A mixture of viruses that weighs heavily
In total, approximately 77,300 people lost their lives last year in the province. This is 4,000 more than the ISQ demographers had predicted. Quebec thus ends 2023 with an excess mortality of 5.5%. This represents 865 fewer deaths than in 2022, the year when Quebec recorded excess mortality propelled by the Omicron wave of 8.8%. However, this year, the root cause of excess mortality seems clear. “We first observed an increase in deaths associated with COVID-19 this fall, but afterward, it was really the presence of other respiratory viruses that seemed to have had an effect at the end of the year. We cannot yet measure it precisely, but this epidemiological mixture is the main cause that we are currently seeing,” illustrates ISQ demographer Frédéric Fleury-Payeur.
Young people more at risk
If the majority of deaths still occur among those aged 70 and over – there will be nearly 60,000 in this age group in 2023 – the most significant statistical increase in excess mortality is observed among Quebecers in under 50 years old. Indeed, Quebec recorded 659 more deaths than expected in this age group, representing an excess mortality of 24.4%. According to Mr. Payeur, this phenomenon could be linked to the rapid increase in the population in this age group, but also to the opioid crisis. “This crisis is less acute in Quebec [qu’au Canada et aux États-Unis], but it is more accentuated than before the pandemic. There is therefore a real excess mortality that could be associated with the increase in overdoses, largely linked to opioids,” he says, recalling nevertheless that the excess mortality rate among young Quebecers “remains among the lowest in the world “.
The regions most affected
Excess mortality affected regions outside Greater Montreal more in 2023. Nearly 34,000 Quebecers who lost their lives this year were in the regions, while fewer than 20,000 of them lived in Montreal or Laval and 24,000 in Lanaudière , the Laurentians or Montérégie. During the pandemic, especially during the first wave, it was quite the opposite: the metropolitan region had been strongly affected by deaths.
PHOTO PATRICE LAROCHE, LE SOLEIL ARCHIVES
The ISQ demographer Frédéric Fleury-Payeur
We also see it in South Korea: regions less affected during the pandemic end up being more affected one day or another. That’s kind of what’s happening here.
Frédéric Fleury-Payeur, demographer at the ISQ
“Perhaps collective immunity is less strong, since the regions were not hit as hard during COVID,” maintains the demographer. According to him, a certain form of “harvest effect”, i.e. the drop in deaths which often follows an excess of mortality, also probably still has an impact in Montreal.
Men and women, same portrait
It’s almost a statistical equality: while approximately 38,525 men died in 2023 in Quebec, 38,780 women lost their lives. In short, excess mortality was practically identical for both sexes, approximately 5.4% to 5.5%. Last year, however, excess mortality was higher among men, whose life expectancy is generally lower than that of women. So why is there such a small difference this year? “Probably men and women were exposed to the same epidemiological phenomena. This demonstrates the importance that it has, especially since the evolution of mortality was very similar throughout the year, from one sex to the other,” replies Mr. Payeur.
Europe at a similar level
Very few countries have data as recent as Quebec in terms of excess mortality. Preliminary data from certain European states such as France, Belgium and Spain, however, seem to indicate that the Old Continent “is roughly in the same situation as Quebec,” argues Frédéric Fleury-Payeur. He adds that as in Quebec, excess mortality accelerated at the end of the year in Europe, to the point where, in all of the 27 countries or nations participating in the EuroMoMo consortium, it was estimated at 9.9% during the last three weeks of the year. Mortality has been above the normal fluctuation range since mid-October. According to data from the World Mortality Dataset, Finland even reached an excess mortality of 35% in the week ending November 11.