One year from Canadas first COVID-19 deaths, what do the numbers tell us? – The Globe and Mail

A man wearing protective clothing, a face mask and gloves at the Lynn Valley Care Centre, in North Vancouver on March 9, 2020.

DARRYL DYCK/The Globe and Mail

One year ago today, Canada reported its first death from a then-mysterious novel coronavirus. The victim was an elderly resident of Lynn Valley Care Centre in North Vancouver. His death turned out to be a harbinger of the horrors that would unfold inside seniors’ facilities and in hospital wards and intensive-care units in the hardest-hit neighbourhoods in the country.

Twelve months later, Canada has approved four vaccines for SARS-CoV-2, the virus that causes COVID-19. The vaccination campaign is providing a dose of hope. But even as Canadians roll up their sleeves to be inoculated, the virus continues to claim lives – albeit at a slower pace than during the recent peak of the crisis in January and February.

Canada’s COVID-19 death toll is now more than 22,250 and counting. Kelly Grant, Jeremy Agius and Murat Yukselir unpack the data behind that grim tally to see how the country fared in the first year of the pandemic.

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Better than most G7 countries, worse than top performers

Since the outset of the pandemic, Canada has recorded nearly 59 deaths for every 100,000 people. That makes the country 57th overall in deaths per capita. Among Group of Seven countries, only Japan did a better job of preventing coronavirus deaths. In fact, Canada saw fewer deaths per capita than any European country except Estonia, Denmark, Belarus, Finland and Norway.

COVID-19 death rates in the world

Per 100,000 people, as of March 7

Where G7 nations stand in the world

MURAT YÜKSELIR / THE GLOBE AND MAIL,

SOURCE: OUR WORLD IN DATA

COVID-19 death rates in the world

Per 100,000 people, as of March 7

Where G7 nations stand in the world

MURAT YÜKSELIR / THE GLOBE AND MAIL,

SOURCE: OUR WORLD IN DATA

COVID-19 death rates in the world

Per 100,000 people, as of March 7

Where G7 nations

stand in the world

MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE: OUR WORLD IN DATA

Canada’s death toll is modest compared with the staggering totals in the United States, Britain and Europe’s largest countries. In the U.S., more than 525,000 people, or 158.6 per 100,000, have died of COVID-19, the most by far of any country. But in per-capita terms, Britain (183.7 deaths per 100,000) and Italy (165) fared even worse.

Still, Canada’s handling of the pandemic looks dismal when compared with global standouts, including its southern hemisphere twin, Australia. Thanks to strict border and quarantine measures, and one of the longest lockdowns of the pandemic in the Melbourne area, Australia boasts a death rate of just 3.6 per 100,000. New Zealand, South Korea, Taiwan, Thailand and Vietnam have all done an impressive job of controlling the virus, recording relatively few deaths.

Few deaths in Atlantic Canada, many in Quebec

Within Canada’s borders, the Atlantic region has been a leader in controlling the coronavirus. Nova Scotia has recorded just 65 deaths, the vast majority of them during a single catastrophic outbreak at a Halifax nursing home last spring. New Brunswick has reported 28 deaths and Newfoundland and Labrador has recorded six. Nobody is known to have died of COVID-19 in Prince Edward Island or the Northwest Territories. Yukon and Nunavut have each reported one death.

Monthly deaths from COVID-19

Deaths per 100,000 people, as of March 7

First wave peak of

10.8 mostly concentrated

in Quebec and Ontario

while second of 11.5

was more evenly spread

toward the West

Note: March, 2021 data incomplete

Cumulative COVID-19 death rates,

by province

Deaths per 100,000 people, as of March 7

JEREMY AGIUS AND MURAT YÜKSELIR /

THE GLOBE AND MAIL, SOURCE: PUBLIC

HEALTH AGENCY OF CANADA

Monthly deaths from COVID-19

Deaths per 100,000 people, as of March 7

First wave peak of

10.8 mostly concentrated

in Quebec and Ontario

while second of 11.5

was more evenly spread

toward the West

Note: March, 2021 data incomplete

Cumulative COVID-19 death rates, by province

Deaths per 100,000 people, as of March 7

JEREMY AGIUS AND MURAT YÜKSELIR / THE GLOBE AND MAIL,

SOURCE: PUBLIC HEALTH AGENCY OF CANADA

Monthly deaths from COVID-19

Deaths per 100,000 people, as of March 7

First wave peak of 10.8 mostly

concentrated in Quebec and Ontario

while second of 11.5 was more

evenly spread toward the West

Note: March, 2021 data incomplete

Cumulative COVID-19 death rates, by province

Deaths per 100,000 people, as of March 7

JEREMY AGIUS AND MURAT YÜKSELIR / THE GLOBE AND MAIL,

SOURCE: PUBLIC HEALTH AGENCY OF CANADA

Compare that with Quebec, where nearly 10,500 have succumbed to the virus. That works out to 122 deaths per 100,000, nearly twice the rate of the next-worse province, Manitoba (65.8 per 100,000), and more than twice the rate of Ontario (48) or Alberta (43.3).

If Quebec were a country, it would rank 27th in the world, just behind virus-ravaged Brazil. Last week the Quebec government revealed that life expectancy in the province had fallen by five months for men and eight for women, reversing the long-standing trend of Quebeckers living longer every year. Over all, there were 10 per cent more deaths recorded in the province in 2020 than in 2019.

COVID-19 is the third-leading cause of death in Canada

Statistics Canada has not yet released the top causes of death for 2020, but it’s almost certain that COVID-19 will be third, behind only cancer and heart disease.

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From 2015 to 2019, the average number of deaths each year caused by cancer and heart disease was around 79,000 and 52,000, respectively. The third and fourth causes of death, strokes and accidents (a category that includes unintentional drug overdoses), caused about 13,000 deaths each.

With more than 22,000 deaths in the 12-month period from March, 2020, to March, 2021, COVID-19 easily slides into third place. That holds even if you count only the 15,472 COVID-19 deaths reported in the 2020 calendar year.

The COVID-19 death toll is greater than the confirmed toll of seasonal flu. Statistics Canada groups influenza and pneumonia deaths together as a single category. The category averaged 7,333 deaths annually from 2015-19.

The vast majority of deaths were in seniors

Throughout the pandemic, COVID-19 has been deadliest for the elderly. According to the Public Health Agency of Canada, 96.1 per cent of deaths for which the agency has complete data have been among people 60 or older. People older than 80 have accounted for nearly 70 per cent.

But the virus hasn’t been equally lethal to all seniors. Those living in congregate settings were infected and killed at significantly higher rates than seniors living on their own, according to a research letter that Toronto geriatricians Samir Sinha and Nathan Stall published last fall. The gap between the two groups was larger in Canada than in 11 other countries in the Organization for Economic Co-operation and Development, the researchers found.

COVID-19-related deaths by age group

As of March 5

Provincial breakdown of COVID-19-related deaths of residents in long-term care and retirement homes

As of Feb. 15

THE GLOBE AND MAIL, SOURCE STATISTICS CANADA;

NATIONAL INSTITUTE ON AGEING

COVID-19-related deaths by age group

As of March 5

Provincial breakdown of COVID-19-related deaths of residents in long-term care and retirement homes

As of Feb. 15

THE GLOBE AND MAIL, SOURCE STATISTICS CANADA;

NATIONAL INSTITUTE ON AGEING

COVID-19-related deaths by age group

As of March 5

Provincial breakdown of COVID-19-related deaths of residents

in long-term care and retirement homes

As of Feb. 15

THE GLOBE AND MAIL, SOURCE STATISTICS CANADA; NATIONAL INSTITUTE ON AGEING

That data was analyzed before Canada’s second wave washed across every province west of the Maritimes. In the end, more residents of Canadian nursing and retirement homes died in the second wave than the first, underscoring a failure to learn the lessons of last spring.

If another wave takes off, there is good reason to believe history won’t repeat itself a third time in seniors’ facilities. With the majority of residents now vaccinated, COVID-19 infections and deaths have plunged faster inside long-term care than in the community. A new study from Ontario’s COVID-19 science advisory table estimates that vaccinations in long-term care homes prevented an estimated 2,079 infections, 249 hospitalizations and 615 COVID-19 deaths in residents.

The tiny number of COVID-19 deaths among young people – 0.5 per cent of deaths have been in those under 40 – does not mean the virus has spared them entirely. At least 747 people in the under-40 category have been admitted to intensive-care units with COVID-19, and an untold number are suffering the lingering effects of long COVID.

Outside of nursing homes, racialized communities hit hardest

The slogan at the start of the pandemic was, “We’re all in this together.” As the months rolled on, it became clear that wasn’t true. The coronavirus tore through certain communities with more speed and lethality than others.

The neighbourhoods that suffered most shared a profile. They were home to racialized Canadians who worked poorly paid front-line jobs and lived in crowded housing, often with older relatives. Recognizing the trend, some cities began collecting data on the race, income and housing situations of people who tested positive.

Toronto found that 77 per cent of infections diagnosed outside nursing homes as of Dec. 31 were in racialized people, despite their making up 52 per cent of the city’s population. Racialized Torontonians were also far more likely than their white counterparts to wind up in hospital with COVID-19.

In neighbouring Peel Region, which includes Brampton and Mississauga, the disparities were similar, with people of South Asian descent accounting for 57.5 per cent of cases while making up just over 30 per cent of the region’s population. In Manitoba, 51 per cent of infections were in racialized people, a rate 1.5 higher times than expected, given their share of the population.

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Data on race and COVID-19 deaths is scarce, but it stands to reason that a significantly higher infection rate would put racialized Canadians at greater risk of dying.

The fatality rate changed over the year

From the earliest days of the pandemic, scientists have been trying to pin down the case fatality rate, or CFR, of SARS-CoV-2. Of all the people the virus is known to have infected, how many die? (The infection fatality rate, a related measure, uses all infections as its denominator, including those never confirmed through testing.)

Many factors influence the CFR for COVID-19, the disease caused by the virus. Testing volume matters, but so does the age of the infected (if they are primarily young, few will die) and the quality of the medical care that patients receive.

In Canada, the overall CFR loosely tracked the waves of disease, according to Public Health Agency of Canada figures crunched at the request of The Globe and Mail. Last spring, the overall CFR was 6 per cent in March, 12 per cent in April and 7 per cent in May, but those figures reflect limits on testing that made the disease seem deadlier than it was. Overall CFR dropped to 1 per cent in July, August and September, then rose to 2 per cent and stayed there until the end of January, the last month for which the agency was able to provide complete data.

Among COVID-19 patients sick enough to be admitted to hospital, including the ICU, the fatality rate peaked at 31 per cent in April, dropped to 15 per cent in August and rebounded to 21 per cent in November and December.

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