'Excess' deaths in N.B. during pandemic need study, expert says

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.

"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.

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.

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. 

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.