A week ago during question period in the Nova Scotia legislature the leader of the opposition accused  the Premier of delaying the monthly release of  the primary care wait-list because it contained bad news. A few hours later – and about a week after the normal delivery date – the list was released. And sure enough, the news was bad. 

 The number of names on the “Need A Family Practice Registry” increased by over 5,500 in September, a jump of five percent. But by the time the news came out  late Friday the legislature had adjourned for the weekend. That conveniently provided  a three-day grace period before the government has to face any questions in the legislature  about a wait-list that has grown by 62 percent since August 2021, when Nova Scotians elected a PC government boasting it would be “laser focused on fixing health care.”

Whether the delayed release was due to administrative problems – as claimed  by the government – or political manoeuvring is no big deal. The numbers are now in the public domain, to be wrangled over until the next batch comes out.  More interesting  was the attempt by Liberal leader Zach Churchill to equate last week’s wait-list peekaboo with the Houston government’s management of  information about COVID-19. 

As Churchill put it  “when COVID got worse, the information was reduced,” a statement that is on the mark.  Consider the time before the numbers became “worse”.

  • Last October, with new cases of about 150 a week, no new deaths reported and only 15 people in hospital, Nova Scotia health provided Monday to Friday daily updates;
  • Between Oct. 19 and Nov. 24, as reported deaths from COVID increased by nine, the Premier and Chief Medical Officer of Health Robert Strang held four media briefings, taking questions from reporters;
  • With the first appearance of the Omicron variant, the frequency of media briefings increased as recorded deaths rose slowly from 110 to 117 between Dec. 7,2021  and Jan. 12, 2022.     

Then consider what happened when the death count began to accelerate through January and February,  and the pace of media briefings featuring the Premier and Dr. Strang slowed, while the messaging changed.

Living with it

  • A briefing on Jan. 26 included condolences to families of the 22 who had died since Jan. 12, but the focus was on urging vaccinations and finding a path to easing restrictions.  
  • Details of the path were laid out on Feb. 9 when, in addition to condolences for 25 more COVID victims, the Premier and Strang announced a phased movement toward “living with COVID-19,” a process that would lead to removal of all restrictions six weeks later. As Houston put it at that Feb. 9 briefing: “The more we continue to allow COVID to control our daily lives, the more we will see the impact, especially on our children and our seniors.”

 As it turned out, one approach to reducing COVID’s influence on daily living was to imitate the proverbial wise monkeys. Daily reports about the “evil” COVID would be cancelled and replaced with weekly, less detailed reporting. And the Premier would adopt the role of the hands-over-the-mouth speechless monkey, Iwazaru. 

Houston would participate in only two more COVID briefings, the last one on March 18, mainly to apologize for extending the masking mandate in schools for another month. Houston mentioned families who had lost loved ones, but did not provide the numbers which would have revealed almost 80 additional deaths since his “living with COVID” announcement of Feb. 9.

The Missing News 

The reduction in briefings and data would mean a lot less seeing, hearing and speaking about the evils of COVID in the news. And quality, as well as quantity, would suffer. Data has been inconsistently reported and numbers bounced around, particularly mortality figures. For example, last Friday one media outlet reported “11 deaths, more than 900 cases reported this week.” Should Nova Scotians have been concerned? Not too much if they went by the CBC report the following Monday, explaining that “Nova Scotia sees dip in COVID-19 deaths in September.” But hold on – yesterday (Thursday) came news that for the week of Oct. 11-17 there were 17 COVID deaths, the most in any week since June.

The reason for the conflicting messages is that last Friday’s report and the one from this Thursday covered the two-week period from Oct. 4-10 and Oct. 11-17, while the Monday report was for the entire month of September. It now appears that COVID deaths in October – 28 so far – will greatly exceed those reported in September. Whether the story will be reported that way remains to be seen.    

As the snapshot of a week’s worth of reporting illustrates, media compilations of cases, deaths and hospitalizations may be up one week and down the next. In fact, in 26 weekly reports between March 30 and Oct. 20, death counts were down 16 times and up 10 times. It’s only when the numbers are added that a full picture of the overall increase emerges. Since Omicron arrived on the scene there have been 460 deaths, on top of 112 to that point. That’s an increase of 411 per cent, about eight times the national increase  of around 53 per cent. 

Usually such a startling fact would rate a mention or two in the media, if not a headline, but I’ve seen neither.

To put that increase in context, one plausible explanation for the enormous gap between Nova Scotia’s and Canada’s rate of increased mortality is that Nova Scotia – like the other provinces in Atlantic Canada – started from a much lower base. 

A more appropriate metric would be COVID deaths per capita since the advent of Omicron, which would show Nova Scotia about seven per cent above the national rate. Based on the federal government’s epidemiology update of Oct. 14, COVID deaths in Nova Scotia since December were 43.3 per 100,000 population versus 40.4/100,000 nationally. That’s a far cry from the numbers experienced during those halcyon “Stay the Blazes Home” days, when people were reportedly moving here to escape the pandemic.

The fact that neither the sensationalism of the 411 percent increase, nor the more balanced “above the national average” have been reported suggest that the government’s wise monkey approach has been aided by spread of “covid fatigue” into the ranks of an already understaffed, beleaguered media. Indeed, the quintessentially beleaguered Chronicle-Herald reported the opposite story, creating the headline “Strang: Death toll below national average” in its August 31 edition.  This is accurate if you count from the beginning of the pandemic in 2020 but is not reflective of what’s been happening since restrictions were eased. 

The ageism thing

In addition to sloppy journalism there is ageism, perpetuated by inclusion in the Province’s weekly updates of the fact that 83 is the average age of those dying from COVID. The unspoken notion that COVID is less of a problem because it mainly kills old people who were going to die soon anyways has been a factor in how the politicians and the media have approached this story from the outset. I wrote about this  here in 2020 when COVID swept through Northwood nursing home.  Then, as now, the concern seemed to be less with the dead than the capacity of hospitals to cope with a widespread outbreak.

For a time the tragedy at Northwood and even worse conditions in other provinces put the spotlight on the plight of long term care residents. Internationally Canada received a black eye for having one of the highest rates of COVID deaths in long term care facilities. There was a half-baked inquiry in Nova Scotia, and larger inquests in some other provinces. 

But that attention has shifted with Omicron.  In July the National Institute on Aging (NIA), based in Toronto, gave up trying to keep track of COVID deaths in long term care because provincial governments were not making enough information available. But the government cover-up exposed by the NIA went virtually unnoticed.

In Nova Scotia the authorities don’t seem to have covered up deaths in long term care facilities, but they have made the numbers hard for a COVID-fatigued media to find.    

The curious have to go through the monthly epidemiological reports and add them up. By my calculations there were 113 COVID deaths in long term care between December 2021 and the end of September, 2022. That’s nearly double the 62 deaths – including 53 at Northwood – reported during the first 21 months of the pandemic. You may be reading it here first.

Avoiding the Dead   

An imaginative attempt to attract public and political attention to the post-restriction death toll played out late this summer prior to the Aug. 30 meeting of the legislature’s health committee, called to hear from Dr. Strang and other officials on the topic of vaccines. According to the CBC, on August 30 legislators were greeted by a string of 492 red and white paper hearts mounted on the fence surrounding Province House.

The hearts were put there by Protect our Province Nova Scotia (PoPNS), to commemorate the 492 citizens who, to that point, had succumbed to the virus. PoPNS (there are similar PoPs in some other provinces) want the government to re-introduce some public health measures (masking, physical distancing)  and improve the lagging vaccination uptake. Aside from the CBC, their efforts didn’t receive much media attention  and the demonstration  doesn’t seem to have made an impact on the meeting that followed.

Pro-forma condolences for a few that marked the early days of the pandemic did not translate, months later, into an expression of sympathy for the many who had died since. In the Hansard account of the meeting the word “deaths” appeared only a couple of times.

Dr. Strang reiterated public health recommendation for Nova Scotians to make the “personal choice” to wear masks in crowded public spaces and stay up to date on vaccines. But two other things he said stand out.

First, he called for Nova Scotians to take “a balanced approach” to the virus.“You have to respect COVID-19, realize it’s here, but you don’t have to be paralyzed by fear, and you need to find that middle ground.” Secondly, he noted  “ it’s an unfortunate fact of COVID-19 that people who are elderly, often with multiple co-morbidities, are at extreme risk.” Translation: unless you are old and infirm, don’t worry too much about COVID – the government’s Omicron message in a nutshell.