Heatwave sets excess mortality records in Belgium

Belgium had the highest national excess mortality rate in Europe during the heatwave at the end of June, according to figures from EuroMOMO, the network that compares mortality rates across more than 20 European countries.

The recent heatwave lasted from 18 June to 1 July and brought the highest death toll during a heatwave since records began in 2000. More than 2,000 people died, according to Belgian health institute Sciensano, which is more than usual.

In Brussels in particular, emergency services were under considerable strain. Five Brussels hospitals had to be temporarily disconnected from the emergency control centre because they were unable to cope with the influx of patients to their A&E departments.

With an excess mortality rate of 48%, Belgium was hit harder than even the severely affected France (+23%) and the Netherlands (+13%), where temperatures were just as high.

People in poorer regions were at greater risk from the heat.

“There is, for example, a big difference between Flanders and Wallonia, and there’s an undeniable socio-economic factor at play here,” said biostatistician Geert Molenberghs.

“It gets less hot in a large, detached house with some greenery around it than in a small flat with too many people.”

Poverty is also correlated with poorer health. “Reasons include economic vulnerability, the poorer state of health among Walloons, and the fact that these were also people living in isolation,” said Lara Kotlar, spokeswoman for Aviq, the agency for quality of life in Wallonia.

“In care homes, our services very quickly began on-site monitoring. But it’s clear that in France, there was a more robust, better-established plan than here, as we have never experienced such a situation.”

The handling of the previous heatwave had caused tension at every level of the Belgian government.

Several politicians, notably Jean-Luc Crucke (Les Engagés), called for a round-table discussion to establish a form of centralised command across the whole country in the event of a climate crisis. These calls went unheeded and had even strained relations within the Council of Ministers.

When questioned about the excess mortality figures, prime-minister Bart De Wever (N-VA) said he believed the figures will be very different in the next heatwave later this week, which is expected to bring temperatures of about 30°C for 10 days.

“I think the municipalities and provinces performed well last June," De Wever said. "The federal government can coordinate efforts. It wasn’t perfect, but we’ve learnt from it and we’ll improve."

Aviq’s Kotlar is also optimistic. “We’re better prepared than last time because all the relevant organisations have remained vigilant and mobilised,” she said.

“Through the mutual health insurance schemes, we have staff dedicated to prevention - just as we did during the pandemic - who are in contact with people living in isolation and those on the BIM scheme (recipients of increased benefits) to raise their awareness of best practices and help them manage the heatwave effectively.”

Aviq reiterated its recommendations for heatwaves, including to stay well hydrated, avoid strenuous activities, cool down in public buildings with air conditioning, check on people who live alone, and keep homes cool by blocking out the sun and ventilating them during the coolest hours of the day.

RTBF’s health editor Johanne Montay emphasised that interpreting the EuroMOMO data requires nuance.

“This ranking must be treated with great caution, because the methods used by different countries to collect data vary and the data is not always comprehensive,” Montay said.

“What’s certain is that France put in place a robust ‘Vigilance Canicule’ heatwave plan following the heatwave of August 2003, which resulted in 15,000 excess deaths over 15 days.

"It has a highly centralised approach, much like the Netherlands. Here in Belgium, we have to get three regions to work together."