Since the 2009 flu epidemic, RIVM National Institute for Public Health and the Environment has been monitoring weekly deaths in consultation with Statistics Netherlands (CBS).  The aim of monitoring mortality figures is to assess the impact of unusual circumstances on the number of people who died – for example due to a heat wave, a wave of seasonal influenza, or the current COVID-19 epidemic. Looking at mortality statistics for previous years, there have been peaks in total mortality during cold snaps, heat waves and outbreaks of infectious disease, such as the flu. Since February 2020, the figures show excess mortality due to the COVID-19 epidemic. Excess mortality means that more people have died in a specific period than would be expected from the number of deaths in the same period in previous years. 

Current situation

The total mortality rate in the Netherlands was not elevated in the week of 25 February to 3 March 2021 (deaths reported within two weeks – about 97% reported). A total of 3,059 deaths were reported in that period; we would normally expect to see between 2,820 and 3,147 deaths at this time of year. There were 228 reported deaths from laboratory-confirmed COVID-19 that week. Mortality was still elevated in the combined region of Groningen/Friesland/Drenthe.

At present, the Netherlands is in a second wave of the COVID-19 epidemic, with significantly elevated mortality from the week of 1 to 7 October 2020 (week 40/41) to last week, 24 February 2021. Total mortality during that period is estimated at 12,727 deaths (based on deaths reported within 2 weeks).

Other trends

There was a heat wave in the Netherlands from 5 to 17 August 2020.

In de week van 25 februari tot en met 3 maart 2021 was de totale sterfte in Nederland niet verhoogd (sterfte binnen 2 weken gerapporteerd - rondom 97% gerapporteerd). In totaal zijn 3.059 sterfgevallen gemeld; gewoonlijk verwachten we in deze tijd van het jaar tussen de 2.820 en 3.147 sterfgevallen.

Figure. Mortality in the Netherlands reported within 2 weeks (all ages and regions combined)

The different lines on the chart can be explained as follows:

  • Black line: mortality up to 3 March 2021, reported within two weeks.
  • Decreased mortality: mortality is below the lowest grey line.
  • Elevated mortality: mortality is above the highest grey line.

The deaths are reported by the municipalities to Statistics Netherlands (CBS). About 97% of all deaths are reported to Statistics Netherlands within two weeks. Cause of death is not yet known when this weekly update is published.

Frequently asked questions

Why do the excess mortality figures published by Statistics Netherlands (CBS) sometimes differ from the figures published by RIVM National Institute for Public Health and the Environment
The method used by RIVM to estimate mortality is slightly different than the method used by Statistics Netherlands. Statistics Netherlands estimates excess mortality based on the average mortality per week in recent years, including increased mortality during unusual circumstances, such as a wave of seasonal influenza, or a heat wave. RIVM does not include the peaks during unusual circumstances in its calculations of average weekly mortality. The height of the peaks is determined by the severity and duration of the flu season. It is not the same every year. Therefore, the excess mortality varies from year to year. Expected mortality according to RIVM’s calculations is therefore lower than that of Statistics Netherlands during the winter season, when flu is normally prevalent. The excess mortality estimates provided by Statistics Netherlands and RIVM complement each other.  

What is excess mortality?
Statistics Netherlands (CBS) monitors how many people die in the Netherlands. By looking at deaths in previous years, it is possible to estimate the expected number of people who will die in a given period. If more people die than estimated for that period, it is referred to as excess mortality. Excess mortality is a temporary, exceptional increase in the number of people dying in the Netherlands. This often coincides with unusual circumstances, such as a flu epidemic, a heat wave, or the current COVID-19 epidemic. 

Why is excess mortality being monitored?
Higher mortality in the short term could be coincidental.  To find out if there is more going on than the usual short-term fluctuations in mortality, Statistics Netherlands (CBS) and RIVM compare actual mortality in a certain period with the expected mortality in that period. If that comparison reveals excess mortality, meaning that more people are dying than expected, something unusual may be happening. That is important information. 

Who monitors mortality in the Netherlands? 
Statistics Netherlands (CBS) has been keeping track of the number of deaths in the Netherlands and estimating the expected excess mortality since 1901. The 2009 flu season saw a major wave of seasonal influenza. At that time, RIVM launched the mortality monitor based on the data provided by Statistics Netherlands.  Both Statistics Netherlands and RIVM use the same data on deaths to determine excess mortality.

How do we know how many people have died from COVID-19?
We do not know that for certain until all the 
cause-of-death certificates in a certain period have been processed by Statistics Netherlands (CBS). These certificates are completed by the attending physician and then sent to Statistics Netherlands by the municipality. They are processed anonymously.

Was the excess mortality in 2020 entirely due to COVID-19? 
Statistics Netherlands (CBS) has noted the cause of death for all deaths in the first eleven months of 2020. The cause of death is recorded by the attending physician. If the coronavirus SARS-CoV-2 played a crucial role in the patient’s death, as assessed by the physician, then COVID-19 is recorded as the cause of death. The data shows that the elevated mortality rate until 1 December 2020 was due to COVID-19, with the exception of elevated mortality during the heat wave in August 2020. 

Is someone who died of something else, but happened to have a coronavirus infection, also counted as a COVID-19 death?
No, Statistics Netherlands (CBS) only counts a person who died as a COVID-19 death if the attending physician recorded COVID-19 as the “immediate cause of death”. A person who died after a car accident and also happened to test positive for COVID-19 is not counted as a COVID-19 death. 

How many people have died of COVID-19 during the second coronavirus wave?
We do not know yet. The final figure will not be available until Statistics Netherlands (CBS) has processed all the cause-of-death forms.