Coronavirus: Why Belgium also counts suspected deaths

Coronavirus: Why Belgium also counts suspected deaths
Credit: Belga

Belgium's goal is to "be as complete as possible" in its reporting of the new coronavirus (Covid-19) pandemic, which is why it also includes suspected cases, said virologist Steven Van Gucht during the daily press briefing by Federal Public Health Service on Wednesday.

On Wednesday, 283 new deaths were reported, of which 179 occurred in residential care centres, according to the daily press briefing by the Federal Public Health Service and the Crisis Centre. However, of the deaths reported by the care centres, only 2.8% were confirmed by the lab, meaning they were mainly suspected cases.

On Monday, Belgian virologist Marc Van Ranst said that he thought it was "dumb" to include the deaths that occur in residential care centres in the coronavirus statistics, as is happening now, according to him.

“Almost all people who die in a residential care centre, which is about a hundred people every day, end up in those statistics,” Van Ranst said, adding that people who die from a heart attack, for example, are also being counted.

The total number of reported deaths in Belgium since the beginning of the pandemic is currently 4,440. "If we look at the confirmed cases only, which are almost exclusively those in the hospitals, we have 2,264 confirmed deaths so far," said Van Gucht.

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The assessment of whether or not a death is related to the coronavirus, as the main cause or as a contributing factor, is made by the attending physician, based on three criteria, according to Van Gucht.

The first condition is epidemiological, meaning the possibility of contact with an infected person will be determined. Second is the presence of symptoms, and the last one is a positive lab test. "When all three criteria are confirmed, we speak of a confirmed or certain case. That's the highest degree of certainty," said Van Gucht.

However, very often, no testing is done and the assessment is based on the possibility of infection, the possibility of contact and the typical symptoms. "We then call this a suspected case. This is an assessment made by the doctor in question, and there may be an overestimation of the number of cases," he said, adding that these cases are also reported as Belgium wants to be "as complete as possible" in its reporting.

Another way of measuring the impact of the virus on mortality in the residential care centre communities is by measuring the general excess mortality. "There is a certain delay with that system. Those figures that will be added to the analysis later on, and it will give an even better picture of the real impact of this virus outbreak," Van Gucht said.

At the moment, comparing the figures reported by different countries is difficult, as many countries count in different ways, he said. "We do this in the first place to be able to assess what is currently going on in Belgium, and in such a way that we can also take action where necessary. That's priority number one," Van Gucht said. "The aim is not to start ranking countries. This is not a competition," he added.

Maïthé Chini

The Brussels Times

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