Canada's child mortality problem
We owe it to our kids to move on, once and for all, from isolating pandemic restrictions.
This chart plots excess all-cause excess mortality P-scores for different age groups in Canada, the US, and the UK.1 What are the trends that stand out here? Look at the graphic, and respond to yourself before reading on.
To me, there are two notable trends. One is good for Canada. The other is really bad.
1. (the Good) Canada has fewer excess-mortality spikes in age groups older than 14.
Compared to the US and UK, Canada has been able to blunt the impact of COVID waves in its older demographics, who are the at-risk groups in this pandemic. I’d reckon this is owed to higher vaccination coverage, lower population density, and stricter non-pharmaceutical interventions (NPIs), among other complex factors.
This is good news. We have accrued some strategic wins, and we have tripped on some wins by fortunate chance. Either way, we should be thankful for this outcome.
2. (the Really Bad) Canada is the only country of the three with consistently high excess mortality in the 0-14 age group2.
When I say “consistently high”, I don’t mean 5-10%. I mean 25-50%. And this trend is not only during COVID waves; it exists throughout the two years since this pandemic began. What’s more, I looked at many other countries in this dataset and I struggled to find any, anywhere in the world, where excess mortality in children approached how high it was in Canada for the last two years.3 COVID deaths are not driving this trend4.
Quite frankly, [the restrictions] worked. We have seen the curves lower in Canada than elsewhere. We’ve seen lower death rates. We’ve seen quicker economic recovery because Canadians stepped up, because Canadians got vaccinated.
Justin Trudeau
Prime Minister Trudeau is right, if you only look at ‘all ages’ excess mortality. As the charts above show, the truth is more nuanced.
Is excess childhood mortality the price we paid for lowering the curves in older age groups? Whether that’s true, or it is an unfortunate side-effect, or it is just random bad luck, you’re going to have a hard time convincing me there is a worse public health outcome than 25-50% excess childhood mortality for nearly two years in this country. I cannot lightly forgive an outcome like this, and ignorance is no excuse.5
The truth is this: Canada has had a high uptake of isolating NPIs compared to the rest of the world. With the possible exception of seniors, children are the most adversely-affected demographic with respect to lockdowns, vaccine mandates, masks, and social distancing. These NPIs are plausibly causative of childhood isolation and depression. Our high NPI uptake correlates with our globally high childhood mortality.
Until our leadership proves that NPIs are not making this problem worse, we should assume they are and move in a different direction immediately. Not gradually. Immediately. Going forward, if whatever public health solutions we deploy aren’t geared to address these childhood excess mortality rates, then we have well and truly lost the plot. If you want to engage me on this go right ahead but the burden of proof is not on me, it is on our officials to explain why, two years into this pandemic, we haven’t addressed the problem of our children dying. Other than by trying to jab needles in all of them.
As I write this today, I am (on the one hand) encouraged that many provinces in Canada are quickly dropping NPIs, and other provinces are considering following the lead. On the other hand, I expect in future months as COVID numbers decline, our politicians and public health leaders will pat each other on the back, reveling in how prudent and successful their pandemic measures were6. And then, if/when COVID numbers escalate, whether its new variants or seasonal trends, they will be quick to deploy the same lockdowns, mandates, masks, etc. that they will claim “worked” the last time. Remember this: When we introduce isolating NPIs, children suffer. Perhaps that suffering buys us lower death curves in older age groups, but if my vote is worth anything, that is not a worthy sacrifice.
We seem today to be at an inflection point. I truly hope that COVID becomes a thing of the past and we never again have to contemplate these types of measures, but that mindset feels naïve. Now is a time of hope and change, but also a time to reflect. This will not be the last good cause that we will be called upon to support. COVID has proven that Canadians will accept significant restrictions to their livelihoods in support of good causes. We need to reflect now on what we are willing to sacrifice next time. Perhaps if we all align ourselves in the same direction, we can manifest something positive out of all this…
The Freedom Convoy…
Speaking of the power of collective will; do you want to know why there are hundreds of trucks and thousands of protestors sitting outside of Parliament Hill? It isn’t for the nice view. It isn’t because they’ve been brainwashed by Trump. It isn’t because they’re confederates, racists, or vandals.
They’re there because they’re the parents of the kids who are suffering. They see the damage firsthand, but they don’t have the freedom, money, or resources to get their kids through it by themselves. I bet even more parents would be protesting if they weren’t already stretched to their limits trying to keep their families on the rails at home. Their elected officials aren’t doing a damn thing7, and so these parents are doing the only thing they can: Getting in the way.
To those officials who say that the protestors have “proven their point” and should move on, you don’t get it. The people in the convoy are fighting for their childrens’ lives. No one in that convoy is willingly going anywhere until they see meaningful engagement and a relaxing of rules. You had months to help. You dropped the ball. You lost their trust.
More power to the convoy. I hope they win the day.
The tragic stories underlying the statistics…
I’ll finish by sharing Mila’s story. I don’t share this out of a desire to cause pain, or to take advantage of tragedy to score points. I share this because, behind every instance of childhood mortality, there is a story like this. Many other children (and adults, for that matter) are at risk of succumbing to similar fates.
Metrics do not tell these stories. Take care in reading this. It is tragic, and it will hurt.
EDIT (March 4, 2022):
The chart shown above from ourworldindata.org has since been updated at least twice for Canada. First, only the 0-14 age group was removed from the chart, and then (having run the chart today), all age stratifications are missing and only the all-ages excess mortality is presented. I have sent a query to the website asking what changed, and have yet to receive a reply. Having viewed some of the independent charts from Statistics Canada, it is clear Canada’s own datasets aggregate excess mortality for ages 0-45 (a huge age range, mind you).
It is possible that the offending data was hidden, for whatever reason. I consider it more likely that the original chart in my post contained erroneous or poorly compiled data; obviously if it did, that would invalidate my analysis. Still, the real-world concerns I have heard expressed by parents suggest that we’d better start minding the consequences of public health measures on our youth. For that reason, I’ve left my original content unadjusted. Therefore, take what I’ve said with a big pinch of salt, especially the graphs. At some point, perhaps better data will emerge from Canada or other sources and I will revisit these conclusions at that time.
P-score: Measured as (Reported deaths less Projected deaths), as a percentage of Projected deaths.
Projected deaths: Based on a 5-year historical average of reported deaths.
Comparison countries: I picked the US and UK to compare because they are culturally and demographically similar to Canada, eliminating some potential confounders. I sampled other countries as well but the insights didn’t change, and it just made the graphs noisier.
It should be noted, of course, since there are normally fewer childhood deaths than deaths in other age groups, the absolute number of deaths in children 0-14 may not jump off the page. That this is true should comfort no one.
Scotland and Croatia were about the worst I could find, and these were because of large spikes in the data (these spikes went above and below 0%). Even for these nations, the average excess childhood mortality appears close to 0%.
It should also be noted that not all countries track excess mortality as Canada does. Most of the Western and first-world nations do, and this alone should be sufficient to consolidate the point. For completeness, it should be noted that less-developed nations who don’t report childhood excess mortality might show worse numbers than Canada. But then again, they may not.
There have been 29 total deaths in people aged under 20 since the start of the pandemic.
Keep in mind also that these statistics are from the time before we locked our children out of school again in winter 2022.
To be fair, the measures were successful by certain metrics (as I’ve said in this post). The point is that what we learned in out-performing other nations on all-age mortality curves can be applied in future, but it need not cost us such abysmal childhood mortality rates.
Free rapid tests at grocery stores? Give me a bloody break.