It is too early to gauge the impact of the Omicron wave, but an increase in excess mortality is anticipated for January 2022. The Statistical Institute of Quebec (ISQ) estimates the overall excess mortality at 3% since the start of the pandemic. The fourth wave seems to have hit the regions more so far.
“We cannot yet comment on the months of December and January, but if the trend continues, there is a good chance that we are heading towards excess mortality for the start of 2022”, commented Frédéric Fleury Payeur on Thursday. , ISQ demographer, who will produce detailed data for this purpose in mid-February.
The Institute published its most recent report on Thursday comparing the deaths for the year 2021 until December 4, i.e. before the Omicron wave, with those of the previous 10 years.
If we do not note excess mortality for all of Quebec in 2021 (-1), we do however observe an increase in excess mortality in regions other than Montreal, and Montérégie, Lanaudière and the Laurentians.
As our graphs show, in the metropolis (Montreal and Laval), the average number of weekly deaths, until December 4, 2021, remained several months below the average due to the large number of deaths that occurred during the previous waves among older people.
“There was an advancement of deaths caused by COVID-19, particularly in Montreal and Laval during the first wave of the pandemic in end-of-life settings. This meant that we were subsequently below normal for a good part of 2021, ”explains the demographer.
But that does not seem to be the case in other regions of Quebec, where the death figures rather seem to indicate an increase in mortality. “It may be due to the age structure of these regions. There are regional differences within Quebec itself. We will need more detailed data to explain them,” says Fleury Payeur.
According to Robert Choinière, a retired demographer, formerly at the National Institute of Public Health of Quebec (INSPQ), the cumulative excess mortality in the regions exceeded 6% in October, even before the arrival of Omicron. “Now that there are more daily deaths, we may be able to analyze this trend further,” he said. Prior to December, the numbers were too small to explain these differences. »
One thing is certain, since the beginning of December (from December 1 to January 19), the death rate with COVID-19 per million inhabitants has been significantly higher in certain regions, particularly in Mauricie and Chaudière-Appalaches, than elsewhere. in Quebec.
However, the ISQ maintains that we must look at long-term trends and not temporary fluctuations in death rates. To this end, the Institute has established the cumulative excess mortality since the start of the pandemic in Quebec at 3%, compared to 15% in the United States, 5% in Ontario and nearly 11% in Alberta. “We are among the lowest excess mortality rates in the world,” says Frédéric Fleury Payeur.
Moreover, Prime Minister François Legault repeats that Quebec is doing better than the rest of Canada, by brandishing these rates, rather than deaths due to COVID-19 per capita. In this regard, Quebec (7.6 deaths related to COVID-19 per million inhabitants) ranks last among Canadian provinces and has even outstripped the United States (5.3 deaths per million) in the last 7 days, according to the INSPQ.
The excess mortality makes it easier to compare Quebec to the rest of Canada and the world, also pleads the ISQ. Because unlike other provinces, Quebec quantifies all deaths where COVID-19 is involved, even if the virus is not the first cause of death. “There are plenty of deaths where COVID-19 is reported, even if it is secondary. The mortality rate includes COVID-19 and its collateral damage, as well as excess or under-mortality due to other causes. That indicates a net result,” explains the ISQ expert.
But as the pandemic hits in waves, the number of deaths “by or with” COVID-19, although imperfect, remains one of the indicators used, along with hospitalizations, to monitor the impact of the virus in real time, says Robert Choiniere. “With Delta, the excess mortality and death curves were getting closer because the variant caused more more severe forms of the disease. With Omicron, COVID-19 is the first diagnosis of approximately half of hospitalized patients. Quebec currently has one of the highest hospitalization rates in the world, but that does not necessarily mean that there will be excess mortality, ”he nuances.
With Laurianne Croteau