In 2021, the excess mortality rate in Belgium was "significantly" lower than in 2020, with over 5,000 additional deaths last year, compared to nearly 19,000 in the first year of the coronavirus pandemic, according to calculations of the Sciensano national health institute.
2021's excess mortality rate was marked by three coronavirus waves, a short period of heat (126 deaths) and the July floods (58) — which together caused 5,192 deaths, on top of the 106,197 expected deaths, the calculations show.
This resulted in a 4.9% excess mortality rate, compared to 17.5% in 2020. For comparison with years before the coronavirus outbreak, excess mortality averaged 2% per year between 2015 and 2019.
Strikingly, an under-mortality was observed among people aged 85 and over in 2021: 291 fewer deaths than expected (-0.6%), mainly among women in that age group (397 fewer deaths than expected).
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The excess mortality mainly affected the 65 to 84 age group with 4,905 additional deaths (+11.1% excess mortality) and the 15 to 64 age group with 1,320 additional deaths (+9.1% excess mortality). In general, the excess mortality for men (+7.9%) was higher than for women (+3%).
In terms of regional differences, the under-mortality of people aged 85 and over is observed in Flanders (-0.2%) and the Brussels-Capital Region (-3%) but not in Wallonia (+0.7%).
The number of additional deaths amounts to 2,643 in Flanders (+4.3%), 2,826 in Wallonia (+7.9%) and 459 in Brussels (+5.7%).
Coronavirus-related deaths
In 2021, a total of 8,532 Covid-19 deaths were counted, nearly half of the 19,819 registered in 2020. However, the number of additional deaths is lower than the total number of Covid-19 deaths.
One explanation is the fact that not every Covid-19 death was necessarily an additional death, according to Sciensano.
"Some of the persons, victims of Covid-19, were at an age at which it could be statistically expected that they would die during the year," the institute said. "When the number of additional deaths is calculated over a longer period — as is the case for a calendar year — this period includes both periods of excess mortality and periods of under-mortality. The excess mortality for a full year is then the result of the sum of the excess and under-mortality periods."
In 2021, Covid-19-related excess mortality was mainly observed in people under 85 years old during mortality peaks in the third and fourth waves. Additionally, the under-mortality in people over 84 years is "unusual but not surprising, taking into account the significant excess mortality in this age group during the first two waves of the epidemic in 2020."
Different Statbel figures
Belgium's statistics office Statbel also published provisional mortality figures for 2021 on Wednesday.
Last year, just under 112,500 deaths were registered provisionally, which is about 14,500 fewer than in 2020. Compared to the average in 2017-2019, a moderate increase of about 2,700 deaths (+ 2.5%) was seen in 2021.
Still, this increase is significantly lower than in 2020, when there was an increase of approximately 17,000 deaths (+15.7%), according to Statbel.
The differences between the Statbel and Sciensano figures (using the Belgian Mortality Monitoring model, Be-MOMO) are due to methodological differences. For instance, Be-MOMO does not take into account deaths abroad, and the two models also use different reference years or weightings to calculate the number of expected deaths.
