Delayed health care during pandemic may have led to thousands of excess deaths: study

Health-care restrictions brought on by the COVID-19 pandemic may have contributed to thousands of excess deaths not related to the virus, along with increased incidents of mental health disorders and substance use, and have put a strain on the Canadian health-care system, according to a study commissioned by the Canadian Medical Association (CMA).

The study shows that delayed treatments or missed health-care services due to pandemic restrictions may have been a factor in more than 4,000 excess deaths unrelated to COVID-19 infections between August and December 2020 and have also resulted in a significant backlog of medical procedures.

Excess deaths refer to the number of deaths above the expected rate. The number of deaths in Canada was higher than expected from spring 2020 into winter early 2021, the study says, and during much of the time between August and December within that period the volume of excess deaths was estimated to be higher than the number of COVID-19 deaths, although it was lower in the following months.

Statistics Canada published a report earlier this month showing that the pandemic resulted in 5.2 per cent more deaths overall than expected if it never happened. 

“We have a health-care system that is deep in crisis,” said CMA President Dr. Katherine Smart on CTV’s Your Morning Tuesday. “No one level of government is going to be able to solve this. But if we start collaborating and working on defining what the problem is and taking action for tangible solutions we can reimagine a health-care system that meets the needs of Canadians.”

Among the delayed procedures highlighted by the study was a reduction in cancer screenings in Ontario, some of which were paused early in the pandemic and apparently remained at 20 to 35 per cent below pre-pandemic levels at the beginning of this year.

Nearly 17 opioid-related deaths occurred per day across Canada in 2020, the study claims, which was a rise of 70 per cent from the previous year. The rate increased to nearly 20 deaths per day in the first three months of 2021.

Regarding mental health, roughly 20 per cent of Canadians reported high levels of anxiety at the onset of the pandemic in April 2020, the study says, and by June 2021 that number had increased to 24 per cent. In the same period, the number of Canadians reporting high levels of depression increased from 10 to 15 per cent.

“It’s really concerning the increase in mental health problems across the country – it’s in children, youth, adults and we know that it’s increasing and our system is very under-resourced to address mental health concerns,” Smart said. “We’re seeing up to 20 deaths a day for opioids and other substance overdoses so this system really needs swift assessment.”

The study estimated the backlog of eight procedures, including CT scans, MRI scans, knee replacement surgeries and cataract surgeries, which totalled 327,800 waiting to be performed across the country. It says the days lost to perform these procedures ranged from 46 days for breast cancer surgeries to 118 days for hip replacement surgeries.

The study also calculated the cost to return wait times for these procedures to pre-pandemic levels would be $1.3 billion in additional funding to the health-care system.

“We’re estimating 1.3 billion dollars to bring that backlog back on track, and that’s just for the six procedures that we looked at,” Smart said. “So it’s going to need significant investment from all levels of government to ensure Canadians get the care they need. What’s been really clear is that system isn’t working right now and is under incredible strain.”

Smart said in a news release she was pleased to see the federal government state its commitment to prioritize investment in health recovery and address the backlog as indicated in last week’s throne speech. 

Doctors and patients throughout the year have been warning about the perils of delayed cancer diagnoses due to limited access to health-care services during the COVID-19 pandemic.

Further research from Statistics Canada earlier this year showed the number of drug overdoses and alcohol-related deaths among Canadians under the age of 65 was on the rise as a result of extended lockdowns and isolation during the pandemic. 

Studies have also shown the pandemic has led to a stark rise in anxiety and depression, especially among youth, across the globe.