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COVID-19 pandemic in Belgium

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COVID-19 pandemic in Belgium
Spread of COVID19 in Belgium.png
Map of Belgium and its provinces with the spread of COVID-19 as of 9 July 2020[1]
COVID-19 outbreak Belgium cases per capita map.svg
Confirmed cases per 100,000 residents
DiseaseCoronavirus disease 2019
Virus strainSevere acute respiratory syndrome coronavirus 2
LocationBelgium
First caseBrussels
Arrival date3 February 2020
(1 year, 1 month and 4 days ago)
OriginWuhan, Hubei, China[2]
Confirmed cases61,007 [nb 1][3]
Deaths
9,726[3] [nb 2]
4,699 in hospitals (including 227 suspected cases)
Official website
www.info-coronavirus.be

The COVID-19 pandemic in Belgium forms part of the ongoing worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was confirmed to have spread to Belgium on 4 February 2020, when a Belgian national out of a group of nine Belgians repatriated from Wuhan to Brussels was reported to have tested positive for the coronavirus.[4][5] Transmission within Belgium was then confirmed in early March; authorities linked this to holidaymakers returning from Northern Italy at the end of the half-term holidays.[6][7] The epidemic increased rapidly in March–April 2020. By the end of March all 10 provinces of the country had registered cases.[citation needed]

As of 25 June, the Belgian authorities had reported 61,007 confirmed cases, with a total of 9,726 deaths and at least 17,688 discharged patients. The actual number of infections, however, is likely to be much higher than the number of diagnosed cases, as laboratory tests are limited to specific people and/or people with severe symptoms, and because many people with mild or no symptoms do not seek medical help, even as they are likely to be transmitting the virus.[8]

Belgium was among the world's worst-affected countries in terms of the number of deaths per head of population (excluding microstates). For example, on 1 June 2020, it was reported that there had been 819 deaths per one million head of population, compared to 442 in France, 580 in Spain, 592 in the United Kingdom,[9] and seven in Japan.[10] However, Belgium may have been over-reporting the actual number of cases.[11] Unlike many other countries, which publish figures based primarily on confirmed hospital deaths, the death figures reported by the Belgian authorities include deaths in the community, especially in care homes, confirmed to have been caused by the coronavirus, as well as a much larger number of such deaths suspected to have been caused by the virus, even if the person was not tested.[12] Such differences in methods of counting complicate any attempt to compare death rates in different countries.

Background[edit source | edit]

On 12 January 2020, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei Province, China, which was reported to the WHO on 31 December 2019.[13][14] First reports of the coronavirus disease started to appear in the Belgian media around 8 January.[15]

The case fatality ratio for COVID-19 has been much lower than SARS of 2003,[16][17] but the transmission has been significantly greater, with a significant total death toll.[18][16]

Timeline[edit source | edit]

Template:COVID-19 pandemic data/Belgium medical cases chart

February 2020 – First case[edit source | edit]

On 2 February, Belgian nationals living in Hubei were repatriated on an evacuation flight landing at Melsbroek Air Base close to Brussels, before being transferred to the Military Hospital of Neder-over-Heembeek where they underwent a 14-day quarantine and got tested for infection with the virus.[19][20]

On 4 February, it was announced one of the repatriated has tested positive for the novel coronavirus,[21] the first case in Belgium.[22] The patient, an asymptomatic 54-year-old male, was then transferred to the Saint Peter's Hospital in Brussels, one of the two referral centres in the country.[citation needed]

On 21 February, a group of ten Belgian citizens were allowed to return to Belgium after having been constrained on the MS Westerdam cruise ship for several days.[23]

On 24 February, following the spread of the COVID-19 in northern Italy, a hundred Belgian citizens were put in quarantine in the H10 Costa Adeje Palace in Tenerife that was put on lockdown.[24][25] Fifteen of them were allowed to travel back to Belgium on 28 February and the remainder on 5 March, without having been tested for the coronavirus upon arrival.[26]

March 2020 – Spread[edit source | edit]

On 1 March, a second case was confirmed in Belgium, a Dutch speaking woman who had returned from Crépy-en-Valois in one of the regions affected in France.[27]

The yearly one week school holiday around carnival lasted from 22 February until 1 March 2020. Many people go on ski vacation during that period and the number of detected virus infections rose sharply upon the return of people from holidays in affected areas.

On 2 March, six additional cases, making a total of eight, had been diagnosed. Five were found in Flanders and one in Brussels, all six infected people having come back from Northern Italy.[28]

As of 3 March, six further cases were confirmed, making a total of 14 cases. Amongst the new cases, a 17-year from Tienen[29] and one person from Sint-Niklaas[30] returned from a ski vacation in northern Italy, a person from Verviers,[31] two cases from Couthuin [fr][32] and a 65-year-old male from Eupen who presented relatively severe symptoms and had not been to any of the regions with a higher risk of infection.[33][34] Steven Van Gucht of the Scientific Committee predicted that in the worst-case scenario the epidemic would cause 13,000 virus infections, with 2,000 to 3,000 hospitalisations and 500 to 700 patients in intensive care.[35] In a later interview van Gucht refined his opinion, adding that 70% of the population (approximately 8 million persons) could become infected.[36]

By 4 March 10 new cases were confirmed, making a total of 23. Nine of the new infected individuals had recently returned from Italy. The other patient had had contact with a prior case.[37] Four cases were in the Leuven area,[38] one case in Hasselt,[39] and one in Pelt.[40] In Wevelgem, a family and a primary school teacher were diagnosed with the coronavirus upon their return from the North of Italy.[41] The Flemish Agency for Care and Health advised the school not to close down.[42] A retirement home in Gooik stopped receiving visitors after discovering that one of its employees could have been in contact with the coronavirus, a precaution[43] the Flemish Agency for Care and Health qualified as inappropriate and "excessive".[44]

On 4 March, the European Defence Agency (EDA) confirmed that a staff member had tested positive for coronavirus, marking the first confirmed case in the agencies of the European Union.[45] He had returned from Italy the previous week and attended a meeting with about thirty other European Union officials before he had started to feel ill.[45] A military staff member of the European External Action Service who attended the meeting then also began to experience symptoms.[45] The EDA cancelled all meetings until 13 March, and other EU institutions also took precautions.[45][46]

On 5 March 27 new confirmed cases were reported by the government (16 in Flanders, nine in Wallonia and two in Brussels), bringing the total to 50.[47] Of the 50 people then infected one had recovered, 48 were quarantined in their homes and one person was being treated in the Sint-Pietersziekenhuis.[48] The new cases were reported to be in Knokke-Heist, Zonhoven, Doomkerke [nl] (Ruiselede) and Vlierzele (part of Sint-Lievens-Houtem).[49]

On 6 March 59 new cases were reported by the government, bringing the total to 109 (65 in Flanders, 12 in Brussels, 31 in Wallonia and one recovered). The new cases were amongst others reported in Oosterzele and Sint-Katelijne-Waver.[50] The FPS Health then confirmed for the first time that infections had occurred in Belgium.

On 7 March 60 new cases were confirmed by the government (40 in Flanders, five in Brussels and 15 in Wallonia), bringing the total to 169 (105 in Flanders, 17 in Brussels, 46 in Wallonia and one recovered). The new cases were amongst others reported in Houthalen, Melle, Lokeren, Mere, Lede, Tildonk and Poppel.[51] The FPS Health mentioned generally that "more and more infections are being contracted locally" but did not provide information on how many.[52]

From 422 samples analysed on 7 March 31 were reported positive on 8 March (16 in Flanders, eight in Brussels and seven in Wallonia), bringing the number of infections to 200. The FPS Health then reported local circulation of the virus in different parts of the country.[53]

On 10 March, the total number of confirmed cases was 267.[54]

On 11 March, the first death on Belgian territory due to COVID-19 was reported,[55] of a 90-year-old female patient from Brussels who was being treated in Etterbeek.[56] Two more patients died on the same day, one aged 73, and one of 86 who died in Sint-Genesius-Rode.[57]

On 12 March, two new infections were detected as well as 32 suspected cases in retirement home Ter Kameren in Watermaal-Bosvoorde, one of the biggest retirement homes of the Brussels region.[58] The total number of confirmed cases rose to 399. Approximately 20 patients out of those 399 were being treated in intensive care.[59] The president of the European Commission, Ursula von der Leyen informed the entire staff that seven of their colleagues had tested positive, six of them in Belgium. She also instructed "all colleagues in non-critical functions" to work from home with immediate effect until 5 April, while those "who ensure critical functions" would need to work in two shifts to minimize the risk of contagion.[60]

By 14 March 689 cases were confirmed with four deaths.[61]

On 21 March it was observed that more than half of the patients in the hospital Oost-Limburg in Genk were of Turkish origin. Secretary of State Zuhal Demir urged the Turkish community in Limburg to abide by the quarantine measures.[62]

On 26 March, Sciensano published a map that showed that the highest recorded concentrations of infections were found in Alken and Sint-Truiden (Limburg) and Quévy and Honnelles (Hainaut). The hotspot in Alken is thought to have been caused because of two parties that were allowed to gather over the weekend of 7 March.[63] The mayor of Sint-Truiden, who was herself infected by the new coronavirus, mentioned she did not understand the reason for the high incidence in her town.[64] The high level of cases in the affluent municipality of Bonheiden is thought to be linked with the number of travellers who had returned from ski resorts in the North of Italy around the beginning of March.[65] While the high incidence in Honnelles could be linked to an outbreak in a centre for disabled people, the mayor of Quévy had no idea what caused the large outbreak in her municipality but complained of the lack of communication and protective equipment.[66][67]

On the daily press conference of 27 March Van Gucht announced that a cat had been infected by its owner. This was only the third time the infection of a companion animal by its human companion had been reported worldwide. The cat had developed respiratory and digestive problems.[68]

The additional number of people reported as having tested positive for the novel coronavirus peaked on 28 March compared to the previous days. The peak occurred because more persons were being tested and because a major Walloon laboratory that had not reported any cases up to that point then belatedlyy reported 500 additional cases from a past period.[69]

As of 29 March, around 20,000 Belgian citizens were stuck abroad due to travel restrictions worldwide, many in Peru, South Africa, Australia and New Zealand.[70]

On 30 March, it was announced that because of the high burden on some hospitals in the provinces of Limburg and Hainaut, a dispersal plan for ICU patients had been activated.[71]

Jan Eyckmans of the Federal Public Service Health claimed hospitals increased their number of ICUs from 1900 to 2650 over a period of two weeks time, corresponding to an increase from 16.5 to 23.0 ICUs per 100,000 inhabitants.[72] However, on the daily press conference of the Belgian National Crisis Centre of 28 March Dr Emmanuel André of the UZ Leuven mentioned that the number of 789 ICUs corresponded to 43% of the capacity, bringing the total capacity to 1835 instead of 2650, while Dr Van Gucht quoted the capacity as 2081 units.[73] The newspaper De Standaard mentioned the number of 1765 on 31 March[74] and 2393 on 3 April.[75]

April 2020 – Peak[edit source | edit]

At the end of March, it became clear that the peak of the only wave thus far of the pandemic within the country was expected in early April.[76] On 8 April, a drop in the number of active hospitalisations could be seen, which meant that a peak in them, and thus perhaps in infections, had been reached a couple days earlier.[77] The mortality peak would follow a bit later, and was retrospectively observed to have occurred on 12 April.[78]

On 1 June Belgium's Prince Joachim issued a public apology following news that he tested positive for COVID-19 after he attended a party in Spain, in violation of the country's lockdown.[79]

Government response[edit source | edit]

Authorities[edit source | edit]

Efforts to address the coronavirus outbreak in Belgium are managed by the nine federal and regional health ministers, Maggie De Block (Open VLD, federal government), Wouter Beke (CD&V, Flemish Community), Christine Morreale [fr] (PS, French Community), Antonios Antoniadis [de] (SP, German-speaking Community), Bénédicte Linard [fr] (Ecolo, French Community), Valérie Glatigny [fr] (MR, French Community), Alain Maron [fr] (Ecolo, Brussels), Elke Van den Brandt [nl] (Groen, Brussels) and Barbara Trachte [fr] (Ecolo, Brussels),[80] with the support of:

Containment measures[edit source | edit]

On 29 January, Belgium issued a travel notice advising against non-essential flights to China, Hong Kong excluded, with some travel companies cancelling all flights to China.[83]

On 1 March, as a second case of coronavirus was confirmed in Belgium, phase 2 of the health risk containment strategy was activated.[84][further explanation needed] The mayor of Sint-Lambrechts-Woluwe, Olivier Maingain, was one of the only mayors to take measures to prevent the spreading of the new coronavirus by restricting access to schools, sports facilities and public places for persons returning from areas at risk[85] and only a few schools, such as the International School Ghent, quarantined pupils returning from infected areas, such as Northern Italy.[86]

On 10 March, the government advised citizens to cancel any indoor scheduled events to be attended by more than 1,000 people for the month of March. Prime Minister Wilmès stressed this was not an interdiction but rather a recommendation.[87] Schools remained open but are advised to cancel both trips abroad and multi-day excursions in general. Companies were advised to have their personnel work from home as much as possible and allow flexible working times to allow a better spread of public transport use throughout the day. The authorities called this reinforced phase 2.[88]

Late in the evening on 12 March, after a meeting of the National Security Council, the Belgian government moved into the federal phase of crisis management, and ordered the closure of schools, discos, cafes and restaurants, and the cancellation of all public gatherings for sporting, cultural or festive purposes from Friday 13 March at midnight onwards.[89] It was stressed that the measures taken were not a lockdown because people were not required to stay home.[90]

Concrete blocks in Mouscron, used to avoid all non-essential travel between France and Belgium (27 March 2020)

On 17 March, the National Security Council decided to take additional measures, based on the spread of COVID-19 in Belgium and on recommendations of experts. Stricter social distancing measures were imposed from noon the following day until 5 April, with non-essential travel prohibited, non-essential shops to close, gatherings banned, with penalties for corporate and individual persons who failed to comply with the restrictions.[91][specify]

On 20 March at 3 pm Belgium closed its borders to all non-essential travel.[92] Earlier, the governor of West Flanders had complained about Dutch and French citizens coming to Belgium for tourism or shopping,[93] while mayors of municipalities close to the border with the Netherlands such as Paul Van Miert of Turnhout urged their Dutch counterparts to request their national authorities in the Netherlands to implement similar measures as in Belgium, to stop Belgian citizens going to Dutch cafés or restaurants.[94] From 25 March onwards, people arriving at Brussels Airport were handed a leaflet with the compelling advice to quarantine themselves for a fortnight.[95]

On 27 March, the National Security Council and the governments decided to extend the measures until 19 April (end of the Easter vacation).[96] On 15 April, the containment measures were extended until the 3 May.[97]

Medical supplies and testing strategy[edit source | edit]

Wearing a mask is mandatory in the subway.

On 6 March, Federal Minister of Public Health Maggie De Block criticised EU governments for blocking the export of medical masks at a time when global stocks were decreasing, asserting that they were acting against the spirit of the European Union.[98] On 19 March, a shipment of 100,000 FFP2 respirators arrived.[99] On 16 March, the Chinese Alibaba foundation donated half a million surgical masks and 30 000 test kits, as a result of the intervention by King Philippe and with the support of the Walloon Export and Foreign Investment Agency (AWEX).[100] Minister Philippe De Backer was assigned to coordinating the efforts of the authorities to supply masks and respirators.[101]

While the number of tests capped at 3,500 and 4,500 a day, an increase in stocks of the required materials[further explanation needed] was announced early April by the Federal Minister Philippe De Backer, to improve the testing capacity to 10,000 tests a day.[102]

In an effort to support international research, Belgium pledged 5 million euro to the Coalition for Epidemic Preparedness Innovations (CEPI) which intends to develop a COVID-19 vaccine.[103]

Exit strategy[edit source | edit]

On 7 April, a Group of Experts for an Exit Strategy (GEES), led by Erika Vlieghe and composed of 10 scientists, economists and top managers, was set up to advise the National Security Council on the restart of the country.[104]

Communications[edit source | edit]

At the outset, the Belgian authorities, mostly through their federal Minister of health Maggie De Block, had focused on reassuring by asserting that there was no reason to panic,[105] that Belgium has good hospitals and laboratories[106] and that the government was attentive to the evolution and well prepared for the possible arrival of coronavirus.[107] From the first report of infection within Belgium, the government communicated on certain developments with the public. An official website[108] of the Federal Public Service Health dedicated to the coronavirus crisis was registered by the authorities before the first case was officially confirmed, at the end of January,[109] to inform the public. Since the 13 March, the FPS Health together with the National Crisis Centre (NCCN) has held a daily press conference[110] led by spokesmen Benoît Ramacker, Peter Mertens and Yves Stevens with doctors Steven Van Gucht and Emmanuel André. Every day, the latest developments on the epidemiological situation in Belgium are reported, with the new figures of confirmed cases, hospitalised patients and deaths, as well as general explanations and forecasts, or reminders of the need to respect the social distancing measures. In an apparent effort at transparency, a daily epidemiological bulletin and a set of raw data are made available on the Belgian Institute for Health website.[111]

The Prime Minister Sophie Wilmès addressed citizens twice via a web video, taking stock of the situation.[112][113][114][115][specify]

Experts and authorities also used the media to express themselves throughout the crisis, either to reproach citizens organising or taking part in so-called 'lockdown or corona parties',[116] or otherwise to give their point of view. On 20 March, the chairman of the Scientific Committee expressed the hope that the measures that came into effect on 14 March would lead to a stabilisation of the number of hospitalisations starting from the middle of the week beginning 23 March.[117] On 21 March, Prof. Dr. Erika Vlieghe of the Scientific Committee mentioned that she expected the peak of the pandemic to occur in early April.[118]

On 16 March, King Philippe addressed the nation and called on all Belgians to respect the COVID-19 measures "for ourselves and for the most vulnerable among us".[119]

Criticism[edit source | edit]

Handling of the crisis[edit source | edit]

While the COVID-19 was already spreading to all regions of Italy in late February, the Belgian government has been criticised for its lack of action. Experts like Marc Wathelet, a virologist specialised in coronaviruses, urged for strict prevention measures, affirming that the Belgian federal minister of health Maggie De Block was underestimating the danger[120] and Professor in microbiology Herman Goossens of the UZA [nl] in Antwerp, called for wider screening for the virus.[121] Pharmacists complained they did not receive clear instructions from the authorities.[122] Zorgnet Icuro,[123] an umbrella organisation in the field of health care and care for the elderly, requested the Flemish Minister for Public health Wouter Beke to take stronger actions with respect to visitor access at retirement homes in Flanders.[124]Template:Obsolete source

When the first measures have been taken by the Belgian government on 10 March, in the form of recommendations, some expressed that more drastic measures were required, like Professors Herman Goossens and Marc Van Ranst who questioned the set limit of maximum 1,000 people for indoor events.[125] The BVAS/ABSyM, the biggest medical trade union in Belgium, warned for a potential collapse of the health care system and called for a closure of all schools at short notice as well as a ban on all gatherings of more than hundred people.[126][127] In an open letter several Flemish rectors with experts in the fields of epidemiology, virology, biostatistics and health economics, including two members of the Scientific Committee for Coronavirus, urged the authorities to take decisive measures and to avoid non-binding instructions and guidelines.[128] Similarly, Leopold Lippens, the mayor of Knokke-Heist, judged the actions of the federal authorities insufficient and therefore ordered the ban on all indoor and outdoor activities in his municipality.[129]

Some media made positive criticism, such as the Financial Times who praised Belgium for its handling of the coronavirus crisis,[130] claiming Belgium had shown that "a fragmented country" could still produce a clear response to the pandemic – by taking decisive actions earlier than other countries – and pointing out the daily briefings are not held by politicians but by scientific experts and spokespersons.[131] De Standaard praised Steven Van Gucht, president of the Scientific Committee, for being "calm, empathic and wonderfully clear".[132]

Shortage of medical supplies[edit source | edit]

Ambulance workers in Brussels wearing PPE during an intervention.

Just as many countries in the world,[133] Belgium faced a shortage of personal protective equipment (PPE) such as respirators, surgical masks or face shields.

Towards the end of January, Belgian newspapers highlighted the shortage of respirators and surgical masks and a retailer questioned whether Belgian would have enough masks if there were to be an outbreak of the virus, but the Federal Public Service Health claimed the Belgian hospitals had sufficient stock.[134][135] On 8 March, Maggie De Block stated she had a solution for the shortage of masks but was unwilling to disclose the potential vendor and the number of masks involved.[136] On 15 March De Standaard newspaper reported that the masks had not been delivered on time,[137] and the following day De Block announced that her department's order of 5 million masks might have involved fraud.[138][139] On 16 March, De Standaard reported that De Block had blundered by ordering all 5 million masks from a single company (M.O.S.S.A. vof), a consultancy firm that had no track record in the medical field and was owned by Mahmut Öz, a Belgo-Turkish politician from her own political affiliation.[140] On 20 March, a shipment from China of 5 million masks arrived at the airport of Bierset, but these were surgical masks and not the type of respirators required to protect the medical staff.[141][142] Hospitals such as the Centre Hospitalier Interrégional Edith Cavell (CHIREC) reported that they were in dire need of protective masks.[143] On 25 March, PVDA-member of parliament Sofie Merckx [nl] complained that since 2009 the various governments had not renewed the strategic reserves of mouth masks due to cost cutting measures in the health care system. Upon reaching their expiration date in 2018, minister of health Maggie De Block decided to destroy and not replace 6 million face masks. [144]

On 7 March, Marc Van Ranst confirmed Belgium was facing a shortage of reagents to do widespread COVID-19 testing, and the laboratory reference (National Reference Centre)[145] at the UZ Leuven was therefore forced to apply a triage system and to limit the number of tests.[146][147] Two surgeons from the Brussels Saint Pierre hospital addressed an open letter to prime minister Wilmès on 22 March demanding increased testing.[148][149]

Situation in care homes[edit source | edit]

In Belgium, the organisation of care homes falls under the regional authorities. On 11 March the care homes were closed for all visitors in Wallonia and Brussels, and a day later in Flanders.[150]

After the closure, the sector requested more protective equipment, more training and guidelines for caretakers on how to handle infected patients, and more tests. However, not much was changed and the care homes kept operating with a lack of tests and a lack of protective equipment while being required to keep many infected residents in the homes.[151][152] On Wednesday 1 April, the government finally promised to also provide more tests to the care homes by the end of the week.[153] But as that deadline wasn't met, on Saturday 4 April, several care homes started to execute tests on their own.[154] Meanwhile, several homes got hit hard with dozens of deaths, and up 90% of the residents and inhabitants being infected.[155] These events led to severe criticism addressing the Flemish minister of public health Wouter Beke. Care organisations accused the minister of losing 3 weeks time, and being very late with an emergency plan.[156] Only on 21 April, masks were advised for all personnel in contact with patients.[157]

On 10 April, about 40% of all COVID-19 deaths in Belgium occurred in care homes.[158][159] In Brussels, coronavirus cases have been confirmed in 116 of the 146 care homes.[160]

High death toll[edit source | edit]

Belgium has very high mortality figures, having the highest death rate from COVID-19 in the world.[12][161]

Steven Van Gucht from Sciensano explained this was partly due to a difference in counting, compared to other countries.[162][163] In Belgium, around 46% of the COVID-19 deaths occurred in hospital and 53% occurred in care homes; and while the deaths in hospital are all confirmed by a test, only 5% of the deaths in care homes are confirmed by a test, the other 95% being suspected cases.[164] The Netherlands on the other hand, only counted confirmed cases.[165]

This way of counting was criticised by some politicians[who?] as it would portray Belgium as bad in the fight against coronavirus and also would harm the Belgian reputation of being a prominent country in the pharmaceutical and biotech industries.[166] Some doctors[who?] complained that deaths caused by other pathologies and causes have been lumped into the COVID-19 category.[167] The virologist Marc Van Ranst, member of the Belgian Scientific Committee for Coronavirus, also criticised the way of counting, saying it is "dumb" that almost all deaths occurring in care homes are being counted as COVID-19 deaths, leading to an overestimation according to him.[168]

Belgian authorities however defend their strategy for being the most transparent and the most detailed method,[167] even if it results in numbers that are "sometimes overestimated".[169] According to Steven Van Gucht, responsible for the reporting strategy, the suspected deaths are being counted as COVID-19 deaths because not everyone can be tested[169] but said this way of counting saved lives by pointing to the dire situation the care homes were in.[170] After this criticism, the official daily reports started to distinguish the deaths figures between confirmed tested and simply suspected cases.[171]

When several countries published excess mortality figures, it appeared that the criticised way[who?] of counting caused the reported COVID-19 death toll in Belgium to be closer to the excess mortality figures, compared to other countries.[172] For example, between 5 March and 5 April, Belgium reported 2,373 COVID-19 deaths with the excess mortality being estimated around 3,000. Causing still an underreporting of around 600 deaths. While the neighbouring Netherlands had an estimated excess mortality of 6,200, with only 3,197 reported COVID-19 deaths in that same period. Causing an underreporting of around 3000 deaths.[173]

Other responses[edit source | edit]

Healthcare sector and Belgian research[edit source | edit]

Hospital prefab-containers built next to the emergency department for the COVID-19 crisis at the University of Antwerp Hospital, 14 March 2020

To cope with the increasing influx of patients, several hospitals started to build new temporary facilities, such as the UZA clinic in Edegem with the construction of containers[174] or the Saint Peter's Hospital in Brussels with the set up of outside tents supported by the Belgian Red Cross.[175]

Even if Belgium belongs to the EU's top five in terms of intensive care unit (ICU) capacity, with a number quoted to be around 15.9[176][177] to 16.5[178] ICUs per 100 000 inhabitants before the outbreak of the pandemic, the Belgian hospitals started to increase their number of intensive care units around 10 March.[citation needed]

Some Belgian hospitals also appealed to the community to help, such as the UZ Leuven who called for mouth masks[179] and financial support for research into COVID-19,[180] or Brussels Saint Peter's hospital who called for donations to buy life-saving ventilators.[181]

Research to find a vaccine against COVID-19, medication for the lung disease or new test methods are concentrated in Belgium amongst others at the KU Leuven (vaccine and new medication, Prof Johan Neyts),[182][183] at the University of Namur (new test method, Benoït Muylkens)[184] and by private companies in collaboration with universities (new 15-minute test method detecting coronavirus antigens, CORIS BioConcept).[185]

Studies conducted by Vrije Universiteit Brussel on patients that were being treated for small procedures and who did not have COVID-19 symptoms, showed that approximately 8 % had an infection in the lungs and were infected with the coronavirus,[186] confirming the suspicion that many people are infected with the coronavirus without knowing and as herd immunity would prevent the spread of the coronavirus.[187]

Attempts to predict the progress of the coronavirus spread with compartmental models are undertaken at Ghent University (Prof Jan M. Baetens)[188] and Hasselt University (Prof Niel Hens).[189] Professor Barbé at the Free University of Brussels-VUB uses a first order differential equation with two proxy variables.[190][191] University of Antwerp, with the assistance of KU Leuven and Hasselt University, launched a study to assess the impact of the containment measures and the evolution of the epidemic in Belgium, through a series of online surveys.[192][specify]

Belgian industry[edit source | edit]

In an effort to alleviate the hand sanitiser shortage in Belgium, several Belgian companies started to make alcohol[193] or to manufacture hand sanitisers themselves, like the pharmaceutical company Janssen Pharmaceutica,[194] the brewing company AB InBev[195] and the Sugar refinery of Tienen,[196] reaching a total of 1 million liters of gel and ending the shortage in the country.[197]

To make up for the shortage of medical masks, the Belgian textile sector was requested but unable to produce masks at short notice because of the lack of manufacturing capacity and of raw materials.[198][199] Eventually around mid-April, two Belgian companies specialised in workwear and interiors for cars, announced they will together start producing surgical masks and FFP2 respirators.[200]

The vaccines division of GlaxoSmithKline, which has its headquarters in Belgium, helped with providing its infrastructure and staff free of charge to carry out at least 6,000 PCR tests per day on their Rixensart site,[201] participating in an increase of the number of analyses in the country, as of 9 April.

Impact[edit source | edit]

Politics[edit source | edit]

While Belgium had been struggling to form a new federal government since the elections of 26 May 2019, the coronavirus pandemic sparked new debate on the ongoing formation, as the actual minority caretaker government Wilmès I wouldn't have all the ability to tackle the coronavirus crisis and its consequences.[202]

The idea of forming an emergency government emerged. Representatives of N-VA and PS, the two majority parties that have not been able to come to an agreement so far, started to discuss again on 13 March,[203] eventually joined by Open Vld, MR, CD&V and sp.a on 14 and 15 March.[204] Those discussions however were inconclusive as Bart De Wever (N-VA) wanted to be the new Prime Minister[205] and as PS and MR refused to nominate new Prime Minister and Ministers, arguing it would be a waste of time.[206] Talks between political parties continued the next hours and were extended to Ecolo, Groen, cdH and DéFI.[citation needed]

An agreement has finally been found on 16 March under the form of a continuation of the Wilmès I Government, with the exception that the government now has full legislative powers rather than being just a caretaker government. The new Wilmès II Government composed of MR, Open Vld and CD&V, while representing only 38 of the 150 representatives, will be supported by opposition parties PS, sp.a, Groen, Ecolo, cdH and DéFI within the limits of handling the coronavirus crisis in Belgium.[207][208] The government also received certain plenary powers to deal with the pandemic quickly and effectively.[209]

Economics[edit source | edit]

Following the containment measures of the federal government, many Belgian businesses had to shut down temporarily or have reduced staff numbers at work, resulting in 1.25 million people on temporary unemployment.[210][specify]

Belgian companies suffer from the corona crisis, such as producers of fries who reported a drop in demand for potato specialities.[211]

Just as most airlines in the world,[212] the national flag carrier Brussels Airlines suspended all its commercial flights as of 21 March, originally until 19 April[213] but delayed the restart of operations first till 15 May,[214] then till 1 June,[215] then gradually from 15 June.[216]

With bars, cafes and other businesses closed, Belgian breweries started delivering directly to people self-isolating at home. Some bars and cafes have raised funds by selling advance vouchers that are redeemable when the establishments reopen.[217]

Society and environment[edit source | edit]

From 12 March onwards many people started hoarding for the next one and a half-week.[218][specify]

The closures and bans ordered by the authorities led to cancellation of many events in the country.[example needed] For example, Chinese New Year celebrations were cancelled at the University of Leuven.[219][relevant? ]

The amount of traffic on Belgian roads dropped sharply after shutdown measures were implemented: traffic dropped by 45% and the structural traffic jams disappeared completely.[220][221]

The Belgian Institute for Space Aeronomy reported that the strong decrease in car and air traffic due to the confinement measures does not necessarily entail as strong a decrease in air pollution.[222][specify] Belgian researchers at the Royal Observatory of Belgium noticed a drop of the background noise on the seismic data that could be the result of transport networks and other human activities being shut down.[223][224]

Statistics[edit source | edit]

Definitions[edit source | edit]

Number of cases (blue) and number of deaths (red) on a logarithmic scale based on numbers reported by the World Health Organization

Confirmed infections[edit source | edit]

The number of confirmed infections is the number of samples tested positive by a reference laboratory. It is estimated that the actual number of cases is much higher than the number of confirmed cases,[225] the tests being limited to specific people and/or to people with severe symptoms. Diagnosed cases are an underestimate of the real number by a factor of between 5 and 10 according to Professor Marc Van Ranst.[226]

In the period of 1 to 6 March the number of detected cases grew on average exponentially with a doubling of the number of cases every day. In the period between 7 and 27 March the number of confirmed cases doubled on average every 3.7 days (20.9 % daily increase).[needs update]

Recoveries[edit source | edit]

The official reports from the national public health institute of Belgium do not refer to recovered people but only to discharged patients.

The patients are discharged after resolution of symptoms, even though they are not being tested again before leaving the hospital.[227] The number of recovered people who were tested positive but not admitted to hospital remains unknown as there is no follow-up on these cases. The total number of recoveries is therefore underestimated, particularly in a context where there are many undetected positive cases presenting mild symptoms and recovering as well.[228] The situation is similar in France.[229]

The first recovered case was on 15 February 2020.[230] As of 5 April, Sciensano reported a total of 3,986 discharged patients since the 15 March.[1]

Deaths[edit source | edit]

Cumulative number of deaths per million inhabitants for European Union countries, over time. The legend is sorted in descending order of these values. Countries without COVID-19 deaths are omitted. Logarithmic vertical axis. Data source: ECDC.[231]

In the period between 17 and 21 March the number of deaths due to COVID-19 doubled on average every 1.4 days (64 % daily increase).[needs update] As of 3 April 92 % of the fatalities in Belgium were 65 years of age and older, 0.6 % were younger than 45 years and 58 % were men. The youngest fatality overall in Belgium was a 12-year-old girl[232][233] while the oldest person to die was 104 years.[234]

On 25 March 2020, Belgium ranked 6th in the list of EU countries with the highest numbers of casualties, while on 1 April Belgium had the third highest death toll after Italy and Spain. As of 3 April the case fatality rate of the COVID-19 disease is in Belgium similar to the neighbouring countries The Netherlands and France but much higher than in Germany. However, not all countries count the deaths in the same way.[235][236] Belgium counts deaths occurring both in hospitals and elsewhere, like in care homes. Deaths with clinical symptoms of the coronavirus disease are considered as "suspicious" and are included in the figures of COVID-19 deaths, even if they were not tested.[159][12]

Notable people[edit source | edit]

By location[edit source | edit]

Unlike most neighbouring countries (the Netherlands, France, Germany and the UK), the Belgian authorities were initially not willing to provide information or statistics on where the cases are located, beyond statistics for each region: Flanders, Brussels and Wallonia.[238]

Sciensano started to publish statistics per province starting 18 March. In the period between 17 and 21 March it became clear that the province of Limburg was a hotspot for the coronavirus where the incidence grew much faster compared to the rest of the country: while on 17 March the incidence in Limburg was 1.5 times the average incidence for the country, this had already increased to 1.9 times the average incidence on 21 March.[1]

Sciensano started to publish a map with incidence numbers per municipality starting 26 March.[citation needed]

The daily Sciensano report of 28 March saw a spectacular rise of the incidence numbers for the province of Liège: from 19 confirmed cases per 100 000 population on 27 March it rose to 77. This was due to underreporting by a lab in the province.[239] On 29 March the province of Liège even became the second worst affected province in Belgium after Limburg. Template:COVID-19 pandemic data/Belgium medical cases

Graphs[edit source | edit]

The graphs below are based on the data collected by Sciensano[240] (Belgian Institute for Public Health), as per the actual dates.
Because of the use of actual dates and as some delay occurs in reporting, all figures are subject to retrospective updating.

Total cases in Belgium (cumulative)
(Data from the last two days still have to be consolidated by Sciensano.)

New confirmed cases per day in Belgium
(Data from the last two days still have to be consolidated by Sciensano.)

Change of hospitalisations per day in Belgium

Active cases in hospital per day (incl. ICU)

New deaths per day in Belgium
(Data from the last two days still have to be consolidated by Sciensano.)

Confirmed new cases per day by region
(Data from the last two days still have to be consolidated by Sciensano.)

7-day running average for daily new cases, hospitalisations, discharges and deaths

Logistic growth models

Logistic growth modelfits for hospitalised COVID-19 cases in Belgium for data from 15 March 2020 until 14 May 2020. We can make out two phases separated by the yellow vertical line. One from 15 March 2020 until 31 March 2020 (with a fit in green) and the one from 1 April 2020 until 14 May 2020 (with a fit in blue). The initial phase (green) had exponential growth/decline rate of 29.3% and the total number of cumulated hospitalised cases stabilises at 7948. The second phase (blue) has exponential growth/decline rate of 9.44% and the total number of cumulated hospitalised cases stabilises at 16878. Also shown in purple is the fitted new hospitalisations from 1 April 2020 until 14 May 2020 (corresponding to the blue fit for cumulative data). Beyond 14 May the curves shown are only a trend according to the logistic growth model, these have an uncertainty range associated to them and should not be seen as a prediction.

See also[edit source | edit]

Notes[edit source | edit]

  1. The actual number of infections is estimated to be much higher than the number of cases confirmed by a laboratory test.
  2. The total number of death cases in Belgium also includes suspected death cases, including those in foster and care homes where only 26% of the reported death cases have been confirmed as CoVID-19 positive.

    It is important to note that in many other countries, the reported deaths following a CoVID-19 infections are only accounted for when they occur in hospital. This is an important note for comparison purposes.

References[edit source | edit]

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  153. Lua error: Internal error: The interpreter has terminated with signal "9".
  154. Lua error: Internal error: The interpreter has terminated with signal "9".
  155. Lua error: Internal error: The interpreter has terminated with signal "9".
  156. Lua error: Internal error: The interpreter has terminated with signal "9".
  157. https://www.hln.be/nieuws/binnenland/richtlijnen-voor-mondmaskers-aangepast-in-woonzorgcentra~a49855ce/
  158. Lua error: Internal error: The interpreter has terminated with signal "9".
  159. 159.0 159.1 Lua error: Internal error: The interpreter has terminated with signal "9".
  160. Lua error: Internal error: The interpreter has terminated with signal "9".
  161. Lua error: Internal error: The interpreter has terminated with signal "9".
  162. Lua error: Internal error: The interpreter has terminated with signal "9".
  163. Lua error: Internal error: The interpreter has terminated with signal "9".
  164. Lua error: Internal error: The interpreter has terminated with signal "9".
  165. Lua error: Internal error: The interpreter has terminated with signal "9".
  166. Lua error: Internal error: The interpreter has terminated with signal "9".
  167. 167.0 167.1 Lua error: Internal error: The interpreter has terminated with signal "9".
  168. Lua error: Internal error: The interpreter has terminated with signal "9".
  169. 169.0 169.1 Lua error: Internal error: The interpreter has terminated with signal "9".
  170. Lua error: Internal error: The interpreter has terminated with signal "9".
  171. Lua error: Internal error: The interpreter has terminated with signal "9".
  172. Lua error: Internal error: The interpreter has terminated with signal "9".
  173. Lua error: Internal error: The interpreter has terminated with signal "9".
  174. Lua error: Internal error: The interpreter has terminated with signal "9".
  175. Lua error: Internal error: The interpreter has terminated with signal "9".
  176. Lua error: Internal error: The interpreter has terminated with signal "9".
  177. Rhodes et al., The variability of critical care bed numbers in Europe Lua error: Internal error: The interpreter has terminated with signal "9"., Intensive Care Medicine, Volume 38, pages 1647–1653 (2012)
  178. Lua error: Internal error: The interpreter has terminated with signal "9".
  179. Lua error: Internal error: The interpreter has terminated with signal "9".
  180. Lua error: Internal error: The interpreter has terminated with signal "9".
  181. Lua error: Internal error: The interpreter has terminated with signal "9".
  182. Lua error: Internal error: The interpreter has terminated with signal "9".
  183. Lua error: Internal error: The interpreter has terminated with signal "9".
  184. Lua error: Internal error: The interpreter has terminated with signal "9".
  185. Lua error: Internal error: The interpreter has terminated with signal "9".
  186. Lua error: Internal error: The interpreter has terminated with signal "9".
  187. Lua error: Internal error: The interpreter has terminated with signal "9".
  188. Lua error: Internal error: The interpreter has terminated with signal "9".
  189. Lua error: Internal error: The interpreter has terminated with signal "9".
  190. Lua error: Internal error: The interpreter has terminated with signal "9".
  191. Lua error: Internal error: The interpreter has terminated with signal "9".
  192. Lua error: Internal error: The interpreter has terminated with signal "9".
  193. Lua error: Internal error: The interpreter has terminated with signal "9".
  194. Lua error: Internal error: The interpreter has terminated with signal "9".
  195. Lua error: Internal error: The interpreter has terminated with signal "9".
  196. Lua error: Internal error: The interpreter has terminated with signal "9".
  197. Lua error: Internal error: The interpreter has terminated with signal "9".
  198. Lua error: Internal error: The interpreter has terminated with signal "9".
  199. Lua error: Internal error: The interpreter has terminated with signal "9".
  200. Lua error: Internal error: The interpreter has terminated with signal "9".
  201. Lua error: Internal error: The interpreter has terminated with signal "9".
  202. Lua error: Internal error: The interpreter has terminated with signal "9".
  203. Lua error: Internal error: The interpreter has terminated with signal "9".
  204. Lua error: Internal error: The interpreter has terminated with signal "9".
  205. Lua error: Internal error: The interpreter has terminated with signal "9".
  206. Lua error: Internal error: The interpreter has terminated with signal "9".
  207. Lua error: Internal error: The interpreter has terminated with signal "9".
  208. Lua error: Internal error: The interpreter has terminated with signal "9".
  209. Lua error: Internal error: The interpreter has terminated with signal "9".
  210. Lua error: Internal error: The interpreter has terminated with signal "9".
  211. Lua error: Internal error: The interpreter has terminated with signal "9".
  212. Lua error: Internal error: The interpreter has terminated with signal "9".
  213. Lua error: Internal error: The interpreter has terminated with signal "9".
  214. Lua error: Internal error: The interpreter has terminated with signal "9".
  215. Lua error: Internal error: The interpreter has terminated with signal "9".
  216. Lua error: Internal error: The interpreter has terminated with signal "9".
  217. Lua error: Internal error: The interpreter has terminated with signal "9".
  218. Lua error: Internal error: The interpreter has terminated with signal "9".
  219. Lua error: Internal error: The interpreter has terminated with signal "9".
  220. Lua error: Internal error: The interpreter has terminated with signal "9".
  221. Lua error: Internal error: The interpreter has terminated with signal "9".
  222. Lua error: Internal error: The interpreter has terminated with signal "9".
  223. Lua error: Internal error: The interpreter has terminated with signal "9".
  224. Lua error: Internal error: The interpreter has terminated with signal "9".
  225. Lua error: Internal error: The interpreter has terminated with signal "9".
  226. Lua error: Internal error: The interpreter has terminated with signal "9".
  227. Lua error: Internal error: The interpreter has terminated with signal "9".
  228. Lua error: Internal error: The interpreter has terminated with signal "9".
  229. Lua error: Internal error: The interpreter has terminated with signal "9".
  230. Lua error: Internal error: The interpreter has terminated with signal "9".
  231. Lua error: Internal error: The interpreter has terminated with signal "9".
  232. Lua error: Internal error: The interpreter has terminated with signal "9".
  233. Lua error: Internal error: The interpreter has terminated with signal "9".
  234. Lua error: Internal error: The interpreter has terminated with signal "9".
  235. Lua error: Internal error: The interpreter has terminated with signal "9".
  236. Lua error: Internal error: The interpreter has terminated with signal "9".
  237. Lua error: Internal error: The interpreter has terminated with signal "9".
  238. Lua error: Internal error: The interpreter has terminated with signal "9".
  239. Lua error: Internal error: The interpreter has terminated with signal "9".
  240. Lua error: Internal error: The interpreter has terminated with signal "9".

Lua error: Internal error: The interpreter has terminated with signal "9".

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Lua error: Internal error: The interpreter has terminated with signal "9".