Mortality in times of corona

© Hollandse Hoogte / Jaco Klamer
For week 21 (ending 24 May), the total number of deaths is estimated at 2,750. It is the second consecutive week with lower mortality than the level expected for this period. Mortality in weeks 11 through 19 (the first nine weeks of the corona epidemic in the Netherlands) was higher than expected, with almost 9 thousand more deaths than the expected mortality over this period. There was relatively higher mortality among people receiving long-term care (under the Long-term Care Act, Wlz), the elderly and men than among those not receiving care, younger people and women. This is reported by Statistics Netherlands (CBS) and the National Institute for Public Health and the Environment (RIVM) on the basis of provisional weekly death counts.

Up to and including week 10 (ending 8 March) of this year, average mortality stood at 3,136 per week. It subsequently rose to reach its highest level in week 14 with 5,080 deaths. As of week 20, mortality is below the level considered normal for this time of year. It is a commonly known fact that periods of increased mortality are often followed by periods of low mortality; the latter is also known as undermortality.
However, the undermortality does not mean that there have not been any deaths related to COVID-19. In week 21, the number of deaths from COVID-19 as reported to RIVM (as at Thursday, 28 May 2020) stood at 104. The final number may turn out even higher, as not all COVID-19 patients are tested.
With a total of 36 thousand deaths over weeks 11 through 19, there were almost 9 thousand more deaths than normal, representing 32 percent excess mortality.

Deaths registered weekly
 2017201820192020*2020 (expected)
13568334330623102
23637335932623364
33487336431523153
43626332231793042
53574340331393160
63446351331833191
73417366032543197
83328369132202957
93152393730653092
103054409231723098
1128433733322532153050
1227783430304336093091
1328503225301344503111
1427643040289850803111
1528102860290249722906
1627132760303642923007
1727782663295638932923
1827692645280633682976
1928022641277229642930
2028012606282127353047
2127722674287327592807
22270127762730
23262426792734
24264325572647
25262726012692
26269126192836
27269727262725
28252026712761
29267427042586
30257127673006
31251027602731
32265727452629
33254026052613
34254526122617
35257625272783
36257026132553
37270725392642
38271527062580
39266926962751
40264128062717
41276327602912
42270627392879
43267626712867
44272628152856
45279727983015
46291627613060
47291728593023
48288629073045
49302729683018
50321830173161
51307930413253
52318729013028
* provisional figures 2020: Data reported for the most recent week are estimates.


This estimate for week 21 has been based on the number of death certificates that Statistics Netherlands (CBS) has received for week 21, up to and including Wednesday 27 May. Expected mortality has been estimated on the basis of mortality as recorded over the previous weeks, adjusted for seasonal effects. Had there not been a COVID-19 pandemic, week 21 would have had an estimated 2,807 deaths.

53 percent excess mortality among long-term care users

In the period week 11 to 19 inclusive, there were more than 15 thousand deaths among people receiving long-term care under the Wlz Act. This is an estimated 5 thousand more deaths than the expected mortality in this group under normal circumstances. Mortality among the rest of the population (over 17 million people) stood at almost 21 thousand in this period. This is around 3,500 or 20 percent more deaths than expected.

Deaths registered weekly
Bevolkingsgroep2017, week 11 to week 19 inclusive2018, week 11 to week 19 inclusive2019, week 11 to week 19 inclusive2020, week 2 to week 10 inclusive*Week 21 (expected)*Week 21 (excess mortality)*Week 21 (total)*Week 21 (excess mortality)*_8
Long-term care (Wlz) users86969773973110407995552461520153
Other population164011722516921178471714934932064220
* provisional figures

Relatively the highest excess mortality among the 75 to 89-year-olds

Relatively the highest excess mortality on account of the COVID-19 epidemic was recorded among the population aged 75 to 89 years. The excess mortality in this age group amounted to 42 percent on average. Although there was excess mortality among the over-90s as well, this was relatively lower than among 75 to 89-year-olds. In the age group 50 to 54 years, mortality was also relative higher than among the 60 to 64-year-olds (27 percent versus 18 percent).

Deaths registered weekly
Leeftijd2017, week 11 to week 19 inclusive2018, week 11 to week 19 inclusive2019, week 11 to week 19 inclusive2020, week 2 to week 10 inclusive*Week 11 to week 19 inclusive (expected)Week 11 to week 19 inclusive (excess mortality)Week 11 to week 19 inclusive (total)Week 11 to week 19 inclusive (excess mortality)_8
0-49 yrs915958890964919629817
50-54 yrs53851249851648213862029
55-59 yrs86590185278274319994227
60-64 yrs13421316130113251292188148015
65-69 yrs18391861180619201854389224321
70-74 yrs26462809284429022808902371032
75-79 yrs298931953264349733431342468540
80-84 yrs393141614267441141981766596442
85-89 yrs466951394888519749382173711144
90-94 yrs364741214021444743081093540125
95 yrs and over17262024201522932218488270622
* provisional figures
 

Higher excess mortality among men

In absolute numbers, there were slightly more deaths among men than among women during the COVID-19 epidemic: 18.2 thousand against 17.7 thousand. This is unlike previous weeks and years, when there were slightly more deaths among women. In relative terms as well, mortality was higher among men in weeks 11-19 of this year. It was 37 percent higher than expected among men against 28 percent among women for this period had there not been a COVID-19 epidemic. Mortality has been relatively higher throughout among men than among women across all age groups.

Deaths registered weekly
Geslacht2017, week 11 to week 19 inclusive2018, week 11 to week 19 inclusive2019, week 11 to week 19 inclusive2020,week 2 to week 10 inclusive2020, Week 11 to week 19 inclusive (expected)2020, Week 11 to week 19 inclusive (excess mortality)2020, Week 11 to week 19 inclusive (total)2020, Week 11 to week 19 inclusive (excess mortality)_8
Men120961304812995138401324649181816437
Women130111394913651144141385838211767928
* provisional figures
 

Regional mortality distribution

Throughout the COVID-19 epidemic, relatively more excess mortality was recorded in the eastern part of Noord-Brabant, in Limburg and around the city of Zwolle. The municipality of Uden had altogether 178 deaths over weeks 11 to 19 inclusive; this is just over 3 times as many as during the weeks before the epidemic. Other municipalities with at least 2.5 times more deaths than normal during the coronavirus epidemic included Heerde, Meierijstad, Boekel, Bernheze, Peel en Maas, Zwartewaterland and Nunspeet.

Average number of deaths registered weekly* in weeks 11 to 19 inclusive, relative to average in weeks 2 to 10 inclusive
Gemeenteweeks 11 to 19 relative to weeks 2 too 10
Appingedam1.76
Delfzijl0.81
Groningen (gemeente)1.00
Loppersum0.78
Almere1.12
Stadskanaal0.84
Veendam0.89
Zeewolde1.13
Achtkarspelen1.00
Ameland1.25
Harlingen1.13
Heerenveen1.10
Leeuwarden0.88
Ooststellingwerf0.94
Opsterland0.90
Schiermonnikoog1.00
Smallingerland1.33
Terschelling1.25
Vlieland2.00
Weststellingwerf0.92
Assen1.04
Coevorden0.93
Emmen1.09
Hoogeveen1.10
Meppel1.00
Almelo1.05
Borne1.44
Dalfsen1.04
Deventer1.72
Enschede1.10
Haaksbergen1.02
Hardenberg0.95
Hellendoorn1.24
Hengelo (O.)0.89
Kampen1.95
Losser1.05
Noordoostpolder0.82
Oldenzaal1.00
Ommen1.34
Raalte1.31
Staphorst1.60
Tubbergen0.98
Urk1.00
Wierden0.96
Zwolle1.79
Aalten1.32
Apeldoorn1.32
Arnhem1.23
Barneveld1.19
Beuningen1.17
Brummen1.56
Buren1.02
Culemborg1.26
Doesburg1.45
Doetinchem1.05
Druten1.96
Duiven0.98
Ede1.19
Elburg1.05
Epe1.65
Ermelo1.50
Harderwijk1.34
Hattem1.05
Heerde3.14
Heumen1.65
Lochem1.35
Maasdriel1.31
Nijkerk1.04
Nijmegen1.24
Oldebroek1.93
Putten0.95
Renkum1.23
Rheden1.22
Rozendaal1.00
Scherpenzeel1.00
Tiel1.07
Voorst1.04
Wageningen0.97
Westervoort1.35
Winterswijk0.82
Wijchen1.21
Zaltbommel1.37
Zevenaar1.05
Zutphen0.89
Nunspeet2.56
Dronten1.39
Amersfoort1.11
Baarn1.26
De Bilt0.94
Bunnik1.25
Bunschoten1.31
Eemnes1.21
Houten1.69
Leusden1.42
Lopik1.19
Montfoort1.36
Renswoude1.83
Rhenen1.36
Soest1.12
Utrecht (gemeente)1.37
Veenendaal1.20
Woudenberg1.28
Wijk bij Duurstede0.77
IJsselstein2.37
Zeist1.09
Nieuwegein1.03
Aalsmeer0.62
Alkmaar1.22
Amstelveen1.47
Amsterdam1.34
Beemster0.46
Bergen (NH.)1.37
Beverwijk1.49
Blaricum1.13
Bloemendaal1.59
Castricum1.32
Diemen1.31
Edam-Volendam0.96
Enkhuizen1.61
Haarlem1.26
Haarlemmermeer1.14
Heemskerk0.97
Heemstede1.88
Heerhugowaard1.53
Heiloo1.18
Den Helder0.90
Hilversum1.09
Hoorn1.00
Huizen1.30
Landsmeer1.06
Langedijk1.12
Laren (NH.)1.04
Medemblik0.90
Oostzaan1.06
Opmeer1.33
Ouder-Amstel0.77
Purmerend1.32
Schagen0.89
Texel0.93
Uitgeest1.07
Uithoorn1.29
Velsen1.59
Weesp1.63
Zandvoort0.95
Zaanstad1.12
Alblasserdam1.13
Alphen aan den Rijn1.07
Barendrecht1.11
Drechterland1.90
Brielle1.50
Capelle aan den IJssel1.59
Delft0.97
Dordrecht1.22
Gorinchem1.28
Gouda1.28
's-Gravenhage (gemeente)1.36
Hardinxveld-Giessendam1.06
Hellevoetsluis0.95
Hendrik-Ido-Ambacht0.60
Stede Broec1.29
Hillegom0.88
Katwijk1.11
Krimpen aan den IJssel1.67
Leiden1.17
Leiderdorp1.04
Lisse1.95
Maassluis0.83
Nieuwkoop1.21
Noordwijk0.99
Oegstgeest0.78
Oudewater2.45
Papendrecht1.27
Ridderkerk1.38
Rotterdam1.38
Rijswijk (ZH.)1.35
Schiedam0.96
Sliedrecht0.85
Albrandswaard1.30
Westvoorne0.65
Vlaardingen1.25
Voorschoten1.14
Waddinxveen0.93
Wassenaar1.36
Woerden1.58
Zoetermeer1.14
Zoeterwoude1.25
Zwijndrecht1.01
Borsele1.61
Goes1.27
West Maas en Waal1.57
Hulst1.12
Kapelle0.95
Middelburg (Z.)1.00
Reimerswaal1.12
Terneuzen0.88
Tholen1.33
Veere0.90
Vlissingen1.03
De Ronde Venen1.02
Tytsjerksteradiel1.65
Asten2.29
Baarle-Nassau1.50
Bergen op Zoom0.97
Best0.84
Boekel2.93
Boxmeer1.84
Boxtel1.67
Breda1.19
Deurne1.38
Pekela0.56
Dongen1.42
Eersel1.33
Eindhoven1.32
Etten-Leur1.49
Geertruidenberg1.05
Gilze en Rijen1.54
Goirle1.22
Grave2.41
Haaren1.23
Helmond1.44
's-Hertogenbosch1.67
Heusden1.45
Hilvarenbeek1.56
Loon op Zand1.05
Mill en Sint Hubert2.14
Nuenen, Gerwen en Nederwetten1.34
Oirschot1.20
Oisterwijk1.08
Oosterhout1.00
Oss1.66
Rucphen1.33
Sint-Michielsgestel1.46
Someren1.97
Son en Breugel1.18
Steenbergen1.10
Waterland1.09
Tilburg1.71
Uden3.24
Valkenswaard1.83
Veldhoven1.78
Vught1.47
Waalre0.90
Waalwijk1.37
Woensdrecht1.32
Zundert1.44
Wormerland1.29
Landgraaf1.41
Beek (L.)0.88
Beesel1.65
Bergen (L.)1.53
Brunssum1.06
Gennep1.69
Heerlen1.56
Kerkrade1.58
Maastricht1.84
Meerssen1.39
Mook en Middelaar2.11
Nederweert1.67
Roermond1.24
Simpelveld1.12
Stein (L.)1.36
Vaals1.00
Venlo1.69
Venray1.24
Voerendaal1.31
Weert1.22
Valkenburg aan de Geul1.40
Lelystad1.13
Horst aan de Maas1.72
Oude IJsselstreek1.14
Teylingen0.84
Utrechtse Heuvelrug1.05
Oost Gelre1.09
Koggenland1.06
Lansingerland1.16
Leudal2.06
Maasgouw1.67
Gemert-Bakel2.07
Halderberge1.15
Heeze-Leende1.13
Laarbeek2.24
Reusel-De Mierden1.00
Roerdalen1.36
Roosendaal0.95
Schouwen-Duiveland1.01
Aa en Hunze1.11
Borger-Odoorn1.00
Cuijk1.52
Landerd2.27
De Wolden1.29
Noord-Beveland0.82
Wijdemeren0.93
Noordenveld1.03
Twenterand0.78
Westerveld0.96
Sint Anthonis1.80
Lingewaard1.68
Cranendonck1.93
Steenwijkerland1.04
Moerdijk1.18
Echt-Susteren1.91
Sluis0.93
Drimmelen1.18
Bernheze2.92
Alphen-Chaam1.47
Bergeijk1.11
Bladel1.19
Gulpen-Wittem1.13
Tynaarlo0.92
Midden-Drenthe1.07
Overbetuwe1.10
Hof van Twente0.94
Neder-Betuwe1.36
Rijssen-Holten1.11
Geldrop-Mierlo1.28
Olst-Wijhe1.34
Dinkelland1.13
Westland1.23
Midden-Delfland1.04
Berkelland1.13
Bronckhorst1.31
Sittard-Geleen1.44
Kaag en Braassem1.30
Dantumadiel1.37
Zuidplas0.88
Peel en Maas2.67
Oldambt0.84
Zwartewaterland2.62
Súdwest-Fryslân1.14
Bodegraven-Reeuwijk1.13
Eijsden-Margraten1.86
Stichtse Vecht0.98
Hollands Kroon1.11
Leidschendam-Voorburg1.04
Goeree-Overflakkee1.64
Pijnacker-Nootdorp1.76
Nissewaard1.28
Krimpenerwaard1.24
De Fryske Marren1.01
Gooise Meren1.21
Berg en Dal1.08
Meierijstad2.98
Waadhoeke1.21
Westerwolde0.81
Midden-Groningen1.27
Beekdaelen1.81
Montferland0.95
Altena1.14
West Betuwe1.54
Vijfheerenlanden1.30
Hoeksche Waard1.25
Het Hogeland1.04
Westerkwartier0.99
Noardeast-Fryslân1.07
Molenlanden1.13
* provisional figures


In certain, mainly northern parts of the country, there was barely any elevated mortality compared to the period before the coronavirus epidemic outbreak. On the other hand, several other municipalities have had substantially lower levels of mortality during the coronavirus epidemic than in the weeks prior to the outbreak. Beemster had a total of 6 deaths over the period week 11-19 as against 13 deaths over the preceding nine weeks. Pekela recorded 14 deaths against 25 in the preceding weeks. Considerably fewer deaths were also recorded in Hendrik-Ido-Ambacht, Aalsmeer, Westvoorne, Wijk bij Duurstede, Ouder-Amstel, Loppersum, Oegstgeest and Twenterand.

Excess mortality, week 11 to 19 inclusive, 2020*
ProvinciesExcess mortality (%)
Groningen (PV)1
Friesland (PV)13
Drenthe (PV)8
Overijssel (PV)28
Flevoland (PV)16
Gelderland (PV)30
Utrecht (PV)27
Noord-Holland (PV)30
Zuid-Holland (PV)28
Zeeland (PV)8
Noord-Brabant (PV)55
Limburg (PV)62
* provisional figures

Elevated mortality during the coronavirus epidemic

The elevated mortality during weeks 11-19 inclusive coincides with the beginning of the COVID-19 epidemic in the Netherlands. The first confirmed COVID-19 patient in the Netherlands was reported on 27 February 2020. The first death involving COVID-19 was reported on 6 March 2020. The COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO) on 11 March 2020.

For the time being, this is the last news release reporting weekly mortality figures. The StatLine dataset and datasets under additional statistical services will continue to be updated on a weekly basis. The latest figures can also be found on the page ‘How many deaths are registered per week?

Data sources for CBS and RIVM

CBS receives mortality data on a daily basis from municipal registers. This is before it receives any information on the causes of these deaths. CBS receives such information by way of the death cause certificates which are completed by the physician who attended the deceased. The publication of data from death cause certificates is normally scheduled for Q3 2020, but CBS will make every effort to release this information at an earlier stage.
RIVM receives data on confirmed COVID-19 deaths from municipal health services (GGD) around the country on a daily basis. Since not all COVID-19 patients are tested, the actual number of COVID-19-related deaths in the Netherlands is expected to turn out higher. A more complete picture emerges by looking at the total weekly number of deaths as based on the data received by CBS, regardless of the cause of death.

Estimates based on death certificates received so far

In general, some time elapses between the actual date of death and the moment when this data reaches CBS. Death certificates are collected weekly on Thursdays. Usually, mortality data collected on Thursday include slightly over 80 percent of all deaths over the previous week. This information provides an indication of the number of deaths that can be expected for that week.
Based on the data obtained over weeks 12 through 20, death certificates are currently being received sooner than usual (as the number of certificates that was received after one week turned out to cover 85 percent of all deaths) with the exception of weeks with public holidays. The estimate for week 21 is based on the assumption that for this week as well, 85 percent has been received. As the percentage is uncertain, the actual number of deaths in week 21 may be higher or lower as a result.

Sources