How Belgium succumbed to the highest Covid death rate in the world

As Covid cases spiralled around the world, attention focused on the UK’s high death toll, the inaction of Donald Trump in the US and Jair Bolsonaro’s controversial claims in Brazil.

But all the while, deaths were quietly creeping up in Belgium, the home of the EU’s institutions, which has now reported almost 757,000 cases and 22,000 deaths, the worst Covid death rate in the world.

Belgium has recorded 192.22 deaths per 100,000 people, according to John Hopkins University, second only to San Marino, the tiny microstate of 33,000 residents, which has reported just 73 deaths during the entire pandemic.

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The country was hit hard by two waves of coronavirus, with Health Minister Frank Vandenbroucke warning in October last year that the country was facing a “tsunami” of infections after having “lost control” of the virus.

Belgium “is one of Europe’s most densely populated countries and is a crossroad of cultures at the centre of the EU”, the New Statesman (NS) says, but “this doesn’t entirely explain the problem”.

The country is often referred to as “a country in name only”, having been federalised into three distinct regions: Dutch-speaking Flanders, French-speaking Wallonia and the mostly Francophone Brussels. These regions split in their response to Covid due to “a lack of trust and coordination between different regions and cultures”, the magazine adds.

As Brussels and Wallonia enacted shutdowns, Flanders - where many of Brussels workers live - remained open. The pandemic response was brought under the jurisdiction of the central government only in October, when a full lockdown was announced.

This “overcomplicated bureaucracy and muddled public messages” both contributed to an inability to suppress the virus, Axios reports, although the country’s unique way of recording Covid deaths is also a contributing factor to its high death rate.

“Belgium’s tally includes suspected Covid-19 deaths in facilities such as nursing homes, even without a positive test”, the site adds, “which authorities have cited as one reason the country’s death rate is so high”.

This method of recording deaths means that more than 50% of registered Covid fatalities in Belgium “are deaths that have not been confirmed by diagnostic tests”, epidemiologist Yves Coppieters told The Brussels Times. “These are possible cases but have been reported as Covid-19 related deaths.”

The country’s “surveillance system was not ready” quickly enough, Coppieters added, meaning it “was quickly overwhelmed at the beginning of the outbreak”. This caused the country to include “a large number of deaths” not necessarily linked to Covid as “it made counting easier”.

Belgian regulators have advised against giving the Oxford-AstraZeneca vaccine to over-55s, in a move that will also slow down the country’s stuttering jab rollout. The country has so far administered just 688,160 doses, according to Oxford University tracking, representing 5.9 jabs - including second vaccinations - per 100 people.