Alberta outpaced Canada in excess deaths in fall as COVID-19, opioids devastated: StatCan

Alberta’s excess death rates led Canada in fall 2020, a spike attributed to both the COVID-19 pandemic and opioid overdoses

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Alberta’s excess death rates led Canada in fall 2020, a spike attributed to the COVID-19 pandemic and opioid overdoses, per new Statistics Canada data.

About 8,700 Albertans died in the fall, 12 per cent more than would have been expected if there was no pandemic. That rate of excess death is more than twice what was logged in the spring, during the province’s first wave of novel coronavirus infections.

In total, nearly 29,000 Albertans died in 2020, compared to the expected 26,900 mortalities in the year — a difference of 2,078 deaths. In the same year, Alberta reported 1,212 deaths from COVID-19 and 1,139 deaths from opioid overdoses.

The data illustrate twin public health crises that each demand interventions, said Katrina Milaney, a University of Calgary associate professor whose research influenced the opening of Calgary’s supervised consumption site.

“There are two public health crises happening at the same time. They may sound like they are distinct from each other, but they are connected, and they are equally important,” Milaney said.

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Alberta has logged an excess number of deaths each week since Oct. 31, peaking the week ending Dec. 26, when 749 Albertans died. The timeline corresponds to the start of the second wave of COVID-19 in Alberta, which accelerated following Thanksgiving and spiked during the holidays.

As a whole, Canada saw about five per cent more deaths than expected in 2020. Alberta and British Columbia led Canada in excess deaths in the second wave, while Quebec and Ontario drove the rates in the first wave.

“They were really hit hard in that first wave and we just weren’t here,” said Dr. Kirsten Fiest, epidemiologist with the Cumming School of Medicine.

“I think what we saw is, they were also hit hard by the second wave but maybe they learned a little bit more whereas for us out west, it really was the first time we were experiencing that massive crush of cases, hospitalizations and ICU admissions.”

Statistics Canada calculates expected mortality by taking the mean value of historical data over the preceding three years, according to analyst Heather Hobson. The calculations give an expected number of deaths for each week during the year, as well as a 95 per cent confidence interval. The agency also takes into account demographics like sex and age.

The data is provisional, Hobson cautioned, with not all provinces having yet reported statistics for the entire year.

“For the most part, it was elderly individuals, individuals over 65, that experienced the majority of the excess mortality, and experiencing the overwhelming majority of the COVID deaths,” Hobson said.

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Another disproportionate group of excess deaths emerged in the data too, Hobson said: young adult men. Citing cause-of-death data, Statistics Canada said the increased mortality in that group is thought to be linked to opioid overdoses.

For Milaney, the link between excess deaths and opioids did not come as a surprise.

She said the pandemic has indirectly increased risks for drug users with some services forced to close or operate under limited capacity, coupled with an increase in toxicity of drug supply. But the core problems driving these deaths are not new.

“We’ve never really had the capacity to respond to the demand. It’s a long-standing problem, that there are far more people struggling with mental health and addictions than there are services available to them,” Milaney said.

“People who use substances and people who have mental health issues typically die a lot younger than people who don’t. … I think we know what we need to do. We know that harm reduction works. We know that providing a full continuum of supports for people, for whatever stage they’re at, in their journey or in their recovery, is the most important thing.”

Fiest posited that in addition to deaths from COVID-19 and opioids, two other factors may have played a role in elevating Alberta’s excess death rates.

The first possibility is delayed surgeries.

“It makes you wonder what effect it had on individuals, delaying surgeries or not being able to see their doctors as they ordinarily would have,” Fiest said.

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“The other thing that comes to mind is whether people were in general avoiding seeking help for their conditions, or waiting until it was quite late or quite severe before they went to the hospital. Anecdotally, we’ve absolutely heard reports of people not coming into hospital with chest pains or other symptoms until it was quite far along, for fear of being exposed to COVID while they were at the hospital.”

The best thing Alberta can do to prevent further excess deaths in coming months is complete widespread vaccinations, Fiest said.

jherring@postmedia.com

Twitter: @jasonfherring


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