As coronavirus cases are rising across Canada, so too are “excess deaths,” according to new data released by Statistics Canada.
Excess mortality reflects data on the number of deaths that exceed what is considered normal during a given period. Throughout the pandemic, some countries have used this as an indicator that the actual death toll related to the coronavirus is much higher than official tallies.
The provisional data, released Wednesday, suggests that the number of deaths attributed to COVID-19 by public health authorities largely aligns with official death statistics.
Between March and June, public health offices across the country reported 8,145 deaths attributable to COVID-19, about five per cent more (7,755) than figures from the Canadian Vital Statistics Death Database, which is the official source of data on deaths in Canada.
While still considered high, Statistics Canada said deaths fell back to normal levels — “that would be expected had there not been a pandemic” — by July. The greatest number of COVID-19 deaths occurred in April and May.
However, things began to look grim again by early fall.
In the first 10 days of October alone, the number of COVID-19 deaths reported by the Public Health Agency of Canada was higher than the monthly totals reported in the entire months of August and September.
“Overall, if the similarities between public health surveillance figures and official death data persist through the resurgence of cases, Canada will likely experience an increase in excess deaths in October,” StatCan said in the report.
Canada is in the midst of what is being considered the second wave of the coronavirus, with daily case counts rising in nearly all provinces — some higher than in the spring.
Over the past two weeks, daily case count records have been broken in Ontario, British Columbia, Alberta, Saskatchewan and Manitoba. On Tuesday, Canada’s death toll surpassed 10,000. The country’s total number of coronavirus infections now stands above 222,600.
There are some potential hiccups in the data, as StatCan notes. The deaths are based on confirmed cases of the virus, which means it might not include all cases where someone died of the virus before getting tested. The figures may also include deaths where COVID-19 was a contributing cause of death or an underlying cause of death.
StatCan points to this as one reason why there is a difference in the number of deaths tallied by public health agencies versus those from Canada’s national death source.
“While they may not always include those who died prior to getting tested, they are within five per cent of the provisional death figures reported by vital statistics offices,” the agency wrote.
There are direct and indirect mortality links also at play here, according to experts.
In direct mortality, people may have had COVID-19 and died without ever being tested for the virus.
In indirect mortality, changes and disruptions in the health-care system during the pandemic may have contributed to a death. For example, people who suffered heart attacks may have died because they were avoiding hospitals.
Some excess deaths during the March-June period could still be the result of “indirect impacts,” StatCan said.
“It shows that the majority of excess mortality can be accounted for by COVID-19, but there could be other excess mortality sometimes as a result of some of the measures that we’ve put in,” Canada’s top doctor, Theresa Tam, said of the report on Wednesday.
“I think we need to look at the severe impacts in a more holistic way, not just COVID-19, but other deaths as well.”
Disproportionate impact
A separate but related report highlights how Canada’s mortality rate due to COVID-19 had a disproportionate effect on visible minorities.
It emphasizes what Canada and other countries have experienced throughout the pandemic — that there is a significant variation in coronavirus-related deaths based on socioeconomic and demographical factors.
Past studies have shown that racialized groups are at increased risk of COVID-19 for a myriad of reasons, including social and economic inequalities, occupational risk, and housing conditions.
In Quebec, Ontario, Alberta and British Columbia, which had the highest number of COVID-19 deaths between March and June, the mortality rate was found to be higher in neighbourhoods with more Canadians identified as visible minorities.
In Quebec and Ontario, the mortality rate for neighbourhoods with these large population groups was three times higher than that with fewer visible minorities. In British Columbia — despite having a lower number of deaths comparatively — the morality rate was 10 times higher in these neighbourhoods.