National health and population academics are pointing to high “excess mortality” numbers as an important riddle for provinces to solve in their understanding of the human cost of the COVID-19 pandemic.
But New Brunswick, with some of the most puzzling numbers in Canada, is resisting the idea it has underreported deaths.
In the legislature on Wednesday, Opposition Leader Roger Melanson asked what the province knows about excess deaths in New Brunswick in 2021, which were among the highest in Canada.
Minister of Health Dorothy Shephard seemed baffled by the questions.
“He’s alluding that something is wrong.” said Shephard.
“I don’t understand where he is going with this.”
Forensic analysis
Earlier this week, University of British Columbia professor and population data scientist Kimberlyn McGrail called for a national “forensic” analysis of why some provinces have been experiencing much higher death counts in their populations during the pandemic than others.
She also said high overall death counts in provinces that officially recorded only moderate numbers of COVID-19 fatalities, like has happened in New Brunswick, needs to be better understood.
“It’s just an important thing to do,” said McGrail in an interview with CBC News.
Tara Moriarty is an infectious disease expert and researcher at the University of Toronto. She has said excess mortality figures in New Brunswick show COVID deaths in the province are grossly underreported. (Lisa Xing/CBC)
“I’s really hard to disentangle all of these different things, which is why I think the focus on excess mortality — saying there’s something going on and at the population level — that’s worth trying to dig into.”
In an ongoing study of what it calls “provisional death counts and excess mortality” related to the COVID-19 pandemic, Statistics Canada has been tracking and recording death counts in each province and comparing them to levels in normal years, after adjusting for population changes.
“To understand the direct and indirect consequences of the pandemic, it is important to measure excess mortality, which occurs when there are more deaths than expected in a given period,” explains Statistics Canada.
Last month it reported that New Brunswick recorded an estimated 7,397 deaths during the first 43 weeks of 2021. According to the agency that was 908 more than would be expected over those weeks in the absence of the pandemic, a difference referred to as “excess mortality.”
It is one of the highest excess mortality rates observed in Canada in 2021 and is in stark contrast to death counts in neighbouring Nova Scotia and Prince Edward Island during the same 43 week period. They were below normal levels by a combined 301.
Excess deaths high
The idea 908 more people than normal died in New Brunswick has also raised questions about whether the 98 people the province claims died of COVID-19 during those 43 weeks can possibly be accurate. And if it is accurate what factors caused the deaths of the other 810.
Excess deaths during the COVID-19 pandemic are believed to be connected to the effects of the virus circulating in the community in some way, although the exact links to individual deaths are not necessarily known.
Some deaths are caused by the virus directly but some can be caused by other factors like delayed or cancelled medical procedures forced by pandemic restrictions.
Health Minister Dorothy Shephard said her department is looking at excess deaths but bristled at suggestions in the legislature that the numbers show more people died of COVID-19 in New Brunswick than government has reported. (Ed Hunter/CBC)
Tara Moriarty, an associate professor and infectious disease researcher at the University of Toronto has said large numbers of excess deaths in New Brunswick are likely COVID-19 cases that went undetected by the province due to inadequate testing and tracking of cases.
McGrail agrees that may be an issue in some provinces and in a paper published in the Canadian Medical Association Journal this week she stressed the importance of sorting issues like that out to understand exactly what has happened in each province. That will help to plan for future crises, she suggested.
“Once clearer data on “true” COVID-19 case counts become available, it may be possible to better estimate to what extent the type and timing of pandemic response mattered to provinces’ overall mortality rates,” she wrote.
Population data scientist Kimberlyn McGrail said provinces with high death counts in the population during the pandemic need to understand what was caused by COVID and what wasn’t. (UBC)
Many of the excess deaths documented in New Brunswick have occurred in and around COVID-19 outbreaks that were happening at the time, including during nine weeks last September and October.
New Brunswick had dropped indoor mask requirements and border restrictions earlier that summer but then declared a state of emergency on Sept. 24 after the Delta variant took hold in the province.
Officially, New Brunswick documented 71 COVID deaths during that September and October period, but Statistics Canada numbers show during those two months 431 more people than normal died.
But so far, government has been resisting the idea those excess deaths might be undiagnosed COVID deaths.
Premier Blaine Higgs and Chief Medical Officer of Health Jennifer Russell danced at New Brunswick Day celebrations in August 2021. A COVID outbreak soon hit and in September and October the province says 71 people died. Statistics Canada says there were actually 431 excess deaths in those months. (CBC News)
In the legislature, Shephard said her department is looking at the issue, but bristled at questions from Melanson asking whether hundreds more people in the province may have died from COVID-19 than the government has officially reported.
“I do not know of any deaths that have not been qualified with a cause of death. So I do not know what the member opposite is alluding to.” she said.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
