Health

Why is Belgiums death toll so high?

Belgium is winning a race in which nobody wants a spot on the podium.

In the country of 11 million people, the coronavirus has so far caused more than 5,000 deaths, according to reported figures. That means Belgium tops the table of deaths per capita in Europe — surpassing both Italy and Spain — and even globally, assuming figures from China are accurate.

According to Belgian authorities, thats because the country has chosen a reporting system that differs from pretty much every other countrys method of counting.

“Whoever wants to compare our number with other countries has to divide it by two,” Steven Van Gucht, who chairs the governments scientific committee for coronavirus, told POLITICO. “Any other comparison isnt relevant at all.”

While most countries are only counting confirmed deaths in hospitals, Belgium is including all potential deaths in nursing homes — even if COVID-19 has not been confirmed as the cause of death.

Criticism of Belgiums reporting method mounted as the numbers started to rise and deaths per capita surpassed even Italy and Spain.

Experts argue Belgiums approach is more transparent, and that other countries are underreporting the total numbers of deaths. But theres also growing political backlash that Belgiums count could be just as misleading, but in the opposite direction.

Of Belgiums registered deaths, 44 percent died in hospital (and were tested). The majority 54 percent died in a nursing home — and only in 7.8 percent of those cases was COVID-19 confirmed as the cause.

Knowing how many people are dying from COVID-19 is crucial to understanding the outbreak but its a surprisingly difficult figure to pin down. Several countries, including France and the U.K., have been pressured to start including deaths in nursing homes in their statistics as official death tolls still undercount the true number of fatalities.

“As in other European countries, there wasnt enough test capacity in the beginning to extensively test patients in nursing homes,” said Joris Moonen, a spokesperson for the agency that oversees nursing homes in the Dutch-speaking region Flanders. “We choose to register every death who had potentially died from COVID-19 to detect in which nursing homes the virus had hit. We were aware this would lead to an overestimation but found the signaling more important.”

Not everyone is on board with the catch-all approach. Belgian virologist Marc Van Ranst called it “stupid” to register so many people as dying from the coronavirus.

A political problem

Criticism of Belgiums reporting method mounted as the numbers started to rise and deaths per capita surpassed even Italy and Spain. While confinement measures appear to have flattened the curve of cases, and Belgian hospitals have remained able to cope, that contrasts sharply with the recorded fatalities.

“It now seems that people are only dying of COVID-19 in our nursing homes, while there are deaths there even in normal times, given the very high average age of their residents,” Van Ranst said on Belgian tv. “Were counting ourselves to the top of the corona ranking worldwide.”

The ranking also agitated politicians. “If its important to be as transparent as possible, you have to get your numbers right,” Prime Minister Sophie Wilmès said in the Belgian parliament, adding that not all residents of nursing homes died because of the coronavirus. “You understand that this elevates our numbers.”

Since last week, authorities have sought to provide more clarity in the figures. Daily tallies are split between the number of deaths in hospitals caused by COVID-19, and deaths in nursing homes. For the latter, there is an added distinction between suspected and confirmed deaths due to the virus.

“Were not changing how were counting, but were communicating in a different way about the origin of the numbers,” a Belgian government official said, speaking on the condition of anonymity. “We dont want people to worry because Belgium is suddenly at the top of a ranking of deaths per capita. Were making an effort to be transparent and to explain that to our citizens.”

“Its true that there has been some pressure to refine our way of reporting,” said Van Gucht, who communicates the numbers at a daily press conference.

But he defended the Belgian method of counting, arguing it ensures nothing remains hidden.

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