Hamilton hospital outbreaks led to 84 COVID deaths

At least 84 Hamiltonians with COVID-19 have died during hospital outbreaks over the course of the pandemic.

The number doesn't include two deaths removed from the tally Nov. 4 after an associate medical officer of health said they were wrongly added.

Dr. Bart Harvey said all Hamilton COVID deaths were being reviewed because public health had inadvertently overexaggerated" the number by including those who clearly died of another cause."

The review is in the early stages and expected to take weeks. There's no estimate of how many deaths could be removed from Hamilton's pandemic toll of 420.

It's really going to be I think a very small group of individuals," said Harvey. The hospice ... and another end of life or palliative care unit is where, I think, we'll find these folks."

The two deaths already removed were on palliative care unit 3W at St. Peter's Hospital where an ongoing outbreak has increased to 11 patients and three staff since being declared Oct. 27.

It's the third outbreak on 3W since the beginning of the pandemic. Six more palliative patients with COVID died in spring 2021 and one in spring 2020.

An outbreak on St. Peter's other palliative care unit 3E saw three deaths in the spring of 2021.

Excluding the deaths of 12 palliative care patients with COVID would drop the outbreak tally at Hamilton Health Sciences (HHS) by nearly 15 per cent.

It makes it really hard to measure the burden of something like COVID," said Colin Furness, infection control epidemiologist and assistant professor at the University of Toronto. My view is that we should be counting them."

Haldimand and Norfolk has come up with a workaround by reporting two different categories for those who die with COVID to ensure none disappear. As of Sunday, the region had 50 COVID-related deaths and seven non-COVID related deaths.

So far, Hamilton has removed the two deaths from its reporting altogether

Inconsistencies in reporting between public health departments has been an issue for the entire pandemic.

A Hamilton death reported Friday was a senior in their 80s - more than 60 per cent have been in this age group. Ages aren't available in the Haldimand and Norfolk Health Unit.

Meanwhile, an unvaccinated person with COVID died in Haldimand and Norfolk, the unit reported Friday. Hamilton public health doesn't provide vaccination status. Instead it provides the rate per 100,000 population.

Making the differences harder to understand is that each public health unit generally cites privacy as the reason for withholding information.

Public Health Ontario (PHO) says it provides guidance to regions to help ensure there is consistency across Ontario."

Advice from PHO was what caused Hamilton public health to reverse course on COVID death reporting, said Harvey.

We're following the province's definitions," he said. We try to get it as accurate and reliable as we can but there are things like this that come up that we need to adapt to and we need to take into consideration."

PHO confirmed that it provided information to Hamilton public health about the ability to keep certain deaths of those with COVID out of the tally.

It appears to be contrary to the definition of a COVID death posted by the province and Hamilton that clearly states: Deaths are included whether or not COVID-19 was determined to be a contributing or underlying cause of death."

Furness raised concern that this loophole could be a slippery slope potentially resulting in the deaths of long-term care patients removed from view.

It's significant considering 179 of Hamilton's COVID deaths have been in outbreaks at long-term care or retirement homes. It accounts for more than 40 per cent of the city's total pandemic death toll.

Nearly two-thirds of Hamilton's 277 COVID outbreak deaths were at seniors' homes.

Knowing the number also helps show the effectiveness of vaccines as 139 of the deaths - more than three-quarters - were before mid-December when there was no COVID shot available.

Hospitals account for the next largest group with 79 deaths at HHS and five at St. Joseph's Healthcare over 48 outbreaks.

Over the course of the pandemic, 14 outbreak deaths have been outside of hospitals and seniors' homes. It accounts for just five per cent.

Two of those deaths are also likely to be removed as they were in an outbreak at Emmanuel House Hospice in April 2020.

Harvey denied the changes would apply more widely than terminally ill patients.

We have to have a clear alternative diagnosis that is clearly not related to COVID-19," he said.

The virus also has to be asymptomatic no matter what other illnesses the patient had, Anybody who had COVID-19 and had symptoms ... they're a COVID-19 death."

Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com