How many people are dying in this pandemic?
The federal statistics agency will try to put a number on how many “extra” people are dying in Canada during the COVID-19 pandemic.
Statistics Canada spokesman Peter Frayne said the agency plans to release an analysis later this month on “excess deaths” — a measure of the number of deaths beyond what’s expected in the country even as COVID-19 is taking thousands of lives.
Epidemiologists say that examining the total number of deaths from any cause — and comparing that with historic averages — can offer a more complete picture of the pandemic’s impact since it can capture those people who have died from COVID-19 without being diagnosed, for instance, or those who have died while awaiting surgery.
Statistics Canada, Frayne said, will compare death rates in the first three months of 2020 with those in the first three months of 2019.
The release, planned for mid-May, is part of a larger effort to publish more timely information on deaths, Frayne said, in conjunction with provincial and territorial vital statistics offices.
Canadian epidemiologists welcomed news of the data release, which they say will provide a better understanding of COVID-19’s human toll.
Officially, the disease has claimed 4,567 lives in Canada.
University of Toronto epidemiologist David Fisman said excess-death data is critical information. “This is the ultimate metric of the impact of COVID-19,” he said, “and whether we make it better with these very costly measures we’ve taken.”
University of Ottawa professor Raywat Deonandan, an epidemiologist specializing in global health, said that right now Canadians only know about those people who have died from the disease after being diagnosed with it.
“But there may be people in the community — in fact there likely are — who are not being captured by this process,” he said.
It includes people who have died from what family members have attributed to flu or stroke, but could be linked to COVID -19. “One of the cleanest ways of accounting for those ‘missed’ deaths,” he added, “is to compare the number of deaths now to the same time period in previous years.”
Deonandan said information about excess deaths is also important in assessing the accuracy of pandemic models: “We can get a sense as to how wrong or how right our existing models were — and maybe improve them down the road.”
An analysis of excess deaths in Canada can help answer a number of questions: Are a significant number of people dying at home from COVID-19-related issues without being diagnosed?
What has been the effect of the dramatic drop in the number of people seeking help at emergency departments?
Is the mortality rate for other diseases on the rise? Have suicide rates increased?
In many provinces, including Ontario and Quebec, there is only anecdotal evidence about the broader death toll.
The Ottawa Citizen, for instance, has published 13 per cent more obituaries in April (863) than in March (761). In Montreal, a city hard hit by COVID-19, the Gazette has witnessed a 45-per-cent increase in the number of obits between March (606) and April (876).
The Gazette also saw a 38-percent jump in April’s obituaries compared with 2019. The Citizen experienced a 9.5-per-cent decrease year over year in the same month.
Dr. Rob Beanlands, head of the division of cardiology at the University of Ottawa Heart Institute, said emergency room visits across the city have fallen by as much as 50 per cent during the pandemic. Meanwhile, the number of people coming to the hospital with major heart attacks has also decreased by as much as 30 per cent.
There are several possible explanations for those numbers, he said, one of which is that people are not seeking timely medical attention.
“We have observed, anecdotally, people presenting late in the course of their cardiovascular illness,” he said. “So instead of calling 911 after 20 or 30 minutes of pain, they’re waiting a longer period of time.”
Beanlands said the heart institute is concerned that people fear coming to the hospital because of COVID-19. But he stressed that anyone with severe symptoms should call 911, while others concerned by their symptoms should contact their family doctor or specialist.
Many physicians, he said, are offering virtual visits, and the heart institute has taken significant measures to protect against COVID-19.
“People can get the attention they need,” he said.
In Europe, weekly mortality statistics are provided by 24 countries and analyzed by a network of epidemiologists. That network estimates that the pandemic has caused 149,447 excess deaths.
Similar data is published in the United States by the Centers for Disease Control and Prevention. A New York Times analysis found that in New York City, the epicentre of the U.S. outbreak, the death count has surged to six times the normal number.
In Canada, the only national death statistics date to 2018, when 283,706 people died.
British Columbia has been among the only provinces to publish information on “all cause” mortality during the pandemic. It reported earlier this week that there were 170 “excess deaths” in March and April — a 2.7-per-cent increase in historical death levels for the two-month period.
Of those deaths, 111 have been attributed to COVID-19. But the provincial health officer, Dr. Bonnie Henry, said officials want to analyze the cases to understand if postponing surgeries led to any of the deaths not attributed to the virus.
“That helps inform us for our response for the next wave, if we have another one, or for the next pandemic,” Henry told reporters.
Deonandan noted that any analysis of excess-death numbers during the pandemic should consider the fact that traffic fatalities have likely declined since so many people are staying home. aduffy@postmedia.com
We can get a sense as to how wrong or how right our existing models were — and maybe improve them down the road.