At least 2,200 ‘excess deaths’ due to virus
StatsCan numbers from three provinces give estimate of true toll
A deeper look at the number of Canadians dying from all causes during the COVID-19 pandemic shows British Columbia, Alberta and Quebec suffered more than 2,200 excess deaths when compared to five-year historical maximums, according to an updated Statistics Canada report released Friday.
Excess deaths are defined by StatsCan as the number of deaths that are more than expected during a specific period of time when considering past trends. Friday’s report covers the first 18 weeks of 2020, ending May 2, and covers 11 provinces and territories.
While provinces currently report the number of deaths directly attributable to the new coronavirus, the measure of excess deaths is important because it provides a glimpse of the number of people who may also have died as an indirect result of the pandemic.
Epidemiologist Raywat Deonandan, a University of Ottawa associate professor in the school of health sciences, said while confirmed COVID-19 death counts are made public, “there are likely people who have died of the disease whom we don’t know about.”
“So ‘excess deaths’ is the best — though clearly not perfect — way we have of estimating the true mortal toll of this disease,” Deonandan continued. “It is a useful statistic because it allows us to calculate a more accurate lethality rate, which in turn allows us to better understand how serious this disease is.”
Ontario — the second-hardest hit province behind Quebec, with more than 2,600 COVID-19 related deaths — was excluded from the StatsCan report which compares mortality rates for all causes of death, including COVID-19. Yukon was not included in the report either.
According to the StatsCan analysis, for eight of the 11 reporting provinces and territories — Newfoundland and Labrador, Prince Edward Island, Nova Scotia, New Brunswick, Manitoba, Saskatchewan, the Northwest Territories and Nunavut — there was no clear evidence of excess mortality over the first 18 weeks of 2020.
“That is to say that the number of reported weekly deaths, in those jurisdictions, is within the range of previous annual figures,” StatsCan stated.
Friday’s analysis notes that “while excess mortality can be examined in various ways, this analysis focuses on instances where the number of people who died in a given week in 2020 was higher than the number of deaths for that same week in each of the five previous years.”
“Beyond deaths attributed to the virus itself, the pandemic may result in increased deaths from other causes,” the report notes. “It is also important to note that not all excess deaths can necessarily be attributed to the pandemic, directly or indirectly, as other factors could also be at play including changes in population composition.”
The analysis shows that there were 372 more deaths between March 15 and April 25 in B.C. than in any of the previous five years for those same weeks. There were 99 reported COVID-19 deaths during this time.
In Alberta, the number of deaths were higher than the five-year historical maximum by 402 in the seven-week period beginning Feb. 23. The report notes that during this period, there were 40 reported deaths due to COVID-19, “suggesting that other factors, such as changes in population composition or increases in other causes of death, likely explain the higher number of observed deaths over this period.”
In Quebec, there were 1,472 more deaths in the six-week period beginning March 22 than in the same period in any of the previous five years. During this same period, Quebec reported 2,132 COVID-19 deaths.
Todd Coleman, an epidemiologist and assistant professor in health sciences at Wilfrid Laurier University, said he believes the excess deaths in Quebec could reflect the movement of the virus through long-termcare homes.
More than 3,600 people in public long-term-care facilities in that province have died from COVID-19.
“The excess deaths altogether and using the five-year averages do lead us to conclude there is some external or out-of-the-ordinary factor, such as COVID, having an impact,” said Coleman, who qualified his comments by saying further indepth study of the causes of death is needed.
“Especially for such a large geographic area, you want to make sure you look at all the extraneous circumstances that might lead to an excess.
He added that while not all the excess deaths captured in the data may be due to COVID-19, the virus could also have had indirect effects. “How many of the excess deaths are due to the avoidance of health care or a delay of important surgeries, heart surgeries for example? Or a delay of cancer treatments?”
The StatsCan report comes a day after Toronto’s medical officer of health, Dr. Eileen de Villa, announced that 1,000 city residents have died from COVID-19. Since the city’s first death on March 21, more than 10 people a day on average have died from the virus. More than 100,000 people have been infected by COVID-19 and more than 8,300 people have died of the virus in Canada.
Estimates based on StatsCan data put the number of daily COVID-19 deaths in Toronto in perspective.
Heart disease, the second biggest killer in the city since at least 2014, is fatal for about 10 people daily. Cancer kills approximately 16 people a day in Toronto and roughly three people succumb daily from accidents and strokes.
That means, based on the StatsCan estimates, it would take roughly two months for cancer to kill 1,000 Torontonians and about three months for heart disease and COVID-19 to tally 1,000 deaths each. Meanwhile, it would take nearly a full year for accidents and strokes to take 1,000 lives.
Colin Furness, an infection control epidemiologist at the University of Toronto, said the true scope of COVID-19’s fatal impact is becoming more sharply defined.
“We’re finally detecting excess deaths in Canada, attributable to COVID,” Furness said after reading Friday’s StatsCan report. “The Ontario tally will probably add to that quite a bit, but it may take until next year for Ontario to report its mortality statistics. Only then will we really know how bad COVID is.”
Until last month, StatsCan did not publish interim mortality data. In general, there is a reporting lag of a calendar year for provinces and territories to submit their official all-cause death registration totals to the federal agency tasked with collecting and reporting the national data. For instance, it may take up to a year to officially register a death in Ontario.
StatsCan spokesperson Peter Frayne said the agency “was working with provinces and territories to accelerate publication of the mortality data.”