Abstract
BackgroundCOVID-19 mortality, excess mortality, deaths per million population (DPM), infection fatality ratio (IFR) and case fatality ratio (CFR) are reported and compared for many countries globally. These measures may appear objective, however, they should be interpreted with caution.AimWe examined reported COVID-19-related mortality in Belgium from 9 March 2020 to 28 June 2020, placing it against the background of excess mortality and compared the DPM and IFR between countries and within subgroups.MethodsThe relation between COVID-19-related mortality and excess mortality was evaluated by comparing COVID-19 mortality and the difference between observed and weekly average predictions of all-cause mortality. DPM were evaluated using demographic data of the Belgian population. The number of infections was estimated by a stochastic compartmental model. The IFR was estimated using a delay distribution between infection and death.ResultsIn the study period, 9,621 COVID-19-related deaths were reported, which is close to the excess mortality estimated using weekly averages (8,985 deaths). This translates to 837 DPM and an IFR of 1.5% in the general population. Both DPM and IFR increase with age and are substantially larger in the nursing home population.DiscussionDuring the first pandemic wave, Belgium had no discrepancy between COVID-19-related mortality and excess mortality. In light of this close agreement, it is useful to consider the DPM and IFR, which are both age, sex, and nursing home population-dependent. Comparison of COVID-19 mortality between countries should rather be based on excess mortality than on COVID-19-related mortality.
Highlights
IntroductionBelgium’s coronavirus disease (COVID-19)-related mortality per million inhabitants has been reported as the highest worldwide (excluding microstates) between 11 April 2020 and 26 August 2020
Belgium’s coronavirus disease (COVID-19)-related mortality per million inhabitants has been reported as the highest worldwide between 11 April 2020 and 26 August 2020
On 28 June 2020 Our World in Data [1] reported that Belgium had 830 COVID-19-related deaths per million population (DPM) vs 107 in Germany, 379 in the United States (US), 456 in France, 539 in Sweden, 574 in Italy and 593 in the United Kingdom (UK)
Summary
Belgium’s coronavirus disease (COVID-19)-related mortality per million inhabitants has been reported as the highest worldwide (excluding microstates) between 11 April 2020 and 26 August 2020. COVID-19 mortality, excess mortality, deaths per million population (DPM), infection fatality ratio (IFR) and case fatality ratio (CFR) are reported and compared for many countries globally. These measures may appear objective, they should be interpreted with caution. Results: In the study period, 9,621 COVID19-related deaths were reported, which is close to the excess mortality estimated using weekly averages (8,985 deaths) This translates to 837 DPM and an IFR of 1.5% in the general population. Discussion: During the first pandemic wave, Belgium had no discrepancy between COVID-19-related mortality and excess mortality In light of this close agreement, it is useful to consider the DPM and IFR, which are both age, sex, and nursing home population-dependent. Comparison of COVID-19 mortality between countries should rather be based on excess mortality than on COVID-19-related mortality
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