The most recent official tally of numbers and causes of death in Alberta (2021) is available publicly,[1] and the trends are alarming. I must admit I got a sinking feeling when I saw the data reveal a large increase in the 2021 death rates over 2020, which were already the highest in the past 20 years.
Things did not go in the right direction, despite government-mandated pandemic interventions (e.g., social distancing, masking, business closures) and vaccines. The story unfolds in a series of charts, starting with Chart 1, showing death rates for Albertans over the past 21 years.
A note about the charts in this article: Most are interactive and allow various selections of displayed categories. Clicking a box will show only the selected data. Multiple boxes may be selected with Ctrl-click, and unselecting all will display the total of all categories. Hovering over the chart will give a readout of values.
Chart 1: Annual deaths of all causes per 100,000 of selected population group. COVID-19 deaths are highlighted in red. Age groups and gender (M, F) are as selected.
In a previous article (A look back at causes of death in the first year of COVID-19), summarizing the data up to and including 2020, I made the observation that in almost all age groups, the death rate was higher in 2020 than at any time in the previous years’ data. 2021 was higher still. COVID deaths only account for a portion of this increase.
While deaths from all causes were higher in 2021 than in 2020, those caused by COVID-19 specifically, also increased. Chart 2 shows COVID only, by age group and gender. 2020 was the first year of the pandemic in Alberta, and the first death in the province attributed to the virus did not occur until March of that year. Hence, the total 2020 deaths represent only 9 out of 12 months, with low exposure at the beginning. As the virus spread, more people were exposed, until, by the end of 2021, a substantial proportion of Alberta’s population of approximately 4.5 million people had likely contracted the virus (although there were only 370,000 confirmed cases,[2] most people were not reporting an infection or testing for the virus). It is not unexpected, therefore, to see the number of deaths go up as time passed.
Complicating these trends was the introduction of vaccines in early 2021 for select vulnerable groups, gradually rolling out to the entire population over 12 years of age. By the end of 2021, 78% of the population older than 12 had received 2 doses or more of the vaccine.[3] The publicly available cause-of-death data did not specify vaccination status, so this article does not address relative effects of the vaccine on death rates. A request for this additional information is pending.
Chart 2: Number of COVID-19 deaths by year and age group. Male (M) and female (F) may be selected.
As is well known, the majority of COVID deaths occurred in the older age groups. While all age groups saw an increase, the largest percentage change year over year was in the 30-59 age category, which saw an increase in COVID deaths of 600%. That would be a shocking headline taken out of context, however it represents a small proportion of the total deaths. For example, the largest percentage increase (1,100%) occurred among men age 35–39 due to a jump from 1 death in this age group in 2020 to 11 in 2021 – not quite as shocking in absolute terms. We will come back to this age group later, though, with news that truly is alarming.
As always, we want to put COVID deaths into perspective for different demographic groups relative to other causes and rates of death. Major causes of death are typically cancer, heart disease, accidents, and, in some age groups, brain disease. Chart 3 shows these causes, with the addition of suicide, COVID, and unknown cause.
Chart 3 illustrates the relative insignificance (statistically speaking) of COVID-19 in the overall deathscape. For women who die before the age of 84, cancer is the deadliest by a wide margin. Up to the age of 49, the leading cause of death in men is accidents, overtaken by cancer and heart disease as the survivors age. COVID deaths are shown in the short, dark-red line at the bottom of the graphs covering only 2020 and 2021.
Chart 3: Major causes of death plus COVID by year, and selected age group and gender.
The unknown cause of death category was already alarmingly high in 2020, but it has more than doubled for some demographics in 2021. From an inquiry to the Alberta government last year, we learned that this unknown category represents unnatural causes of death such as accidents, suicides, and homicides that have yet to be investigated. As they are investigated and appropriately reassigned, the number of unknowns should decrease to levels observed before 2016 in the graphs in Chart 3, with the other categories increasing accordingly.
If this reallocation is consistent with the explanation we received from the Alberta government, then the sum of accidents, homicides, suicides, and unknown (AHSU) should be relatively constant over the years. Chart 4 investigates that assumption. This is largely true until 2019, but as you click through Chart 4, you will see that from age 20-64 for women, and 20-69 for men, the total of those categories jumps drastically in 2020 and 2021.
In the age group I mentioned earlier that we were going to revisit, men age 35–39, there were 195 additional deaths in the four AHSU categories in 2021, relative to 2019 (pre COVID), which is 1,625% higher than the 12 COVID deaths over the same period. That should have made headlines.
Chart 4: Accidents, homicides, suicides, and unknown causes of death, by year and selected age group and gender. Top: rates per 100,000; bottom absolute number of deaths.
Incidentally, the largest proportion of the accidental death category is “accidental poisoning by and exposure to drugs and other biological substances”. In recent years, this makes up close to half the total of known accidental deaths (Chart 5). Other top contributors are “pneumonitis due to food and vomit”, “other and unspecified”, “mental and behavioural disorders due to use of alcohol”, and falls.
Chart 5: Top ten categories of accidental death for males age 20-69, in recent years.
Certainly, COVID was a factor in increasing the death rate overall in both 2020 and 2021, but slicing the data into separate demographic categories reveals many more deaths that were not directly caused by the virus. Intentional societal action involves tradeoffs. Were the tradeoffs in 2020 and 2021 considered carefully and the consequences weighed objectively? It seems not, given the resulting death trends.
Every jurisdiction has specific factors contributing to mortality in the region. In Alberta, especially among younger men, the death rate historically shows an inverse correlation with oil price[4] (Chart 6). Until 2020, that is. 2020 and 2021 death rates for men between the ages of 20 and 49 diverge from the oil price curve significantly. However, the constructive interference of the COVID virus, simultaneous restrictions on lifestyle and livelihood and resulting oil price crash may have all contributed to a perfect lethal storm.
Chart 6: Deaths of all causes per 100,000 for men, age 20-49 by year to 2019, compared with average annual oil price. Note: the death rates for this age group in the pandemic years 2020 and 2021 were 202 and 225 per 100,000, respectively, well above the highest death rates correlated with low oil price.
Note: Many thanks to Zack Warren and Poorni Gopalapillai for lending their Power BI expertise for the interactive charts in this article.
[1] Deaths, cause by gender and age, accessed Dec 10, 2022.
[2] Alberta Health COVID-19 Alberta statistics – Total cases, accessed May 7,2023.
[3] Alberta Health COVID-19 Alberta statistics – Vaccination data, accessed May 7, 2023.
[4] US Energy Information Administration (EIA), Petroleum and Other Liquids, accessed May 7, 2023
