Breaking down the number of deaths
Figures show mortality from outbreak equal to all deaths during normal times
Close to as many Quebec nursing home residents died from COVID -19 in the past two months as would have died of all causes combined during the same period under ordinary circumstances.
In fact, taking only the 130 longterm care facilities that have been hit with COVID -19, the number of residents who have died from the illness is double the number that would have died in those institutions during the same period without the pandemic.
The Montreal Gazette calculated the stark toll of the new coronavirus on the province’s long-term care facilities by examining the government’s COVID-19 figures, year-over-year mortality rates and studies indicating the average length of stay in nursing homes.
The province counts just over 400 public and private long-term care facilities, known as Centres d’hébergement et de soins de longue durée, or CHSLDS, with 40,101 beds. The 130 CHSLDS that have COVID-19 deaths or active cases represent one-third of the network and offer about 15,550 beds.
The latest data from the Institut national de santé publique related to the pandemic show that 2,442 residents have died from COVID-19 in about the past two months.
They are in 130 CHSLDS, which currently count 2,056 active cases, according to the government’s bulletin on the situation in CHSLDS.
Without COVID -19, the number of deaths that would be expected in the 130 CHSLDS during the same two-month period would be about 1,150.
That estimate is based on a December 2017 report by Quebec’s Commissaire à la santé et au bien-être, which showed that an average length of stay in a CHSLD was two years and three months. The duration had dropped as the proportion of CHSLD residents aged 90 and older had grown more than any other age group.
The Quebec figure jibes with a British study that found a two-year length of stay in nursing homes, said José Morais, chief of geriatric medicine at Mcgill University.
So, with about 15,550 residents in the 130 CHSLDS and a little over a two-year stay expectancy, it’s fair to estimate that a little less than half of the residents would die in a single year, he said. Dividing the expected number of deaths in a year by 12 then provides an estimate for the number of deaths per month.
The 2,442 COVID-19 deaths in the 130 CHSLDS is high even across the province’s entire CHSLD network. Calculating the average length of stay of two years and three months for the 40,000 residents in Quebec CHSLDS, about 2,970 deaths would be expected from all causes combined in a two-month period without the pandemic.
“It’s a big price to pay,” Morais said of the 2,442 COVID -19 deaths in CHSLDS.
“And we don’t know about those who have died without (having) COVID -19.”
Indeed, the government doesn’t provide figures for NON-COVID -19 fatalities in CHSLDS or deaths indirectly related to COVID-19 in those institutions, such as deaths resulting from a lack of care, dehydration and malnutrition in residences that had major staff shortages.
The case of Résidence Herron, a privately owned CHSLD in Dorval, shows that the total number of deaths in CHSLDS could greatly exceed the government’s COVID -19 tally.
The government’s latest bulletin shows 22 deaths from COVID -19 at Herron.
However, the Quebec coroner’s office said this week that 51 deaths have occurred at the residence since the pandemic began. The coroner’s office is investigating the causes and circumstances of each of those deaths.
“Excess mortality” in CHSLDS, involving “people who might have died from other causes but that might be linked to COVID,” will be the subject of studies to come, Quebec health department spokesperson Marie-claude Lacasse said in an email on Friday.
Even if the 3,865 COVID-19 deaths in the province as of Friday are concentrated among seniors and in CHSLDS, the number is high enough to have caused a spike in the overall number of deaths — from all causes and for all age groups — registered in the province, according to new figures released by the Institut de la statistique du Québec on Thursday.
The number of weekly deaths across the province started to spike during the week of March 23, the figures show.
The province registered 1,460 deaths that week, 15 per cent more than the 1,270 deaths recorded during the same week of 2019.
The gap in the number of deaths this year compared with last year has grown every week since then.
During the week of April 20, the last week for which data is available so far, the province registered 1,965 deaths, a 51.2 per cent increase over the 1,300 deaths recorded during the same week of 2019.
By age group, there were 1,560 deaths among people aged 70 and over during the week of April 20, a nearly 60 per cent increase over the same period a year ago.
From the week of March 23 to the week of April 20, 6,595 people over the age of 70 died in Quebec of all causes combined, compared with 5,040 deaths during the same period in 2019.
The data doesn’t provide the number of deaths from all causes in CHSLDS.
It’s a big price to pay. And we don’t know about those who have died without (having) COVID-19.