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30 May 2020 7:53
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  •   Home > News > International

    Belgium appears to have the highest coronavirus mortality rate in the world. Here's why

    With attention focused on the strategies of bigger countries, such as the United States and the United Kingdom, Belgium has been little talked about. Yet, on the face of it, the EU country has been one of the worst hit by coronavirus.

    As the Belgian Prime Minister's motorcade passed a procession of doctors and nurses on Sunday, each person turned their backs in a silent protest.

    There didn't appear to be any signs or shouts, but a collective cold shoulder suggested Sophie Wilmes wasn't welcome as she arrived at a hospital.

    It comes just a few weeks after US President Donald Trump pointed to a graph on the number of deaths relative to population size, which showed Belgium at the top and the US in seventh place.

    On the face of it, it does appear Belgium, which hosts the de facto capital of the European Union, has been one of the worst hit by coronavirus.

    It tops the global table with the most deaths proportionally to their COVID-19 cases, with an observed case-fatality ratio of 16.4 per cent.

    And with a population of just 11.5 million, Belgium has the most deaths in terms of its population with 78 deaths per 100,000 people, according to statistics compiled by Johns Hopkins University.

    But while it's a grim picture, the statistics don't tell the full story.

    Belgium's experts have suggested there could be one explanation for why it's death rate is so high: its reporting system.

    Is that why staff were protesting?

    While it wasn't immediately clear what the frontline workers were protesting, according to local media, representatives later explained that they were disappointed in the Government's handling of the crisis, and its approach to health care in general.

    Representatives also said staff were unhappy about the Government's attempts to recruit unqualified staff to provide support to nursing personnel, rather than pay for trained professionals.

    Why Belgium is recording coronavirus deaths differently

    For most countries around the world, the COVID-19 death toll is tallied from patients in hospital who tested positive for the coronavirus.

    But Belgium has gone further than that, also including the deaths of non-hospitalised people who are suspected of having the virus.

    So, in nursing homes, for instance, it is registering deaths based on the assessment of the medical doctor, which takes into account symptoms they've shown and if they've been in contact with confirmed cases.

    According to the BBC, earlier this month, when Belgium passed 7,700 deaths, 53 per cent were in care homes.

    Of those, some 16 per cent of deaths were tested positive for coronavirus, while the rest were only suspected.

    It has led Belgian coronavirus task-force spokesman and virologist Steven van Gucht to suggest that comparing Belgium to places like the United States with statistics alone wasn't right.

    "It's not a fair comparison because our counting system is much more comprehensive," he told Reuters last month.

    "We take into account not only the hospital cases but also cases that occur in the community, for example, in the nursing homes."

    In fact, the rate of new cases, hospital admissions and deaths have fallen steadily from early April peaks and the Government's team of health experts has described the trend as "encouraging".

    For a more accurate comparison with other countries, Mr Van Gucht said the Belgian death rate should be divided by two.

    That said, the different reporting isn't necessarily the only factor behind Belgium's high mortality rate.

    The Government has still been criticised for some of its handling of the virus and officials have reportedly acknowledged mistakes were made at the beginning.

    Some have begun to turn to 'excess mortality'

    According to Johns Hopkins, countries throughout the world have reported very different case-fatality ratios, which is the number of deaths divided by the number of confirmed cases.

    Those differences can be partly due to a number of factors, including differences in the number of people tested, demographics and the characteristics of the healthcare system.

    With countries not measuring the impact in the same way, it could suggest the numbers of coronavirus deaths in some places are likely higher than the official count.

    Take France for example, which early last month saw a jump in COVID-19 deaths after the country included deaths in some nursing homes for the first time.

    Some have already suggested a better way to measure the damage caused by the pandemic is to look at "excess mortality," which looks at the gap between the total number of people who died, and the historical average for the same place and time of year.

    While there are some potential issues with using this method as well, some experts — along with the Economist magazine — have begun using it to better compare countries.

    Going by this method, the Economist suggests that the United Kingdom has one of the worst excess death tolls when measured against the overall population.

    According to Reuters, Belgian Health Minister Maggie De Block said last week that national science body Sciensano was working on a system to enable more accurate comparisons to the countries around Belgium.

    In the meantime, the chair of the European Union Parliament's environment and health committee suggests the differences in reporting between countries could lead to different perceptions.

    "We are still in a situation where within the EU we do not count the same way, which could lead to political misunderstandings," Bloomberg cited Pascal Canfin as saying.

    "It leads to different perception awareness of the crisis."


    © 2020 ABC Australian Broadcasting Corporation. All rights reserved

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