Pandemic and its effects killed far more than originally thought

Difficult to pinpoint just one factor causing excess deaths, study author says

There has been a nearly 13 per cent increase in deaths in Ontario during the COVID-19 pandemic in 2020, with a significant proportion of those excess deaths due to causes other than the SARS-CoV-2 virus, according to cremation data obtained and analyzed by Ontario’s Science Advisory Table.

Nearly 81,000 people were cremated in 2020 compared to a yearly average of 71,625 from 2017 to 2019.

The pandemic “has influenced so many aspects of our (lives),” that it’s difficult to pinpoint one factor causing the excess deaths, said Gemma Postill, the study’s lead author.

Ontario began categorizing cremation records electronically in 2017, allowing Postill to search the database for any deaths mentioning COVID-19.

When researchers removed deaths caused by the virus, they found that the overall number of weekly deaths from January to December 2020 had increased by 12.8 per cent among those who were cremated.

The cremation data also shows that from March to May 2020, during the first wave, more than 50 per cent of the 3,505 excess deaths were the result of non-COVID illnesses, which the study suggests could be related to under-diagnosed cases of the virus.

But from August to December 2020, in the early part of the second wave when there was more frequent testing, nonCOVID deaths accounted for about 70 per cent of the 3,812 excess deaths during that time period.

More recently, about a quarter of excess deaths from January to March of this year were attributable to causes other than COVID-19, according to the report.

During that time period, 21,379 people were cremated compared to the 19,000 or so cremations that are typical for January to March in the base years.

Postill pointed to new research showing a large jump in Ontario’s monthly opioid-related deaths as just one cause for the increase in deaths.

The excess deaths could also reflect the impact of delays in cancer and cardiac care, according to the report.

In some months, the data also showed there were noticeable increases in certain age groups.

In April and May of 2020, noted Postill, a rise in deaths among those 85 and over could be attributed to the outbreaks in Ontario’s long-term-care facilities.

The study also found that, during both waves of the pandemic, people aged 65 and older, represented the largest proportion of the excess deaths, with the youngest age group, those 44 years and younger, accounting for the biggest increase in excess deaths compared to the pre-pandemic data.

To measure the increase, the study, published by the advisory panel Wednesday, compared the number of weekly cremations during 2020 to a baseline average of weekly cremation data from 2017 to 2019.

As 70 per cent of Ontarians choose to be cremated, and the vast majority of cremations happen within three weeks of a death, the study authors opted to use the data, because it provides immediate insight into mortality rates, explained Postill.

Burial practices didn’t change during the pandemic.

Postill said the study is based on Statistics Canada’s preliminary mortality data for the first wave of the pandemic, which showed the percentage of Ontarians being cremated “stayed remarkably stable through the pandemic, even when mortality increased.”

Statistics Canada mortality data, meanwhile, lags by about five months because of “routine data verification processes needed for official Vital Statistics records,” according to the report.