Why StatsCan says Nova Scotia is seeing 'significant' excess mortality

Statistics Canada says there are several reasons behind the "significant" excess mortality Nova Scotia has been seeing since late July 2022.

Excess mortality — or deaths above what would be normally anticipated — is a signal to public health officials that something concerning is happening and needs to be addressed.

Indirect impacts of the pandemic have to be factored in, "such as missed medical appointments or treatments, or cases — especially early in the pandemic — where individuals may have died from the virus prior to getting tested or treated," a spokesperson for the agency said in a statement.

"Excess mortality ... is one key measure that accounts for these effects."

Colin Furness, an infection control epidemiologist at the University of Toronto, said excess mortality helps draw attention to deaths that aren't officially listed as resulting from COVID-19 even though it may have been a contributing factor.

"COVID has many pernicious effects all over the body and we're still just learning that, and the bug is still evolving," he said.

While Nova Scotia received praise early in the pandemic for its response, that changed with the arrival of the Omicron variant in December 2021.

Statistics Canada said the province started seeing periods of significant excess mortality in early 2022. It singled out the four-week period ending Feb. 12, 2022, during which there were a record 65 deaths from COVID-19 in the province.

An estimated 1,014 excess deaths occurred over that time, which was 18.2 per cent more than expected.

Statistics Canada singled out "diseases of the heart" as another factor that may have contributed to excess mortality. It caused 175 deaths during that four-week period.

Furness said COVID-19 has a "terrible effect" on the vascular system, so those deaths don't come as a surprise.

"You had COVID everywhere, and then you've got these heart attack deaths in very, very close proximity to that," he said. "That's pretty compelling."

Data 'still very incomplete,' says StatsCan

Statistics Canada also disclosed that during the 28-week period ending Feb. 4, 2023, there were 975 excess deaths, or 17 per cent more than expected.

During that period, it said 210 deaths were because of COVID-19, while influenza and pneumonia accounted for 90 deaths.The comparable period in 2020-2021 saw 30 deaths from influenza and pneumonia, while the same 28 weeks in 2021-2022 saw 45 deaths.

But Statistics Canada said the data it's been provided is "still very incomplete." In about 30 per cent of the deaths for the 28-week period in 2022-2023, the cause has yet to be determined or reported to the agency.

That doesn't surprise Furness, who said Canada is poor at reporting deaths in a timely fashion.

But the available data suggests that "not only is COVID the number 3 killer [nationally], it's contributing to increases in the number 1 and the number 2, which are cancer and cardiovascular," he said.

Aging population

Statistics Canada said Nova Scotia's aging population is also part of the reason behind the excess mortality, but its modelling tries to account for factors like this.

"Death counts may be affected by changes in the composition of the population, owing to immigration, changes in mortality rates and the effects of an aging population," it said.

"In the Canadian context, with an aging and growing population, the number of deaths has been increasing steadily in recent years, so a higher number of deaths would be expected, regardless of COVID-19."

Since the start of the pandemic, authorities in the province said 869 people have died from COVID-19 in Nova Scotia, with 383 of those deaths occuring since July 1, 2022.

The Nova Scotia government is confident its COVID death numbers are accurate, saying deaths attributed to COVID-19 capture both people who died from a coronvairus infection or when it was believed to be a contributing factor.

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