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Why Belgium's Death Rate Is So High: It Counts Lots Of Suspected COVID-19 Cases

President Trump speaks as he points to China on a chart showing death rates per 100,000 inhabitants during a coronavirus task force briefing on April 18. Belgium surged to the top of the chart because authorities are including all deaths that are even suspected of being caused by the virus, whether the deceased was tested or not.
President Trump speaks as he points to China on a chart showing death rates per 100,000 inhabitants during a coronavirus task force briefing on April 18. Belgium surged to the top of the chart because authorities are including all deaths that are even suspected of being caused by the virus, whether the deceased was tested or not.

In a recent news briefing, President Trump pointed to a bar chart that showed one country's coronavirus death toll per capita stretched out distinctively beyond all the others. It was not Italy or Spain, the countries with the highest total fatalities in Europe — but Belgium.

Meanwhile, the graph placed the U.S. rate below six European nations.

The display enraged Belgian government minister Denis Ducarme, who called it "macabre" and "level zero" politics for Trump to suggest Belgium's numbers are so poor and "all is well" in the U.S. "Our method of counting [COVID-19 deaths] is the most exhaustive possible!" he tweeted in French.

Ducarme is right — but Trump's chart wasn't wrong.

Belgium has surged to the top of the grim leaderboard because authorities decided to be radically transparent, if perhaps a bit speculative, about the toll from the novel coronavirus. They include not only deaths that are confirmed to be virus-related, but even those suspected of being linked, whether the victim was tested or not.

As of Wednesday, Belgium, with a population of over 11.4 million, has counted a total 6,262 deaths from COVID-19 — roughly 540 per million citizens — and more than half of those deaths were in nursing homes. Of those 52%, just 4.5% were confirmed as having been infected, yet all are counted in the national tally.

Other countries, such as the U.S., are still grappling with how to handle that situation.

Belgian authorities have come under pressure to change their method due to the negative perception. Even Prime Minister Sophie Wilmès has suggested the count has been exaggerated. But Emmanuel André, the spokesman for the government's coronavirus emergency task force, is unapologetic. He insists other governments have been undercounting fatalities attributable to the virus, and in fact, he said in a news conference Monday, "more and more countries are starting to copy the Belgian surveillance model ... which allows us to measure the severity of the situation."

"When you don't know, it's more difficult to act," he says.

Experts at Wednesday's briefing said the country likely hit the coronavirus' peak on April 12. On Friday, a special task force is due to unveil a gradual exit strategy from lockdown measures that have been in place since March 18.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

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