Last October I discussed how the Nova Scotia government’s management of COVID-19 information has worked to keep bad news about the pandemic on a low key. Since the first quarter of 2022, at least 600 Nova Scotians have succumbed to the disease and hospital admissions have averaged more than 50 per week. Despite that, news coverage over the last year or so has been muted.
A key tactic for keeping COVID deaths out of the headlines has been the abandonment of regular briefings by the Premier and the Chief Medical Health Officer. Also gone are daily reports of hospitalizations and deaths, replaced by weekly and monthly summaries that have often been downplayed in the media or reported without context – up one week, down the next, but rarely mentioning that deaths have more than tripled since restrictions were lifted 14 months ago.
Regular briefings and daily updates ended more than a year ago but last November the government came up with another reporting wrinkle that has had the effect of suppressing bad news about COVID. Nova Scotia Health’s weekly Dashboard introduced two classes of COVID deaths – those from the previous week and those that happened during a previous reporting period. Since that change was made, new weekly deaths have often been reported as zero, and have never totalled more than three. Meanwhile deaths from earlier reporting period have exceeded 250, an average of ten per week over the past six months. The effect of this is to further the notion that with few new deaths reported “COVID is over,” its deadly impact a thing of the past.
Excess mortality surges
It may be just a coincidence, but the “that was then this is now” approach took effect just as Nova Scotia was entering a three-month period over Christmas during which there was a spike in what Statistics Canada calls “excess mortality,” i.e. more deaths than would be typical during a span of time.
That information comes to us in a roundabout way. Last Thursday’s Daily Stats put out by the Economics and Statistics Branch of Nova Scotia Finance contained news that “Nova Scotia reported significant excess mortality above the upper bound of expected deaths through much of November, December and January.”
The Daily Stats didn’t put numbers on the “significant” increase, but numbers can be calculated by going to the source – Statistic Canada’s “provisional weekly estimates of the number of deaths, expected number of deaths and excess mortality.” Those estimates, compiled from data on births and deaths provided by provincial governments, show that between early November 2022 and the beginning of February this year Nova Scotia had 544 more deaths than expected. That’s more than two-and-a-half times the number estimated for roughly the same three-month period a year earlier.
Table 1: Excess mortality selected time periods
|Time frame||Excess mortality|
|Nov. 6, 2021 to Jan. 29, 2022||209|
|Nov. 5, 2022 to Feb. 4, 2023||544|
Source: Statistics Canada Table 13-10-0784-01
With an estimated 209 excess deaths between November 2021 and the end of January 2022 Nova Scotia had the lowest rate per 100,000 population among all provinces, well below the national rate of 287. A full comparison with national trends for the more recent three-month timeframe is not possible because a number of provinces have not yet reported vital statistics for those months. However, among the six provinces that had reported to February 4, Nova Scotia’s excess mortality was the highest, by a significant margin.
Table 2: Excess mortality by selected province, November-February 2022-23
|Province||Per/100,000 Nov.4/22-Feb.4/23||Per/100,000 Dec.31/22-Feb.4/23|
|Prince Edward Island||16.1||-0.03|
Source: Table 13-10-0784-01
As Table 2 shows, at 52.4 excess deaths per 100,000 population, Nova Scotia had by far the highest rate among the provinces for whom comparable data is available. The difference is even greater for the five-week period from the end of 2022 to February 4, 2023, shown in the third column. Nova Scotia is almost double the next closest province, Newfoundland and Labrador, while Prince Edward Island actually shows fewer deaths than expected during the five-week period. COVID may be over somewhere, but maybe not here.
To summarize, Nova Scotia did indeed have a significant increase in excess mortality in the three months from November through January. Excess mortality was 160 percent higher than the same three months the previous year. And the Province’s rate per 100,000 population for the November-January period was far and away the highest among the six Provinces for whom comparable data are available.
The thing is, we are only finding out about it now, when it’s too late to take any protective action. And we still don’t know how much of the excess mortality was the result of COVID.
COVID takes a holiday
Over roughly the same period in 2022-3 when excess mortality numbers were surging, Nova Scotia publicly reported six new previous week COVID-19 deaths and 120 deaths from a previous reporting period, a total of 126. Almost half – 57 – were reported in November.
In the three weeks leading up to the December holidays the number reported dropped to just 18. Meanwhile, according to Statistics Canada, excess mortality for those three weeks totalled 101. A January release from Nova Scotia Health, covering the two weeks over Christmas and the New Year, announced one new death and 19 previous for a reported December total of 38 deaths. But the StatsCan estimate of excess mortality for December is 185, leaving 147 excess deaths unexplained.
At 185, excess mortality in December 2022 was four times higher than the previous year, but courtesy of Daily Stats, we get this StatsCanada caution about attributing increased excess mortality strictly to COVID-19.
“There are also several challenges that come with measuring excess mortality, most importantly properly estimating the number of expected deaths that would occur in a non-COVID-19 context as a basis for comparison with current death counts. Significant variations may be observed from year to year in the annual death counts, especially in the least-populated provinces and the territories. Moreover, yearly death counts may be affected by changes in the composition of the population…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 in 2021 and 2022 would be expected, regardless of COVID-19.”
Fair enough, but subsequent releases from Nova Scotia Health suggest that COVID claimed more lives in December than the 38 reported at the time. In January, as excess mortality rose further to 191, the province announced 51 additional COVID deaths. That was followed by 71 in February, all but five of those from previous reporting periods – reporting periods which very likely included December.
Of those February deaths, 27 were announced in the first week. That death toll was a record high for a week, one that would almost be matched with the announcement of 26 more deaths the week of Feb.7-13. Such numbers attracted the attention of a few reporters, who asked Nova Scotia Health why there was a lag in reporting such high numbers.
The explanation given was that there’s a lag because there’s a lag. As reported in The Coast, a spokesperson explained that “Investigations can take some time to be completed as there may be multiple co-morbidities which can result in a lag in reporting.”
Although The Coast asked, the department didn’t cite the holidays, capacity challenges or staff shortages to further explain the lag. And of course no one would suggest for a moment that there was no rush to release December COVID death data that would throw a wet blanket over holiday festivities.