They Saw a Second Wave Coming. They Still Couldn’t Stop It.

Belgium is one of the wealthiest countries in Europe, with excellent standards of healthcare. But the coronavirus doesn’t care how rich you are.
November 20, 2020, 4:57pm
Gent University Hospital is at the centre of the city's COVID response. Having enough trained staff to deal with patients is proving more critical than providing enough beds
Gent University Hospital is at the centre of the city's COVID response. Having enough trained staff to deal with patients is proving more critical than providing enough beds. All photos: Devin Yuceil.

GENT, Belgium – Nothing has been spared from the impact of the second wave of the COVID-19 pandemic in Europe – not even how people can mourn the victims of the virus.

Most days of the week, Annelies Heeze will visit the morgue of one of the many hospitals dotted around the Belgian city of Gent. Heeze is a funeral director, in business with her husband Bart van Lent.

Typically, she’ll visit a morgue to pick up a recently deceased person in order to make them presentable for their family to see one final time.

Although this work is enough to make most people squeamish, for Heeze it’s routine and necessary - her business centres around comforting families as they say goodbye to the dead.

But the arrival of a second wave of the pandemic has complicated things.

VICE World News went with Heeze to a morgue as she inspected the body of a woman who had recently died from the coronavirus. Belgian government rules state that if a recently deceased person is suspected of having died of COVID-19, they must stay in contamination for 72 hours.

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On removing the victim from the mortuary’s storage freezers, Heeze conducted an inspection, but quickly discovered there was nothing she could do to make the body presentable - in three days the body had decomposed to a point where showing it to the woman’s family would cause distress.

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Gent funeral director Annelies Heeze is having to adapt the way she does business to cope with the COVID-19 restriction, which extend to when she can prepare the bodies of coronavirus victims.

Heeze spoke of her frustration. “It's the feeling that I'm failing,” she said. “I really wanted it so the children could say goodbye to their mum in a nice way. We have to tell [the families] that they have waited [three days] for nothing.”

Gent’s normally busy canal-side bars are currently closed, and even on a weekday the city of a quarter million is mostly quiet, with the majority of businesses ordered shut.

At the start of November, Belgium found itself in the ignominious position of having Europe’s highest rate of infection over the previous two weeks – 1390.9 cases per 100,000 people.

It was those soaring numbers which prompted the Belgian government to introduce its second nationwide lockdown of the year, complete with a nightly curfew, ban on gatherings in public spaces with more than four people, along with the now-familiar closure of restaurants and bars.

From his home in Gent’s southern suburbs, Jan Van Landeghem is familiar with the disruption caused by this year’s lockdown, but knows first hand it's more than just an inconvenience. 

Van Landeghem has been an ICU nurse for 18 years. He works in an acute care ward at Gent University Hospital, which is one of the largest medical facilities in Belgium, and recalls a strange sense of excitement in March, when he and his team prepared for the arrival of COVID-19 patients.

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“At first, it was just kind of thrilling,” he said. “How many patients will there be? Would it be like in Italy… which was totally overwhelmed?”

Van Landeghem took VICE World News around his ICU ward on a busy Wednesday afternoon.

All of the 14 beds in the unit where Van Landeghem works are full. One patient waves through a glass window – he’s recovered well and will be moved to a recovery ward a little later that day – but the rest of the patients are unconscious, most intubated with plastic tubes.

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Jan Van Landeghem (right) has been an ICU nurse for 18 years, and is treating patients made sick by the second wave of COVID-19.

One of Van Landeghem’s tasks on his eight-hour shift is to pay special attention to a patient in his late 60s, who has been in the ward for 10 days, but has seen his condition worsen.

He was intubated yesterday and didn't go well. He needed oxygen, so we put him on his belly. He's in a coma, he’s sedated, gets a cocktail of painkillers, sleep medication.”

Gent University Hospital has a total of 43 ICU beds for COVID-19-patients, and can expand that capacity to 67 beds if necessary – but the problem isn’t bed space, it’s having enough trained staff to work the COVID wards.   

Across the country, Belgium has 2,000 ICU beds. Some of the patients in Gent have been transferred from other regions in the country which can’t cope.

If Belgium’s health system became overwhelmed, it would likely appeal to neighbouring countries like Germany or the Netherlands to take patients. 

Van Landeghem said that morale among his fellow medics is still high, but they saw the approaching second wave with dread.  

“When you see the curves going up and they say maybe within two weeks, it will be double, then I don't know… then it’s like war,” he said.

With around 11 million people living in a relatively small land mass, Belgium is densely populated.

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It’s also divided into two main regions, the Dutch-speaking Flanders and the French-speaking Wallonia, along with a smaller German-speaking community.

The cultural complexity extends to how Belgium is governed, with different layers in different regions, often with different rules on containing COVID-19.

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The city of Gent is located in the Dutch-speaking Flemish region of Belgium, which make up 60 percent of the country's 11.5 million people. Most of the rest speak French, in a region called Wallonia.

This led to confusion, and a lack of uniformity in restrictions designed to contain the pandemic.

Worse, in September the Belgian government bowed to public pressure and relaxed measures to combat the virus, before being replaced in October by a coalition led by current Prime Minister Alexander De Croo.

Compounding the problem, according to a senior medic at Gent University Hospital, was the slow response of the incoming government to the second wave.

“We have had the first wave, and then we had a loosening of the measures to get back to more or less normal,” said Dr Pieter Depuydt, a COVID specialist at the hospital. 

“Then we had the first signs that the second wave was coming. In the beginning, these were very subtle signs. The government was very hesitant to take further measures.”

Virologist Steven van Gucht has been the face of the Belgian government’s COVID-19 response, giving frequent televised updates on the state of the battle with the virus.

He said that Belgium was still trying to establish the right balance between giving the public freedom, and keeping the public safe. 

“We need to find the right balance and that balance can be different in winter and autumn than in summer,” he said.

“I think in summer it worked relatively well, but now in autumn and winter the conditions have changed, and perhaps we get to be more strict now because the virus can spread more easily.”

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Since the start of the pandemic, Belgium has suffered more than 15,000 COVID-19 deaths, and its death rate per million citizens – 1,308 – is the worst in the world.

But indications suggest Belgium may have finally crested the peak of the second wave and is sliding down the other side.

On Thursday, Belgian public health body Sciensano reported a 38 percent decrease in positive cases compared to the previous week, and a drop in the infection rate in the population.

To avoid a third wave of COVID-19, Belgium is joining the rest of the world in pinning its hopes on the swift arrival of a vaccine.

Belgium has joined a mass European order of the Pfizer-BioNTech vaccine, which has so far proved 95 percent effective in combating the coronavirus in clinical trials, and has hedged its bets by also ordering other promising vaccines. 

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A second wave of COVID-19 prompted Belgium to go back into lockdown on October 30.

Until the vaccine becomes widely available - and is proved effective - funeral director Heeze is continuing her work, in challenging conditions.

We accompanied Heeze as she held a socially distanced funeral, where only 15 people were allowed to attend in a venue which can normally accommodate 250 people.

The family was forced to choose who could attend, with those left out able to watch via a video live stream.

Like the rest of her country, Heeze is unsure when life might even vaguely resemble normal again.  

“For me it's surviving now, she said. “We just stay strong and we do what we can do.”