OTTAWA, Canada — The number of Canadians who died from the COVID-19 pandemic is likely double the official numbers, according to an investigative report published by the Royal Society of Canada on Tuesday.
Canada has reported a cumulative total of 1,414,158 COVID-19 cases, including 26,238 deaths.
The report, titled Excess All-Cause Mortality During the COVID-19 Epidemic in Canada, suggests that largely racialized communities and essential workers were the ones who died at home and going unreported as COVID-19 deaths.
This contradicts current reporting of COVID-19 fatalities in Canada as being overwhelmingly concentrated in long-term care homes, a focus which may have distracted people from other communities.
The investigation reviewed death reports in 2020 and compared them to the expected number of deaths in a normal year, finding some 6,000 extra deaths among those aged 45 and older between February and November 2020.
Assuming this pattern of missing deaths continued after last November, it’s possible that as many as 50 percent of deaths missed being counted as COVID-19 deaths and included in that official number, the report suggests. This could mean that instead of 26,000 deaths, up to 52,000 Canadian deaths may be linked to the pandemic.
“They weren’t recognized as COVID-19 deaths, for whatever reason, and there are quite a number of possibilities and they vary by province,” Tara Moriarty, an infectious disease researcher with the University of Toronto and one of the authors of the report, told CTV.
“What it really looks like right now is that the COVID death toll is very likely to be double what we think in all regions outside of Quebec, (which) is probably accurate,” Moriarty said.
The report detailing this enormous oversight is a complicated indictment of Canada’s response to COVID-19, exposing a failure to test, report deaths consistently, and to pay attention to marginalized communities.
Moriarty said she started to realize something was off while she was tracking long-term care deaths in Canada.
“I was looking at things like the case for case fatality rates in Canada, and the numbers didn’t seem quite right,” she said. “Over time I started realizing that, in fact, there were quite a few more deaths than we had expected and so it took months to sort of be sure that what I was seeing was likely COVID-19 deaths.”
She said that researchers adjusted for an aging population as well as the number of deaths due to toxic drugs, and still found a disparity in the excess deaths.
Right now, the official data for COVID-19 deaths in Canada suggests that about 80 percent of COVID-19 deaths occurred in long-term care homes.
But the report says that’s wrong – like most other countries, two-thirds of Canadian deaths likely happened outside of long-term care homes, when the elderly living at home and lower-income racialized front-line workers became ill.
“That suggests that people have been dying in their homes, unrecognized, with COVID-19,” Moriarty said. “And for them and their families for everyone, we need to understand exactly how that could have happened because that’s actually quite horrifying.”
She said that Canada should’ve known from data from other countries that something was off about our numbers.
The report also cited a study that looked at cremation records in Ontario in 2020 and found that there was a rise in at-home deaths, with 63 percent of excess deaths occurring there as opposed to only 30 percent in long-term care homes.
“We know that twice as many COVID-19 deaths, for example, have occurred in racialized communities, communities that have lots of essential workers, high-density apartment buildings, larger households,” Moriarty said, adding that those receiving home care were a population overlooked as well.
One of the problems that led to these deaths failing to be counted, according to the report, is that Canada tested 75 percent less than the average for Canadian peer countries early on in the pandemic, missing cases until doctors spoke up, recognizing atypical symptoms.
Another contributing issue in having accurate death records is that Canada’s requirements for filing death reports are lax.
“Every one of our peer countries legally requires deaths to be recorded nationally within a week of them occurring,” Moriarty said. “Canada is months to years behind — we don’t have any requirement for that.”
She pointed out that there is still incomplete data even now. “We don’t have complete cause of death reporting in many provinces past February 2020, June 2020.”
The report pointed out that if a person died mysteriously and had symptoms clinically similar to COVID-19 cases, if they did not have a known close contact who had COVID-19, their death would not be considered to be connected to COVID-19 unless a post-mortem was done to confirm the cause of death.
It’s imperative for Canada to learn from these uncounted deaths, Moriarty said, adding that Canada could still be undercounting deaths right now. “This could be very important as the Delta variant spreads.”