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Why Belgium Has Europe's Highest COVID-19 Death-Rate

Belgium has skyrocketed to the top of the list of coronavirus deaths per 100,000 people – surpassing much larger nations like China and the U.K., despite only having a population of 11 million people. 

That is, if the Chinese numbers are to be believed.

Regardless, according to officials out of Belgium, the problem doesn’t have anything to do with lack of bed space. In fact, 43% of the country’s intensive care beds are vacant, according to Bloomberg.

Rather, the number is high because the country is counting deaths at nursing homes, even without a confirmed infection. 

Steven Van Gucht, head of the viral disease division at the Sciensano public-health institute said: “We often get criticism — oh, you’re making Belgium look bad — we think it’s the opposite. If you want to compare our numbers with a lot of other countries, you basically have to cut them in half.”

About 95% of Covid-19 deaths from elderly homes have not been diagnosed, but Belgium will register them based on their symptoms and the people they were in contact with. The goal is to paint a clear picture of the outbreak and the country’s hotspots. Belgian officials continue to draw attention to deaths outside of hospitals during their briefings.

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Agoritsa Baka, a senior expert at the European Centre for Disease Prevention and Control, commented on the impact of the virus at nursing homes: “It’s a disaster. We did not realize how devastating Covid would be if it entered these populations.”

But not all countries are using such a wide funnel to count deaths. In France, they reported the data from nursing homes for the first time in April and fatalities almost doubled from those who had died in hospitals.

Spain had to adjust legacy data after Catalonia started including people who had symptoms but didn’t test positive. One local report this week stated that 6,800 elderly people had died in Spanish nursing homes with symptoms, but their deaths weren’t recorded.

Germany only counts deaths that have a positive virus test, perhaps helping along their low mortality rate.

Belgium has also been tracking its “excess mortality rate”, which is the number of people who die in any given day versus its historical average. Over 300 people usually die per day in Belgium – this year, that number has popped to 600.

What the world lacks is a standard set of parameters for measuring these deaths so that countries can be compared on an “apples to apples” basis. Even better tracking across Europe alone could help. 

“We are still in a situation where within the EU we do not count the same way, which could lead to political misunderstandings. It leads to different perception awareness of the crisis,” said Pascal Canfin, chair of EU Parliament’s environment and health committee.

Van Gucht concluded: “When you have a good surveillance system, you report a lot of cases,” he said. “It’s the countries that are not reporting or that are reporting very low numbers, you should be more worried about.”

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