An episode of excess mortality that continues

An episode of excess mortality that continues

Quebec has recorded more deaths than expected since the beginning of the summer of 2022, a long episode of excess mortality which could be due to the drop in restrictions linked to COVID-19 and the multiplication of viruses.


After several episodes of strong increases and decreases linked to the waves of COVID-19, a stagnant trend of excess mortality has been felt since July in Quebec.

Over the past 20 weeks, the province has mourned 2,037 more deaths than expected. This is more than the balance sheet of 1536 additional deaths recorded during the six weeks that the Omicron wave lasted last winter.

“We are looking in particular at what is happening on the side of COVID-19. There was a wave in July and deaths linked to the virus have remained fairly regular since then, ”explains Frédéric Fleury-Payeur, demographer for the Institut de la statistique du Québec (ISQ).

Multiplication of viruses

In addition to the pandemic, the multiplication of viruses this fall could contribute to the increase in deaths. Respiratory syncytial virus (RSV) and influenza could also have an impact on the excess mortality rate.

We do not yet have many specific analyses, but we are seeing a significant increase in the circulation of certain respiratory viruses, in particular RSV.

The Dre Rodica Gilca, analyst for the National Institute of Public Health of Quebec

“The flu is also starting to rise, which is unusual since it is normally observed in December. Circumstances caused these viruses to concentrate during this period, ”adds the Dre Rodica Gilca, analyst for the National Institute of Public Health of Quebec.

How can this unusual concentration of viruses be explained? Among the hypotheses, the Dre Gilca designates one more specifically: the sanitary measures introduced during the pandemic would have made it possible to prevent the spread of the usual winter diseases. “Viruses were waiting for the door to be opened to spread to the population […] People are more often in situations where viruses are being transmitted now,” she explains.

“A new phenomenon”

This long episode of excess mortality is not unique to Quebec, as several states are currently experiencing a similar situation. “Other countries are concerned, in particular Korea, which had been relatively spared since the start of the pandemic. […] Australia’s rate, which had also been relatively spared, has fluctuated around 15% since the start of the year. In most of the countries presented in our curves, we observe a comparable phenomenon in Quebec,” notes Frédéric Fleury-Payeur.

Historically, however, this phenomenon would be more exceptional.

It can be said that this situation of moderate but sustained excess mortality stands out from other episodes of excess mortality observed since the start of the pandemic. The peaks of previous excess mortality episodes were higher, but shorter.

Frédéric Fleury-Payeur, demographer for the Quebec Institute of Statistics (ISQ)

“It’s a new phenomenon. We are really surprised by all the changes we see in the behavior of viruses. It’s hard to predict what’s coming. But it will surely take several years before returning to an ecological balance between the viruses, ”analyzes the Dre Rodica Gilca.

The elderly

Although young people are currently being hit hard by the proliferation of viruses, good news, the ISQ data does not show any excess mortality among them. The long episode mainly affects older Quebecers. According to the ISQ curves, the excess mortality rate among people under 50 has been -4.8% since the beginning of the summer, compared to 9% among people over 70. “For the moment, it remains a concentrated excess mortality among older people,” explains demographer Frédéric Fleury-Payeur. “Viruses contribute very little to deaths among young people. This is exceptional. Severe complications occur mostly in older people. We know that these viruses can kill, ”confirms the Dre Gilca.

“Harvest effect”

Still according to data from the Quebec Institute of Statistics and Frédéric Fleury-Payeur’s analysis, the excess mortality rate varies by region. Strongly affected by the first wave, Montreal and Laval have since shown a lower mortality rate than expected. “There may be a harvest effect, a shift in mortality. You only die once. People in this region, especially in CHSLDs, were hard hit during the first wave. »

PHOTO PATRICE LAROCHE, LE SOLEIL ARCHIVES

Frédéric Fleury-Payeur, demographer for the Quebec Institute of Statistics (ISQ)

The harvest effect – or displacement of mortality – is explained by the premature death of people who risked dying in the following months. As these deaths occur earlier, the excess mortality is lower for the following weeks and months. In the case of Montreal and Laval, the large number of contaminations and deaths during the first wave helped to lower the excess mortality rate thereafter.



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