Authorities Efforts to address the COVID-19 pandemic in Belgium are managed by the nine federal and regional health ministers,
Maggie De Block (Open VLD, federal government),
Wouter Beke (CD&V, Flemish Community), (PS, French Community), (SP, German-speaking Community), (Ecolo, French Community),
Valérie Glatigny (MR, French Community),
Alain Maron (Ecolo, Brussels),
Elke Van den Brandt (Groen, Brussels) and (Ecolo, Brussels), with the support of: • the National Crisis Centre (NCCN) led by Bart Raeymaekers; • the national public health institute of Belgium (
Sciensano); • the Risk Assessment Group (RAG) presided by Sciensano; • the Risk Management Group (RMG) led by Paul Pardon MD; • the Scientific Committee for Coronavirus (Steven Van Gucht,
Marc Van Ranst, Nathalie Bossuyt, Erika Vlieghe and Charlotte Martin); • other regional agencies such as the
Agency for Care and Health in Flanders, the
Agence wallonne pour une vie de qualité (AViQ) in Wallonia and the
Common Community Commission in Brussels.
Containment measures On 29 January, Belgium issued a travel notice advising against non-essential flights to China, Hong Kong excluded, with some travel companies cancelling all flights to China. On 1 March, as a second case of coronavirus was confirmed in Belgium, the country entered into phase 2 of its response, with official measures focusing on preventing the virus from spreading within Belgium. The mayor of
Sint-Lambrechts-Woluwe,
Olivier Maingain, was one of the only mayors to take measures to prevent the spreading of the new coronavirus by restricting access to schools, sports facilities and public places for persons returning from areas at risk and only a few schools, such as the
International School Ghent, quarantined pupils returning from infected areas, such as
Northern Italy. On 10 March, the government advised citizens to cancel any indoor scheduled events to be attended by more than 1,000 people for the month of March. Prime Minister
Wilmès stressed this was not an interdiction but rather a recommendation. Schools remained open but are advised to cancel both trips abroad and multi-day excursions in general. Companies were advised to have their personnel work from home as much as possible and allow flexible working times to allow a better spread of public transport use throughout the day. The authorities called this
reinforced phase 2. Late in the evening on 12 March, after a meeting of the
National Security Council, the Belgian government moved into the federal phase of crisis management, and ordered the closure of schools, discos, cafes and restaurants, and the cancellation of all public gatherings for sporting, cultural or festive purposes from Friday 13 March at midnight onwards. It was stressed that the measures taken were not a lockdown because people were not required to stay home. , used to avoid all non-essential travel between France and Belgium (27 March 2020) On 17 March, the National Security Council decided to take additional measures, based on the spread of
COVID-19 in Belgium and on recommendations of experts. Stricter social distancing measures were imposed from noon the following day until 5 April, with non-essential travel prohibited, non-essential shops to close, gatherings banned, with penalties for corporate and individual persons who failed to comply with the restrictions. On 20 March at 3 pm Belgium closed its borders to all non-essential travel. Earlier, the governor of
West Flanders had complained about Dutch and French citizens coming to Belgium for tourism or shopping, while mayors of municipalities close to the border with the Netherlands such as Paul Van Miert of
Turnhout urged their Dutch counterparts to request their national authorities in the
Netherlands to implement similar measures as in Belgium, to stop Belgian citizens going to Dutch cafés or restaurants. From 25 March onwards, people arriving at
Brussels Airport were handed a leaflet with the compelling advice to quarantine themselves for a fortnight. On 27 March, the National Security Council and the governments decided to extend the measures until 19 April (end of the Easter vacation). On 15 April, the containment measures were extended until the 3 May.
Medical supplies and testing strategy On 6 March, Federal Minister of Public Health
Maggie De Block criticised EU governments for blocking the export of medical masks at a time when global stocks were decreasing, asserting that they were acting against the spirit of the
European Union. On 19 March, a shipment of 100,000 FFP2 respirators arrived. On 16 March, the Chinese
Alibaba foundation donated half a million
surgical masks and 30 000 test kits, as a result of the intervention by
King Philippe and with the support of the
Walloon Export and Foreign Investment Agency (AWEX). Minister
Philippe De Backer was assigned to coordinating the efforts of the authorities to supply masks and respirators. While the number of tests capped at 3,500 and 4,500 a day, an increase in stocks of the materials required to perform tests was announced early April by the Federal Minister Philippe De Backer, to improve the testing capacity to 10,000 tests a day. In an effort to support international research, Belgium pledged 5 million
euro to the
Coalition for Epidemic Preparedness Innovations (CEPI) which intends to develop a
COVID-19 vaccine.
Exit strategy On 7 April, a
Group of Experts for an Exit Strategy (GEES), led by Erika Vlieghe and composed of 10 scientists, economists and top managers, was set up to advise the National Security Council on the restart of the country.
Communications At the outset, the Belgian authorities, mostly through their federal Minister of health
Maggie De Block, had focused on reassuring by asserting that there was no reason to panic, that Belgium has good hospitals and laboratories and that the government was attentive to the evolution and well prepared for the possible arrival of coronavirus. From the first report of infection within Belgium, the government communicated on certain developments with the public. An official website (info-coronavirus.be) was registered by the authorities at the end of January, before the first case was officially confirmed. It has then been used by the
Federal Public Service Health and the National Crisis Centre (NCCN) to inform the public. Since the 13 March, the FPS Health together with the NCCN has held a daily press conference led by spokesmen Benoît Ramacker, Peter Mertens and Yves Stevens with doctors Steven Van Gucht and Emmanuel André. Every day, the latest developments on the epidemiological situation in Belgium are reported, with the new figures of confirmed cases, hospitalised patients and deaths, as well as general explanations and forecasts, or reminders of the need to respect the social distancing measures. In an apparent effort at transparency, a daily epidemiological bulletin and a set of raw data are made available on the
Belgian Institute for Health website. The Prime Minister
Sophie Wilmès addressed citizens twice via a web video in March and April 2020 to speak about the government's response to the pandemic. Experts and authorities also used the media to express themselves throughout the crisis, either to reproach citizens organising or taking part in so-called lockdown parties, or otherwise to give their point of view. On 20 March, the chairman of the Scientific Committee expressed the hope that the measures that came into effect on 14 March would lead to a stabilisation of the number of hospitalisations starting from the middle of the week beginning 23 March. On 21 March, Prof. Dr. Erika Vlieghe of the Scientific Committee mentioned that she expected the peak of the pandemic to occur in early April. On 16 March,
King Philippe addressed the nation and called on all Belgians to respect the COVID-19 measures "for ourselves and for the most vulnerable among us".
Criticism Handling of the crisis While COVID-19 was already spreading to all regions of Italy in late February, the Belgian government has been criticised for its lack of action. Experts like Marc Wathelet, a
virologist, urged for strict prevention measures, affirming that the Belgian federal minister of health
Maggie De Block was underestimating the danger and Professor in
microbiology Herman Goossens of the in Antwerp, called for wider screening for the virus. Pharmacists complained they did not receive clear instructions from the authorities. Zorgnet Icuro, an
umbrella organisation in the field of health care and care for the elderly, requested the Flemish Minister for Public health
Wouter Beke to take stronger actions with respect to visitor access at
retirement homes in Flanders. When the first measures were taken by the Belgian government on 10 March, in the form of recommendations, some expressed that more drastic measures were required, like Professors Herman Goossens and Marc Van Ranst who questioned the set limit of maximum 1,000 people for indoor events. The BVAS/ABSyM, the biggest medical trade union in Belgium, warned for a potential collapse of the
health care system and called for a closure of all schools at short notice as well as a ban on all gatherings of more than hundred people. In an
open letter several Flemish
rectors with experts in the fields of
epidemiology,
virology,
biostatistics and
health economics, including two members of the Scientific Committee for Coronavirus, urged the authorities to take decisive measures and to avoid non-binding instructions and guidelines. Similarly, Leopold Lippens, the mayor of
Knokke-Heist, judged the actions of the federal authorities insufficient and therefore ordered the ban on all indoor and outdoor activities in his municipality. Some media made positive criticism, such as the
Financial Times who praised Belgium for its handling of the coronavirus crisis, claiming Belgium had shown that "a fragmented country" could still produce a clear response to the pandemic – by taking decisive actions earlier than other countries – and pointing out the daily briefings are not held by politicians but by scientific experts and spokespersons.
De Standaard praised Steven Van Gucht, president of the Scientific Committee, for being "calm,
empathic and wonderfully clear".
Shortage of medical supplies wearing PPE during an intervention. Just as many countries in the world, Belgium faced a shortage of
personal protective equipment (PPE) such as
respirators,
surgical masks or
face shields. Towards the end of January, Belgian newspapers highlighted the shortage of
respirators and
surgical masks and a retailer questioned whether Belgian would have enough masks if there were to be an outbreak of the virus, but the
Federal Public Service Health claimed the Belgian hospitals had sufficient stock. On 8 March,
Maggie De Block stated she had a solution for the shortage of masks but was unwilling to disclose the potential vendor and the number of masks involved. On 15 March
De Standaard newspaper reported that the masks had not been delivered on time, and the following day De Block announced that her department's order of 5 million masks might have involved fraud. On 16 March,
De Standaard reported that De Block had blundered by ordering all 5 million masks from a single company (M.O.S.S.A.
vof), a consultancy firm that had no track record in the medical field and was owned by Mahmut Öz, a Belgo-Turkish politician from her own political affiliation. On 20 March, a shipment from China of 5 million masks arrived at the airport of Bierset, but these were surgical masks and not the type of respirators required to protect the medical staff. Hospitals such as the Centre Hospitalier Interrégional Edith Cavell (CHIREC) reported that they were in dire need of protective masks. On 25 March,
PVDA-member of parliament
Sofie Merckx complained that since 2009 the various governments had not renewed the strategic reserves of mouth masks due to cost cutting measures in the health care system. Upon reaching their expiration date in 2018, minister of health
Maggie De Block decided to destroy and not replace 6 million face masks. On 7 March,
Marc Van Ranst confirmed Belgium was facing a shortage of reagents to do widespread
COVID-19 testing, and the
laboratory reference (National Reference Centre) at the
UZ Leuven was therefore forced to apply a
triage system and to limit the number of tests. Two surgeons from
St. Peter's Hospital in Brussels addressed an open letter to prime minister Wilmès on 22 March demanding increased testing.
Situation in care homes In Belgium, the organisation of care homes falls under the regional authorities. On 11 March the care homes were closed for all visitors in Wallonia and Brussels, and a day later in Flanders. After the closure, the sector requested more protective equipment, more training and guidelines for caretakers on how to handle infected patients, and more tests. However, not much was changed and the care homes kept operating with a lack of tests and a lack of protective equipment while being required to keep many infected residents in the homes. On Wednesday 1 April, the government finally promised to also provide more tests to the care homes by the end of the week. But as that deadline wasn't met, on Saturday 4 April, several care homes started to execute tests on their own. Meanwhile, several homes got hit hard with dozens of deaths, and up 90% of the residents and inhabitants being infected. These events led to severe criticism addressing the Flemish minister of public health
Wouter Beke. Care organisations accused the minister of losing 3 weeks time, and being very late with an emergency plan. Only on 21 April, masks were advised for all personnel in contact with patients. On 10 April, about 40% of all
COVID-19 deaths in Belgium occurred in care homes. In Brussels, coronavirus cases have been confirmed in 116 of the 146 care homes.
High death toll and unusual method of counting In April, Belgium had very high mortality figures, the highest death rate from
COVID-19 in the world at that time. Steven Van Gucht from
Sciensano explained this was partly due to a difference in counting, compared to other countries. In Belgium, around 46% of the
COVID-19 deaths occurred in hospital and 53% occurred in care homes; and while the deaths in hospital are all confirmed by a test, only 5% of the deaths in care homes are confirmed by a test, the other 95% being suspected cases. The Netherlands on the other hand, only counted confirmed cases. This way of counting was criticised by Flemish Minister for Tourism,
Zuhal Demir, as it would portray Belgium as bad in the fight against coronavirus and also would harm the Belgian reputation of being a prominent country in the pharmaceutical and biotech industries. Some doctors complained that deaths caused by other pathologies and causes have been lumped into the COVID-19 category. The virologist
Marc Van Ranst, member of the Belgian Scientific Committee for Coronavirus, also criticised the way of counting, saying it is "dumb" that almost all deaths occurring in care homes are being counted as COVID-19 deaths, leading to what he described as an overestimate. Belgian authorities however defend their strategy for being the most transparent and the most detailed method, According to Steven Van Gucht, responsible for the reporting strategy, the suspected deaths are being counted as COVID-19 deaths because not everyone can be tested After this criticism, the official daily reports started to distinguish the deaths figures between confirmed tested and simply suspected cases. When several countries published
excess mortality figures, it appeared that Belgium's way of counting caused the reported
COVID-19 death toll in the country to be closer to the excess mortality figures, compared to other countries. For example, between 5 March and 5 April, Belgium reported 2,373 COVID-19 deaths with the excess mortality being estimated around 3,000. Causing still an underreporting of around 600 deaths. While the neighbouring Netherlands had an estimated excess mortality of 6,200, with only 3,197 reported COVID-19 deaths in that same period. Causing an underreporting of around 3000 deaths. According to professor Yves Van Laethem, Belgium uses the approach recommended by the
World Health Organisation and the
European Centre for Disease Prevention and Control, which congratulated Belgium for choosing this approach. ==Other responses==