Statbel, the Belgian statistical office, publishes today the causes of deaths for 2020. The COVID-19 pandemic caused 22,012 deaths in Belgium, or 17.4% of all deaths. Therefore, COVID-19, the contagious disease caused by the SARS-CoV-2 virus, is the third cause of death in 2020. As in 2019, tumours were the main cause of death. A total of 27,209 people died from tumours (malignant, benign or uncertain), or 21.4% of all deaths in 2020. The number of deaths due to tumours is quite similar to a year earlier (27,739 deaths).

All these figures are available in our dashboard

26,289 Belgians died from diseases of the circulatory system, i.e. 20.7% of all deaths. For diseases of the circulatory system, we observe a limited decrease compared to 2019, when there were 27,297 deaths (-3.7%).

COVID-19: main cause of death in Brussels

COVID-19 is the main cause of death in the Brussels-Capital Region, with 2,512 deaths, or 22.9%. In second place are deaths due to tumours (1,976, 18.0%), followed by deaths with diseases of the circulatory system as underlying cause of death (1,922, 17.5%).

The Flemish and Walloon regions follow the national ranking for the three main causes of death.

It should be noted that, for the first time in Wallonia too, there were now more deaths due to tumours (9,100 deaths; 20.2%), than due to diseases of the circulatory system (8,886 deaths; 19.8%), while this was already the case in the other regions in 2019. This is mainly due to the downward trend observed in deaths from diseases of the circulatory system. While 12,929 people still died of diseases of the circulatory system in Wallonia in 2000, they were 9,206 in 2019 and finally 8,886 in 2020. Wallonia also recorded 8,658 deaths due to COVID-19 (19.3%).

In Flanders, 16,133 people died from tumours (22.7%), followed by 15,481 from diseases of the circulatory system (21.8%). There were 10,842 COVID-19 deaths, or 15.3% of Flemish deaths in 2020.

Number of deaths per region, for the three main causes of death

Men die most often from tumours, women from diseases of the circulatory system

Men follow the national ranking more closely: the main cause of death is a tumour in 23.9% of cases (14,879 deaths) and a disease of the circulatory system in 19.6% of cases (12,164 deaths). For women, the order is reversed. The main causes of death are diseases of the circulatory system (21.8% or 14,125 deaths), followed by tumours with 12,330 deaths among women (19.1%). We observe the same trends per gender in the three regions of the country: in each region, women died more often than men from diseases of the circulatory system than from a tumour.

Two mortality peaks due to COVID-19

The first death due to COVID-19 was registered in Belgium in March 2020. That was the beginning of a first wave of infection, followed by a mortality peak. This is illustrated by the three weeks between 30 March and 19 April 2020. They registered the highest number of deaths due to COVID-19 (1,714, 2,132 and 1,791 cases respectively, or a total of 5,637 deaths). More than a quarter (25.6%) of all COVID-19 deaths in 2020 took place in those three weeks.

A second peak in COVID-19 mortality was also observed in October and November. In the three weeks between 2 and 22 November, 4,395 people died, or 20.0% of all COVID-19 deaths.

People dying from COVID-19 were on average older than for other causes

The data show that people dying from COVID-19 were generally older, with a high concentration in the age group 75 and over (81.8% of all COVID-19 deaths). The average age of people dying from COVID-19 was 83 in 2020. The average age for the other causes of death was 78.6.

Breakdown COVID-19 deaths per age group

More COVID-19 victims among women than men

In 2020, a little more women died from COVID-19 than men (11,281 women compared to 10,731 men, or about 51% compared to 49% of all COVID-19 deaths).

This corresponds to a mortality rate ^[1] of 193.2 deaths per 100,000 women, compared to 189.3 deaths per 100,000 men. However, that does not necessarily mean than women are more vulnerable to COVID-19. Other factors can also be the cause of these differences in mortality figures, including age differences.

COVID-19 mortality rate is the highest in Wallonia

The highest number of deaths due to COVID-19 was observed in the Flemish region (10,842 deaths, or 49.3% of all COVID-19 deaths). In Wallonia and Brussels, there were 8,658 (39.3%) and 2,512 (11.4%) deaths, respectively. However, if we take the population size into account, Wallonia ranks first, with a mortality rate of 237.4 deaths per 100,000 inhabitants. It is followed by the Brussels-Capital Region, with a mortality rate of 206.1 deaths per 100,000 inhabitants. The mortality rate in Flanders was 163.3 deaths per 100,000 inhabitants.

COVID-19 deaths per region

The number of suicides remains stable

Finally, 1,732 Belgians committed suicide in 2020 (ICD-10 codes X60-X84), which corresponds to a mortality rate of 15.1 deaths per 100,000 inhabitants. This is in line with the number of deaths in 2019 (1,728 deaths, mortality rate: 15.1). Based on these data, it seems that the pandemic had no impact on the number of suicides. However, these figures should be interpreted with caution. Suicide is a complex phenomenon, and various factors can lead to underreporting (for example, when the intent is not clear or wrongly interpreted).

Notes

Based on statistical death bulletins, which are managed by the federated entities, the statistic on causes of death has now a homogeneous series for the period 1998-2020. This homogeneity of the series is achieved because the three federated institutions concerned use the tenth revision of the World Health Organization's International Classification of Diseases and Related Health Problems (ICD-10) to code the causes of death and to identify, among them, the initial cause on the basis of which the main tables of the statistic are produced.

^[1] The mortality rate is calculated as:

, or the number of deaths divided by the average population on 1 January 2020 and 2021 (midyear population), multiplied by 100,000.