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Are all fatalities counted as Saskatchewan’s COVID-19 death toll climbs?

Saskatchewan’s COVID-19 death toll continues to rise, passing 900 on Wednesday.

A researcher says that figure may not count everyone who passed away from of the disease because it hasn’t in the past.

“The excess mortality data that we had for Saskatchewan,” Tara Moriarty said, “and all provinces outside Quebec, suggested that what we were missing was a lot of the deaths in community.”

Moriarty is an infectious disease researcher at the University of Toronto and co-author of a Royal Society of Canada report that found “evidence that at least two thirds of the deaths caused by COVID-19 in communities outside of the long-term care sector may have been missed.”

“Most other Canadian provinces (besides Quebec) look like they missed probably 50 per cent of COVID deaths or more,” she said, speaking from near French River in Ontario.

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“Saskatchewan, B.C. are especially high,” she added.

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To make that determination, Moriarty and her co-authors examined death statistics from across Canada, paying special attention to cremation records in Ontario, which include where the deceased died.

Moriarty said that data show many more people were dying in the community, as opposed to in hospital and in long-term care homes, than governments reported initially.

And by comparing the amount of excess deaths — essentially, the measure of untimely deaths, a figure that would rise in a pandemic — to the COVID-19 mortality figures, Moriarty and her colleagues were able to conclude the official tally missed some deaths.

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Quebec plays a very important role in the calculations because the province tests dead people for COVID-19, Moriarty explained, so it helps provide an accurate picture of the disease in the population.

She told Global News it’s hard to compare data after the end of last year because death statistics are often delayed, even up to two years after someone dies.

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However, she said she is sure the trend continuing.

Moriarty said Canada lags behind most other countries in the Organization for Economic Coordination and Development (OECD), a group of mostly rich countries in reporting death statistics.

The report, published last June, called for Canadian governments to perform COVID tests on anyone who dies in any setting and to mandate weekly preliminary reporting of deaths from all causes.

A Statistics Canada report on provisional death counts from October, the most recent available, states there were 19,501 excess deaths between March 2020 and July 2021, while approximately 25,000 people died from COVID-19 over that same period.

It also states Saskatchewan, Ontario, Alberta and B.C. experienced periods of excess mortality that generally coincided with higher COVID-19 deaths during the same period.

The report states the pandemic can contribute to death statistics in indirect ways that increase or decrease the number of deaths through various factors, like delayed medical procedures, increased substance use or declines attributable to other causes.

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In a statement, the Saskatchewan health ministry said it considers a death a “’COVID-19 death’ when the death is a result of a clinically-compatible illness in a COVID-19 case, unless there is a clear and immediate alternative cause of death that cannot be related to COVID-19  (e.g., trauma). The reported cases would have tested positive for COVID-19.”

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“Not all COVID-19 deaths will be reported to public health for a variety of reasons, for example, the death was due to symptoms not associated with COVID-19 symptoms.”

Global News asked if the province had changed how it tests dead people for COVID-19.

The statement said the province has different standards and slower processes to register deaths and their causes.

“Until this process occurs, it is difficult to determine the exact number of deaths caused by or related to COVID-19.”

Part of the problem, epidemiologist and doctor Cory Neudorf said, is determining if someone died from COVID or died with COVID, which can take time.

He echoed Moriarty about data and pandemic responses.

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Another way to gauge COVID spread in the population is testing rate and numbers, which have declined 24 per cent in the past 30 days, according to the Saskatchewan government.

“All through the pandemic, we know there’s more positives out there than we’re picking up by testing because people either just have chosen not to go and get tested or they’re very mildly symptomatic or asymptomatic at the time,” he said.

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The government delivered hard proof of that fact when it reported in October that half of people receiving treatment for COVID-19 only get tested for the first time when they enter the hospital, or shortly afterwards.

Less testing, pandemic fatigue, people not reporting when they test positive through a rapid test and people avoiding testing drives that trend, Neudorf said.

“We still need to be encouraging people to get tested, even though people are getting tired of it,” he said.

Not knowing the true scope of the pandemic, either through the death count or testing, means policymakers must make choices without important information, Neudorf said.

So, he said the province should wait to remove the current public health orders, which could expire at the end of November.

“We need to keep the measures in place for a while after numbers have come down to ensure it’s a true decrease,” he said, saying the province should also take lagging factors like hospital and ICU admissions into account as well.

Moriarty said knowing how many people died from the disease, and testing more people, both living and dead, gives health-care workers and policymakers a better idea of how much the virus has spread, and therefore better information to keep people safe.

But not knowing limits their ability to understand the actual impact of the pandemic.

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“In terms of planning and everything else, the death information we have (after 2020) is not particularly useful,” she said.

© 2021 Global News, a division of Corus Entertainment Inc.

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