Provisional death counts and excess mortality, January 2020 to February 2022
The emergence of COVID-19 variants of concern, the rollout of COVID-19 vaccines, and community response to shifting public health measures continue to influence the course of the COVID-19 pandemic in Canada and worldwide. Today, in its commitment to keep Canadians informed of the effects of the pandemic, Statistics Canada is releasing a new and updated provisional dataset from the Canadian Vital Statistics Death Database, covering the period from January 1, 2020 to March 5, 2022.
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.
The provisional data released today reveal that an estimated 30,146 excess deaths occurred in Canada from March 2020 to the end of December 2021. This amounts to 5.8% more deaths than would be expected if there was no pandemic, after accounting for changes in population, such as aging. Within the same period, 29,230 reported deaths were directly attributed to COVID-19. In addition to deaths directly caused by COVID-19, the pandemic could also have indirect consequences that increase or decrease the occurrences of deaths. Trends in mortality statistics during the pandemic could be affected by various factors, including delayed medical procedures, increased substance use or declines in deaths related to other causes, such as influenza.
Nationally, there have been three significant periods of excess mortality March 2020–June 2020; October 2020–February 2021; and August 2021–November 2021) over the period of observation. However, these trends are merely a summary of what has been happening across the country. Not all regions have experienced the pandemic in a similar fashion and provincial and territorial trends in excess mortality tend to differ from those exhibited by Canada as a whole.
Excess mortality in spring 2020 characterized by COVID-19 deaths among those over 85 years of age
The first national period of excess mortality during the pandemic started in April 2020 and lasted until the start of June 2020, resulting in 8,156 excess deaths, 14.8% more than expected. Individuals aged 85 years and older, particularly in Quebec and in Ontario, were most impacted, and COVID-19 was a principal cause of death among this population.
Quebec experienced much of its excess deaths during these early months, when 4,218 excess deaths were reported in the province, constituting 31.9% more deaths than expected. Over the same time, there were 5,265 deaths (30.2% of all deaths during this period) due to COVID-19 reported for the province.
Similarly, this was Ontario's deadliest period of excess mortality observed so far during the pandemic, with 3,358 excess deaths, 16.2% more than expected. Over the same period, there were 2,815 deaths (11.7% of all deaths within this period) attributed directly to COVID-19 in the province.
Excess mortality among Canadians under the age of 45 observed since May 2020; not COVID-19-driven
While no overall significant excess mortality was observed nationally over the summer of 2020, a different story played out for younger Canadians. In fact, those under the age of 45 have been experiencing excess mortality almost continuously since May 2020. From the start of May 2020 to the end of December 2021, there have been 4,494 excess deaths among those younger than 45 in Canada, 19.0% more than expected if there was no pandemic. This pattern has been observed in various parts of the country, including Alberta and British Columbia. Excess mortality is measuring both the direct and indirect impacts of the pandemic, and it has been observed that many excess deaths observed among younger Canadians during the pandemic may be due to other causes, such as overdoses. For example, the number of deaths among Canadians younger than 45 due to accidental poisonings, including overdoses, rose 30.7% in 2020 to 2,639 from 2,018 in 2019.
Excess mortality in the winter of 2020/2021 was felt across Canada
The second period of national excess deaths was marked by a shift across Canada. This second period was longer in duration than the first, observed from the end of October 2020 to the end of January 2021 and resulted in 8,159 excess deaths, 9.9% more than expected. This coincided with 10,040 deaths attributed directly to COVID-19 over the same period. While Quebec and Ontario were predominantly affected in the early months of the pandemic, Manitoba, Saskatchewan, Alberta and British Columbia all experienced extended periods of excess mortality over the winter of 2020/2021.
While older Canadians were particularly affected by deaths due to COVID-19 directly, this period marked a shift in mortality among younger Canadians. This was, in part, due to the ongoing excess mortality felt by those under the age of 45 since May 2020.
Heat is a factor in excess mortality rates in some provinces in spring/summer 2021
While nationally there was no significant excess mortality observed in spring 2021, Ontario and Saskatchewan saw periods of excess mortality during a period corresponding to increased COVID-19 deaths in both provinces. Ontario experienced 1,236 excess deaths from mid-April to mid-May 2021, 11.9% more than expected. Over the three weeks ending on May 15, 2021, Saskatchewan reported a period of excess deaths, with 120 (23.1%) more than what would have been expected.
Beginning in mid-May 2021 and extending through the summer and into the third period of national excess, British Columbia experienced significant excess mortality. While the number of deaths has remained above what would have been expected if there was no pandemic, this period has had a lot of different factors at play. In early summer, alongside Alberta, British Columbia experienced a heat dome which coincided with more than 3,500 deaths in the two provinces over a two-week period ending July 10. Furthermore, those under the age of 45 continued to experience greater-than-expected mortality.
Excess mortality in fall 2021 and early 2022 coincided with the emergence of COVID-19 variants of concern
When the Delta variant was most prevalent and coinciding with increased numbers of deaths reportedly due to COVID-19, Canada experienced significant excess mortality from the start of August 2021 until the middle of November 2021. Over this 15-week period, there were 7,132 (8.8%) more deaths than expected if there was no pandemic. New Brunswick, Ontario, Saskatchewan, Alberta and British Columbia all saw periods of significant excess mortality during these months.
With the emergence of the Omicron variant in late 2021 and early 2022, reported cases of COVID-19 and hospitalizations increased to record highs. Provisional figures at the national level, and for most provinces and territories, are not yet available for January 2022 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 second period of excess deaths in Alberta began in mid-August 2021 and was still ongoing at the end of the observation period (at the end of February 2022). So far, there have been 3,017 excess deaths, constituting 19.0% more than expected. Over this time, there were particularly elevated periods starting in fall 2021, which coincided with when the Delta variant was dominant. Following a decline in December 2021, the number of excess deaths in Alberta accelerated in January 2022, reaching about 150 excess deaths per week by the end of the month and continuing into February. This represents about 26% more deaths than expected if there was no pandemic.
These more recent periods of excess mortality have continued to increasingly impact younger Canadians. To some extent, this shift may be caused by indirect effects of the pandemic, such as missed medical appointments and increased substance use. As noted above, those under the age of 45 have continued to experience excess mortality since May 2020.
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 the 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 to Statistics Canada. Because of these reporting delays, the provisional data would underrepresent the true number of deaths attributed to certain causes, including suicides. 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 December 2021 refer to the period from the week ending March 28, 2020, to the week ending January 1, 2022.
References to the period from the 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 start of May 2020 to the end of December 2021 refer to the period from the week ending May 9, 2020, to the week ending January 1, 2022.
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 mid-April 2021 to mid-May 2021 refer to the period from the week ending April 24, 2021, to the week ending May 22, 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).