Politics, resources, or policy? Why B.C. may be dramatically underreporting COVID-19 deaths

As a fall wave of the pandemic appears to be building, infectious disease experts are warning B.C.’s risk is high and the government-reported number of COVID-19 deaths is misleading.

The fine print on the B.C. Centre for Disease Control’s weekly COVID-19 Situation Report reads that as of April, the province is only including deaths that occurred "within 30 days of their first positive COVID-19 lab result date."

Sarah Otto, a UBC biomathematics professor and core member of the B.C. COVID-19 Modelling Group said she’s had confirmation that if someone had a lab-confirmed case of COVID-19 in August 2020, got sick again in August of this year and was hospitalized, tested positive and died from the virus, that person would not be counted, since it was well in excess of 30 days since their first positive test.

“I think it's really important that we don’t just say, 'Oh, you're re-infected, you don't count in our hospital admissions, you don't count in our deaths,’” said Otto. “Of course, if people are dying from COVID-19, we want to know that. We want to know what the total death rate is from this disease.”

The 30-day reporting change has been criticized as potentially leading to an over-count of COVID-19 deaths, since someone who tested positive but died for another reason, like a car crash or terminal illness, would count. But Dr. Bonnie Henry has clarified that even hospitalized patients with symptoms are only tested for the virus if it would changed their course of treatment.

A Canada-wide “COVID-19 Hazard Index” run by a collection of academics, researchers, data scientists and others, rates B.C. as “severe” with a score of 9 out of 10, whereas the national rating is 7.

LONG-RUNNING SCRUTINY OF B.C.’S DEATH RATE

Last year, a study by the Royal Society of Canada found the province’s death toll could be double what was reported, since B.C. has an exceptionally high excess mortality rate – that is, more deaths than would typically happen without a specified cause, like a mass disaster.

At the time, Henry tried to dismiss the finding as inaccurate and blamed reluctance to seek medical attention for the excess deaths, but they have continued: British Columbia has thousands of deaths without an attributed cause.

“What there hasn't been is the political will to address that. To answer, ‘Why are all these people dying in this province and we don't know what's causing their deaths?'” said Tara Moriarty, an associate professor of infectious disease at the University of Toronto.

“B.C. has always had a big gap between expected and unexplained excess mortality that's not explained by the number of COVID-19 deaths or reported toxic drug deaths, and a lot of these deaths are in people 65 and older.”

The official count of COVID-19 deaths in the province is 4,370, according to the latest figures from the B.C. Centre for Disease Control. The Public Health Agency of Canada has the per-capita deaths in B.C. at 84 per 100,000 people, compared to 98 in Ontario and 195 in Quebec. But B.C. and Ontario both have much higher excess mortality.

Moriarty says both Quebec and Manitoba take great pains to count pandemic fatalities, often doing post-mortem testing if someone had possible symptoms, resulting in very few excess deaths and higher COVID-19 death rates.

WHY NOT FIX THE PROBLEM?

Through the majority of the pandemic, B.C.’s government and health officials have been criticized for holding COVID-19 statistics, studies, and various data close to the vest, despite calls to “show (their) work.”

The premier and health minister have repeatedly bragged about having weathered the pandemic better than most other provinces, but B.C. has consistently tested for the virus well below the national average, and enjoyed pointing to lower infection rates as a result.

COVID testing in BC is low and there have been issues since day 1.
In fact, exactly a year ago I wrote this piece about how we didn't know our true infection numbers because at the time, testing capacity was a major issue. 🧵https://t.co/iVPT0CFgSz

— Penny Daflos (@PennyDaflos) March 19, 2021

At the same time, the coroners service is overwhelmed and struggling to keep up with drug toxicity deaths and heat-related deaths, making diagnosis challenging, even without the strain of enhanced screening for COVID deaths.

CTV News asked Moriarty whether she thought it was pandemic politics, inaccurate accounting of toxic drugs, underreported hyperthermia cases, or insufficient resources leading to the excess deaths.

“It's probably a confluence of all those things, despite the fact it's obvious there's a problem, and there's multiple research groups including our own pointing to these glaring problems,” she replied. “It's never the wrong time to do the right thing.” 

B.C. continues to have more excess deaths than any other province, per capita, according to the latest data from Statistics Canada: