In defense of Belgium’s coronavirus response

Maggie De Block is Belgium’s minister of public health.

The international press has got it wrong about Belgium and the coronavirus. Since the peak of the crisis in April, commentators from around the world have pointed to our country’s per capita death toll as evidence that we mishandled the public health response. Recently, a report by the Economist Intelligence Unit (EIU) even ranked Belgium as the last of all OECD countries in their “quality of policy responses to the pandemic.”

I have thought long and hard whether to respond to this accusation. Ultimately, I decided to put all tactical considerations aside and set the record straight.

Of course, Belgium was not perfect in its response to the crisis. Although we secured sufficient respirators and personal protection equipment for hospital staff, we did not manage to provide enough protective gear for our caregivers in the nursing homes on time. As in many other countries, this resulted in a high proportion of elderly people among our COVID-19 victims. These are human tragedies we should seriously investigate and learn from.

Nevertheless, Belgium was definitely not the worst country in its response to the pandemic. The virus hit our country hard, but the high numbers in deaths attributed to COVID-19 are also the result of diligent counting by independent epidemiologists who did not want to miss a single potential victim of the coronavirus, whether the patient had been tested or not.

The local epidemic is at its lowest level since the outbreak.

This was a courageous choice driven by the desire to protect every Belgian citizen from potential new outbreaks. The transparent manner in which we report our figures has been praised by the scientific community as a good practice that should be followed.

Unlike other countries, Belgium has not had to cope with dramatic scenes of people lying on hospital floors waiting for treatment, or been the scene of horror stories as doctors are forced to choose between treating the old or the young. Even during the peak of the pandemic, the occupancy rate of our intensive care units never exceeded 60 percent, resulting in a relatively high survival rate of patients in those facilities.

The EIU report could therefore not be farther from the truth. It is a textbook example of what happens when you attempt to create a ranking using a small number of variables chosen for their availability, rather than for their relevance, with arbitrary cutoff points and time periods, and a complete lack of data curation.

A careful observer would notice an irony: Belgium scores outstandingly on all the EIU’s metrics that a government can actually influence (the number of tests and the provision of non COVID-19 health care). The one exception is excess mortality. And yet, with no explanation, this factor is seemingly arbitrarily weighted so that it makes up nearly half the final score.

Even the most basic — but crucial and easy-to-calculate — measures like a country’s population density are left out of the EIU model, let alone factors like the number of highly populated clusters within a country or the multiple pathways through which the virus could enter our small but very international country with its many open borders.

Today, more than two months have passed since the first relaxation of Belgium’s lockdown rules. The local epidemic is at its lowest level since the outbreak. Meanwhile, the United States has been given a “good” score by the EIU, but keeps struggling to get the virus under control.

I am disappointed by the simplistic way statistics on COVID-19 deaths are all too often used in the public debate. Different approaches in methodology are overlooked, and the comparison between countries seems to be reduced to a sport competition, instead of treating the figures for what they are: a human tragedy that requires scientific analysis and critical but careful investigation.

The media have an enormous impact on a country’s reputation and on the views of influential people in all walks of life. It’s important we be on guard against inaccurate and unfair characterizations. More than ever, we need a high-quality press that takes pride in its job and holds us, politicians, to account in a serious manner.