Provisional death counts and excess mortality, January 2020 to July 2021
COVID-19 continues to affect communities and families in Canada. Beyond deaths attributed to the disease itself, the pandemic could also have indirect consequences that increase or decrease the number of deaths as a result of various factors, including delayed medical procedures; increased substance use; or declines in deaths attributable to other causes, such as influenza.
To understand both the direct and indirect consequences of the pandemic, it is important to measure excess mortality, which occurs when there are more deaths than expected in a given period. It should be noted that, even without a pandemic, there is always some year-to-year variation in the number of people who die in a given week. This means that the number of expected deaths should fall within a certain range of values. There is evidence of excess mortality when weekly deaths are consistently higher than the expected number, but especially when they exceed the range of what is expected over several consecutive weeks.
From March 2020 to the beginning of July 2021, there were an estimated 19,501 excess deaths in Canada, or 5.3% more deaths than what would be expected were there no pandemic, after accounting for changes in the population, such as aging. Over this same period, 25,165 deaths were directly attributed to COVID-19.
While COVID-19 claimed the lives of 6,940 Canadians between mid-January 2021 and the beginning of July 2021, significant excess mortality was not observed nationally during this time. However, some provinces, including Ontario, Saskatchewan, Alberta and British Columbia, experienced periods of excess mortality, generally coinciding with a higher number of deaths attributable to COVID-19 over the same period. In addition, British Columbia and Alberta saw periods of higher-than-expected mortality at the end of June 2021 and into July, when a heat wave gripped the two provinces.
As part of Statistics Canada's commitment to providing timely and relevant information on COVID-19 and its impact on Canadians, a new updated provisional dataset from the Canadian Vital Statistics Death Database, covering the period from January 2020 to July 2021, was released today. Updates were also made to the provisional death estimates, which have been adjusted, where possible, to account for the incomplete nature of the counts. The provisional estimates will continue to be revised in future releases, as more information is reported by provincial and territorial vital statistics agencies, and as estimation methods continue to be enhanced.
Users are advised to exercise caution when using these provisional datasets. The data are provisional because they do not reflect all of the deaths that occurred over that period of time. Certain deaths investigated by coroners or medical examiners often require lengthy investigations. Consequently, cause of death information for investigated deaths can take longer to be reported to Statistics Canada. Because of these reporting delays, the provisional data would underrepresent the true number of deaths attributed to certain causes, including suicides, in that period of time. More comprehensive data on causes of death will be available with the annual release of preliminary data covering the 2020 reference year, scheduled for January 24, 2022.
British Columbia and Alberta experienced excess mortality in early summer 2021 associated with the heat
While deaths attributable to COVID-19 were declining, Canada's westernmost provinces experienced a sharp increase in deaths overall at the start of the summer. From the week ending June 26, 2021, to the week ending July 31, 2021, British Columbia recorded 5,472 deaths—an estimated 1,262 more deaths than expected. In fact, the 1,456 deaths in the week ending July 3, 2021, are the highest weekly death toll observed over the last 20 years. Over the same six-week period, an estimated 3,406 deaths were observed in Alberta, 443 more than expected. During this period, daily temperatures consistently exceeded 40°C in both provinces.
The final cause of death has not been reported for many of these cases, and many may still be under investigation. However, where information is available, it suggests a sharp increase in deaths caused by extreme heat in this period. In addition, British Columbia's chief coroner has noted that, as a preliminary estimate, more than two-thirds of deaths in that province between June 20 and July 29 were a result of the extreme heat.
No conclusive evidence of a change in suicide rates during the pandemic
So far, 3,780 suicides have been reported by the provinces and territories for 2020. This represents 232 fewer than the number reported in 2019 (4,012) and is similar to the 3,811 reported in 2018. At this time, it is premature to assess whether or not the rate of suicide in Canada has increased or declined during the COVID-19 pandemic. As noted above, deaths investigated by coroners or medical examiners, such as suicides, accidents and homicides, often require lengthy investigations. Consequently, information on the causes of death, particularly among people younger than 45, whose deaths are more likely to result in an investigation, typically takes more time to be reported to Statistics Canada. Given these factors, the provisional data would underrepresent the true number of suicides that occurred during the pandemic.
To better understand the direct and indirect impacts of the COVID-19 pandemic, Statistics Canada will continue to provide timely information on a regular basis on excess deaths, causes of death and comorbidities, as it becomes available.
Note to readers
A new updated provisional dataset from the Canadian Vital Statistics Death Database, covering the period from January 2020 to July 2021, was released today. Updates were also made to the provisional death estimates, which have been adjusted, where possible, to account for the incomplete nature of the counts. The provisional estimates will continue to be revised in future releases as more information is reported by provincial and territorial vital statistics agencies and as estimation methods continue to be enhanced.
The data released today are provisional, as they are not based on all deaths that occurred during the reference period because of reporting delays, and they do not include Yukon. Provisional death counts are based on what is reported to Statistics Canada by provincial and territorial vital statistics registries. Provisional death estimates have been adjusted to account for incomplete data, where possible. The numbers of excess deaths discussed in this analysis refer to provisional estimates. Information on the methods used can be found in the "Definitions, data sources and methods" section for the Canadian Vital Statistics Death Database.
The provisional death counts and estimates released today may not match figures from other sources, such as media reports, or counts and estimates from provincial and territorial health authorities and other agencies.
There are a number of ways to measure excess mortality, and each has its strengths and weaknesses. There are also a number of challenges with measuring excess mortality, most importantly properly estimating the number of expected deaths that would occur in a non-COVID-19 context as a comparison basis for the current death counts. Significant variations may be observed from year to year in the annual death counts, particularly in the less populated provinces and in the territories. Moreover, yearly death counts may be affected by changes in the composition of the population, in regard to age more particularly, and changes in mortality rates (e.g., improvement of mortality). In the Canadian context, with an aging and growing population, the number of deaths has been steadily increasing in recent years and so a higher number of deaths in 2020 and 2021 would be expected regardless of COVID-19.
A second challenge is the difficulty of collecting timely death counts. In Canada, death data are collected by the provincial and territorial vital statistics offices. Their capacity to provide death data to Statistics Canada in a timely manner varies greatly. Taking these considerations into account, the method chosen by Statistics Canada to estimate expected deaths—which has also been adopted by organizations in several other countries, including the US Centers for Disease Control and Prevention—is adapted from an infectious disease detection algorithm that has been largely utilized in the context of mortality surveillance in recent years.
The tabulation of the causes of death is based on the underlying cause of death, which is defined by the World Health Organization as the disease or injury that initiated the train of events leading directly to death, or as the circumstances of the accident or violence that produced the fatal injury. The underlying cause of death is selected from the causes and conditions listed on the medical certificate of cause of death completed by a medical professional, medical examiner or coroner. More information on causes of death, including the certification and classification of COVID-19 deaths, can be found in the study "COVID-19 death comorbidities in Canada."
The provisional figures on the number of deaths, the causes of death and excess mortality will continue to be updated as more information is reported to Statistics Canada by the provinces and territories and as further enhancements are made to the estimation models. More information on excess mortality during the COVID-19 pandemic in Canada is available in the article "Excess mortality in Canada during the COVID-19 pandemic." Detailed information on the causes of death in Canada for 2020 will be released on January 24, 2022.
Figures related to the report of the British Columbia chief coroner on deaths associated with the heat during the summer are based on the BC Coroners Service July 30 news brief "Chief coroner's statement on public safety during high temperatures."
References to the period from March 2020 to the beginning of July 2021 refer to the period from the week ending March 28, 2020, to the week ending July 3, 2021.
References to the period from mid-January 2021 to the beginning of July 2021 refer to the period from the week ending January 23, 2021, to the week ending July 3, 2021.
To facilitate the identification of trends in excess deaths by province or territory, the product "Provisional weekly estimates of the number of deaths, expected number of deaths and excess mortality: Interactive Tool" has been updated.
To facilitate the identification of trends in the number of weekly deaths by age group and sex and by province or territory, the product "Provisional weekly death counts: Interactive tool" has also been updated.
For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; STATCAN.infostats-infostats.STATCAN@canada.ca) or Media Relations (613-951-4636; STATCAN.mediahotline-ligneinfomedias.STATCAN@canada.ca).