Provisional death counts and excess mortality, January 2020 to January 2022
Statistics Canada continues to inform current and future public health policy through its collection and dissemination of mortality statistics during the COVID-19 pandemic. Today, the Canadian Vital Statistics Death Database is releasing updated provisional data, covering the period from January 2020 to January 2022.
By the end of November 2021, the highly transmissible Omicron variant was detected in Canada. In the weeks and months that followed, both the number of reported infections and hospital stays related to COVID-19 increased, peaking in January 2022, with the highest counts of infections and hospitalizations ever recorded during the pandemic.
To understand 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.
Today's release of the provisional data reveals that an estimated 28,987 excess deaths occurred in Canada from March 2020 to the end of November 2021. This amounts to 6.0% more deaths than would be expected if there were no pandemic, after accounting for changes in population, such as aging. Meanwhile, 28,600 deaths directly attributed to COVID-19 were reported during the same period. 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.
With the emergence of Omicron in late 2021, excess mortality increased in January 2022 in some provinces
Canada has experienced periods of significant excess mortality since the start of the pandemic, typically coinciding with rises in deaths attributed to COVID-19. When the Delta variant was most prevalent, Canada experienced significant excess mortality from the start of August 2021 until the middle of November 2021. Over this 15-week period, there were 7,395 (9.1%) more deaths than expected if there was no pandemic.
With the emergence of the Omicron variant, reported cases of COVID-19 and hospitalizations increased to record highs. However, with this wave, did Canada experience significant excess mortality, or more deaths than expected if there was no pandemic?
Provisional figures at the national level, and for most provinces and territories, are not yet available for December 2021 and onwards. However, among jurisdictions for which data is available, excess mortality was observed for some provinces following the emergence of Omicron.
For example, the number of excess deaths in Alberta declined in December 2021, following a period of significant excess mortality in the fall. After the rise of reported cases of COVID-19 in December, the number of excess deaths in Alberta accelerated in January 2022, reaching about 150 excess deaths per week by the end of the month. This represents about 25% more deaths than expected if there was no pandemic.
As the pandemic has evolved, excess mortality has increasingly impacted younger Canadians
Since the onset of the pandemic, there have been three distinct periods of overall excess mortality observed on a national scale. Over these periods, the impacts of excess mortality have shifted from predominantly affecting older Canadians to increasingly affecting younger age groups. To some extent, this shift may be caused by increased indirect effects of the pandemic, such as missed medical appointments and increased substance use.
The first period of excess deaths during the pandemic started in April 2020 and lasted until the start of June 2020, resulting in 8,156 excess deaths—14.8% more deaths than expected. Women (22.5%) and men (17.4%) over the age of 85 were impacted most, with a higher-than-expected number of deaths, occurring from the beginning of April to early June. For older Canadians, excess mortality figures aligned closely with deaths attributed directly to COVID-19 during this period. On the other hand, although excess deaths were experienced by younger age groups in this first period, males and females under the age of 45 were the least impacted, with 11.8% and 8.6% higher-than-expected number of deaths, respectively. Unlike their older counterparts, however, excess mortality among the younger population did not align with deaths caused by COVID-19. About 1.3% of deaths involving males under the age of 45, and 1.0% of deaths involving females in the 0-44 age category were attributed to COVID-19. This suggests that other factors, including possible indirect impacts of the pandemic, were at play. For example, there was an observed increase in 2020 for deaths caused by accidental poisonings, including overdoses, which disproportionately affected younger Canadians.
The second period of excess deaths was marked by a decline in the impact of excess deaths among the most elderly and an increase among younger Canadians. This second period was much longer in duration, observed from the end of October 2020 to the end of January 2021, resulting in 8,163 excess deaths, or 9.9% higher than expected. Males and females aged younger than 45 became the most impacted, with 19.7% and 11.7% more deaths than expected, respectively. Similar to the first period, excess mortality among younger Canadians continued to outpace deaths attributed directly to COVID-19. About 1.6% of deaths involving males under the age of 45, and 1.9% of deaths involving females in the same age group, were attributable to COVID-19. This suggests that the role of the indirect effects of the pandemic, such as increased substance use leading to overdoses, may have increased from the first wave. On the other hand, among Canadians 85 and older, the impact of excess mortality declined to 10.4% (for women) and 13.1% (for men) above the expected number of deaths. Unlike for younger Canadians, deaths caused by COVID-19 continued to play an important role in the observed excess mortality among Canadians aged 85 and older—16.0% of deaths among women and 15.1% among men were attributed to COVID-19 during this period.
In the third national period of excess deaths, from early August to mid-November 2021, individuals aged younger than 45 continued to be the most impacted. Excess deaths among younger males and females were 24.4% and 17.6% more than expected, respectively. Excess deaths among the most-elderly age category—those aged 85 and older—decreased, at 6.4% (men) and 3.8% (women) higher than expected. For more recent periods, information on causes of death may be less complete. This means that it is still too early to fully understand how deaths attributed directly to COVID-19 may have impacted excess mortality trends during this third period.
Users are advised to exercise caution when using these provisional datasets. The data are provisional because they do not reflect all the deaths that occurred over that period. Certain deaths investigated by coroners or medical examiners often require lengthy investigations. Because of this, it can take longer to report cause-of-death information for investigated deaths to Statistics Canada. Because of these reporting delays, the provisional data would underrepresent the true number of deaths attributed to certain causes, including suicides, during that period. More comprehensive data on causes of death for 2020 were made available on January 24, 2022.
Statistics Canada will continue to update, on a monthly basis, more recent data on deaths, causes of death and comorbidities as these data become available, to keep Canadians informed as the pandemic continues.
Note to readers
The data released today are provisional, as they are not based on all the deaths that occurred during the reference period because of reporting delays, and because 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 of the Canadian Vital Statistics Death Database.
The provisional death counts and estimates 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 basis for comparison with current death counts. Significant variations may be observed from year to year in the annual death counts, particularly in the least-populated provinces and the territories. Moreover, yearly death counts may be affected by changes in the composition of the population, particularly in regard to age, and changes in mortality rates (e.g., reduced mortality). 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 2020 and 2021 would be expected, regardless of COVID-19.
A second challenge is the difficulty of collecting timely death counts. 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.
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."
The tabulation of 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."
References to the period from March 2020 to the end of November 2021 refer to the period from the week ending March 28, 2020, to the week ending November 27, 2021.
References to the period from the beginning of April 2020 to the beginning of June 2020 refer to the period from the week ending April 4, 2020, to the week ending June 6, 2020.
References to the period from the end of October 2020, to the end of January 2021 refer to the period from the week ending October 31, 2020, to the week ending January 30, 2021.
References to the period from early August 2021 to mid-November 2021 refer to the period from the week ending August 7, 2021, to the week ending November 13, 2021.
The Life expectancy and deaths statistics portal, presenting information related to death in Canada, was updated today. It features a Provisional deaths and excess mortality in Canada dashboard, which brings recent insights into the trends in excess mortality together with interactive data visualization tools.
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; firstname.lastname@example.org) or Media Relations (email@example.com).