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Experts question Belgium’s call to relax coronavirus rules

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On Wednesday, Belgium turned red on the European Centre for Disease Prevention and Control’s coronavirus map because of its rising rate of infections. Only hours later, the Belgian government decided to ease its coronavirus measures.

The timing, say many experts, couldn’t have been worse.

“Those who claim that there is nothing wrong, that the figures are only going up because we are testing more and that we therefore need to relax measures, bear a great deal of responsibility for the rising curve,” said Belgian virologist Marc Van Ranst.

Rik Van de Walle, the head of the University of Ghent and a fierce critic of the government’s pandemic response, took to Twitter to blast the announcement as “downright astonishing.” Other heads of universities also called on their students and staff to be more careful than the government is advising.

Indeed, ahead of Wednesday’s decision, some medical professionals had exhorted the government to take the opposite course and tighten the rules. They included the deans of the medicine departments of universities in Brussels and the northern region of Flanders, who asked for tougher restrictions on the grounds that “there’s no more time for unclear and half-hearted measures.”

“There’s no point in imposing rules that are useless or that cannot be controlled” — Jan Jambon, Flemish state premier

Instead, the Belgian government announced it’s moving from a strategy of crisis management to risk management over the longer term. This shift includes substantially loosening the rules on how many people Belgians can be in close contact with.

“It’s like giving a present to a virus that’s already spreading enormously,” warned epidemiologist Pierre Van Damme of the University of Antwerp.

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Rules made to be broken?

At the same time, experts and politicians admit that the current rule of keeping social contacts contained to a “bubble” of five has neither been obeyed nor enforced.

“There’s no point in imposing rules that are useless or that cannot be controlled,” tweeted Flemish state premier Jan Jambon, who sits on the Belgian National Security Council. It’s more useful to appeal to common sense, he added.

As KU Leuven biostatistician Geert Molenberghs sees it, the new concept shouldn’t be seen as a relaxation but an adjustment.

“The old concept, the bubble, worked to get the numbers down,” he said late Wednesday. “We clearly saw that over the summer.

“But the bubble was far too rigid,” he added. “The new concept, on the other hand, is flexible: You can relax or increase the number of people with whom family members may have close contact as the epidemic progresses.”

Molenberghs’ views remain the exception, however. There’s broad consensus among experts that the Belgian government has been struggling in its response to the rising rate of infections.

In the last few weeks, researchers say, the return from holiday travel and the reopening of schools have led to a rising number of infections. It’s not that infections are rampant in schools — in the first two weeks of the school year, only 0.05 percent of pupils and 0.05 of staff tested positive in Flanders. It’s that the increased mobility of families and commuters is helping drive the increase.

Politicians have also cited the lack of popular support for the current measures. That sentiment has been bolstered by the fact that amid rising cases and a jump in hospitalization rates, the death rate has remained stable, averaging three a day. Belgian hospitals are still fully able to cope, and the sense of urgency felt in the spring has faded away. Instead, people long for more normality.

Also compounding the problem is that the country’s virologists and experts have publicly disagreed in recent weeks, sometimes accusing each other of shattering the fragile support for the measures. This squabbling has left the public looking to the government for guidance.

Health care economist Lieven Annemans, who is a part of Celeval, a group that directly advises the government, has been among those caught in the fray. Annemans argues that government policy has been based too much on fear and has called on experts to be more vigilant and clear about their interpretation of data. For example, he noted, it’s difficult to compare the absolute number of positive tests now with the number at the beginning of the pandemic because a lot more people get tested now.

A political morass

With experts divided, politicians have tried to call the shots. But the National Security Council itself is riven by internal disagreements, as it represents different governments in Belgium with different views.

Within the Council, the final call is always up to Prime Minister Sophie Wilmès, whose minority government got emergency powers to manage the crisis in March. But in the waning days of her placeholder government, she barely has any political capital left. In particular, she has come under fire for staying in power only due to the fact that she didn’t keep her promise from March to hold a vote of confidence within six months of the emergency order.

For now, Wilmès remains in post because the seven parties who are trying to form a coalition are close to a breakthrough — and they hope to have a new government in place by October 1. This deadline has further undermined Wilmès’ credibility, making it harder for her to force her coalition partners or the regional governments toward a new set of restrictions, Belgian officials admit.

Belgian Prime Minister Sophie Wilmès | Pool photo by Olivier Hoslet/EPA

Meanwhile, the government is pitching a new “barometer” based on a more quantitative approach. If particular indicators, especially the hospital admissions, go up, the country will switch to a new color code with a whole set of rules, as is the case in Ireland. This could also be applied within regions, rather than nationally.

But here, too, several government ministers want more answers from experts, said one Belgian official. For example, cities such as Brussels and Antwerp fear they could immediately be hit because their hospitals admit many patients well outside the cities, according to a spokesperson for Belgian Health Minister Maggie De Block. This, in turn, could artificially lift their number of hospitalizations and throw them into a higher-risk category.

When these issues will get clarified, however, remains uncertain.

There’s also the issue of timing.

Maarten Vansteenkiste, a psychologist working alongside the experts on the government response, said the National Security Council should have met a week earlier and introduced the barometer — which has been ready since May — then. That tool would let Belgians “make a better assessment of the current risks and adjust their behavior accordingly,” he explained.

Jillian Deutsch contributed reporting.

This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.

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