The COVID-19 pandemic has caused more deaths in Canada’s four most populous provinces than those resulting from infections of the virus, suggests new data from Statistics Canada.
The data, released Friday, shows overall that there were 386 more deaths in British Columbia in a six-week period beginning in mid-March than the highest number of deaths reported in those same weeks in the past five years. During those six weeks in 2020, 99 deaths were attributed to COVID-19 in B.C.
That means there’s no official explanation for nearly 75 per cent of the deaths that led to this year’s surge in mortality data — and, experts say, it opens up a lot of questions about the true toll of the pandemic.
The death gap — which falls between higher than expected death counts and confirmed COVID-19 cases — has been discussed around the world as public health officials and epidemiologists try to wrangle the coronavirus’s full impact.
Friday’s StatCan data, while still preliminary and far from complete, especially in Ontario and Quebec, helps paint a picture of that gap across Canada.
Raywat Deonandan, an associate professor and epidemiologist at the University of Ottawa, says it’s fair to say that a large portion of excess deaths not directly attributable to COVID-19 are still related to it.
The causes could cover a wide range, including domestic violence and delayed medical procedures. It could be months before that information is available.
“If we didn’t know the pandemic had happened and we saw these numbers, we’d say what happened this year? What horrible thing happened?” Deonandan said. “Well, that’s what it is. This horrible thing happened.”
Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto’s Faculty of Information, echoed that.
“When we see this very predictable death rate and then all of a sudden there’s this bunch of extra deaths, we want to attribute it to something,” he said. “We can attribute it to all kinds of things that are out of the ordinary, and obviously there’s one big thing that’s out of the ordinary and that is going to be COVID.”
The death gap is based on what StatCan calls excess deaths — the number of deaths that are more than expected or typical during a time period when past trends are taken into account — with official COVID-19 counts removed.
StatCan’s preliminary count of the weekly excess mortality since the pandemic began reveals that B.C., Alberta, Ontario and Quebec combined had more than 4,500 excess deaths between March and June of this year when compared to five-year historical maximums. There was no clear evidence of excess deaths in other provinces and territories.
In Alberta, the data shows that from the last week of February to the first week of May, with the exception of two weeks, there were 639 more deaths than the highest number recorded in the same period in the last five years. Over this 15-week period, 146 of those deaths were due to COVID-19, leaving 493 — or 77 per cent — with no official cause.
Stephanie Willbond, an analyst with StatCan’s Centre for Population Health Data, said that even though the data suggest COVID-19 could explain only about a quarter of those excess deaths, there are limitations to drawing conclusions because the information is provisional.
“It’s not cut and dry saying COVID-19 was responsible for this amount of excess deaths because we don’t know exactly what’s happening with the other causes of death,” she said.
StatCan notes in its report that this “suggests that some of the excess mortality observed during the pandemic period could reflect other factors, such as changes in population composition or increases in the number of deaths due to other causes.”
In Quebec, excess deaths were observed for 10 straight weeks beginning at the end of March, with 3,384 more deaths during this time period when compared to the same weeks in any of the previous five years. At the same time, however, there were 4,435 deaths attributed to COVID-19 in the province, meaning it is not possible to calculate the death gap, at least not yet.
Willbond said the lower excess death figure could be a result of a decrease in deaths caused by things other than COVID-19, or the agency has not received full provisional death counts from the province.
“So will that 3,000 number increase next month or the month after when we produce our monthly updates? That’s also very possible,” she said.
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In Ontario, StatCan says data for the province are less complete for April and May than those of other provinces, but the agency noted that there were 126 excess deaths between April 5 and 18 compared to the highest number of deaths for the same time period in the past five years. There was a significant decline in the number of deaths starting in mid-April, which the agency says is consistent with reporting delays.
In a statement to the Star, Ontario’s Ministry of Government and Consumer Services said that, since the beginning of the pandemic, “we have improved the quality and timeliness of Ontario’s death registration data. And, as of July, Statistics Canada is including Ontario’s preliminary death registration data in their monthly reporting.”
Deonandan said some COVID-19 deaths may not be captured in the excess death numbers because of a lack of testing of people who died at long-term-care homes or at home in the community.
“It’s a bigger problem in the U.S. where there’s a financial disincentive from encountering the health-care system,” he said, but noted that it’s still a problem here, especially among the elderly who may have been thought to be dying of other causes and weren’t thoroughly investigated.
StatCan said that the excess deaths observed up to now seem to disproportionately affect people over 85.
“Excess deaths as a measure are important to understand whether something unusual is happening,” said Todd Coleman, an epidemiologist and assistant professor in health sciences at Wilfrid Laurier University. “I think there’s still a lot more work to be done, but it’s clear that something is happening. Really, if you’re trying to point to the very obvious thing that’s resulted in a lot more deaths that just didn’t happen previously, it is very possibly COVID-19 related.”