop from 549 to 252 deaths per million.

While most states only count confirmed hospital deaths, in Belgium all potential deaths in nursing homes, even when Covid-19 has not been confirmed as the cause of death, have been included in the death toll.

Belgium has recorded 6,262 coronavirus deaths, 2,881 were in hospitals (46 per cent) and 3,381 (54 per cent) were suspected Covid-19 cases of deaths in nursing homes or at home with no testing carried out.

Emmanuel André, virologist and spokesman for the Belgian coronavirus science team, said: “The way in which we count deaths is to give us the best full view.

“Our surveillance system, which takes into account the situation in nursing homes, is not directly applied in most of the countries with which we are compared.”

But the raw death toll data has tarnished Belgium internationally and health minister Maggie de Block has called for the creation of a new system to “prevent the figures from being so high” and facilitate fairer comparisons with others.

David Gómez Ullate, a member of the committee of experts of the Spanish Committee of Mathematics, told Efe that “there are two levels by which figures can be analysed: the political (which he goes into no detail over) and the technical which is what these data and series will be used for”.

“They serve to better understand the epidemiological aspects, to prepare strategies that allow you to monitor where there are outbreaks and to make models that allow you to decide what type of strategy you should follow,” he added.

Despite the distortion generated by this inclusive way of accounting for deaths, the coronavirus has been raging in Belgium, according to BE-MOMO, a Belgian Mortality Monitoring think tank which has compared monthly deaths to historical averages.

Between 16 and 22 March, there was a 12 per cent increase in deaths compared to the expected projections.

A week later, the increase spiked to 41 per cent and in early April it shot up to 77 per cent, although the data collected will not be definitive for several weeks.

Another factor that has helped mitigate the impact of the pandemic is Belgium’s robust healthcare system which is propped up by the fact it has one of the highest tax to GDP ratios in Europe.

Health spending based on GDP in Belgium stands at 10.4 per cent, above Spain (8.9 per cent) and Italy (8.8 per cent), according to 2018 OECD data.

The same report also highlights that the number of doctors in Belgium (3.1 out of 1,000 inhabitants) is lower than the European average (3.6) but the country has more nurses (11) than the EU average (8.5) and they are highly qualified.

Belgians also have 566 hospital beds per 100,000 inhabitants, far from the 800 Germany boasts but well ahead of Italy (318) and Spain (297), according to Eurostat data from 2017.