COVID-19 impact

1. Key messages

The COVID-19 health surveys collected a variety of information in order to assess how the Belgian population experienced the coronavirus crisis in 2020 and 2021:

  • Anxiety and depression disorders were high in the population in 2020 and 2021, particularly among youngsters (18-29 years old). One third of the population expressed a low life satisfaction in December 2020 and March 2021.
  • Suicidal thoughts and suicide attempts have increased in the population. One out of 4 young people (18-29 years old) reported having seriously considered suicide during the last 12 months.
  • Poor social support was reported by an increasing share of the population.
  • The compliance with the measures imposed by the government to reduce the spread of the epidemic varied along the year. In March 2021, the lack of compliance for some measures ranged between 50% for having only one close social contact (outside the household) and 3% for not respecting the ban on non-essential travel.
  • Lockdowns impacted the access to healthcare and home care, but the impact was much smaller during the second lockdown.
  • Around 20% of the population saw their financial situation worsening during the crisis; around 10% of the population worried that they would lack food before being able to buy more.

2. Background

In Belgium, restrictive measures have been put in place by the National Security Council since 13 March 2020 with the objective to stem the spread of the coronavirus within the population. Beside the direct impact of the COVID-19 epidemic on the health of the population, these restrictive measures also have indirect consequences on the health and lifestyles of citizens.

In order to capture some consequences of this crisis Sciensano organized online surveys at regular time intervals. In total, six surveys took place between April 2020 and March 2021 with the number of participants varying between
44 000 for the first survey and 20 410 for the sixth survey. Each survey included some core modules; mental and social wellbeing, compliance with the restrictive measures put in place, and COVID-19 infections. Besides, every edition included some additional modules (e.g. impact on lifestyles, attitudes towards vaccination…). To assess the impact of the crisis, some results were compared to the results of the Health Interview Survey (HIS) 2018. HIS surveys give a representative image of the health status of the Belgian population under “normal” circumstances.

The COVID-19 surveys were announced through the websites of Sciensano and some other organizations (health insurance funds, community centers…), through the press and through social media. People were asked to forward the invitation to their personal networks (“snowball principle”). The samples of respondents to the COVID-19 surveys are not representative of the Belgian population: Flemish residents, women, and people with a higher education level are overrepresented, while Walloon residents, men, younger people, and people with at most a degree of secondary education are underrepresented. To reduce this bias, the results are weighted to represent the age, gender, and province distribution of the country. Since the 3rd survey also the distribution of the education level was taken into account in the weighting.

The full set of results can be found in the different survey reports. On this page, you will find an overview of the topics covered by the six surveys and links to the results. Then, we highlighted some indicators which seem to reveal issues in the mental or social wellbeing, indicators related to the compliance with the restrictive measures, and indicators related to the impact of coronavirus crisis on the access to care and on the financial situation.

3. Overview

TopicsSurvey 1Survey 2Survey 3Survey 4Survey 5Survey 6
02-09/04 2020 16-23/04 2020 28/05-05/06 2020 24/09-02/10 2020 03-11/12 2020 18-25/03 2021
First wave First wave End of first wave Start of second wave Second wave Second wave
First strict lockdown First strict lockdown Progressive relaxation of first lockdown Gradual return of restrictions Second lockdown Second lockdown
Knowledge and compliance with restriction measures X X X X X X
COVID-19 infections X X X X X X
Accessibility to health care X       X  
Social health X X X X X X
Mental health X X X X X X
Work and income   X X X   X
Physical activity   X       X
Nutritional status and habits   X       X
Alcohol, tobacco, sedatives, and drugs consumption   X     X X
Domestic violence   X       X
Financial situation     X      
Food security     X   X  
COVID-19, present and future     X      
Impact of COVID-19 crisis on diabetic people       X    
Vaccination       X X X
Contact tracing       X    
Health literacy related to COVID-19       X    
Confidence in institutions and sources of information       X X  
Impact of the COVID-19 crisis on different domains of life       X   X
Financial accessibility to health care         X  
Health-related quality of life           X
Frailty among older people           X

4. Mental health

Studies abroad have well documented the negative consequences of the COVID-19 crisis on the mental health of the population. The COVID-19 health surveys have monitored the mental health of the Belgian population through 2020 and 2021.

Anxiety and depressive disorders

Prevalence of anxiety and depression disorders in the population seem to follow the strictness of the measures put in place, with higher prevalence rates in April and December 2020 and in March 2021 than in the summer. More people reported anxiety problems (between 16% and 23%) during the pandemic than in 2018 (11%). Depression was also more prevalent (between 14% and 22%) than in 2018 (9.5%).

More information about anxiety and depression in the previous years can be found on the page 'Anxiety and depression'.

Percentage of the population aged 18 and over presenting anxiety or depression in the COVID-19 health surveys 2020-2021 compared to the health interview survey 2018, Belgium, 2021
Source: COVID-19 health surveys and HIS 2018, Sciensano [1,3-7]

Women are more likely to present anxiety disorders than men. In both genders, anxiety and depressive disorders were more prevalent among the youngest age group (18-29 years old). For anxiety disorders, the prevalence reported in March did not show improvements compared to December where the prevalence was the highest recorded, particularly in the youngest age group. This shows that the COVID-19 crisis has a particularly heavy impact on the mental health of young people, with a worsening over time.

  • Men
  • Women

Percentage of men aged 18 and over presenting anxiety disorders, by age group, Belgium, 2021
Source: COVID-19 health surveys, Sciensano [1,3-6]

Percentage of women aged 18 and over presenting anxiety disorders, by age group, Belgium, 2021
Source: COVID-19 health surveys, Sciensano [1,3-6]

  • Men
  • Women

Percentage of men aged 18 and over presenting depressive disorders, by age group, Belgium, 2021
Source: COVID-19 health surveys, Sciensano [1,3-6]

Percentage of women aged 18 and over presenting depressive disorders, by age group, Belgium, 2021
Source: COVID-19 health surveys, Sciensano [1,3-6]

Life satisfaction

Life satisfaction is a subjective evaluation of one’s life as a whole. In the HIS 2018, 12% of the population reported low life satisfaction. This percentage raised to 22% in September 2020 and to 32% in December 2020 and March 2021.

Percentage of the population aged 18 and over with low life satisfaction in the COVID-19 health surveys 2020-2021 compared to the health interview survey 2018, Belgium, 2021
Source: COVID-19 health surveys and HIS 2018, Sciensano [4-7]

Suicidal thoughts and attempts

12.5% of the respondents to the 6th survey reported to have seriously considered suicide in the last 12 months (April 2020 to March 2021). Among young people (18-29 years), this percentage rises to 25%. In comparison, only 4.3% of respondents to the HIS 2018 reported considering suicide in the last 12 months.

0.6% of the respondents reported having attempted suicide in the last 12 months (April 2020 to March 2021). Among young people (18-29 years), this percentage rises to 2.3% for men and 1.1% for women. In comparison, only 0.2% of respondents to the HIS 2018 reported having attempted suicide in the last 12 months.

  • Men
  • Women

Percentage of men aged 18 and over having had suicidal thoughts or having attempted to commit suicide in the last 12 months, by age group, Belgium, 2021
Source: COVID-19 health surveys, Sciensano [6]

Percentage of women aged 18 and over having had suicidal thoughts or having attempted to commit suicide in the last 12 months, by age group, Belgium, 2021
Source: COVID-19 health surveys, Sciensano [6]

5. Social health

Quality of social contacts and social support is important to cope with unstable situations and health issues. The perceived quality of social support has been monitored since the beginning of the epidemic. Twice more people reported low social support in 2020 (between 30% to 40%) compared to 2018 (16%). This number only slightly decrease in March 2021 and stayed at a high level (38%).

Percentage of the population aged 18 and over reporting low social support in the COVID-19 health surveys 2020-2021, compared to the health interview survey 2018, Belgium, 2021
Source: COVID-19 health surveys and HIS 2018, Sciensano [1-7]

6. Compliance with containment measures

The compliance of measures reflects the compliance of the citizen with the political decisions. Non-compliance can have different reasons: lack of confidence in policymakers or specific policies, different priority order, the perception that being cautious is enough, need of social contacts, etc.

In March 2021, the part of respondents reporting not strictly complying with the measures increased compared to December 2020. 1 in 2 people reported not limiting its close contacts to one person and 40% reported not social distancing. Wearing a mask when mandatory and the ban on non-essential travel were the most followed measures.

Percentage of the population aged 18 and over reporting not strictly complying with the measures in place, Belgium, 2021
Source: COVID-19 health surveys, Sciensano [1-6]
*Survey 3 organized in June: formulated as 'covering mouth and nose in public transports' (also mandatory at the time)

7. Access to health care and home care

Lockdown measures and fear of the virus have reduced contacts with healthcare professionals for problems not linked to COVID-19. These delays in receiving adequate healthcare can have a negative impact on the health status of the Belgian population.

During the first lockdown, the percentage of people with a canceled or postponed medical appointment ranged between 90% for rehabilitation appointments and 25% for GP appointments. The second lockdown had a lower impact on access to care due to efforts made to keep healthcare accessible to everybody. The percentage of people with a canceled or postponed medical appointment ranged between 30% for medical-technical treatment appointments and 4% for GP appointments.

It should be noted that we do not know the source of the appointment’s cancellations, it could be from the patient or from the healthcare provider.

Percentage of the population aged 18 and over having canceled or postponed appointments with care providers during the last 4 weeks (for care not linked to COVID-19), Belgium, 2020
Source: COVID-19 health surveys, Sciensano [1,5]

The measures also have an impact on access to home care. During the first lockdown, 49% of the people saw their elderly care assistance stopped and 15% saw it reduced. For 28 % of people, the assistance of a home nurse stopped, and for 15% of people it reduced.

During the second lockdown, fewer people reported a cessation in the assistance they usually receive (elderly care assistance stopped for 9% of people and home nurse assistance for 11%), but more people reported a reduction in the assistance (32% and 16% of people respectively for elderly care assistance and home nurse).

Percentage of the population for which home assistance stopped or reduced during the last 4 weeks among the population aged 18 and over who usually have assistance, Belgium, 2020
Source: COVID-19 health surveys, Sciensano [1,5]

15% of people aged 18 and over indicated that because of financial problems, they had to postpone their medical care, dental care, purchase of (prescribed) medication, purchase of glasses and/or mental health care during the COVID-19 crisis. This percentage is higher than the rate reported in the HIS 2018 (9% with a one-year reference period).

8. Financial situation

Research has documented the negative impact of the COVID-19 crisis on people’s economic situation. Using the COVID-19 health surveys, the change in the financial situation during the crisis was examined for the Belgian population.

In June, 22% of people indicated that the financial situation of their household was worse than 3 months ago. This rate was highest among single-parent families (one-third of them) and among couples with children (one-quarter of them).

Percentage of the population aged 18 and over reporting worse financial situation than 3 months ago, by household type, Belgium, June 2020
Source: COVID-19 health surveys, Sciensano [3]

Food security was investigated in June and December and captured: the fear of lacking food, the effective lack of food, and the difficulty/impossibility to afford healthy balanced meals. Between 10% and 12% of people reported that they could not afford to eat healthy balanced meals or that they worried that food would run out before being able to buy food again. 5% of people in June and 6% in December reported that they ran out of food before being able to buy food again during the 3 last months.

Percentage of the population aged 18 and over who, during the COVID-19 crisis, often or sometimes worried that food would run out, actually run out of food, or could not afford to eat healthy balanced meals, Belgium, 2020
Source: COVID-19 health surveys, Sciensano [3,5]

9. Read more

COVID-19 epidemiological situation
HISIA: Interactive Analysis of the Belgian Health Interview Survey

If you are in distress or in need of emotional/psychological support, do not hesitate to call 02 648 40 14 for the community help service helpline, or visit the Community Help Service online.

References

  1. Première enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/50. Brussels: Sciensano; 2020. doi: 10.25608/ydnc-dk63
  2. Deuxième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/52. Brussels: Sciensano; 2020. doi: 10.25608/rkna-ee65
  3. Troisième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/54. Brussels: Sciensano; 2020. doi: 10.25608/xkg3-xz50
  4. Quatrième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/80. Brussels: Sciensano; 2020. doi: 10.25608/jmgf-2028
  5. Cinquième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/96. Brussels: Sciensano; 2020. doi: 10.25608/xcxd-7784
  6. Sixième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2021/14.440/30. Brussels: Sciensano; 2021. doi: 10.25608/j877-kf56
  7. Health Interview Survey, Sciensano, 2018. https://his.wiv-isp.be/