Belgium: Time to Get Serious About the New Spike in Covid19 Infections

Sadly, the Kingdom of Belgium was called out by the world press in April – May of this year for having one of the highest mortality rates of all countries battling the Covid19 pandemic. The death toll here subsequently tapered down with the progression of the lockdown that was belatedly instituted, so that by mid-July there were only 3 deaths reported each day nationwide. The total loss of life directly attributable to the infection now stands at about 9500 in a population of 11.5 million. 

To comprehend what this loss means, let us compare it with the situation in the United States, which we all know is the country that has mismanaged the pandemic in every way, starting from confusing and unhelpful messages from the Chief Executive, failures at the local level in a great many states to follow federal guidelines for lifting lockdown, and general disregard for the experience of the rest of the world in combatting this disease, not to mention the experience of New York City and the Northeast, where COVID19 first settled in and created havoc with the medical infrastructure, as well as regional death rates perhaps four times higher than in Belgium. Though the world may be aghast at American failures, the death toll there will have to reach 270,000 to match the per capita mortality of Belgium to date.  The latest figures from the States are at the level of 165,000. 

Regrettably, in the past week Belgium has again been featured on Euronews coverage of the pandemic, as the country has been among the few in the EU to see a very disturbing spike in infections.  At first this was attributed to localized communities. It was noted that half of all new Covid19 infections here have been in the province of Antwerp, where fingers were pointed at the Muslim water-pipe store fronts and at the Hassidic community, known to flout rules on gatherings for weddings and the like.

Here in French-speaking Brussels some of us took malicious pleasure in seeing Antwerp at the center of the pandemic storm. It was a demonstration that the city’s mayor, Bart DeWever, has taken his eye off the ball and ignored warning signs in his back yard while busy negotiating with the Socialists to possibly form a new coalition government at the federal level. We smirked when a curfew was imposed in Antwerp and other curtailment of freedoms was imposed.

However, most recent developments signal that the infections are moving out of control despite the best efforts of tracing and testing nationwide.  French-speaking Wallonia has just been moved from Green to Orange status, meaning extreme caution must be exercised and prospective visitors are put on notice because the daily infection rate per 100,000 has moved adversely to a new plateau well above 20.  And there is talk of the situation in the  Brussels-Capital Region likely to deteriorate as well, because many of the factors behind community transmission in Antwerp are found in the city center of Brussels, namely active socializing of young people in the bars, cafes and similar venues that were the last to reopen after de-confinement.

These developments have arisen with blinding speed.  I think of the medical status quo when I left Brussels for a nine-day vacation in Italy on 20 July compared to what is being reported daily now.  New cases then were roughly 85 per day nationwide, today they are 490; hospital beds occupied by Covid patients then numbers about 125, now they are 250; patients in Intensive Care Units then were then less than 30, today they are the double. The only statistic that has not changed significantly is daily reported deaths, still under three per day. But that is a lagging statistic and surely will rise in the month ahead.

All of this adverse change was easily foreseeable and we were told by the Acting Prime Minister that appropriate steps would be taken if and when the statistics of infection turned against us.  Indeed, some measures have been put in place, most particularly as regards wearing face masks, which now are required not only in public transport and all shops and enclosed public areas but also in designated shopping streets. Moreover, the “social bubbles” of persons with whom a given household may associate have been cut back sharply.  And mandatory reporting has been instituted for all those returning from travel abroad to facilitate tracing in case they or anyone in their near surroundings on planes, boats or other transport proves to be infected.

However, no steps have yet been taken to address the most obvious platform for transmission of the infection: bars and cafes. It is not hard to guess why:  because shutting down these enterprises is a direct attack on identifiable business interests. 

This is not to say that such a measure is not discussable here any more than it is a taboo elsewhere in Europe. In fact, this measure is already being selectively applied in the United Kingdom where some government spokesmen pose the policy choices without any sugar coating: either you close the pubs or you close the schools.

Living as I do in downtown Brussels, just a five minute walk from active shopping streets where bars and cafes abound, I see firsthand how they constitute a cesspool of infection. Tables may now be out on the sidewalks and they may be spaced somewhat apart, but the young clientele sits shoulder to shoulder at one table and turns to socialize with friends at other tables, making utter nonsense of social distancing. The owners and staff of these establishments are also almost uniformly young people who are not about to step forward as enforcers of regulations. 

I have omitted mention of restaurants because both owners-operators and clientele tend to be older, more risk averse, and the capital invested in the establishments is far greater than in the bars and cafes.

There can be no doubt that given the exponential growth of infection we are now seeing in Belgium, the order will eventually go out to shut down these Horeca platforms.  One may only hope that this is done NOW and not after the situation becomes irremediable except by total lockdown as happened in the spring wave of the pandemic.  Some part of the business community must be made to suffer right now lest the economic damage of total confinement be repeated. This is all the more relevant as the opening of schools is less than a month away.

Having made this point, I insist that much more could be done to avert medical disaster.  It is inexcusable that Belgium has done nothing to prepare dedicated hospitals for admission of Covid patients, so as to avert the chaos that prevailed in the first wave when patients were shared out to more than one hundred normal hospitals, many of which had no relevant experience with epidemiology, operation of multiple ICUs and use of ventilators.

It is also inexcusable that Belgium, like all other EU Member States is sitting on its hands with regard to acquiring medicines proven effective against Covid19,  both those that reduce sharply replication of the virus at the start of the infection, thereby reducing time in hospital, and those administered in severe cases to prevent fatal complications.  So far there has only been talk of negotiating a deal with Gilead, the American manufacturer of Remdesivir, although the U.S. government has already bought up much of the company’s production capacity, leaving in question when and at what price Belgium and other EU States will get allocations.  There has not been a word about approaching the Russian Federation for supplies of its Avifavir, which is claimed to be still better at stopping the virus in its tracks than the Gilead drug. 

Avifavir, like Remdesivir, is a repurposed antiviral drug that has been on sale for more than a decade. It was not “invented” in Moscow, but in fact came from Japan, so that the notion of Russians cooking up some wonder drug in a few months is little more than slander from our Russia-bashers in the West. 

The same question may be raised as regards the vaccine which the Russians are registering in the coming days and will be mass producing in mid-Autumn, with doses initially to be made available to medical professionals and first responders; mass inoculations are scheduled for early winter.

Note that the Russians, like their counterparts in the West and in China, have several competing vaccines undergoing testing at various stages.  Also note that the Russians have concluded a deal with AstroZeneca to procure its vaccine when it receives regulatory approval and goes into mass production. They are not relying solely on their own good luck with their distinctive vaccine technology.  Why do we not do the same and reciprocate by taking options on the Russian solution?

If our health professionals in Belgium were truly interested in saving lives and not playing along with Cold War mentality blackout on Russian science, they would be negotiating right now for allocations of the Russian medicines and vaccine.  This is a question for the Prime Minister.  Who will put it to her?

©Gilbert Doctorow, 2020

[If you found value in this article, you should be interested to read my latest collection of essays entitled A Belgian Perspective on International Affairs, published in November 2019 and available in e-book, paperback and hardbound formats from amazon, barnes & noble, bol.com, fnac, Waterstones and other online retailers. Use the “View Inside” tab on the book’s webpages to browse.]