2020 coronavirus pandemic in Belgium

The 2019-20 coronavirus pandemic was first 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 tested positive for the COVID-19 virus.[4][5] Transmission within Belgium was then confirmed early March at the end of the school holidays around carnival, when many tourists back from Northern Italy returned to work or school,[6][obsolete source] leading to an epidemic with a rapid increase in cases in March–April 2020. By the end of March, cases had been registered in all 10 provinces of the country.[citation needed]

2020 coronavirus pandemic in Belgium
Spread of COVID19 in Belgium.png
Map of Belgium and its provinces with the spread of COVID-19 as of 5 April 2020[1]
COVID-19 outbreak Belgium cases per capita map.svg
Confirmed cases per 10.000 inhabitants by province (as of 5 April 2020)
  < 12
  12–15
  15–18
  18–21
  21–24
  24+
DiseaseCOVID-19
Virus strainSARS-CoV-2
LocationBelgium
First outbreakWuhan, Hubei, China[2]
Index caseBrussels
Arrival date4 February 2020
(2 months and 4 days ago)
Confirmed cases23,403[nb 1][3] (=202 cases per 100,000 head of population)
Recovered4,681[nb 2][3]
Deaths
2,240[3] (=194 deaths per 1,000,000 head of population)
Official website
www.info-coronavirus.be

As of 8 April 2020, there have been 23,403 confirmed cases reported by the Belgian authorities, with a total of 2,240 deaths and 4,681 discharged patients. Currently, 5,688 people in Belgian hospitals are suffering from COVID-19, including 1,276 in intensive care.[7] The actual number of infections, however, is likely to be much higher than the number of diagnosed cases, as laboratory tests are being limited to specific people and/or people with severe symptoms, as well as many people with mild or no symptoms do not seek medical help while they are likely to be transmitting the virus.[8]

BackgroundEdit

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.[9][10] First reports of the coronavirus disease started to appear in the Belgian media around 8 January.[11]

The case fatality ratio for COVID-19 has been much lower than SARS of 2003,[12][13] but the transmission has been significantly greater, with a significant total death toll.[14][12]

TimelineEdit

COVID-19 cases in Belgium  ()
     Deaths        Recoveries        Active cases
Date
# of cases
# of deaths
2020-02-04
1(n.a.)
1(=)
2020-03-01
2(+100%)
2020-03-02
8(+300%)
2020-03-03
13(+62%)
2020-03-04
23(+77%)
2020-03-05
50(+117%)
2020-03-06
109(+118%)
2020-03-07
169(+55%)
2020-03-08
200(+18%)
2020-03-09
239(+20%)
2020-03-10
267(+12%) 1(n.a.)
2020-03-11
314(+18%) 3(+200%)
2020-03-12
399(+27%) 3(=)
2020-03-13
559(+39%) 3(=)
2020-03-14
689(+23%) 4(+33%)
2020-03-15
886(+29%) 4(=)
2020-03-16
1,058(+19%) 5(+25%)
2020-03-17
1,243(+17%) 5(=)
2020-03-18
1,486(+20%) 14(+180%)
2020-03-19
1,795(+21%) 21(+50%)
2020-03-20
2,257(+26%) 37(+76%)
2020-03-21
2,815(+25%) 67(+81%)
2020-03-22
3,401(+21%) 75(+12%)
2020-03-23
3,743(+10%) 88(+17%)
2020-03-24
4,269(+14%) 122(+39%)
2020-03-25
4,937(+16%) 178(+46%)
2020-03-26
6,235(+26%) 220(+24%)
2020-03-27
7,284(+17%) 289(+31%)
2020-03-28
9,134(+25%) 353(+22%)
2020-03-29
10,836(+19%) 431(+22%)
2020-03-30
11,899(+10%) 513(+19%)
2020-03-31
12,775(+7.4%) 705(+37%)
2020-04-01
13,964(+9.3%) 828(+17%)
2020-04-02
15,348(+9.9%) 1,011(+22%)
2020-04-03
16,770(+9.3%) 1,143(+13%)
2020-04-04
18,431(+9.9%) 1,283(+12%)
2020-04-05
19,691(+6.8%) 1,447(+13%)
2020-04-06
20,814(+5.7%) 1,632(+13%)
2020-04-07
22,194(+6.6%) 2,035(+25%)
2020-04-08
23,403(+5.4%) 2,240(+10%)
Remark:
  • The dates above are the dates of reporting which can be different than the actual dates of diagnosis or death.

Sources:

February 2020 – First caseEdit

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.[15][16]

On 4 February, it was announced one of the repatriated has tested positive for the novel coronavirus,[17] the first case in Belgium.[18] 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.

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.[19]

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.[20][21] 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.[22]

March 2020 – SpreadEdit

On 1 March, a second case of coronavirus was confirmed in Belgium, a Dutch speaking woman who had returned from Crépy-en-Valois in one of the regions affected in France.[23]

The yearly one week school holiday around carnival lasted from 22 February until 1 March 2020 and quite a few people go on ski vacation during that period. The number of detected virus infections therefore sharply rose upon the return of people having resided in the ski resorts of the North of Italy.[citation needed]

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 having come back from Northern Italy.[24]

As of 3 March, six additional cases were confirmed, making a total of 14 cases. One of the infected persons was a 17-year old teenager who returned to his school in Tienen after a ski vacation in the North of Italy.[25] Another person from Sint-Niklaas also returned from a skiing holiday.[26] A patient from Verviers was hospitalised in a Brussels clinic,[27] and two cases were found in Couthuin [fr] (part of Héron).[28] One patient is 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.[29][30] 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.[31] In a later interview he mentioned different numbers saying that 70% of the population (approximately 8 million persons) could become infected.[32]

As of 4 March, ten new cases were confirmed, making a total of 23. Nine of the new patients recently returned from Italy. The other patient had contact with a prior case.[33] Four cases were in the Leuven area,[34] one case in Hasselt,[35] and one in Pelt.[36] In Wevelgem two related cases appeared. A complete family of 7 was infected upon their return from a ski holiday in the North of Italy. Initially the Belgian authorities did not want to test the family for the virus, notwithstanding the request of the family.[37] Additionally a teacher in a primary school in Wevelgem, who was on the same ski vacation as the family of seven and even went to work for two and a half days after the school holiday became sick and was diagnosed with the covid-19 virus.[38] The Agentschap Zorg en Gezondheid advised the school to not close down.[39] A retirement home in Gooik stopped receiving visitors as a precautionary measure, because one employee could have been in contact with the new coronavirus.[40] Joris Moonens, the spokesman of the Flemish Agency for Care and Health, expressed the opinion that this was not an appropriate measure.[41]

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.[42] The senior EDA official had returned from a trip to Italy the previous week.[42] After returning from Italy, he attended a roughly four-hour meeting with about thirty other European Union officials last week before he started feeling ill on Saturday (29 February).[42] A military staff member of the European External Action Service who attended the meeting has also begun experiencing symptoms.[42] The EDA has cancelled all meetings until 13 March, and other European Union institutions are also taking precautions.[42][43]

On 5 March, 27 new confirmed cases were reported by the government (16 in Flanders, 9 in Wallonia and 2 in Brussels), bringing the total to 50.[44] Of the 50 persons 1 patient recovered, 48 are quarantined in their home and 1 person is being treated in the Sint-Pietersziekenhuis.[45] The new cases were reported to be in Knokke-Heist, Zonhoven, Doomkerke [nl] (Ruiselede) and Vlierzele (part of Sint-Lievens-Houtem).[46]

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 1 cured). The new cases were amongst others reported in Oosterzele and Sint-Katelijne-Waver.[47] The Ministry of Health confirmed for the first time that infections occurred on Belgium territory.

On 7 March, 60 new cases were confirmed by the government (40 in Flanders, 5 in Brussels and 15 in Wallonia), bringing the total to 169 (105 in Flanders, 17 in Brussels, 46 in Wallonia and 1 cured). The new cases were amongst others reported in Houthalen, Melle, Lokeren, Mere, Lede, Tildonk and Poppel.[48] The ministry of public health mentioned that "more and more infections are being contracted locally” but did not provide the information on how many.[49]

From 422 samples taken on 7 March 31 were tested positive on 8 March (16 in Flanders, 8 in Brussels and 7 in Wallonia), bringing the number of infections to 200. The ministry of health confirmed "local circulation of the virus from various locations" but did not disclose these locations.[50]

On 10 March, the total number of confirmed cases was 267.[51]

On 11 March, ministers De Block and Maron announced that the first death on Belgian territory due to COVID-19 occurred on 10 March,[52] a 90-year-old female patient from Brussels who was being treated in Etterbeek.[53] Two more patients died on the same day, one person aged 73 and one person aged 86 who died in Sint-Genesius-Rode.[54]

On 12 March, 2 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.[55] The total number of confirmed cases rose to 399. Approximately 20 patients (approx. 5%) out of those 399 were being treated in intensive care.[56] The president of the European Commission, Ursula von der Leyen informed the entire staff that 7 of their colleagues had tested positive, six of whom 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.[57]

By 14 March, 689 cases were confirmed with 4 deaths.[58]

On 21 March it was observed that more than half of the patients in the hospital Oost-Limburg in Genk were from Turkish origin. Secretary of state Zuhal Demir urged the Turkish community in Limburg to abide by the quarantine measures.[59]

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 by two parties that were allowed to go on in the weekend of 7 March.[60] The mayor of Sint-Truiden, who was herself infected by the new corona virus, mentioned she did not understand the reason for the high incidence in her town. The only potential explanation so far were the festivities around carnival (24 February, 75th Verloure Moondagstoet).[61] The high level of cases in the affluent municipality of Bonheiden is thought to be linked with a high amount of families that returned from ski resorts in the North of Italy beginning of March.[62] Both Quévy and Honnelles are located at the border with the French commune of Bavay in the Nord department. 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 high numbers in her municipality and complained about the lack of communication and protective equipment.[63][64]

On the daily press conference of 27 March Steven Van Gucht announced that one cat had been infected by its owner. This was a rare occurrence and only the third time an infection of a pet was observed worldwide. The cat developed respiratory and digestive issues.[65]

The additional number of people that tested positive for the novel coronavirus was rather high on 28 March compared to the previous days because more persons were being tested and because a major Walloon laboratory had not reported any cases so far and reported 500 additional cases from the past days with a delay.[66]

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.[67]

On 30 March, it was announced that because of the high burden on some hospitals in the provinces of Limburg and Hainaut, the distribution plan for ICU patients had been activated.[68]

Jan Eyckmans of the Federal Public Service Health claimed hospitals increased their number of ICUs from 1900 to 2650 in two weeks time, corresponding to an increase from 16.5 to 23.0 ICUs per 100 000 inhabitants.[69] 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 Steven Van Gucht quoted the capacity to be 2081 units.[70] The newspaper De Standaard mentioned the number of 1765 on 31 March[71] and 2393 on 3 April.[72]

April 2020Edit

On 31 March (data reported on 1 April), a drop in the daily increase of patients being treated in hospitals was observed. This can be explained by the rise of discharged patients: 436 people left hospital in the last 24 hours.

On 2 April, the monarch had a phone call with Chinese president Xi Jinping in the framework of the quest to secure medical equipment, of which China is a major supplier, saying I will forever cherish our friendship.[73]

On 7 April Erika Vlieghe was appointed to head a team (GEES) of 10 scientists, economists and top managers that will advise the National Security Council on the restart of the country.[74]

Government responseEdit

AuthoritiesEdit

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),[75] with the support of:

Containment measuresEdit

Phases 1 and 2Edit

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.[78]

On 1 March, as a second case of coronavirus was confirmed in Belgium, phase 2 of the health risk containment strategy was activated.[79][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, preschools, sports facilities and public places for persons returning from areas at risk[80] and only a few schools, such as the International School Ghent, quarantined pupils that returned from areas at risk, such as Northern Italy.[81]

Reinforced phase 2 and lockdown lightEdit

On 10 March, the government advised to cancel any indoor scheduled events to be attended by more than 1000 people for the month of March. Prime minister Wilmès stressed this was not an interdiction but rather a recommendation.[82] Schools remain open but are advised to cancel trips abroad and multi-day excursions in general. Companies are 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'.[83]

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.[84] It was stressed that the measures taken were not a lockdown because people are not required to stay home.[85]

 
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 evolution of 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, and penalties to force companies and individuals to abide by the rules.[86][specify]

On 20 March, from 3 p.m. onwards Belgium closed its borders to all non-essential travel.[87] Earlier, the governor of West Flanders had complained about Dutch and French citizens coming to Belgium for tourism or shopping,[88] 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, in order to stop Belgian citizens going to Dutch cafés or restaurants.[89] From 25 March onwards, people arriving at Brussels Airport were handed over a leaflet with the compelling advice to quarantine themselves for a fortnight.[90]

On 27 March, the National Security Council and the governments decided to extend the measures taken so far until at least 19 April (until the end of the Easter vacation) with an option to extend the period with two weeks until 3 May.[91]

CommunicationsEdit

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,[92] that Belgium has good hospitals and laboratories[93] and that the government was attentive to the evolution and well prepared for the possible arrival of coronavirus.[94]

The government actively communicates since the first case. An official website[95] 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,[96] in order to inform the public. Since the 13 March, the FPS Health together with the National Crisis Centre (NCCN) hold a daily press conference[97] 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 effort of transparency, a daily epidemiological bulletin and a set of raw data are made available on the Belgian institute for health website.[98]

The Prime Minister Sophie Wilmès used twice a web video to address herself to the citizens and take stock of the situation.[99][100][101][102][specify]

Experts and authorities expressed their indignation about citizens organising or taking part in so-called 'lockdown or corona parties'.[103]

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 mid of the week of 23 March.[104] On 21 March, Prof. dr. Erika Vlieghe of the Scientific Committee mentioned that the she expected the peak of the pandemic to occur early April.[105]

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”.[106]

CriticismEdit

Handling of the crisisEdit

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. Some experts[vague] like Marc Wathelet urged for strict prevention measures, affirming that the Belgian federal minister of health Maggie De Block was underestimating the danger.[107] Professor Herman Goossens of the UZA in Antwerp called for wider screening for the virus.[108] Pharmacists complained they did not receive clear instructions from the authorities.[109] Zorgnet Icuro[110], a major 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.[111][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.[112] 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.[113][114] 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.[115] 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.[116]

Some media made positive criticism, such as the Financial Times who praised Belgium for its handling of the coronavirus crisis,[117] 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.[118] De Standaard praised Steven Van Gucht, president of the Scientific Committee, for being "calm, empathic and wonderfully clear".[119]

Shortage of medical suppliesEdit

Just as many countries in the world,[120] Belgium faced a shortage of personal protective equipment such as respirators, surgical masks or face shields.

Towards the end of January it became clear[weasel words] that Belgium had an insufficient stock of respirators and surgical masks but Jan Eyckmans of the Federal Public Service Health department claimed the Belgian hospitals had sufficient stock.[121][122] On 6 March, the Federal Minister of Public Health Maggie De Block calls out EU governments who decided to block medical masks exports as global stocks decrease, adding they were acting against the spirit of the European Union.[123] 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.[124] On 15 March, it became clear[weasel words] that the masks had not been delivered on time,[125] and the following day De Block announced that her department's order of 5 million masks might have involved fraud.[126][127] 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.[128] On 19 March, a shipment of 100.000 FFP2 respirators arrived.[129] On 16 March, the Chinese Alibaba foundation donated half a million surgical masks and 30 000 test kits, thanks to the intervention of King Philippe and with the support of the Walloon Export and Foreign Investment Agency (AWEX).[130] 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.[131][132] Hospitals such as the Centre Hospitalier Interrégional Edith Cavell (CHIREC) reported that they were in dire need of protective masks.[133] Minister Philippe De Backer was charged with coordinating the efforts of the authorities to supply masks and respirators.[134] 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. [135]

On 7 March, it became clear[weasel words] that Belgium lacked enough reagents to do widespread COVID-19 testing and the National Reference Centre for Pathogens (NRC)[136] was forced to apply a system of triage.[137] The UZ Leuven confirmed they were forced to limit the number of tests for the virus because of a shortage of reagents for the test.[137] Two surgeons from the Brussels Saint Pierre hospital addressed an open letter to prime minister Wilmès on 22 March demanding increased testing.[138][139]

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, in order to improve the testing capacity to 10,000 tests a day.[140]

Other responsesEdit

Healthcare sector and Belgian researchEdit

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

In order 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[141] or the Saint Peter's Hospital in Brussels with the set up of outside tents supported by the Belgian Red Cross.[142]

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[143][144] to 16.5[145] 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[146] and financial support for research into COVID-19,[147] or Brussels Saint Peter's hospital who called for donations to buy life-saving ventilators.[148]

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),[149][150] at the University of Namur (new test method, Benoït Muylkens)[151] and by private companies in collaboration with universities (new 15 minute test method detecting coronavirus antigens, CORIS BioConcept).[152]

Studies conducted by UZ 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,[153] confirming the suspicion that many people are infected with the coronavirus without knowing and as herd immunity would prevent the spread of the coronavirus.[154]

Attempts to predict the progress of the coronavirus spread with compartmental models are undertaken at Ghent University (Prof Jan M. Baetens)[155] and Hasselt University (Prof Niel Hens)[156]. Professor Barbé at the Free University of Brussels-VUB uses a first order differential equation with two proxy variables.[157][158] 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.[159][specify]

Belgian industryEdit

In an effort to alleviate the hand sanitiser shortage in Belgium, several Belgian companies started to make alcohol[160] or to manufacture hand sanitisers themselves, like the pharmaceutical company Janssen Pharmaceutica,[161] the brewing company AB InBev[162] and the Sugar refinery of Tienen, [163] reaching a total of 1 million gel and ending the shortage in the country.[164]

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.[165][166]

ImpactEdit

PoliticsEdit

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.[167]

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,[168] eventually joined by Open Vld, MR, CD&V and sp.a on 14 and 15 March.[169] Those discussions however were inconclusive as Bart De Wever (N-VA) wanted to be the new Prime Minister[170] and as PS and MR refused to nominate new Prime Minister and Ministers, arguing it would be a waste of time.[171] Talks between political parties continued the next hours and were extended to Ecolo, Groen, cdH and DéFI.

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.[172][173] The government also received certain plenary powers in order to deal with the pandemic quickly and effectively.[174]

EconomicsEdit

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.[175][specify]

Belgian companies suffer from the corona crisis, such as producers of fries who reported a drop in demand for potato specialities.[176]

Just as most airlines in the world,[177] the national flag carrier Brussels Airlines suspended all its commercial flights as of 21 March, originally until 19 April[178] then until mid-May.[179][specify]

SocietyEdit

From 12 March onwards many people started hoarding for the next one and a half week.[180][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.[181][relevant? ]

EnvironmentEdit

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.[182][183]

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.[184][185]

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.[186][specify]

StatisticsEdit

DefinitionsEdit

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

Confirmed infectionsEdit

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,[187] 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.[188]

In the period of 1 March 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 March and 27 March the number of confirmed cases doubled on average every 3.7 days (20.9 % daily increase).

RecoveriesEdit

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.[189] 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.[190] The situation is similar in France.[191]

The first recovered case was on 15 February 2020.[192] As of 5 April, Sciensano reported a total of 3,986 discharged patients since the 15 March.[193]

DeathsEdit

In the period between 17 March 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[194][195] while the oldest person to die was 104 years.[196] Belgium counts deaths occurring both in hospitals and in nursing homes.

On 25 March 2020, Belgium ranked 6th in the list of EU countries with the highest amounts 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, it is to be noted that not all countries report the deaths in the same way.[197]

By locationEdit

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.[199]

Sciensano started to publish statistics per province starting 18 March. In the period between 17 March 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.[200]

Sciensano started to publish a map with incidence numbers per municipality starting 26 March.

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.[201] On 29 March the province of Liège even became the second worst affected province in Belgium after Limburg.

COVID-19 confirmed cases in Belgium by province ()

Province
+ Brussels-Capital Region
Cases Hosp. Deaths Refs
  Antwerp 2,978 1,481
  East Flanders 2,792 1,098
  West Flanders 2,465 1,105
  Flemish Brabant 2,396 560
  Limburg 2,789 1,122 145 [202]
  Brussels-Capital Region 2,515 1,369
  Hainaut 2,509 1,081
  Liège 2,583 987
  Namur 726 253
  Walloon Brabant 600 139
  Luxembourg 673 230
N/A 377 N/A
Note:
  • The deaths number by province is non-official and based on very partial data.

Sources:

  • Cases and hospitalisations: data collected by Sciensano, as of 2020/04/07.[203]
  • Deaths: various news sources.

COVID-19 confirmed cases in Belgium by region ()

Region Cases Deaths CFR
(%)
# % # %
  Flanders 13,420 57.34 1,043 46.56 7.77
  Brussels-Capital Region 2,515 10.75 363 16.21 14.43
  Wallonia 7,091 30.30 834 37.23 11.76
N/A 377 1.61 N/A N/A N/A
  Belgium 23,403 100.0 2,240 100.0 9.57
Source: Data collected by Sciensano, as of 2020/04/07.[204]

By dayEdit

COVID-19 confirmed cases in Belgium by day and region ()

Date  
Flanders
 
Brussels
 
Wallonia

Unknown
Cases Deaths Active Hosp. adm Hosp. disch Tested Notes
New Total New Total ICU Total New Total New Total % pos. Total
Unknown 24 11 24 59 59
2020/03/01 8 6 2 16 75 28.57 56
2020/03/02 12 4 1 17 92 6.05 281
2020/03/03 21 2 13 36 128 7.56 476
2020/03/04 31 5 12 6 54 182 8.53 633
2020/03/05 59 2 20 81 263 11.55 701
2020/03/06 74 9 23 1 107 370 10.54 1,015
2020/03/07 16 5 6 27 397 6.59 410
2020/03/08 37 7 19 1 64 461 15.65 409
2020/03/09 37 12 42 3 94 555 17.25 545
2020/03/10 57 13 22 7 99 654 1 1 13.38 740
2020/03/11 106 17 46 1 170 824 3 4 16.75 1,015
2020/03/12 136 37 69 5 247 1,071 1 5 17.52 1,410
2020/03/13 166 39 113 19 337 1,408 3 8 14.08 2,393
2020/03/14 74 30 66 7 177 1,585 5 13 8.84 2,002
2020/03/15 125 27 53 10 215 1,800 5 18 54 264 71 71 18 18 18.57 1,158
2020/03/16 204 61 115 8 388 2,188 10 28 79 368 90 161 14 32 23.42 1,657
2020/03/17 257 24 127 10 418 2,606 10 38 100 496 123 284 31 63 21.75 1,922
2020/03/18 288 58 185 5 536 3,142 17 55 131 648 183 467 48 111 22.35 2,398
2020/03/19 383 55 246 32 716 3,858 24 79 165 841 212 679 49 160 24.46 2,927
2020/03/20 393 70 189 11 663 4,521 23 102 234 1,081 288 967 54 214 25.46 2,604
2020/03/21 248 44 164 14 470 4,991 30 132 290 1,380 332 1,299 74 288 23.76 1,978
2020/03/22 235 65 176 13 489 5,480 39 171 322 1,643 290 1,589 61 349 41.62 1,175
2020/03/23 808 116 394 13 1,331 6,811 64 235 385 1,881 278 1,867 82 431 50.23 2,650
2020/03/24 686 122 378 8 1,194 8,005 64 299 474 2,137 434 2,301 115 546 36.12 3,306
2020/03/25 716 142 325 12 1,195 9,200 84 383 612 2,655 540 2,841 128 674 32.83 3,640
2020/03/26 818 149 375 15 1,357 10,557 77 460 690 3,008 490 3,331 183 857 36.52 3,716
2020/03/27 937 186 371 25 1,519 12,076 87 547 789 3,640 575 3,906 205 1,062 37.01 4,104
2020/03/28 477 147 206 13 843 12,919 104 651 867 4,068 629 4,535 296 1,358 25.34 3,327
2020/03/29 366 93 213 13 685 13,604 102 753 942 4,468 545 5,080 169 1,527 33.40 2,051
2020/03/30 1,033 138 533 27 1,731 15,335 128 881 1,021 4,784 478 5,558 168 1,695 51.97 3,331
2020/03/31 874 178 581 18 1,651 16,986 144 1,025 1,088 4,875 553 6,111 436 2,131 30.27 5,455
2020/04/01 840 145 444 23 1,452 18,438 212 1,237 1,144 5,206 584 6,695 363 2,494 30.17 4,813
2020/04/02 800 153 451 12 1,416 19,854 187 1,424 1,205 5,358 568 7,263 377 2,871 29.28 4,836
2020/04/03 932 154 469 19 1,574 21,428 208 1,632 1,245 5,492 504 7,767 375 3,246 30.57 5,149
2020/04/04 455 93 221 14 783 22,211 253 1,885 1,261 5,509 499 8,266 504 3,750 18.45 4,243
2020/04/05 288 64 184 9 545 22,756 204 2,089 1,267 5,600 358 8,624 235 3,985 21.83 2,496
2020/04/06 394 32 210 3 639 23,395 128 2,217 1,260 5,738 314 8,938 171 4,156 21.52 2,969 [a]
2020/04/07 5 3 8 23,403 23 2,240 1,276 5,688 487 9,425 524 4,680 3.11 257 [a]
Total 13,420 2,515 7,091 377 N/A 23,403 N/A 2,240 N/A N/A N/A 9,425 N/A 4,680 27.78 84,248 N/A
 
Flanders
 
Brussels
 
Wallonia

Unknown
New Total New Total ICU Total New Total New Total % pos. Total Notes
Cases Deaths Active Hosp. adm Hosp. disch Tested
Remarks:
  • Because of the use of effective dates and as some delay occurs in reporting, all numbers are subject to retrospective updating.
  • The dates are to be understood as follows:
    • cases: date of diagnosis (or when not available, date of reporting);
    • deaths: date of death;
    • tested: date of laboratory diagnosis (or when not available, date of sampling).
  • Numbers about hospitalisations are from 15 Mars, date from which >99% of hospitals were notifying.

Notes:

  1. ^ a b The numbers of new cases, deaths and tests are still incomplete for this day.
Source: Data collected by Sciensano, as of 2020/04/07.[205]

By gender and ageEdit

Note: For some reason, Sciensano is using different age ranges for confirmed cases and for deaths.


GraphsEdit

The graphs below are based on the data collected by Sciensano[209] (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 two last days still have to be consolidated by Sciensano.)

 

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

 

New hospitalisations per day in Belgium

 

Active cases in hospital per day (incl. ICU)

 

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

 

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

 

Logistic growth models

 
Logistic growth model fit for hospitalised COVID-19 cases in Belgium for data (see table above for data used) from 15/03/2020 until 06/04/2020. The exponential phases have a growth/decline rate of 25.9% and the total number of cumulated hospitalised cases stabilises at 10515. Beyond 6 April 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 alsoEdit

NotesEdit

  1. ^ The actual number of infections is estimated to be much higher than the number of cases confirmed by a laboratory test.
  2. ^ The official reports do not refer to recovered people but to discharged patients.

External linksEdit

ReferencesEdit

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