10 thousand COVID-19 deaths during first wave of the pandemic

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© Hollandse Hoogte / Robin Utrecht
In the first six months of 2020, there were more than 86 thousand deaths registered in the Netherlands. This is almost 9 thousand more than in the first half of 2019 and over 5 thousand more than in the same period in 2018. The higher mortality coincides with the novel coronavirus epidemic in the Netherlands. From March to June 2020 inclusive, altogether 7,797 people died whose cause of death was confirmed by the attending physician as due to COVID-19, the disease caused by the novel coronavirus. Suspected COVID-19 was the cause of death in another 2,270 cases as indicated by the attending medical practitioner. Therefore, there were altogether 10,067 deaths caused by either confirmed or suspected COVID-19. Of this group, 60 percent were people who had been receiving care under the Long-term care act (Wlz) and 53 percent were males. This is evident from the latest provisional figures on mortality, published today by Statistics Netherlands (CBS).

The figures on causes of death are compiled based on cause-of-death certificates which are completed by an attending medical practitioner. CBS receives these certificates via the municipality where the death occurred. As of this moment, CBS has received cause-of-death certificates for more than 97.5 percent of all deaths over the first six months of 2020. For more information: How CBS compiles mortality figures in times of corona.

Excess mortality entirely due to novel coronavirus

Based on death records received by CBS on a daily basis, it is estimated that almost 9 thousand more people died than might be expected over the period week 10 to 19 inclusive (i.e. between 2 March and 10 May). This is referred to as excess mortality. Based on the cause-of-death certificates that have been received to date, it is now being confirmed that the excess mortality is entirely due to deaths caused by the novel coronavirus.
By week 20 (11 to 17 May inclusive), total mortality had returned to a level that was similar to previous years. As shown by the cause-of-death certificates that were received, still 4.6 percent of all deaths from week 20 up to and including the month of June were caused by COVID-19.

60 percent of COVID-19-related deaths were Wlz care recipients

Almost 6,000 of the 10,067 deaths caused by confirmed or suspected COVID-19 that were registered up to June inclusive had been recipients of long-term care under the Long-term Care Act (Wlz). In week 15, at the peak of the first wave in the coronavirus pandemic, over half of all deaths among Wlz care users were caused by confirmed or suspected COVID-19. Among the rest of the population (non-Wlz care users), the peak occurred slightly earlier and one-third of deaths were caused by COVID-19.

More men died from COVID-19 than women

More than half of all deaths due to confirmed or suspected COVID-19 were men. There were 5,345 men (53 percent) against 4,722 women (47 percent). In relative terms as well (per 100 thousand inhabitants), more men than women died from COVID-19 in all age groups. In the age group 75 to 79 years, there were relatively almost twice as many men as women who died from confirmed COVID-19.
The average age among all male COVID-19 deaths was 79.7 years, among female COVID-19 deaths this was 83.8 years. The average age was slightly higher among the suspected COVID-19 deaths, 81.8 years among men and 84.4 years among women.

Data sources for CBS and RIVM

For the period week 10 to 26 inclusive (2 March-28 June 2020), the National Institute for Public Health and the Environment (RIVM) reported 6,115 COVID-19 deaths based on data received from municipal health services. In the same period, CBS registered 7,790 confirmed COVID-19 deaths based on cause of death certificates. There are several explanations for the discrepancies between CBS and RIVM figures. Firstly, there may have been cause-of-death certificates stating COVID-19 as the cause of death based on the clinical picture of COVID-19, but not confirmed by laboratory testing. These deaths are not included in the RIVM figures. Secondly, deaths which were confirmed cases of COVID-19 and tested positive in the laboratory may not have been reported (yet) as such to the municipal health services (GGD), which also means they are not included in the RIVM figures. Furthermore, mortality figures over previous periods are still subject to revision by the RIVM, due to more data on COVID-19 deaths over earlier periods that are received by RIVM at a later stage.

Mortality due to other causes of death

The provisional figures over the first six months of 2020 show that mortality from other leading causes of death was roughly the same as in the first half of last year. This includes deaths from malignant neoplasms (including cancer), cardiovascular diseases, mental and behavioural disorders and diseases of the nervous system (e.g. dementia). The number of deaths caused by respiratory diseases declined slightly as of April 2020. Moreover, the number of deaths with non-natural causes such as accidents, suicides, murder and manslaughter remained virtually unchanged. Final conclusions can only be drawn after all the data on causes of death are complete.

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