If Omicron is a milder version of the coronavirus, why are so many people dying in Ontario?
While the rate of new COVID-19 infections in Ontario appears to have slowed from record highs, the number of daily deaths in this wave of Omicron is still on the rise and approaching as high as ever. any point in the pandemic.
There are also no signs that the death rate is slowing. Scientists expect daily reports from Ontario to continue to rise in February, even after the province began easing COVID-19 restrictions on Monday.
In the third week of January, the most recent week for which full numbers are available, Public Health Ontario recorded an average of 52 COVID-19 deaths per day, a rate surpassed only at the peaks of the first and second waves. .
The growing number of deaths raises questions. If Omicron is a less severe version of the new coronavirus than previous variants, why are so many people dying – and what’s going on with vaccine effectiveness?
The answers lie in the large numbers of people infected with the Omicron variant, says Tara Moriarty, an infectious disease researcher and associate professor at the University of Toronto.
“We’re seeing scales of infection that we haven’t seen in the entire outbreak to date,” Moriarty said in an interview. “There are going to be a lot of deaths, even if the virus is half as serious [as previous variants].”
The official number of COVID-19 deaths from Public Health Ontario so far this month has already exceeded 1,000. Given the lag between the day a death occurs and its entry into the provincial database, this puts January 2022 on track to be one of the deadliest three calendar months of the pandemic.
The growing death toll shows the impact of the Omicron wave, says Dr. Jerome Leis, medical director of infection prevention and control at Sunnybrook Health Sciences Center in Toronto.
The Omicron variant “probably infected more people in five weeks than all the rest of the pandemic combined,” he said in an interview.
“Because of so many infections, even a milder severity will result in a significant number of hospitalizations and deaths, and that’s what we’re seeing right now.”
Among those who died are some people who had been vaccinated against COVID-19. However, this does not prove that vaccines do not work.
“Without the high level of vaccination we have in Ontario, it would have been a lot worse,” Leis said.
There is substantial evidence from around the world showing reduced rates of death and hospitalization among vaccinated populations. There is also new Ontario-based research demonstrating the effectiveness of vaccines against serious health conditions, particularly the Omicron variant.
The new study, which has not yet been peer-reviewed, found that having three doses of a vaccine is about 95% effective in preventing hospitalization or death from the Omicron variant, while two doses are 80 to 85 percent effective, said Dr. Jeff Kwong, principal investigator at ICES, a health-focused research institute in Ontario.
“Mortality rates are much higher in those who are unvaccinated than in those who are vaccinated,” Kwong said in an interview. Research also shows the importance of getting a third booster dose, he added.
Both Kwong and Moriarty said they expect Ontario’s daily and weekly death toll to continue to rise in February.
“Given that we believe the peak of cases may have been earlier in January, it may be another week or two before we see deaths decline,” Kwong said.
Infectious disease and epidemiology experts also believe the true number of COVID-19 deaths in Ontario in the current wave is actually higher than the official count. Indeed, new provincial rules strictly limit eligibility for testing, a move that could mean some deaths from COVID-19 are not being recorded as such.
All of this leads to the possibility that the actual number of COVID-19 deaths in Ontario’s current wave could eventually exceed numbers from the first or second wave.
Die ‘with’ or ‘of’ COVID?
Officially, Ontario reports the number of people who die “with” a confirmed case of COVID-19. This particular wording has prompted some skeptics to cast doubt on the death toll, saying people who didn’t actually die “from” COVID-19 are counted.
These skeptics claim that people killed in car crashes or died of other unrelated causes are counted as COVID-19 deaths because they test positive.
It’s a complete myth, Moriarty said. The Public Health Agency of Canada has ordered provinces not to include deaths that are unrelated to the virus in their pandemic-related death counts.
On the contrary, the official number of COVID-19 deaths counted by Ontario and most other provinces is an underestimate, according to a study led by Moriarty.
“We’ve missed a lot of COVID deaths, and we’re almost certainly missing a lot now,” she said, following Ontario’s recent restrictions on who can get an official PCR test for the virus.
“If you die with COVID, even if it looks like COVID, smells like COVID, everything… if they don’t test positive, they won’t be reported as a COVID death,” Moriarty said. “We know this is a very important issue.”
Ontario officials are trying to establish whether Omicron, the older Delta variant or a combination of the two is driving the current rise in deaths, said Ontario’s Chief Medical Officer of Health, the Dr Kieran Moore.
“During the first weeks of January, we are convinced that a significant proportion of [the deaths] were from Delta,” Moore said at a press conference Thursday.
Genetic sequencing to determine the type of variant that caused COVID-19 infection takes several weeks.
Essentially 100% of outbreaks in the community are Omicron right now, but about 10% of hospital admissions are still “Delta relevant,” Moore said.
He said he was trying to refine Ontario’s death reporting process to clarify whether each death is caused by or associated with COVID-19. Ontario also plans to do a “screening review” of death certificates and documented deaths to assess data quality.
Additionally, Moore said, he will look at “all-cause mortality” to see if the province’s reporting structure is missing any deaths that might be associated with COVID-19.