Fewer COVID-19 deaths in Q2 than in Q1 2021

The COVID-19 mortality rate has decreased since February 2021. In April, 1,397 deaths were caused by suspected or confirmed COVID-19; this number stood at 935 and 248 in May and June, respectively.

Figures on causes of death are based on the cause-of-death certificates that are completed by an attending medical practitioner. CBS receives these certificates via the municipality where the death occurred. CBS publishes data when more than 95 percent of the cause-of-death certificates related to the publishing period have been received and processed. The figures presented in this news release are based on 97.4 percent of all cause-of-death certificates received in April, on 96.7 percent of the certificates in May and on 96.0 percent of those in June. CBS also publishes mortality statistics on a weekly basis. The numbers are based on death records received by CBS on a monthly basis from the municipalities. These records do not contain any information about the cause of death.

COVID-19 mortality down among long-term care users

In Q2 2021, there were 424 COVID-19 deaths among people receiving care under the Long-term Care Act (Wlz). This is over 4,025 fewer than in the first quarter. Fifty-three percent (16,550) of the 31,384 deaths caused by confirmed or suspected COVID-19 and registered since March 2020 were people who had been receiving long-term care, such as in a nursing home. Since the second half of February 2021, this share has been declining: in Q1, it was 51 percent, while it was still 16 percent in Q2.

COVID-19 continued to be one of the main causes of death among long-term care recipients in the first quarter, accounting for 26 percent of mortality. This was still 3 percent in Q2. Among the rest of the population, COVID-19 also accounted for a smaller share of deaths in Q2: 8 percent (Q1: 15 percent).

Decline continued into June

On a weekly basis as well, the number of deaths due to COVID-19 decreased. In the last week of June, 27 people died of this disease, equivalent to 1 percent of deaths. In April, the weekly number of COVID-19 deaths still stood at over 300, i.e. around 10 percent of total mortality.

Mortality with other causes of death

In Q2 2021, COVID-19 ranked fourth among the largest groups of causes of death: there were more deaths due to cancer, cardiovascular diseases, mental disorders and diseases of the nervous system (including Alzheimer's disease and dementia). In the previous two quarters, COVID-19 mortality was still significantly higher and virtually the same as mortality from cardiovascular diseases.

Mortality from respiratory diseases tends to peak in the first quarter. This peak was not observed in 2021, possibly due to the absence of a flu outbreak. In Q1 2021, there were also fewer deaths from cardiovascular diseases and from mental disorders and diseases of the nervous system than in the same quarter of 2020 and 2019.

Data sources for CBS and RIVM

From 21 September 2020 to 27 June 2021 inclusive (as at 1 November), the National Institute for Public Health and the Environment (RIVM) reported 11,379 COVID-19 deaths based on data received from the municipal health services (GGD). In the same period, CBS registered 20,298 confirmed COVID-19 deaths based on cause-of-death certificates. In addition, there were 515 deaths from suspected COVID-19 as the underlying cause of death. Altogether, this is 20,813 COVID-19 deaths.

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 (directly) reported as such to the GGD (partially because there is no reporting obligation for COVID-19 deaths). This 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.