Mortality in second week of April estimated at 5,000

Since registration was delayed around Easter, which is usually the case after a public holiday, this estimate has a wider error margin. The number of deaths in week 15 is very likely to be in the range between 4,700 and 5,300. At least certain is that mortality is still higher than the weekly average throughout the period week 1 to 10 inclusive of this year. Weekly mortality over this period stood at 3,132 on average.

The rising mortality coincides with the outbreak of the coronavirus crisis in the Netherlands. The first confirmed COVID-19 patient in the Netherlands was reported on 27 February 2020. The first death involving COVID-19 was reported on 6 March 2020. The COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO) on 11 March 2020.
As established on Thursday 16 April, in week 14 a total of 1,077 deaths were reported that involved COVID-19, against 892 in week 15. Since not all COVID-19 patients are tested, the actual numbers in the Netherlands are higher than the numbers stated in the report. A more complete picture emerges by looking at the total weekly number of deaths as based on the data received by CBS, regardless of the cause of death.

Mortality rises mainly among the elderly

The rise in mortality is mainly seen among the elderly part of the population. Based on information received so far, mortality among elderly people in week 15 is more or less comparable to week 14. Excess mortality stood at an estimated 1,850 among people aged 65 years and over relative to the weekly average in the first ten weeks of 2020 (i.e. a 65-percent increase).
Mortality has declined in the age group 0 to 64 years as of week 13. In week 15, it was still approximately 12 percent higher than the weekly average in the first ten weeks.

Higher mortality among men

Over the past few weeks, mortality among men has been higher than among women. The mortality gap declined in week 14. This decline continued through week 15. In week 15, there were 1,050 more deaths among the male population, i.e. two-thirds up from the weekly average in the first ten weeks of 2020; and 850 more deaths among the female population, over 50 percent up from the average. In week 13, mortality was up by almost two-thirds among men and by around 50 percent among women. The share of men among COVID-19 deaths as reported to RIVM has declined as well (from two-thirds to 60 percent).

Noord-Brabant and Limburg still recording highest excess mortality

Based on the most recently available data, mortality in week 15 (ending 12 April) is still estimated at double the weekly average over the first ten weeks of 2020 in the provinces of Noord-Brabant and Limburg. This has been the case since week 13.
According to similar estimates, in the other provinces as well, mortality in week 15 is barely different from week 14. Gelderland, Overijssel and Utrecht all show excess mortality figures which areof at least 50 percent higher compared to the first ten weeks of this year. In Zuid-Holland and Noord-Holland, mortality it is up by over one-third.

Mortality distributions by municipality

In several municipalities in Noord-Brabant, Limburg and around the city of Zwolle, the number of deaths in week 14 was more than double the weekly average in the first ten weeks of this year. In ten different municipalities including Grave, Meijerijstad, Uden, Heerde and IJsselstein, the number of deaths is even 5 or more times that average. The provinces of Noord-Holland, Zuid-Holland and Gelderland recorded the largest increase relative to week 13.
Mortality figures at the municipal level may fluctuate significantly, especially in the smaller municipalities. A (significant) rise over a particular week may therefore be coincidental and is not necessarily related to the coronavirus crisis.

Data sources for CBS and RIVM

CBS receives mortality data on a daily basis from municipal registers. This is before it receives any information on the causes of these deaths. CBS receives such information by way of the medical certificate of cause of death which is completed by the physician who attended the deceased. The publication of data from cause of death certificates is normally scheduled for Q3 2020, but CBS will make every effort to release this information at an earlier stage.
RIVM receives data on confirmed COVID-19 deaths from municipal health services (GGD) around the country on a daily basis.

Estimates based on death certificates received so far

In general, some time elapses between the actual date of death and the moment when this data reaches CBS. Death certificate information is being collected every Thursday. Usually, mortality data collected on Thursday include slightly over 80 percent of all deaths over the previous week. This information provides an indication of the number of deaths that can be expected for that week.
Based on the experience from week 12 to week 14, it can be derived that the death certificates are received earlier than usual (as the number of certificates that was received after one week turned out to cover 86 percent of all deaths). The Easter weekend caused some delay in receiving death certificates. According to experience from the three previous years, on average 68 percent of all death certificates was received by CBS on the Thursday following the Easter weekend. The estimate for week 15 is based on the assumption that 74 percent was received so far, since the death certificates do arrive earlier than usual. However, the actual number of deaths in week 15 may be higher or lower as a result of uncertainty. The provisional count for week 14 was 1 percent (61 deaths) higher than the estimate made last week.