Ontario counts ‘COVID-19 positive deaths, not specifically if death was caused by COVID-19,’ official says

EASTERN ONTARIO — Residents of this region may have realized by now that Ontario’s official COVID-19 death count is a more complicated affair — and a somewhat greyer area — than the bare provincial statistic might suggest, let alone a smiling news anchor’s confident assertion that each one in that number perished “from” the virus.

To put it plainly, it’s not accurate to describe all of the COVID-19 fatalities registered by Public Health Ontario (PHO) as dying “from” or “of” COVID-19 — as popular as that timesaving shorthand might be in the media and elsewhere. An arm of the provincial government has acknowledged for NVN that a “COVID-19 positive” death doesn’t necessarily mean a death “caused by” the virus.

“PHO is reporting all COVID-19 positive deaths, not specifically if the death was caused by COVID-19,” Stephanie Rea, Issues Manager in the Office of the Chief Coroner at the Ontario Forensic Pathology Service, said by email yesterday. Rea’s entity falls under Ontario’s Ministry of the Solicitor General, which is responsible for coroners, and as it turns out, coroners are “not generally called” to investigate if a death is attributed to COVID-19.

“The Office of the Chief Coroner (OCC) investigates approximately 17 percent of all deaths in Ontario specifically those that are believed to have occurred unexpectedly and from non-natural causes. As deaths from COVID-19 result from a natural disease process (infection), a coroner would not generally be called to investigate a death that is believed to be COVID-19 related. Further, it can take months to complete a death investigation, and to determine the cause and manner of death,” she explained.

NVN began taking a harder look at the definition of a COVID-19 death after retroactive changes and obvious nuance in the mortality numbers within the Eastern Ontario Health Unit (EOHU) region.  On one or two occasions, Eastern Ontario Medical Officer of Health Dr. Paul Roumeliotis has attributed a late retroactive addition to his region’s fatality number to the decision of a coroner. The EOHU region has also seen deaths retroactively removed from the list, including a 12th fatality occurring at Pinecrest Nursing Home in Plantagenet last spring; that death was itself only retroactively recognized in early September before being removed again as a COVID-19 death just this week, returning  Pinecrest back down to 11.

More starkly, the ongoing Prescott and Russell Residence outbreak has coincided with 19 deaths, only 12 of which are now on the COVID-19 death list. That’s also down from the 16 COVID-19 deaths reported by Dr. Roumeliotis on Nov. 6. But by the following week, when the number of dead had reached 19, seven were left out of the COVID-19 column because of a “change in nomenclature” in how deaths are defined, the doctor explained.

He has explained further that individuals who die after their COVID-19 infection has resolved are no longer counted in the death statistic. That issue — whether a resolved case should still be counted if an individual passes away shortly after supposedly ‘beating’ the virus — came into play with the very first fatality in the outbreak at the Prescott and Russell Residence. The deceased wasn’t initially recorded as a COVID-19 death in that circumstance but was included several days later.

By Nov. 2, the COVID-19 death count had hit 12 at the Prescott and Russell Residence, as reported by Roumeliotis during his media briefing that day — at which point the operator of the home, the United Counties of Prescott and Russell (UCPR), ceased issuing its own regular updates verifying the numbers. At the time, the UCPR chose not to verify that particular number (12) in its final statement turning over further reporting of the numbers to the EOHU exclusively.

Today, the EOHU region counts a total of 27 COVID-19 deaths in the region, down from 30 listed earlier — a decrease due to “causes other than COVID-19 in persons who were COVID-19 positive at the time of death,” according to the EOHU website. The latest figure also includes individual deaths at St. Jacques Nursing Home in Embrun and Maxville Manor, as well as two deaths in the general population plus a pair of others at an Alexandria retirement home, Dr. Roumeliotis reported yesterday.

The EOHU figure goes into Ontario’s total “COVID-19 positive” death count, which stands at 3,466 as of today.

When asked how many of those provincial deaths were specifically caused by the virus, Rea suggested NVN get in touch with Public Health Ontario for a further breakdown on the numbers.

“I am not aware of any change to the nomenclature in classifying COVID-19 deaths. Public Health Ontario provides the case definition for COVID-19 infection, including laboratory positive testing for COVID-19,” she wrote.


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