Nearly 13 thousand COVID-19 deaths up to November 2020

CBS has been publishing mortality statistics on a weekly basis since 3 April 2020. The numbers are based on death records received by CBS from the municipalities. These records do not contain any information about the cause of death. Figures on causes of death are based on the cause-of-death certificates completed by an attending medical practitioner. CBS receives these certificates via the municipality where the death occurred. The figures presented today are based on 97.8 percent of all cause-of-death certificates received up to week 44 (26 October to 1 November) inclusive. For more information: How CBS compiles mortality figures in times of corona.

Excess mortality entirely due to the novel coronavirus

During the first wave of the pandemic, excess mortality was entirely on account of COVID-19 deaths. In the first six weeks of the second wave, i.e. in weeks 39 through 44 (21 September to 1 November inclusive), there were over 2,300 more deaths than expected. In the same period, 2,482 people died from the novel coronavirus. This means that at the beginning of the second wave, excess mortality was entirely on account of COVID-19-related deaths.

Nearly 60 percent of COVID-19 deaths were long-term care recipients

Over 7,500 of the 12,872 deaths caused by confirmed or suspected COVID-19 that were registered up to October inclusive were people who had been receiving long-term care under the Long-term Care Act (Wlz), such as in nursing homes. Just as in the first half of 2020, around half of the men who died of COVID-19 between July and October were Wlz care users. Among the women who died of COVID-19, this share was 70 percent.

During the first wave, mortality among long-term care users peaked in week 15 with 2,409 deaths. Half of these deaths were caused by coronavirus. In week 33, during the heat wave, mortality among long-term care users was elevated again (1,311 people). This peak was due to the heat; 3 percent of Wlz care recipients died of COVID-19 in that week. In week 44 and weeks 52-53 of 2020, two consecutive peaks were seen in mortality among long-term care users. During the peak in week 44, 1 in 3 deaths among Wlz care recipients were caused by COVID-19; among the rest of the population, 1 in 6 deaths were caused by the virus. Cause-of-death data for the last peak in 2020 will follow later when more data become available.

31 percent more male than female COVID-19 deaths at the start of the second wave

In the first six weeks of the second epidemic wave (weeks 39 through 44), there were 31 percent more male than female COVID-19 deaths (1,409 men against 1,073 women). The gap is wider than during the first wave (March through June), when 13 percent more men than women died of COVID-19 (5,380 against 4,774).

In relative terms, per thousand inhabitants, there were more male than female COVID-19 deaths across the different age groups. At the beginning of the second wave, there were twice as many male as female deaths among 60 to 89-year-olds. The highest mortality rate per thousand inhabitants was in the age group 90 years and over.

In the first six weeks of the second wave (weeks 39 through 44), 67 percent of all COVID-19 deaths were aged 80 years or older (1,659 people). Almost one-third (31 percent) of all COVID-19 deaths occurred in the 60-79 age bracket (766 people) and 2 percent among those younger than 60 (57 people). This age distribution is similar to that during the first wave.
The average age of the men who died of COVID-19 in the first six weeks of the second wave was 80.8 years; for women, it was 84.2 years. This is similar to the first wave.

Mortality with other causes of death

The provisional figures over the period March through October 2020 show that the number of deaths caused by malignant neoplasms (including cancer) was similar to the same period in 2019. However, slightly fewer people died from cardiovascular diseases (-3 percent) and from mental disorders or diseases of the nervous system, such as dementia (-6 percent). The number of deaths caused by respiratory diseases was down by 16 percent relative to the period March through October 2019.

The number of deaths with non-natural causes (accidents, suicides, homicides and manslaughter) went up in the months of March to October, by 5 percent year-on-year. The number of deaths from road traffic accidents, suicides, homicides and manslaughter was similar to the same period in 2019. The increase in mortality from non-natural causes of death is due to more accidental falls (unintentional falls, tripping or slipping).

During the period March to October 2020, 13 percent more people died from a fall than one year previously. The number of deaths from accidental falls has been increasing for a number of years: in the period from 2015 to 2019, it rose by an average of approximately 9 percent (35 percent) per year. This increase is not only attributable to an ageing population. Even with a correction for the changing age structure of the population, an increase can be observed.

Data sources for CBS and RIVM

For the first six weeks of the second pandemic wave (weeks 39 through 44, 21 September to October 2020), the National Institute for Public Health and the Environment (RIVM) reported 1,437 COVID-19 deaths based on data received from municipal health services. In the same period, CBS registered 2,335 confirmed COVID-19 deaths based on cause-of-death certificates. In addition, there were 147 deaths from suspected COVID-19 as the underlying cause of death. There are several explanations for the discrepancies between CBS and RIVM figures. Firstly, there may have been cause of death forms carrying the indication COVID-19 as the cause of death based on the clinical picture, 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 as such to the municipal health services (GGD) (partially because there is no reporting obligation for COVID-19 deaths), which also means they are not included in the RIVM figures. Furthermore, reported mortality figures over previous periods are still subject to revision, due to more data on COVID-19 deaths over earlier periods that are received by RIVM at a later stage. CBS will update the figures on causes of death when these data have also been processed.