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Abstract

Background

COVID-19-related mortality in Belgium has drawn attention for two reasons: its high level, and a good completeness in reporting of deaths. An ad hoc surveillance was established to register COVID-19 death numbers in hospitals, long-term care facilities (LTCF) and the community. Belgium adopted broad inclusion criteria for the COVID-19 death notifications, also including possible cases, resulting in a robust correlation between COVID-19 and all-cause mortality.

Aim

To document and assess the COVID-19 mortality surveillance in Belgium.

Methods

We described the content and data flows of the registration and we assessed the situation as of 21 June 2020, 103 days after the first death attributable to COVID-19 in Belgium. We calculated the participation rate, the notification delay, the percentage of error detected, and the results of additional investigations.

Results

The participation rate was 100% for hospitals and 83% for nursing homes. Of all deaths, 85% were recorded within 2 calendar days: 11% within the same day, 41% after 1 day and 33% after 2 days, with a quicker notification in hospitals than in LTCF. Corrections of detected errors reduced the death toll by 5%.

Conclusion

Belgium implemented a rather complete surveillance of COVID-19 mortality, on account of a rapid investment of the hospitals and LTCF. LTCF could build on past experience of previous surveys and surveillance activities. The adoption of an extended definition of ‘COVID-19-related deaths’ in a context of limited testing capacity has provided timely information about the severity of the epidemic.

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Establishing an ad hoc COVID-19 mortality surveillance during the first epidemic wave in Belgium, 1 March to 21 June 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Fran%C3%A7oise+Renard&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Renard Françoise</a>, <a href="/search?value1=Aline+Scohy&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Scohy Aline</a>, <a href="/search?value1=Johan+Van+der+Heyden&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Van der Heyden Johan</a>, <a href="/search?value1=Ilse+Peeters&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Peeters Ilse</a>, <a href="/search?value1=Sara+Dequeker&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dequeker Sara</a>, <a href="/search?value1=Eline+Vandael&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vandael Eline</a>, <a href="/search?value1=Nina+Van+Goethem&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Van Goethem Nina</a>, <a href="/search?value1=Dominique+Dubourg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dubourg Dominique</a>, <a href="/search?value1=Louise+De+Viron&option1=author&noRedirect=true" class="nonDisambigAuthorLink">De Viron Louise</a>, <a href="/search?value1=Anne+Kongs&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kongs Anne</a>, <a href="/search?value1=Na%C3%AFma+Hammami&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hammami Naïma</a>, <a href="/search?value1=Brecht+Devleesschauwer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Devleesschauwer Brecht</a>, <a href="/search?value1=Andr%C3%A9+Sasse&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sasse André</a>, <a href="/search?value1=Javiera+Rebolledo+Gonzalez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rebolledo Gonzalez Javiera</a>, <a href="/search?value1=Natalia+Bustos+Sierra&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bustos Sierra Natalia</a></span>. Establishing an ad hoc COVID-19 mortality surveillance during the first epidemic wave in Belgium, 1 March to 21 June 2020. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(48):pii=2001402. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.48.2001402" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.48.2001402</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 17 Jul 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 16 Feb 2021 </span> </p>
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