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Coronavirus in Belgium: Your general questions answered
What are the trends?
Belgium's coronavirus infection rate is estimated at 1.27. This means that 100 people who test positive for the virus will typically go on to infect 127 others - and the virus is growing. The number of new coronavirus infections has grown by 89% in the past week. Antwerp province is the worst affected, with 599 new confirmed cases in seven days, up 163%, and representing about 40% of the total nationwide infections. Luxembourg province had 58 cases, also up 163%. Hainaut's infection rate doubled from 55 to 111 in a week and Liège province grew 115% from 52 to 110 cases. Brussels had 128 new cases in the past week, up 27%
VUB has developed an online tool, tracking the evolution of coronavirus on a commune-by-commune basis. Using data from Sciensano, the tool identifies which municipalities still have a growing number of cases, while the national trend is one of decline. See www.coronafacts.be
Population growth in Belgium will slow down when this year's official stats are published. The Federal Planning Bureau forecasts a 17,000 population rise this year, instead of the usual annual population increase of around 50,000. It is predicting a 50% drop in migration - people moving in and out of Belgium - for 2020 because of the coronavirus epidemic.
What symptoms should I be looking out for?
A sudden onset of fever (at least 38°C), a persistent cough and difficulty breathing. The most at-risk groups are the elderly and people with an existing medical condition. If you think you might be affected, call a doctor. They will either arrange a home visit or give you an appointment at a time when no one else is in the waiting room. Do not turn up at the doctor's surgery or hospital unannounced. The Brussels region has created a helpline for anyone who is not registered with a general practitioner. By phoning 1710, you will be put in contact with a GP who can discuss your symptoms with you.
According to a study in the Netherlands, relayed by Belgium's interfederal crisis centre, the earliest symptoms of coronavirus are not coughing, a sore throat or high temperature. Those symptoms tend to appear later. The earliest signs are intense fatigue, severe muscle pain, headaches and a disturbed sense of taste and smell.
What do we know about the virus?
Since the outbreak began, almost 250 separate pieces of university research have been launched into different elements of the pandemic. Now a new initiative has brought all those pieces of research together in one place. Some of them have already been published, others are a work in progress. See www.covid19-wb.be
Researchers at the University of Liège say there is not just one version of coronavirus ciculating in Belgium, but many different strands. "They have minimal but clear genetic differences, which shows their different origins", says medical genetics expert Vincent Bours. "The epidemiologists studied the postcodes of residence of the infected patients and the dates of diagnosis. From there, they were able to measure the speed of circulation of these different viruses in the country." The researchers recommend testing for at least two different strands of the virus to ensure more reliable results.
Researchers at ULB and KU Leuven have analysed several hundred samples of the virus to learn more about the history of how it has spread. There was no "first infected patient" with coronavirus in Belgium, but several at the same time. These first "imports" were in early February, before the half-term holidays, although it is true that the carnival school holidays played an important role in the virus's spread, especially among people who went on ski holidays in Austria and Italy.
At least 5,000 of the 17,000 patients admitted to hospital with coronavirus were treated with chloroquine or a similar derivative, Le Soir and De Standaard reported on Monday. At the beginning of the epidemic, chloroquine and hydroxychloroquine were routinely used to treat high-risk patients. It was not until 27 May that public health institute Sciensano advised against its use, following several adverse side-effects and pending the results of clinical trials into its effectiveness. According to a study by infectiologist Emmanuel Bottieau, chloroquine did not cause any extra deaths.
Will there be a second wave?
Coronavirus will remain with us for several months to come. For the virus to be considered eradicated, there must be 28 consecutive days with no Covid-19 hospital admissions.
Epidemiologist Marius Gilbert, one of the 10 experts sitting on Belgium's "exit strategy" committee said: "We will have to remain vigilant for a long time - several months, certainly until the autumn. There will be a risky phase in the autumn, with the return of the cold weather, with more people indoors, with a return to school. This will be the period when all of our preventative measures, including contact tracing, must be totally operational."
Jacques Creteur, head of the intensive care unit at Erasmus hospital in Brussels, says a second wave in the summer holidays could be difficult to manage: "Hospitals are quieter in summer, because there are fewer hospitalisations and scheduled surgeries, and therefore there are fewer staff. So it would probably be difficult if this second wave were to arrive early in the summer. But if it happens later, in the winter, it would coincide with the classic flu. The period at which this second wave arrives is important."
One of Belgium's leading coronavirus experts has warned that the country's complicated governmental structure means Belgium is not prepared for a possible second wave of the virus. Virologist Erika Vlieghe, who chairs the expert panel on Belgium's coronavirus measures, told the Flemish parliament's coronavirus committee: "There must be a captain on the deck of the ship. We have met many people at all political levels, but no one knows who is allowed to press which button."
Interfederal spokesman Yves Van Laethem believes three scenarios are possible for a second wave of the epidemic in Belgium. "Either we do not respect the gradual easing of the measures and the second wave will occur quickly in the coming weeks, which must be avoided at all costs," he said on Wednesday. "Or it is possible that it will occur at the end of August if precautions during the holidays are not sufficiently well observed." The third scenario is that coronavirus will become a winter illness: "Respiratory infection is more common in cold weather than in the summer, so it could become more frequent and more aggressive during the winter period." He added that, instead of a second wave of the virus, he would prefer to see several "small mini-waves".
Virologist Marc Van Ranst says the virus will "stay" and become a seasonal illness, like flu. Asked about a vaccine, he said: "Whether it takes 10, 12 or 18 months, it will come. I am confident."
Interfederal spokesman Steven Van Gucht said: "We think that over time, in a few years, coronavirus will behave more and more like a cold virus. It is possible that it will return on a regular basis. Since there will be partial immunity by then, the consequences will be less serious."
Collective immunity from Covid-19 remains low in Belgium. Among analysis of blood samples supplied by the Red Cross between 8 and 10 June, only 4.3% of people had the presence of antibodies. The samples came from blood donors aged 18 to 75, who were in good health at the time of giving blood.
Belgium is ready to face a possible second wave of Covid-19, according to federal minister Philippe De Backer. He said Belgium had built up a strategic stock of more than 200 million surgical masks, 20 million gowns, half a million visors and about 40 million gloves for medical personnel. According to De Backer, Belgium is within the global top 10 countries for coronavirus testing per million inhabitants.
But a report for the national security council from the expert committee advising on Belgium's coronavirus exit strategy has warned that Belgium is not prepared for a second wave of the virus. The committee was critical of Belgium's efforts in terms of testing, contact-tracing and preparing the healthcare system for a possible resurgence. It says contact-tracing "suffered from an extremely low success rate from the start" and that "improvements are slow". The committee said resources and budgets needed to be allocated now to preparing for a second wave.
Seven out of 10 people in Belgium are prepared to comply with a second stay-at-home order, if necessary, according to an RTL/Ipsos/Le Soir survey. 19% of respondents opposed the idea.
What can I do to reduce my chances of getting it?
Wash your hands with warm, soapy water more frequently than usual. Cover your nose and mouth when sneezing with a paper tissue that you then throw away and try to avoid touching your face with your hands. If you do not have a tissue, sneeze or cough into your elbow, not your hands. Wear a facemask in busy places.
Social distancing is a measure that will need to be respected for some time to come, according to Dr Philippe Devos, head of CHU Liège's intensive care unit. "Social distancing is something that will have to last until the vaccine is ready," he said. "Pharmaceutical companies reckon that's between 12 and 18 months." While the figures are heading in the right direction, Belgium's federal crisis centre says it would be "totally irresponsible to adapt our behaviour" based on individual interpretation of the figures.
Antwerp university's ongoing coronavirus research has found a slight increase in people who say they shake hands and kiss people they meet. It had been around the 5% mark for a long time and has now risen to 10% among respondents who share their home with others, and 17% among respondents who live alone.
Can Belgium's coronavirus stats be fairly compared with other countries?
Stats can be interpreted in different ways - and some commentators have compared Belgium's reported coronavirus deaths with other countries on a per-capita basis. And the per-capita figure does not show Belgium in a positive light. But the comparison should be taken with a pinch of salt. Belgium's method of counting coronavirus deaths is relatively thorough - for example: it includes deaths outside hospital.
"The way we count the number of deaths in Belgium aims to give us the best view of the situation," said former interfederal spokesman Emmanuel André. "In Belgium, we count both deaths confirmed by a laboratory test and suspected coronavirus deaths. We count deaths in the hospital network, but also in the community and particularly in care homes. This approach can set us apart from other countries. We will maintain this system which we think is very complete. We will continue to separate out the different categories."
How are the tests done?
Belgium is currently testing about 10,000 people per day - and has done 900,000 tests since the outbreak began. "We could perform up to 45,000 tests per day but hopefully we will not need to reach this capacity if we hold the virus by the skin of its neck and don't let go," he said. So far, more than 250,000 tests have been carried out in Belgium since the epidemic began.
UZ Brussel university hospital has moved its coronavirus testing facility to its car park. The drive-in service aims to save time and make the hospital safer for everyone. Adults with a scheduled appointment at the hospital should turn up at the drive-in two days earlier, at an agreed time. Drivers can stay in their car. Anyone coming by public transport can walk through the testing facility. The results are known the next day.
The University of Liège will be able to carry out more than 50,000 screening tests per day within a few weeks, reports L'Echo. The university has developed a new technique, based on a self-administered saliva test, which could be rolled out to the wider population, allowing everyone to take a test regularly, at least once a month. Liège university hospital has also reopened its drive-in coronavirus testing facility. It is capable of carrying out 250 tests a day, and on average 2% of the tests are coming back positive.
Today, the Belgian strategy is to test people who are suspected to have been infected. As a result, the numbers are lower than the reality, because many people do not show symptoms, and the number of tests carried out is limited by the capacity of labs. But RTBF reports that another way is possible. An antibody test makes it possible to find out if someone has built up immunity to the virus - and could therefore be able to leave their house and return to work.
It is possible to ask your doctor to prescribe an antibody test, costing €9.60, to find out whether you have come into contact with the virus. According to an early batch of results - 1,000 tests in two days - a large number people who thought they had been in contact with coronavirus, and were potentially immunised, are not. Only 5-10% of the serological tests came back positive.
A Belgian man is suing the Belgian state and the Federal Agency for Medicines and Health Products for refusing to allow coronavirus antibody self-testing kits in pharmacies. Unlike in France, the test in Belgium has to be prescribed by a GP. It costs €9.80. The man taking legal action against Belgium is reportedly in his 60s and considered at-risk. "Being able to access the test would avoid stress," his lawyer said. Interfederal spokesman Yves Van Laethem said: "Roughly 40% of people lose the coronavirus antibodies after two months, so a negative test now does not necessarily mean that you did not come into contact with coronavirus in March, for example. And this test does not tell you if you are protected for the future. It shouldn't give people a false assurance."
What about a vaccine?
More than 400 people have volunteered to test a potential coronavirus vaccine, developed by the Belgian lab Janssen Pharmaceutica and its parent company Johnson & Johnson. The first tests should be carried out in mid-July, two months earlier than planned. More volunteers are needed - 500 are needed for the first phase. They will be compensated up to €1,500.
How is Belgium handling this?
Virologist and interfederal spokesman Steven Van Gucht has responded to criticism that Belgium was too slow to act against the coronavirus outbreak. Scientists Philippe Devos and Marc Wathelet, who were the first to alert the government to the threat, told VRT's Terzake programme that Belgium intervened too late. Van Gucht said their claim was "a bit exaggerated", adding: "Since the start of the crisis, we have taken the situation very seriously. From January we were busy day and night. All possible scenarios have been taken into account. The reality is that no one could calculate precisely what the impact of the corona outbeak would be." Did Belgium shut down too late? Van Gucht said: "When we announced the shutdown, we had 560 infections and three deaths. We confined much faster than the Netherlands or the United Kingdom. The first local case occurred on 1 March. Twelve days later, we shut down."
Two federations representing Belgian nurses are taking legal action against the Belgian state and federal health minister Maggie De Block, claiming they acted negligently during the coronavirus crisis. The National Federation of Belgian Nurses (FNIB) and the Federation of Independent Belgian Nurses claim medical staff, especially nurses, were put in danger and that Belgium showed a lack of preparedness and foresight. They point to a shortage of protective gear, a lack of systematic testing of healthcare workers and little psychological support. Some 56 nurses have registered as civil claimants in the class action. The federations said they tried to alert the minister and the authorities to "difficult and dangerous situations", adding: "All of these attempts were unsuccessful."
A study by the Economist Intelligence Unit claims Belgium had the worst response to the coronavirus crisis out of 21 OECD countries. Belgium ranked bottom with a score of 2.11 out of four. It scored well for its testing capacity, but scored poorly for its death rate per capita. Federal health minister Maggie De Block said the stats "did not tell the whole story", to which virologist Emmanuel André replied: "The numbers still say something. We cannot deny everything if we are to learn from our mistakes."
Belgium's handling of the coronavirus crisis has won praise from British newspaper the Financial Times and could be "a useful example to other countries". Its Brussels correspondent Jim Brunsden writes that Belgium's daily briefing "is fronted not by politicians, but by scientific experts and spokespeople of the Belgium government’s crisis centre", the paper says. "The briefings are an opportunity to scotch rumours and conspiracy theories, counter misunderstandings and admonish attempts to evade the conditions. The briefings have also focused on the human impact, emphasising the importance of mental health, and countering the spread of false information." The FT concludes: "Contrary to what many might have predicted, Belgium’s government has shown that a deeply fragmented country can still produce a clear, decisive response to a national crisis. Here’s hoping it continues."
Staying safe online
A growing number of coronavirus-related scams are doing the rounds online, Belgium's federal computer crime unit has warned. They include fraudulent listings for disinfectant gel and masks and fake online shops claiming to sell medical supplies. There are also reports of scammers visiting elderly people door-to-door, claiming to be from the town hall and offering to disinfect their home. For more info about common online scams, see www.safeonweb.be
Consumer protection body Test Achats has set up an online platform to specifically address coronavirus-related scams and fraud. The group is also monitoring price increases for medical supplies. See www.test-achats.be/stopabuscorona
Scam text messages are being sent out, claiming to be from Belgium's official contact tracing centres. The messages say you have been in contact with someone who has tested positive - and that you should click the link to find out more. Official contact from the contact tracers will come from the phone number 02 214 19 19, or by text message from the number 8811.
What is the economic impact?
Belgium's gross domestic product in the first quarter of 2020 was 2.8% down on the same period last year, the Belgian national bank has confirmed. The coronavirus crisis has put an end to five and a half years of falling unemployment in the Brussels region. At the end of April, Brussels had 87,271 jobseekers - an unemployment rate of 15.5%. The number of job vancies listed at Actiris has almost halved in April to 1,677.
Brussels chamber of commerce Beci fears that 52,000 jobs could be lost permanently in the capital because of business closures and restructuring following the coronavirus crisis. In Brussels, 160,000 people are currently on temporary unemployment. Beci believes many of them risk finding themselves permanently unemployed in the weeks and months to come. Another 10,000 temp jobs in the capital are forecast to disappear.
According to Flemish business body Voka, the coronavirus crisis could cost the Belgian economy €16 billion. Brussels chamber of commerce Beci says more than half of the region's businesses have lost at least 75% of their turnover. Belfius bank forecasts that the Belgian economy will shrink by 5% this year - but it says the recovery should be "rapid" and "solid". The National Bank of Belgium is forecasting an "V-shaped" economic fallout from coronavirus - an 8% drop in GDP this year, followed by an 8.6% rebound in 2021.
A series of measures to support freelances and small businesses has been announced. The deadline for paying second-quarter and third-quarter social charges has been extended to 15 December. The deadline for paying VAT has been extended by two months.
Belgium's four biggest banks - ING, BNP Paribas Fortis, KBC and Belfius - have all agreed to offer businesses a break with their loan repayments - and to make it easier for firms to borrow if they need to. The Brussels government has set aside €110 million to help business in difficulty. The social security body for self-employed people, Inasti, has a helpline for independent workers facing difficulties: 0800 12 018 (weekdays 8.00-20.00). The Brussels Hotels Association says the majority of hotels have closed, and those that remain open are currently operating at about 5% capacity. The Audi car plant in Forest hopes to resume activity after the Easter holidays, after making adaptations to the production line to allow for social distancing. Volvo in Ghent is also preparing to restart its production line.