The impact of COVID-19 on Forensic Pathology Services in Antwerp, Belgium - Perspectives of Forensic Pathologists

The COVID-19 pandemic, which reached Belgium in early 2020, significantly impacted the country's healthcare system, including forensic medicine. Illustrating the knowledge vacuum the medical world was working in, the first ten patients arriving in Belgium were hospitalized in a police-secured medical facility. By 2021, Belgium was among the most severely affected countries in Europe, reporting over 730,000 cases and more than 21,000 COVID-19-related deaths. In response to these unprecedented challenges, forensic medicine implemented critical reforms to enhance operational safety and maintain service continuity during the crisis. The pandemic altered practices by intensifying morgue-based examinations and relying on postmortem CT (PMCT) scans as an initial screening method. Autopsy protocols were revised to incorporate protective measures and collaboration between forensic and anatomical pathology departments. Despite a surge in domestic violence and mental health issues during the pandemic, there was no corresponding increase in forensic cases. Through close interdepartmental collaboration, forensic services maintained pre-pandemic autopsy rates, contributing valuable insights into COVID-19 pathology and strengthening future preparedness. Lessons learned emphasize the importance of resilient forensic systems in addressing public health crises and enhancing the role of forensic medicine within healthcare.