Nova Scotia nears 500 official COVID-19 deaths, but the real number is likely much higher

As Nova Scotia's official death count from the COVID-19 pandemic nears a tragic milestone, data reporting delays are preventing researchers from getting an accurate picture of how many people have died because of the coronavirus.

The issue is something Statistics Canada tracks called excess mortality, which compares the number of deaths in each province and territory with the expected number of deaths. 

The number of deaths are provided by vital statistics offices to Statistics Canada. However, the latest numbers for Nova Scotia are from Oct. 23, 2021, meaning the province trails only Manitoba in timeliness among provinces.

These numbers also pre-date the Omicron wave of the pandemic, which has been the deadliest for Nova Scotia, with almost 80 per cent of the official 497 COVID-19 deaths happening since Dec. 8, 2021.

"There's still a lot of numbers that need to come in," says Tara Moriarty, an infectious diseases researcher at the University of Toronto.

Moriarty said that to get an accurate picture of how many COVID-19 deaths are going unreported, one has to look at excess mortality.

Moriarty is part of a team at the COVID-19 Resources Canada project doing modelling to help members of the public better understand the COVID-19 situation. It receives funding from the Public Health Agency of Canada for its work.

In June, Statistics Canada published a report noting that as of mid-February 2022, Canada had experienced seven per cent more deaths since the start of the pandemic than was expected.

The increase isn't necessarily attributable entirely to COVID-19, it warned.

"Trends in mortality statistics during the pandemic could be affected by various factors, including delayed medical procedures; increased substance use; or declines in deaths related to other causes, such as influenza," said the report.

Moriarty estimates at least 50 per cent of excess mortality during the pandemic is because of COVID-19.

"If there is a substantial amount of excess mortality that is not attributable to COVID-19, then it's likely … there is some other cause of death or something that is killing a significantly elevated number of people and you really need that reporting to be as fast and complete as possible so that you can identify what that cause of death is," she said.

Moriarty said Nova Scotia is not alone in its delays in reporting death data, but the lag has other implications.

"It means that provinces don't have the essential information they need to make decisions about COVID, for example, and about other causes of mortality to protect their populations," she said. "So yes, it is very concerning."

This extends to residents, said Moriarty, because it impacts the decisions people make about protecting themselves, such as wearing masks.

850 deaths estimated

Moriarty estimates the number of COVID-19 deaths in Nova Scotia to be around 850, with 150 of those stemming from the Omicron wave.

In total, nearly 10,000 people die in Nova Scotia each year. 

She said Nova Scotia wasn't always slow at reporting death data, but said that's been the case since the fall of 2021.

Moriarty said when there are large COVID-19 waves and subsequently more deaths, data reporting generally slows down.

In a joint statement from the Department of Health and Wellness and Service Nova Scotia and Internal Services, it said the delay in sending data to Statistics Canada is "for a variety of reasons," but did not specify what they were.

The statement said a plan is in place to clear the backlog.

How Nova Scotia classifies COVID deaths

In Nova Scotia, deaths attributed to COVID-19 capture both people who died from infection with the coronavirus or when COVID was believed to be a contributing factor.

In cases where the cause of death is unknown or a person is suspected to have had COVID-19, tests are carried out to find evidence of the disease.

"We have confidence that we are capturing all deaths where COVID-19 is listed on a death certificate as the cause of death or is a contributing factor," said the joint statement.

Moriarty said these approaches can still miss deaths.

"A lot of deaths in older people don't necessarily look like the way we typically think of COVID as a respiratory infection," she previously told CBC News. "A lot of older people, when they develop respiratory infections don't have obvious symptoms, until they can no longer breathe and they die."

According to Nova Scotia's COVID-19 dashboard, the median age of death during the Omicron wave has been 83. 

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