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. 2022 Jan 29;80(1):45.
doi: 10.1186/s13690-022-00794-6.

COVID-19 cases, hospitalizations and deaths in Belgian nursing homes: results of a surveillance conducted between April and December 2020

Eline Vandael  1 , Katrien Latour  1 , Esma Islamaj  1 , Laura Int Panis  1 , Milena Callies  1 , Freek Haarhuis  1 , Kristiaan Proesmans  1 , Brecht Devleesschauwer  1   2 , Javiera Rebolledo Gonzalez  1 , Alice Hannecart  1 , Romain Mahieu  3 , Louise de Viron  3 , Etienne De Clercq  4 , Anne Kongs  5 , Naïma Hammami  6 , Jean-Marc François  7 , Dominique Dubourg  7 , Sarah Henz  8 , Boudewijn Catry  1   9 , Sara Dequeker  10
Affiliations

COVID-19 cases, hospitalizations and deaths in Belgian nursing homes: results of a surveillance conducted between April and December 2020

Eline Vandael et al. Arch Public Health. .

Abstract

Background: In Belgium, the first COVID-19 death was reported on 10 March 2020. Nursing home (NH) residents are particularly vulnerable for COVID-19, making it essential to follow-up the spread of COVID-19 in this setting. This manuscript describes the methodology of surveillance and epidemiology of COVID-19 cases, hospitalizations and deaths in Belgian NHs.

Methods: A COVID-19 surveillance in all Belgian NHs (n = 1542) was set up by the regional health authorities and Sciensano. Aggregated data on possible/confirmed COVID-19 cases and hospitalizations and case-based data on deaths were reported by NHs at least once a week. The study period covered April-December 2020. Weekly incidence/prevalence data were calculated per 1000 residents or staff members.

Results: This surveillance has been launched within 14 days after the first COVID-19 death in Belgium. Automatic data cleaning was installed using different validation rules. More than 99% of NHs participated at least once, with a median weekly participation rate of 95%. The cumulative incidence of possible/confirmed COVID-19 cases among residents was 206/1000 in the first wave and 367/1000 in the second wave. Most NHs (82%) reported cases in both waves and 74% registered ≥10 possible/confirmed cases among residents at one point in time. In 51% of NHs, at least 10% of staff was absent due to COVID-19 at one point. Between 11 March 2020 and 3 January 2021, 11,329 COVID-19 deaths among NH residents were reported, comprising 57% of all COVID-19 deaths in Belgium in that period.

Conclusions: This surveillance was crucial in mapping COVID-19 in this vulnerable setting and guiding public health interventions, despite limitations of aggregated data and necessary changes in protocol over time. Belgian NHs were severely hit by COVID-19 with many fatal cases. The measure of not allowing visitors, implemented in the beginning of the pandemic, could not avoid the spread of SARS-CoV-2 in the NHs during the first wave. The virus was probably often introduced by staff. Once the virus was introduced, it was difficult to prevent healthcare-associated outbreaks. Although, in contrast to the first wave, personal protective equipment was available in the second wave, again a high number of cases were reported.

Keywords: Belgium; COVID-19; Epidemiology; Nursing homes; Surveillance.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Incidence of COVID-19 cases per 1000 residents/staff members by week
Fig. 2
Fig. 2
Prevalence of COVID-19 cases per 1000 residents and COVID-19 cases absent from work per 1000 staff members
Fig. 3
Fig. 3
Percentage of participating nursing homes that declared at least 1/2/10 possible/confirmed COVID-19 cases among residents by week
Fig. 4
Fig. 4
Incidence of hospitalizations due to COVID-19 per 1000 residents by week
Fig. 5
Fig. 5
Number of (possible/confirmed) COVID-19 deaths among residents by week
See this image and copyright information in PMC

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