Study struggles to explain why Quebec's COVID death toll rises as death rate drops

Study struggles to explain why Quebec’s COVID death toll rises as death rate drops

MONTREAL – Researchers are struggling to explain why Quebec had the highest official death toll from COVID-19 in the country despite the relatively low number of excess deaths between March 2020 and October 2021.

MONTREAL – Researchers are struggling to explain why Quebec had the highest official death toll from COVID-19 in the country despite the relatively low number of excess deaths between March 2020 and October 2021.

A new study released Monday by the Journal of the Canadian Medical Association attempted to answer that question, but it came up short.

“I would say at this point it’s something we need to understand,” Kimberlyn McGrill, a professor in the University of British Columbia’s School of Population and Public Health, said in an interview.

The study, “Excess deaths, COVID-19 and Canada’s healthcare systems,” says Quebec had 4,033 excess deaths between March 2020 and October 2021, but reported 11,470 deaths from COVID-19 — nearly three times as much. It’s the largest gap recorded in Canada during the pandemic. Excess mortality refers to the degree to which observed mortality exceeds expected mortality based on previous years’ modeling.

McGrill said she noted many factors to provide a definitive answer.

“Quebec was an interesting case,” she said. “What we’re seeing is that in Quebec, you have these periods where there are a lot of excess deaths, but you also have periods where the excess death rates are below zero, which means there were fewer deaths in those weeks than expected.”

Between February 2021 and July 2021, for example, Quebec’s death rate was lower than in the pre-pandemic years, but the province’s officials are reporting as many as 10 COVID-19 deaths per 100,000 people each day.

“I don’t have a definitive answer,” McGrill said. “That’s part of the reason why I’m interested in writing the paper, because of the number of things that can play into this.”

One reason that could explain the gap, she said, was that Quebec officials were testing so many people — for reasons unrelated to COVID-19 — that they were close to dying.

“Quebec was doing more testing, especially with people who were about to end their lives,” McGrill said. They may have been picking up people with COVID-19 who are really going to die in the coming days or weeks regardless. ”

Earlier in May, the Statistical Institute of Quebec released a report indicating that there were 6,400 excess deaths between the start of the COVID-19 pandemic and March 12, 2022. The province has officially reported more than 15,000 deaths from COVID-19 during that period.

In response to the report, Prime Minister Francois Legault said data from the Quebec Statistical Institute indicated that his government’s health orders had worked to reduce deaths in the province. “What this says is that the actions that we have taken over the past two years have produced results,” he said at the time.

The McGrill study indicated that Nova Scotia has the lowest ratio of COVID-19 deaths to excess deaths. The county reported 98 deaths from COVID-19 during March 2020 and October 2021, yet there were 217 more people who died during that period than was expected based on previous years.

While McGrill was careful to give definitive answers to explain the gap between Quebec’s excess death rate and the COVID-19 death rate, Frédéric Fleury-Bauer, of the provincial statistical institute, offered several theories.

On Monday, he said in an interview that one explanation is that older adults stayed indoors more than usual between March 2020 and October 2021, resulting in fewer chances of harming themselves.

“Falls among the elderly remain a significant cause of death,” Florey Bauer said. “It leads to a fracture of the hip or other bones, and since the elderly were less mobile during periods of isolation and curfews, this may have a role.”

Another explanation, he said, is that Quebec doctors listed COVID-19 as the cause of death in medical reports more liberally than did doctors in other provinces. He said it was well known in the Canadian medical community that medical reports in Quebec are more detailed than in other provinces.

“We have known for a long time that there is more detail in the cause of death department in Quebec (medical reports) than in other provinces,” said Fleury-Bauer. “When the epidemic began, were Quebec doctors, by virtue of custom or tradition, more sensitive to identifying and reporting every suspicious death of COVID-19?”

Florey-Bauer said a full picture of the situation will be available when all forensic reports on deaths during the pandemic are published and studied.

This report was first published by The Canadian Press on May 30, 2022.

This story was produced with financial assistance from the Meta Fellowship and Canadian Press News.

Virginie Anne, Canadian Press

2022-05-30 19:59:32

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