A new study of cremation data from Ontario detected nearly 1,600 more deaths than previous years through the first five months of 2020, even when accounting for all known victims of COVID-19 during that time.
The number of cremations performed between January and May in Ontario exceeds the average number performed in three previous years according to the study, with researchers saying the increase reflects deaths directly caused by COVID-19, but also excess deaths caused by the impact of the widespread lockdown.
The study found 3,871 more cremations were performed in the province between Jan. and May 2020, when compared to the average number performed in each of 2017, 2018 and 2019.
During that same period, 2,276 people were known to have died due to COVID-19, leaving another 1,595 additional deceased people over and above both what was normal for that portion of the previous three years and the number known to have died from the novel coronavirus in 2020.
The cremation numbers in Jan. 2020 and Feb. 2020 were relatively similar to the three-year average, at 2.3 and 4.5 per cent above average respectively, but began to spike in March.
March saw 517 more cremations than average, an 8.4 per cent increase, while April saw 1,830 more cremations than average, a 32.2 per cent increase over the average.
In May 2020, 1,111 more cremations were performed than average, a 19.5 per cent increase.
“A portion of the observed increase in late March and early April 2020 may be due to under-recognition of COVID-19 mortality early in the pandemic,” the authors wrote. “Furthermore, there could be an under-recognized number of COVID-19 deaths throughout the pandemic period due to a lack of testing or false-negative test results.”
The authors said the excess deaths could be explained in part by factors associated with changes to healthcare made during the pandemic period.
“There are several reasons why non-COVID-19 deaths may also increase including delay in emergency and routine medical care for cardiovascularand other conditionsas well as other factors such as fears of dying in isolation in hospital.”
A preliminary study by doctors from several Toronto hospitals found delays to cardiac surgeries between March and May of 2020 alone could be blamed for up to 35 early deaths.
Data released by the Ontario COVID-19 Health Table in October showed that emergency room visits, diagnostic testing and surgeries all fell sharply in March, rebounding only temporarily to normal volumes in the summer.
The study found that cremations resulting in deaths of people in their own homes was significantly higher than average in March (23 per cent above average), and April (68 per cent above average) indicating the excess mortality was not just from people housed in the long-term care system.
It is important to note cremations are only chosen for roughly 70 per cent of deaths in Ontario. There is a chance conditions imposed during the pandemic led more people than is normal to choose cremation at end of life.
“It is important to note that some of the changes observed may be due to a preference for cremation over burial in response to international, national, and provincial restrictions on travel and social gatherings,” Chief Coroner of Ontario spokesperson Stephanie Rea told CP24. “Families may also be experiencing financial hardship and find cremation to be a more cost-effective measure.”
“However, this is not anticipated to be the main reason for the increase.”
The study was conducted by researchers from Public Health Agency of Canada, the Dalla Lana School of Public Health at the University of Toronto, Western University, the Office of the Chief Coroner of Ontario and the Institute for Clinical Evaluative Sciences.
