<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Geert Molenberghs</style></author><author><style face="normal" font="default" size="100%">Christel Faes</style></author><author><style face="normal" font="default" size="100%">Johan Verbeeck</style></author><author><style face="normal" font="default" size="100%">Patrick Deboosere</style></author><author><style face="normal" font="default" size="100%">Steven Abrams</style></author><author><style face="normal" font="default" size="100%">Lander Willem</style></author><author><style face="normal" font="default" size="100%">Jan Aerts</style></author><author><style face="normal" font="default" size="100%">Heidi Theeten</style></author><author><style face="normal" font="default" size="100%">Brecht Devleesschauwer</style></author><author><style face="normal" font="default" size="100%">Natalia Bustos Sierra</style></author><author><style face="normal" font="default" size="100%">Françoise Renard</style></author><author><style face="normal" font="default" size="100%">Sereina Herzog</style></author><author><style face="normal" font="default" size="100%">Patrick Lusyne</style></author><author><style face="normal" font="default" size="100%">Johan Van der Heyden</style></author><author><style face="normal" font="default" size="100%">Herman Van Oyen</style></author><author><style face="normal" font="default" size="100%">Pierre Van Damme</style></author><author><style face="normal" font="default" size="100%">Niel Hens</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">COVID-19 mortality, excess mortality, deaths per million and infection fatality ratio, Belgium, 9 March 2020 to 28 June 2020</style></title><secondary-title><style face="normal" font="default" size="100%">Eurosurveillance</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">COVID-19</style></keyword><keyword><style  face="normal" font="default" size="100%">Excess mortality</style></keyword><keyword><style  face="normal" font="default" size="100%">nursing homes</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2022</style></year><pub-dates><date><style  face="normal" font="default" size="100%">May-02-2023</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">27</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Background&lt;/p&gt;

&lt;p&gt;COVID-19 mortality, excess mortality, deaths per million population (DPM), infection fatality ratio (IFR) and case fatality ratio (CFR) are reported and compared for many countries globally. These measures may appear objective, however, they should be interpreted with caution.&lt;/p&gt;

&lt;p&gt;Aim&lt;/p&gt;

&lt;p&gt;We examined reported COVID-19-related mortality in Belgium from 9 March 2020 to 28 June 2020, placing it against the background of excess mortality and compared the DPM and IFR between countries and within subgroups.&lt;/p&gt;

&lt;p&gt;Methods&lt;/p&gt;

&lt;p&gt;The relation between COVID-19-related mortality and excess mortality was evaluated by comparing COVID-19 mortality and the difference between observed and weekly average predictions of all-cause mortality. DPM were evaluated using demographic data of the Belgian population. The number of infections was estimated by a stochastic compartmental model. The IFR was estimated using a delay distribution between infection and death.&lt;/p&gt;

&lt;p&gt;Results&lt;/p&gt;

&lt;p&gt;In the study period, 9,621 COVID-19-related deaths were reported, which is close to the excess mortality estimated using weekly averages (8,985 deaths). This translates to 837 DPM and an IFR of 1.5% in the general population. Both DPM and IFR increase with age and are substantially larger in the nursing home population.&lt;/p&gt;

&lt;p&gt;Discussion&lt;/p&gt;

&lt;p&gt;During the first pandemic wave, Belgium had no discrepancy between COVID-19-related mortality and excess mortality. In light of this close agreement, it is useful to consider the DPM and IFR, which are both age, sex, and nursing home population-dependent. Comparison of COVID-19 mortality between countries should rather be based on excess mortality than on COVID-19-related mortality.&lt;/p&gt;
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