COVID hasn't given many surprises lately in Nova Scotia. An outbreak of Kraken subvariant infections, which seemed to be an imminent threat at the start of 2023, thankfully hasn't happened. There was an increase in new cases around the December holiday season, then cases stabilized to about 650 per week. The number of people admitted to hospital with the disease has also been holding pretty steady. But the statistics released Thursday, Feb. 9 at the provincial COVID data dashboard held a major shock: 27 people killed by the disease, the most deaths Nova Scotia has reported in any week during the entire pandemic.
Even the province, which tends to divulge only the bare minimum in terms of COVID information, realized this record high death count warranted some explanation: When the @nshealth Twitter account announced on Thursday that the data dashboard had been updated, it took the unusual step of adding some context.
“Deaths are routinely reported to Public Health through a number of channels. There is sometimes a lag in reporting a death as it does not always appear immediately in the data system due to reviews, and investigations as appropriate,” read the first tweet added to the thread. “Of the 27 new deaths being reported, 2 occurred within the past seven days, 13 between eight and 30 days, and the remaining 12 more than 30 days ago,” said the second.
Deaths are routinely reported to Public Health through a number of channels. There is sometimes a lag in reporting a death as it does not always appear immediately in the data system due to reviews, and investigations as appropriate.
— Health & Wellness (@nshealth) February 9, 2023
In reality, information about deaths almost *always* lags other disease indicators, for exactly the reasons the @nshealth tweets describe. To be more transparent about lags, the province tweaked the data dashboard in late 2022; instead of the past practice of reporting a single number of new deaths being announced that week, the dashboard divided out "New Deaths from Previous Reporting Periods” separately from deaths that could be confirmed as occurring in the latest seven-day period. The most significant thing this change revealed is that the reporting lag is indeed pervasive—the overwhelming majority of deaths take more than seven days to be announced. Otherwise, as The Coast said before, the two time frames for deaths are “a distinction without a difference.”
The province reported 27 COVID deaths this week, period. These can be categorized the way the dashboard does—two deaths that happened in the last seven days and 25 deaths from earlier that only came to light in the last seven days—although the fact remains the province is reporting 27 new deaths, establishing a new record for Nova Scotia’s deadliest pandemic week. The previous high was 24 deaths, the same number reported on two different weeks in 2022, April 28 and May 19. And the same systemic lags for finding COVID deaths were in place then, as now.
So we wondered what made this week special. Was there extra lagging related to slowdowns around the December holidays? Did COVID monitoring capacity or processes change in some way? Could a key person have been on vacation? The Coast put these scenarios to the province, asking for any information to help explain the high death count.
Unfortunately, we didn't get much of an answer. Instead of giving an explanation for how reporting lags played a bigger role than usual, the province simply repeated its assertion that lags are to blame. Here's the entire response to our questions, as emailed from a provincial health spokesperson:
“As noted, deaths are routinely reported to Public Health through a number of channels. There is sometimes a lag in reporting a death as it does not always appear immediately in the data system due to reviews, and investigations as appropriate. It is not uncommon for deaths to be investigated and this has been the case throughout the pandemic. Investigations can take some time to be completed as there may be multiple comorbidities which can result in a lag in reporting. As soon as the deaths were confirmed to have met the national deceased case definition, they were reported on the weekly COVID-19 dashboard.”
It’s frustrating that the province gives such an incomplete answer. But not much of a surprise.
