Canada

The study struggles to explain why Quebec has a high death toll from COVID but a low death rate

MONTREAL – Researchers find it difficult to explain why Quebec had the highest official number of COVID-19 deaths in the country, despite the relatively low number of deaths between March 2020 and October 2021.

MONTREAL – Researchers find it difficult to explain why Quebec had the highest official number of COVID-19 deaths in the country, despite the relatively low number of deaths between March 2020 and October 2021.

A new study published Monday by the Canadian Medical Association Journal tried to answer this question, but it turned out to be short.

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

The Excessive Mortality, COVID-19 and Healthcare Systems in Canada study says that Quebec had 4,033 deaths between March 2020 and October 2021, but reported 11,470 deaths from COVID-19 – almost three times more. This is the largest difference recorded in Canada during the pandemic. Redundant deaths refer to the extent to which observed deaths exceed expected deaths based on modeling from previous years.

McGrail said she had observed too many factors to offer a definite answer.

“Quebec was an interesting case,” she said. “What we are seeing is that in Quebec you have those periods where there is high over-mortality, but you also have periods when over-mortality rates are below zero, which means there have been fewer deaths in those weeks. than foreseen.

Between February 2021 and July 2021, for example, mortality in Quebec was lower than in the years before the pandemic, but provincial officials reported up to 10 COVID-19 deaths per 100,000 people each day.

“I don’t have a definite answer,” McGrail said. “That’s part of the reason I was interested in writing this article, because of the number of things that could play into it.”

One reason that may explain the difference, she said, is that Quebec officials have tested many people who – for reasons unrelated to COVID-19 – were already close to death.

“Quebec was doing more tests, especially with people who were apparently nearing the end of their lives,” McGrail said. “They may have taken in people with COVID-19 who would indeed die in the next few days or weeks, nonetheless.”

Earlier in May, the Quebec Statistical Institute published a report stating that there were more than 6,400 deaths between the start of the COVID-19 pandemic and March 12, 2022.

In response to the report, Prime Minister Francois Lego said data from the Institut de la statistique du Québec showed that health orders imposed by his government had worked to reduce mortality in the province. “This shows that the measures we have introduced in the last two years have paid off,” he said at the time.

The McGrail survey shows that Nova Scotia has the lowest death rate from COVID-19 compared to excessive deaths. The province reported 98 deaths from COVID-19 in March 2020 and October 2021, but there were still 217 fewer deaths during that period than expected from previous years.

While McGrail was cautious in giving definite answers to explain the difference between the excessive mortality rate in Quebec and its death rate from COVID-19, Frederick Florey-Payor, with the Provincial Statistical Institute, proposed several theories.

One explanation, he said in an interview Monday, is that older people stayed inside more than usual between March 2020 and October 2021, leading to fewer chances of injury.

“Falling among the elderly is still a very important cause of death,” said Flory-Payor. “This leads to a fracture of the thigh or other bones, and because older people have been less mobile during periods of isolation and curfew, this may have played a role.”

Another explanation, he said, is that doctors in Quebec include COVID-19 as a cause of death in medical reports more liberally than doctors in other provinces. He said the Canadian medical community knows 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 section on the cause of death in Quebec (medical reports) than in other provinces,” said Flory-Payor. “When the pandemic began, were Quebec doctors, by habit or tradition, more sensitive to identifying and reporting any suspicious deaths from COVID-19?”

Florey-Payor said a full portrait of the situation would be available when all forensic reports, including deaths during the pandemic, were published and investigated.

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

This story was created with the financial support of the Meta and Canadian Press News Fellowship.

Virginia Ann, the Canadian press