With context and compassion: a comprehensive analysis of COVID-19 statistics Part 2

Interpreting depersonalized numbers with appropriate situational and human context, and a consideration of long-term implications
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Interpreting depersonalized numbers with appropriate situational and human context, and a consideration of long-term implications

This is the second article in the series, following a Flawed Lockdown Model, a study of the imperial lockdown model and its economic impacts in Canada. 

MENTAL HEALTH, SUICIDE AND OPIOID USE 

The lockdown model that crippled Canadas economy did not consider the cost of its extreme suppression strategy on the economy, mental health, suicide or opioid use.  

Experts and public servants both locally and globally have called for changes to the COVID19 response in order to mediate lockdown impacts on mental health, suicide and opioid use. Here are the relevant findings. 

According to the Chief Public Health Officer of Canada’s Report on the State of Public Health in Canada 2020, there are significant indirect health consequences due to the COVID-19 lockdowns. In fact, Statistics Canada found that those with excellent self-perceived mental health decreased by 20% when compared to the 2018 statistics. Covid fatigue, economic instability, media polarization, higher rates of drug and alcohol consumption, isolation and loneliness all serve as contributing factors challenging the mental health of Canadians. 

Thoughts of Suicide Increasing During Pandemic: Collective trauma caused by COVID-19 lockdown.

The Canadian Journal of Psychiatry has synthesized the analysis of nearly a dozen primarily Canadian psychiatrists. They describe the “parallel epidemic” of mental health problems, triggered by the viral outbreak, and provide recommendations to support the special needs of population subgroups. They conclude that a “sustainable public policy requires both a rational public health strategy and a rational economic strategy to curtail the virus and prevent widespread poverty.” 

Children are of particular concern since they are experiencing the pandemic during their formative years and because socialization is imperative for healthy childhood development. This journal reveals that social isolation during childhood is correlated with lower educational attainment, psychological distress in adulthood and lower socio-economic achievement.  

Kids Help Phone messages for help with grief and isolation increased 246% and 158% over last year in Toronto. 

Parents are justifiably concerned, with 61% of a Statistics Canada survey were very or extremely concerned with managing their child’s behaviour, stress levels, anxiety and emotions. Human Rights Watch further investigated the impact of COVID-19 on children, asserting that children exhibit less severe symptoms and have a much lower mortality rate, but are disproportionately impacted by indirect consequences of the lockdown. 

Studies clearly indicate that marginalized groups or those in economically disadvantageous circumstances are disproportionately affected by both direct and indirect effects of the COVID-19 pandemic.  

Researchers have put forth recommendations, calling for a more targeted approach to mediate anticipated negative outcomes on those with pre-existing mental illness and substance abuse. They conclude that policy decisions must be reinforced by in-person services to maintain care and expand human connections, in order to reduce both short and long-term mental health effects of COVID-19. 

There is plenty of research examining the correlations between unemployment rates and opioid mortality For example, according to one research spanning five years and 16 US states by the National Bureau of Economic Research, per 1%-point increase in the unemployment rate is associated with an additional 3.6% increase in the rate of opioid deaths. The research concludes that, “Overall, we obtain strong evidence that opioid-related deaths and Emergency Department visits increase during times of economic weakness.”  

In fact, it seems the pandemic has exasperated this opioid crisis far beyond projections, with some provinces reporting more than double the number of opioid deaths over last year. In British Columbia, the First Nations fatal overdoses increased 93% over last year. Ontario saw a 49.2% increase in opioid related mortality over last quarter. In Toronto, The Toronto Medical Officer of Health reported a 85% increase in suspected opioid related deaths during the COVID-19 pandemic compared to last year.  

COVID-19 Fatality rates are extremely varied. This leads to question how these rates are being calculated and how to legitimately identify these numbers. Read our report on COVID-19 mortality to understand Canadian mortality reporting and to see how policies have inflated mortality rates. 

Given the special needs of these communities, a responsible public-policy response to COVID-19 must include the recommendations put forth by experts, which might conflict with generalized lockdown orders.  

In Canada, a research group studied suicide mortality between 2000 and 2018 and unemployment rates during those same years, finding that a “percentage point increase in unemployment was associated with a 1% increase in suicide.”  

They conclude that in a scenario where there is an increase in unemployment of 10.7% in 2020 and 8.9% in 2021, there would be 2114 excess suicides in 2020-2021. Based on the most recent data, the current unemployment rate rests at 9%. 

According to the Canadian Mental Health Association, the number of Canadians having suicidal thoughts has doubled since the beginning of the pandemic.  In 2019, 2.5% of Canadians reported having suicidal thoughts in the previous year. Comparatively, 6% of Canadians had recently experienced thoughts of suicide as a result of the pandemic.  

Using only the two studies linking a statistical correlation between unemployment and opioid or suicide mortality, one can anticipate a minimum increase of mortality within these categories totalling 2490 over last year.  

This excess mortality is calculated without accounting for the particular circumstances related to the pandemic that accelerate suicide and opioid mortality. These include increased depression due to extreme isolation, the sudden and severe financial hardship due to job and business loss, increased drug and alcohol consumption, limited access to mental health services and shelters, trauma due to increased mortality and cumulative impacts of COVID-19 public health measures. 

What’s more, the consequences of COVID-19 and lockdowns disproportionately affect people of lower income, increasing food insecurity within these communities. 

These statistics clearly show that Canada’s public servants have been documenting the indirect impact of the pandemic on communities. Looking at the varying recommendations, it appears that the policy suggestions are all motivated by the special needs of the groups in question. Since individuals imminent and long-term risk profiles vary, public health policies must represent the complex and nuanced realities of Canadian lives 

Part 3 of the Covid-19 Analysis: Mortality Rate with Context coming soon.

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