How many people died in BC during the first COVID-19 waves? - Powell River Peak

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How many people died in BC during the first COVID-19 waves? – Powell River Peak

Published

2 years ago

May 30, 2022

Harry Miller

British Columbia’s excess mortality rate dwarfed all other provinces in Canada during the first year of the COVID-19 pandemic, a new study says.

The peer-reviewed report, published in the Canadian Medical Association Journal Monday, used public data to look at how many excess deaths occurred in each of Canada’s provinces from March 2020, at the start of the pandemic, to October 2021, over a year and a half later.

Excess mortality measures how many deaths actually occurred compared to what was expected under normal circumstances. It’s one way researchers have been able to figure out the true number of lives lost due to COVID-19. But what emerged from the research was a huge gap in the number of unexpected deaths each province recorded in period just before the Omicron variant hit.

“I think we all know that there have been deaths related to COVID. But to see the differences, at least in these estimates? …It was surprising,” said the study’s author, Kimberlyn McGrail, a professor at the University of British Columbia’s School of Population and Public Health.

In her analysis, McGrail used Statistics Canada data to track the observed number of deaths. She then compared those numbers with a model that estimated how many deaths would have occurred if the pandemic never happened.

She found that during the first year of the COVID-19 pandemic, Canada saw a roughly five per cent increase in excess mortality. That’s higher than many countries but fewer than the United Kingdom, which recorded an 18 per cent increase in excess deaths, or the United States, which saw excess mortality climb to 22 per cent into early 2021.

In Canada, McGrail calculated the mortality rates on a per 100,000 population basis. That way, she could directly compare provinces with different populations. The researcher avoided analyzing excess deaths in Canada’s three territories because of the small number of pre-Omicron COVID-19 cases reported there.

In the end, McGrail found excess mortality was lowest in Canada’s eastern provinces — even dropping below what was expected in Prince Edward Island and Nova Scotia.

Quebec had the highest reported COVID-19 mortality rate in Canada. But while there were moments during the pandemic where excess deaths outpaced reported deaths, at other times, there were “substantial periods during which mortality rates were lower than expected,” even dropping below zero.

Ontario appeared to have the smallest gap between reported COVID-19 deaths and excess mortality, something that suggested the province was the best at tracking pandemic deaths.

With a 4.5-fold gap between reported COVID-19 deaths and excess mortality, B.C. outstripped all other provinces in the number of excess deaths that went unreported. Only Alberta and Saskatchewan came close to Canada’s westernmost province.

Determining how people have died throughout the pandemic has challenged health officials and vital statistics agencies globally. To date, nearly 6.3 million people have officially died from COVID-19 across the world. But some have estimated the real COVID-19 death toll could be three times higher.

As the gap in B.C. makes clear, the virus wasn’t the only factor pushing up death rates to unexpected highs.

Heat dome drives highest weekly excess mortality rates in Canada

During the 2021 heat dome in late June, excess deaths per 100,000 people in B.C. literally spike off the chart, climbing to 90 deaths per 100,000 people. That’s higher than the weekly excess death rate anywhere in Canada at any time during the pandemic.

“Alberta, B.C. and Saskatchewan stand out for having had excess mortality rates nearly double (or more) those of other provinces,” wrote McGrail.

McGrail says the “remarkably diverse” mortality patterns across Canada likely have a number of explanations. She notes limited testing capacity, deaths occurring in the community rather than a hospital and different public health reporting practices all likely played a role in deciding whether or not to classify a cause of death as COVID-19-related.

“These provincial variations suggest to me that the very first thing to understand is how the different approaches to testing, contact tracing and encoding — identifying COVID-related deaths — might vary across the provinces,” she said.

Another wildcard factor that could have impacted how many people died in the first year of the pandemic: delayed or cancelled surgeries, diagnostic tests or doctor appointments.

To get a better understanding of which province actually had a “COVID-19 problem,” McGrail says differences in public health reporting practices need to be ruled out as a cause first.

In places and times where mortality rates dipped below what was expected, McGrail points to a pandemic decline in car accidents due to fewer people on the road, and a reduction in influenza-related deaths. The Statistics Canada data, she said, currently doesn’t count avoided deaths as a result of COVID-19 measures.

Other factors that need to be looked at include how pandemic policies and border shutdowns impacted an unsafe drug supply, leading to more people using and overdosing on opioids alone, said McGrail in her report.

A surge in unexpected deaths in B.C.

B.C. reported 9,496 excess deaths by October 2021, more than double that of Quebec and nearly as many as Ontario, a province with a much larger population.

Of those deaths, only 2,109 — or 22 per cent — were attributed to COVID-19. It’s not clear to what degree the opioid crisis and June 2021 heat wave drove the other nearly 7,400 unexpected deaths. But over that same period, the BC Coroners Service reported 3,416 people died overdosing on illicit drugs — more than suicides, murder and motor vehicle accidents combined. The heat wave is thought to have killed just shy of 600 people.

Even if those two causes of death were taken away, that still leaves roughly 3,000 deaths unaccounted for under normal conditions.

Pointing to the collision of the SARS-CoV-2 virus, public policy and climate change, McGrail noted a potential cascading effect leading to the most vulnerable facing a double or even triple crisis.

McGrail cited a Human Rights Watch report released in October 2021 that concluded an inadequate response from B.C. authorities made heat-related deaths worse in the province. But because those deaths were “highly associated with social and material deprivation,” COVID-19 and the poverty that came with it may well have set the stage for the most vulnerable to suffer the worst effects from extreme heat.

“If you think about the implications of COVID, they would have had some impact on the heat dome deaths because it would have affected the policy response,” McGrail said, pointing to public health measures that pushed people, in particular older British Columbians, to isolate.

McGrail called for all provinces and territories to come together and conduct a forensic analysis of how mortality has played out over the pandemic. To that end, she has shared her work with federal and B.C. government health authorities and plans to reach out to more now that her work is public.

Reforming the system tracking deaths could not come too soon. One international analysis from The Economist found that Canada is three to four months behind its peers in reporting deaths.

“Even the basic recording of mortality, we’re very slow in Canada. That surely could and should be fixed,” said McGrail.

But it’s not just the government she is trying to convince.

On a second front, McGrail says more work needs to be done to involve the public in responding to public health crises.

“When we have another one of these events… part of our response is going to be being able to rally community organizations, community groups and the public at large very quickly,” she said.

“And that requires information. That requires trust.”

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Toronto reports 2 more measles cases. Use our tool to check the spread in Canada – Toronto Star

Published

12 hours ago

April 19, 2024

Harry Miller

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Canada has seen a concerning rise in measles cases in the first months of 2024.

By the third week of March, the country had already recorded more than three times the number of cases as all of last year. Canada had just 12 cases of measles in 2023, up from three in 2022.

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Cancer Awareness Month – Métis Nation of Alberta

Published

16 hours ago

April 18, 2024

Harry Miller

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Cancer Awareness Month

Posted on: Apr 18, 2024

April is Cancer Awareness Month

As we recognize Cancer Awareness Month, we stand together to raise awareness, support those affected, advocate for prevention, early detection, and continued research towards a cure. Cancer is the leading cause of death for Métis women and the second leading cause of death for Métis men. The Otipemisiwak Métis Government of the Métis Nation Within Alberta is working hard to ensure that available supports for Métis Citizens battling cancer are culturally appropriate, comprehensive, and accessible by Métis Albertans at all stages of their cancer journey.

Receiving a cancer diagnosis, whether for yourself or a loved one, can feel overwhelming, leaving you unsure of where to turn for support. In June, our government will be launching the Cancer Supports and Navigation Program which will further support Métis Albertans and their families experiencing cancer by connecting them to OMG-specific cancer resources, external resources, and providing navigation support through the health care system. This program will also include Métis-specific peer support groups for those affected by cancer.

With funding from the Canadian Partnership Against Cancer (CPAC) we have also developed the Métis Cancer Care Course to ensure that Métis Albertans have access to culturally safe and appropriate cancer services. This course is available to cancer care professionals across the country and provides an overview of who Métis people are, our culture, our approaches to health and wellbeing, our experiences with cancer care, and our cancer journey.

Together, we can make a difference in the fight against cancer and ensure equitable access to culturally safe and appropriate care for all Métis Albertans. Please click on the links below to learn more about the supports available for Métis Albertans, including our Compassionate Care: Cancer Transportation program.

I wish you all good health and happiness!

Bobbi Paul-Alook
Secretary of Health & Seniors

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Type 2 diabetes is not one-size-fits-all: Subtypes affect complications and treatment options – The Conversation

Published

17 hours ago

April 18, 2024

Harry Miller

You may have heard of Ozempic, the “miracle drug” for weight loss, but did you know that it was actually designed as a new treatment to manage diabetes? In Canada, diabetes affects approximately 10 per cent of the general population. Of those cases, 90 per cent have Type 2 diabetes.

This metabolic disorder is characterized by persistent high blood sugar levels, which can be accompanied by secondary health challenges, including a higher risk of stroke and kidney disease.

Locks and keys

In Type 2 diabetes, the body struggles to maintain blood sugar levels in an acceptable range. Every cell in the body needs sugar as an energy source, but too much sugar can be toxic to cells. This equilibrium needs to be tightly controlled and is regulated by a lock and key system.

In the body’s attempt to manage blood sugar levels and ensure that cells receive the right amount of energy, the pancreatic hormone, insulin, functions like a key. Cells cover themselves with locks that respond perfectly to insulin keys to facilitate the entry of sugar into cells.

Unfortunately, this lock and key system doesn’t always perform as expected. The body can encounter difficulties producing an adequate number of insulin keys, and/or the locks can become stubborn and unresponsive to insulin.

All forms of diabetes share the challenge of high blood sugar levels; however, diabetes is not a singular condition; it exists as a spectrum. Although diabetes is broadly categorized into two main types, Type 1 and Type 2, each presents a diversity of subtypes, especially Type 2 diabetes.

These subtypes carry their own characteristics and risks, and do not respond uniformly to the same treatments.

To better serve people living with Type 2 diabetes, and to move away from a “one size fits all” approach, it is beneficial to understand which subtype of Type 2 diabetes a person lives with. When someone needs a blood transfusion, the medical team needs to know the patient’s blood type. It should be the same for diabetes so a tailored and effective game plan can be implemented.

This article explores four unique subtypes of Type 2 diabetes, shedding light on their causes, complications and some of their specific treatment avenues.

Severe insulin-deficient diabetes: We’re missing keys!

In severe insulin-deficient diabetes, beta cells limit production of the keys that unlock cells to allow entry of sugar from the blood.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Insulin is produced by beta cells, which are found in the pancreas. In the severe insulin-deficient diabetes (SIDD) subtype, the key factories — the beta cells — are on strike. Ultimately, there are fewer keys in the body to unlock the cells and allow entry of sugar from the blood.

SIDD primarily affects younger, leaner individuals, and unfortunately, increases the risk of eye disease and blindness, among other complications. Why the beta cells go on strike remains largely unknown, but since there is an insulin deficiency, treatment often involves insulin injections.

Severe insulin-resistant diabetes: But it’s always locked!

A diagram of three closed locks and lots of keys — In severe insulin-resistant diabetes, the locks start ignoring the keys, triggering the beta cells to produce even more keys to compensate.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

In the severe insulin-resistant diabetes (SIRD) subtype, the locks are overstimulated and start ignoring the keys. As a result, the beta cells produce even more keys to compensate. This can be measured as high levels of insulin in the blood, also known as hyperinsulinemia.

This resistance to insulin is particularly prominent in individuals with higher body weight. Patients with SIRD have an increased risk of complications such as fatty liver disease. There are many treatment avenues for these patients but no consensus about the optimal approach; patients often require high doses of insulin.

Mild obesity-related diabetes: The locks are sticky!

Illustration of a lock and key — In mild obesity-related diabetes, the locks are ‘sticky,’ making it difficult for the keys to open the locks.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Mild obesity-related (MOD) diabetes represents a nuanced aspect of Type 2 diabetes, often observed in individuals with higher body weight. Unlike more severe subtypes, MOD is characterized by a more measured response to insulin. The locks are “sticky,” so it is challenging for the key to click in place and open the lock. While MOD is connected to body weight, the comparatively less severe nature of MOD distinguishes it from other diabetes subtypes.

To minimize complications, treatment should include maintaining a healthy diet, managing body weight, and incorporating as much aerobic exercise as possible. This is where drugs like Ozempic can be prescribed to control the evolution of the disease, in part by managing body weight.

Mild age-related diabetes: I’m tired of controlling blood sugar!

Illustration of a lock and a beta cell — In people with mild age-related diabetes, both the locks and the beta cells that produce keys are tired, resulting in fewer keys and stubborn locks.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Mild age-related diabetes (MARD) happens more often in older people and typically starts later in life. With time, the key factory is not as productive, and the locks become stubborn. People with MARD find it tricky to manage their blood sugar, but it usually doesn’t lead to severe complications.

Among the different subtypes of diabetes, MARD is the most common.

Unique locks, varied keys

While efforts have been made to classify diabetes subtypes, new subtypes are still being identified, making proper clinical assessment and treatment plans challenging.

In Canada, unique cases of Type 2 diabetes were identified in Indigenous children from Northern Manitoba and Northwestern Ontario by Dr. Heather Dean and colleagues in the 1980s and 90s. Despite initial skepticism from the scientific community, which typically associated Type 2 diabetes with adults rather than children, clinical teams persisted in identifying this as a distinct subtype of Type 2 diabetes, called childhood-onset Type 2 diabetes.

Childhood-onset Type 2 diabetes is on the rise across Canada, but disproportionately affects Indigenous youth. It is undoubtedly linked to the intergenerational trauma associated with colonization in these communities. While many factors are likely involved, recent studies have discovered that exposure of a fetus to Type 2 diabetes during pregnancy increases the risk that the baby will develop diabetes later in life.

Acknowledging this distinct subtype of Type 2 diabetes in First Nations communities has led to the implementation of a community-based health action plan aimed at addressing the unique challenges faced by Indigenous Peoples. It is hoped that partnered research between communities and researchers will continue to help us understand childhood-onset Type 2 diabetes and how to effectively prevent and treat it.

A mosaic of conditions

Illustration of different subtypes of Type 2 diabetes — Type 2 diabetes is a mosaic of conditions, each with its own characteristics.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Type 2 diabetes is not uniform; it’s a mosaic of conditions, each with its own characteristics. Since diabetes presents so uniquely in every patient, even categorizing into subtypes does not guarantee how the disease will evolve. However, understanding these subtypes is a good starting point to help doctors create personalized plans for people living with the condition.

While Indigenous communities, lower-income households and individuals living with obesity already face a higher risk of developing Type 2 diabetes than the general population, tailored solutions may offer hope for better management. This emphasizes the urgent need for more precise assessments of diabetes subtypes to help customize therapeutic strategies and management strategies. This will improve care for all patients, including those from vulnerable and understudied populations.

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