As COVID-19 hit Belgium, many elderly were left to die

BRUSSELS » Runaway coronavirus infections, medical gear shortages and government inattention are woefully familiar stories in nursing homes around the globe. But Belgium’s response offers a gruesome twist: Paramedics and hospitals sometimes flatly denied care to elderly people, even as hospital beds sat unused.

Weeks earlier, the virus had overwhelmed hospitals in Italy. Determined to prevent that from happening in Belgium, the authorities shunned and all but ignored nursing homes. But while Italian doctors said they were forced to ration care to the elderly because of shortages of space and equipment, Belgium’s hospital system never came under similar strain.

Even at the height of the outbreak in April, intensive-care beds were no more than about 55% full.

“They wouldn’t accept old people,” said Shirley Doyen, who runs the Christalain nursing home with her brother in an affluent neighborhood in Brussels. “They had space, and they didn’t want them.”

Belgian officials say denying care for the elderly was never their policy. But in the absence of a national strategy, and with regional officials bickering about who was in charge, officials now acknowledge that some hospitals and emergency responders relied on vague advice and guidelines to do just that.

The situation was so dire that the charity Doctors Without

Borders dispatched teams of experts more accustomed to working in war-hardened countries.

Seventeen people had died there in the past 10 days.

There was no protective equipment.

Oxygen was running low. Half the staff was infected. Others showed signs of trauma common in disaster zones, a psychologist from the medical charity concluded.

The director and her deputy were sick with COVID-19, and the acting chief collapsed in a chair, crying, as soon as the team met her.

Belgium went into lockdown March 18. By late March and early April, hospitals quietly stopped taking infected patients from nursing homes.

The policy — officially it was just advice — took shape in a series of memos from Belgian geriatric specialists.

“Unnecessary transfers are a risk for ambulance workers and emergency rooms,” read an early memo, signed by the Belgian Society for Gerontology and Geriatrics and two major hospitals.

The gerontology society says that its advice — drafted in case of an overwhelmed hospital system — was misunderstood.

The society is not a government agency, doctors there note, and it never intended to deny hospital care for the elderly.

But that is what happened. It is impossible to know how many deaths were preventable. But hospitals always had space. Even at the peak of the pandemic, 1,100 of the nation’s 2,400 intensive care beds were free, according to Niel Hens, a government adviser and University of Antwerp professor.