Belgium’s unwanted position at the head of Europe’s second coronavirus surge has dismayed Philippe Devos, head of the country’s association of medical unions.
Rates of cases and hospital admissions in the country are more than double European averages and medics in Belgium feared they would soon be faced with agonising decisions of selecting which patients to save if the health system was overwhelmed.
“I don’t want doctors to make that choice,” Dr Devos told broadcaster RTL TVI at the weekend. “I’d prefer the government to do it.”
This week, the north European country where the main EU institutions and Nato are based went into a second national lockdown. Belgium’s struggles are both a microcosm and an intense form of problems seen elsewhere in Europe as countries reluctantly put in place painful restrictions in response to soaring infection rates.
One reason Belgium is suffering so badly is its long history of weak central government and deep regional divisions. A “very complex political structure” has hobbled a response already made challenging because the country is a densely populated international hub, said Philippe Lamberts, a Belgian MEP and co-leader of the Green group in the European parliament.
“The federal government has made some emergency measures and the state governments have made some emergency measures,” Mr Lamberts said of the many rules enforced and repealed since the first lockdown in the spring. “Since none of the levels has precedence over the others, you have confusion, and confusion does not help.”
The new measures involve closing non-essential shops, further limits on social contact and compulsory homeworking. But even that may not be enough, with Elio Di Rupo, minister-president of the French-speaking Wallonia region, warning of possible further restriction if hospitals face a “cataclysmic situation”.
The curbs were introduced after national Covid-19 infection rates became the most severe in the 31 countries comprising the European Economic Area and the UK, according to official data published on Tuesday.
Belgium had a 14-day cumulative number of 1,753 cases per 100,000 people, more than twice the rate of France, nearly eight times greater than Germany’s, and 34 times higher than that of Finland.
Wallonia includes five of the six highest case rates out of 900 subnational regions across Europe. Worst is Liège province, which recorded 3,355 cases per 100,000 in the past 14 days.
Covid-positive doctors in Liège were last month asked to continue working because of staff shortages. On Tuesday, Belgium’s military said it had deployed 17 personnel to help with the reception and care of patients in the emergency wing of a hospital in Liège’s outskirts.
The soaring caseload provoked alarm from top Belgian officials. Alexander De Croo, prime minister, has called the lockdown a “last chance” move essential to stop the health system from collapsing. Frank Vandenbroucke, health minister, had earlier branded the situation out of control in the face of a threatened “tsunami” of cases.
The crisis has placed a strain on a governance system in which authority is delicately balanced between the federal administration, the richer Dutch-speaking Flanders and poorer Wallonia. Christoph D’Haese, mayor of Aalst in Flanders, drew criticism last month when he said he would no longer take patients from harder-hit and predominantly francophone Brussels, because medical solidarity had “limits”.
Regional rivalries had already forced the country to tackle the pandemic under an improvised and time-limited government, because of deadlock in talks to form a new administration after elections last year. The new coalition took power only on October 1, after nearly 500 days of wrangling.
Sophie Wilmès, prime minister until last month, won praise for her communications during the first stage of the crisis. But questions are now being asked — as elsewhere in Europe — about whether the government lifted social restrictions too quickly over the summer.
Significant powers wielded by Belgium’s city and district authorities have added another level of disorder to the response. In one example, regulations on outdoor mask-wearing in Brussels — now compulsory everywhere in the city — have varied street by street and even within single roads. In one sparsely populated street in the commune of Woluwe-Saint-Lambert, the pre-lockdown rule mandated the wearing of masks from 7.30am to 9am, midday to 1pm, and 3pm to 5pm — weekends excepted.
At a nearby park, authorities shut down a football pitch as the lockdown loomed — yet another remained open in a neighbouring municipality. “That’s Belgian politics — it’s a real lasagne,” a park official noted of the smorgasbord of official pandemic policies.
Another question is the potential political impact if popular annoyance grows at the return to lockdown. This is particularly pertinent as the country prides itself on its healthcare and levies high taxes and social insurance contributions by EU standards.
As in some other European countries, small protests have sprung up in Belgium against pandemic social curbs. But there has not been a public swell of criticism against a government that is still barely a month old.
Belgian officials have begun to express cautious hopes this week that the rise in Covid-19 infection rates is starting to slow. If case numbers are brought under control again, the big question will be how a small country at the symbolic heart of the EU can avoid a third instalment of the lockdown nightmare.