'It's COVID plus': B.C.'s pandemic death toll under renewed scrutiny

British Columbia had more excess deaths than any other province in the first 18 months of the pandemic, according to a new analysis.

That finding is renewing scrutiny of just how many of those deaths were due to COVID-19.

In her Canadian Medical Association Journal paper titled “Excess mortality, COVID-19 and health care systems in Canada,” a UBC School of Population and Public Health professor found western Canada had the most excess deaths in the country, with B.C. recording the highest proportion of all.

“Really, it’s COVID -- plus the COVID-related sorts of things like delayed care, plus the other things that are happening,” said author, Kim McGrail, in an interview with CTV News, noting the heat dome and toxic drug crisis played roles, but the pandemic is the key.

“People with delayed surgeries, people who had delayed diagnoses for new conditions and delayed treatment for ongoing conditions -- all those could’ve contributed. What we don't know at this point is the relative contribution of each of those.”

She said public health measures, like masks and other precautions, varied significantly by province, as did access to medical care. But there were also differences in how or whether deaths were attributed to the virus – with B.C. having an exceptionally low official count.

“Reporting practices by provincial public health agencies were likely affected by decisions regarding whether or not to classify deaths of both people whose primary cause of death was COVID-19 (those who died “from” COVID-19) and people who were infected with SARS-CoV-2 whose primary cause of death was other than COVID-19 (those who died “with” COVID-19) as being related to COVID-19,” she wrote in the piece.

HOW BIG IS THE UNDERCOUNT?

McGrail declined to estimate how high she thinks B.C.'s death rate could actually be, but a previous study by the Royal Geographic Society of Canada believes the official provincial toll from the early days of COVID could be undercounting by as much as half.

https://bc.ctvnews.ca/it-s-really-distressing-study-estimates-b-c-s-covid-19-death-toll-could-be-double-what-s-reported-1.5489806

But the collection of academics and independent scientists, analysts and other experts in the B.C. COVID-19 Modelling Group has maintained for some time that the province has been minimizing the number of death and focussed on the issue in their most recent analysis.

“It's very hard to think we haven't been undercounting," said Jens Von Bergmann, a high-profile data scientist in Vancouver and member of the group. “With cumulative data coming in over two years now it seems pretty clear that all the official counts that we have -- even if we count in excess drug toxicity deaths and the heat dome -- there’s still a lot of room left unexplained and that's before we start to think public health measures were probably effective at preventing deaths of other types, like the flu."

MINISTER DOUBLES DOWN ON B.C. EXCEPTIONALISM

The health minister was asked about the latest analysis of B.C.’s excess mortality and refused to acknowledge the official count may be inaccurate.

“There are always going to be discussions about the impact on public health of different emergencies we're facing,” said Adrian Dix. “In B.C. the facts are just the facts, and the mortality rate is the lowest of any jurisdiction of its size in North America.” 

CTV News asked to speak with someone at B.C.’s Vital Statistics agency to find out more about how data is gathered, reported, and analyzed, but the ministry of health ignored that request and instead sent a lengthy email statement.

“We note that the weeks in which excess deaths were highest in B.C. were the weeks in which COVID transmission was lowest,” wrote a spokesperson.

But it’s a long-established fact that deaths are a lagging indicator for infections, meaning someone will die weeks after getting infected, which is a pattern seen in B.C. over successive waves of the virus.

While McGrail’s analysis ran from March 2020 to just September 2021 and doesn’t include the entirety of the Delta wave or either Omicron wave, it does suggest there’s still much to be learned from her work: the notion B.C. had fewer COVID-19 deaths is a claim fading in credibility, public health officials should expect that they’re not detecting many of the deaths due to the virus in the community, and they could respond much better to fatalities – whether due to decreased medical care, a new variant, extreme weather, drug toxicity or anything else – if they had more timely information.