How focusing on the age of pandemic victims could blind us to the bigger picture

Canada crossed a sad threshold this week, with the number of Canadians killed by the pandemic passing the 2,000 mark.

Despite that sobering number, provinces are beginning to think about how they might get people back to work and provide them with a greater sense of normalcy.

Pandemic planning has turned to this next phase in part because the vast majority of those who have died of COVID-19 in this country have been seniors, many of them in long-term care facilities and far from schools and places of work.

That shouldn't mean those lives lost are any less valuable, of course. Their deaths aren't normal.

On Thursday, Saskatchewan released its plan to phase out some pandemic restrictions over the coming weeks. The province has seen relatively few cases of the disease.

In Quebec, the province hit hardest by the outbreak, Premier François Legault is expected next week to reveal his government's plan to return some children to classes before the summer break and open up some parts of the economy again.

But April has been particularly cruel to Quebec. When the month began, the province had seen only 33 reported deaths due to the novel coronavirus. But if the last days of April are anything like the past week or so, the total number of lives lost in Quebec alone will increase to somewhere around 2,000 this month.

That's a staggering toll. On average, just under 5,500 Quebecers die in a typical April. At the current rate, COVID-19 is likely to become this month's deadliest killer in the province — outpacing the number of Quebecers who usually die from cancer in an average month.

Though most of the people who have died of COVID-19 in the province were over the age of 80, it's highly unlikely that their deaths were imminent, regardless of the cause.

Analysis by The New York Times has found that the number of deaths in various countries, regions and cities over the last few weeks — from all causes, including COVID-19 — is significantly higher than normal for this time of year. This suggests that a lot of these deaths probably are not being accurately attributed to the disease and that the pandemic could be contributing to an increase in deaths from other causes.

But it also makes it obvious that what is happening is nowhere close to normal.

Median age of COVID-19 victims is 84

It all argues against the notion that most of these deaths were somehow inevitable, that they should not get in the way of getting people back to work.

This argument has been heard from some corners of the right-wing media universe in the United States. It also was (briefly) expressed earlier this month by B.C. Conservative MP Marc Dalton, who asked in a tweet whether it was "time to start moving Canada back to work" after pointing out that most pandemic deaths were happening in long-term care facilities where life expectancy is lower.

The tweet did not survive long before it was deleted.

In a recent interview with Blackburn News, Ontario Conservative MP Marilyn Gladu said that "for people that are seniors, for people that have underlying medical issues, yes, they need to be isolating themselves and protecting themselves, but for the rest of the public, we need to get back to work."

The COVID-19 caseload is not limited to seniors, of course. In fact, most of the Canadians who have been infected to date have been under the age of 60. The median age of COVID-19 cases is around 52, according to the Public Health Agency of Canada (PHAC).

But those dying of the disease are predominantly older Canadians. The median age of people killed by COVID-19 is around 84.

In Quebec, where about half of all the pandemic deaths in the country have occurred, less than three per cent of those killed were under the age of 60, according to official figures.

Legault cited that number on Thursday as a reason for parents not to worry about their children returning to schools, and suggested sending kids back to class might help the province achieve "herd immunity" in the wider population. (At this point, however, we still don't know if people who have recovered from COVID-19 are immune to re-infection.)

About 25 per cent of the pandemic deaths in Quebec have been among people between the ages of 60 and 79, with 42 per cent between the ages of 80 and 89 and 31 per cent over the age of 90.

We've known almost from the beginning that older people face an elevated risk of dying from the disease. But the conclusion to be drawn should not be that these people had little time left to live anyway.

Leaving a lasting impact

Certainly, a vastly disproportionate number of the victims have been in long-term care facilities (Legault said on Thursday this did not make their deaths "less serious") — and so were already in worse health than most elderly people living outside of these facilities.

But a study found that the average stay in residential care in British Columbia in 2016-17 was 871 days — over two years.

In general, the life expectancy of someone who already has reached old age is longer than one might think — and it continues to stretch out the longer someone lives.

At birth, the life expectancy of the average Canadian is around 82 years. But according to Statistics Canada, someone who has defied those odds by making it to 84 — the median age of a COVID-19 victim — can still expect to live another eight years or so.

That's a long time. A grandparent or great-grandparent can attend a lot of graduations, weddings and births over eight years. That amount of time — even a significantly shorter amount of time — can make the difference between someone being known to their grandchildren only through old photographs and having an important and enduring impact on their lives.

The daily updates on the number of new cases and deaths, the focus on shifting rates of increase and decrease in infections and hospitalizations, the bar charts and epidemiological curves — they can make it easy to forget that these numbers represent real people with families and stories of their own.

Ontario Premier Doug Ford, whose mother-in-law has tested positive for COVID-19, made this point on Tuesday. Asked at a press briefing when and how the economy can be opened up again, he replied that "even when we open up … sadly and unfortunately, people will still be dying."

"We still have deaths happening every day. They want to open up and I'm thinking, really? … It hits you hard in the heart, believe me," he said.

"Every day you're hearing these numbers and how many families are affected. I can't even comprehend all these families. Every day we see 30, 40, 50 people passing away. It's heart-wrenching."

Statistics don't suffer. Focusing on them can make it easy to overlook the fact that while more than 2,000 Canadians have lost their lives to COVID-19, there are many more who are feeling that loss now — and many more who will.