Why the World’s Highest Virus Death Rate Is in Europe’s Capital

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In an art-deco building in the heart of Brussels, Belgium’s leading scientists gather daily to announce the country’s coronavirus toll. It’s been grim reading.

Despite having only 11 million people, the country has reported more deaths from the disease than China. With some 57 fatalities per 100,000 inhabitants, it has the highest per-capita death rate in the world — almost four times that of the U.S.

Belgian Toll

Europe’s highest coronavirus death rates are in tiny Belgium

Source: ECDC, data as of April 24

According to Belgian officials, the reason for the grisly figures isn’t overwhelmed hospitals — 43% of intensive-care beds were vacant even at the peak of the crisis — but the country’s bureaucratic rigor.

Unlike many other countries, the home of the European Union’s top institutions counts deaths at nursing homes even if there wasn’t a confirmed infection.

“We often get criticism — oh, you’re making Belgium look bad — we think it’s the opposite,” Steven Van Gucht, head of the viral disease division at the Sciensano public-health institute, said while maintaining the requisite distance of 1.5 meters (5 feet). “If you want to compare our numbers with a lot of other countries, you basically have to cut them in half.”

Clearer Picture

About 95% of COVID-19 deaths in elderly care homes haven’t been diagnosed, yet Belgium makes the decision to register them based on the symptoms shown and who the people have been in contact with. The goal is to get a clearer picture of the outbreak and better target hot spots.

At the start of each briefing at the Residence Palais, a stone’s throw from the European Commission, Belgian officials detail the day’s statistics in French and Dutch. They draw particular attention to those who die outside of hospitals — typically around half the total.

The impact of the disease on vulnerable care-home residents is a growing issue. While Europe knew it would need more ventilators and intensive-care capacity once the virus spread beyond China, the impact on nursing homes was unexpected, according to Agoritsa Baka, a senior expert at the European Centre for Disease Prevention and Control.

“It’s a disaster,” she said. “We did not realize how devastating COVID-19 would be if it entered these populations.”

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