1) Quebec Premier François Legault elaborated on Thursday about his endorsement of two tweets suggesting that Ontario might be under-reporting its #COVID19 deaths. In this thread, I will fact-check this assertion and show why it is inaccurate.
2) Legault was responding to a question by CTV Montreal reporter @KellyGreig to explain why he retweeted a couple of tweets on this issue. The first was a retweet of a comment by @EricGrenierJB, editor-in-chief of L’actualité médicale regarding one by an Ontario epidemiologist.
3) In the original tweet, epidemiologist David Fisman was alluding to a July study, titled, “An analysis of mortality in Ontario using cremation data.” Fisman tweeted there was “a LOT of excess cremations.” But Fisman did not suggest Ontario was under-reporting #COVID19 deaths.
4) Grenier retweeted Fisman’s tweet, and posed the following rhetorical question: “Under declaration of COVID deaths in Ontario?” The Premier then retweeted Grenier’s tweet. He also retweeted a reply to Grenier’s tweet by Stéphane Gobeil, one of his own advisers.
5) In that reply, Gobeil asked the question: “70% more deaths than announced? That’s really a lot, I find.” So what was the motivation of the Premier in retweeting those tweets? Does he really believe that Ontario is under-reporting its #COVID19 deaths?”
6) Here is what Legault stated at his news conference on Thursday: “What I have to say is that we have to be prudent. I don’t like to hear at all (Liberal leader) Mrs. (Domnique) Anglade every day saying Quebec was the worst place in the world for the first wave.”
7) “I’ve read this report,” Legault said. Fisman’s original tweet contains charts drawn from a study by researchers at the University of Toronto, Western University, the Institute for Clinical Evaluative Sciences and the Office of the Chief Coroner of Ontario.
8) “What this report is showing is that until June 30, when you look at the cremations, we know that about 70 per cent of the people are getting cremations,” Legault sought to explain of the mortality trend in Ontario in 2020.
9) Legault then added “that when you compare the number of deaths with the average of the preceding three years, there’s a lot more deaths than what was reported for deaths of COVID-19. So I’m just saying, be prudent.”
10) I reached out to David Fisman, who wrote the original tweet. I also read the study (which everyone can peruse below). I also scanned the news media coverage of that study at the time. medrxiv.org/content/10.110…
11) I asked Fisman if, in fact, he was suggesting that Ontario was under-reporting its #COVID19 deaths, and that the cremations proved this. Fisman responded that he was tweeting about “some question of whether some of the younger deaths may be overdose(s).”
12) Of the Ontario cremations, Fisman added that “most are COVID deaths. We know that because of the requirement that coroners certify cause of death pre-cremation to prevent people being disappeared à la Hoffa” — a reference to the notorious U.S. union leader.
13) So how did the news media report on this study after it was released? The National Post did not write that Ontario was under-reporting its #COVID19 deaths because that is not what the study concluded. Rather, the study was about so-called excess mortality in the #pandemic.
14) “There’s more evidence that COVID-19 has significantly added to the overall death toll in Canada, with a new study suggesting the pandemic boosted the number of fatalities in Ontario by a third in recent months,” the National Post reported at the time.
15) Let us now turn to the source, the study itself. Let me quote from its conclusion: “Cremations were higher in the months during the pandemic compared to previous years.”
16) Here is another observation: “We noted a substantial increase in the number of cremation deaths occurring in long-term care, which is consistent with the high burden of COVID-19 in this population.” Quebec likely observed a similar trend during the first wave.
17) There is one line in the study that could appear to partly support Legault’s assertion: “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.”
18) But that is only one line, not the main thrust of the study. Certainly, the problem of a lack of testing and false negatives has been true for all provinces, including Quebec, and not just Ontario. The study does not conclude Ontario has been under-reporting #COVID19 deaths.
19) Meanwhile, Quebec added 25 #COVID19 deaths on Thursday to a #pandemic death toll that has reached 6,214. According to the Institut national de santé publique, the province's mortality rate is 728 per million population, higher than the rate in the U.S. See the chart below.
20) By comparison, Ontario added five #COVID fatalities to a death toll of 3,118. Its rate stands at 214 per million population, less than one-third Quebec’s rate. Can that big a difference be explained by implying Ontario is drastically under-reporting its deaths? End of thread.

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More from @Aaron_Derfel

31 Oct
1) Montreal’s public health director finally acknowledged on Friday what many suspected — that it’s the schools in the city that are witnessing the biggest increase in both #COVID19 cases and outbreaks. In this thread, I will examine the implications of this in the weeks ahead.
2) Dr. Karl Weiss, one of Quebec’s leading infectious diseases expert, suggested at the end of September that the province’s second wave was triggered by the reopening of schools. Weiss told me recently he caught a lot of flak for making that remark.
3) For weeks, public health officials maintained that #COVID19 clusters in schools were merely a reflection of what was going on in the community. But on Friday, there were more outbreaks in the city’s schools (93) than in the workplace and health-care institutions combined (85).
Read 10 tweets
29 Oct
1) Montreal’s #COVID19 testing positivity rate has increased to 5.6% from 5.2% last week, signalling that the #pandemic's second wave is far from over in the city. A couple of boroughs are reporting rates as high as 7.6% In this thread, I will try to explain what this means.
2) By comparison, the city of Boston’s positivity rate jumped to 5.7% last week from 4.5% a week earlier, prompting authorities to close all public schools. This raises the question as to why Quebec has not imposed more restrictions on Montreal schools.
3) On Monday, Premier François Legault did require that Grade 9 students in high schools in red zones like Montreal learn online at home one out of two days a week. Legault did so as the number of active #COVID19 cases has risen steadily in schools across the province.
Read 10 tweets
28 Oct
1) Montreal on Tuesday reported mixed results in the #pandemic, with #COVID19 cases increasing, but the number of outbreaks in the workplace dropping from a week ago. In this thread, I will try to make sense of these conflicting trends during the second wave.
2) The chart below released late Tuesday afternoon by the Montreal public health department shows that 196 workers have tested positive for the #coronavirus, down by 50 from Oct. 20. What’s more, the number of #COVID19 clusters has decreased by 10 to 58.
3) The workplace category that is observing the most dramatic drop (13 fewer outbreaks) includes restaurants, bars, gyms, hotels, motels and temporary employment agencies. That stands to reason, since the government closed restos, bars and gyms on Oct. 1.
Read 10 tweets
27 Oct
1) Three weeks after Quebec required high school students to wear masks all day in red zones, Premier François Legault announced Monday Grade 9 students will join those in Grades 10 and 11 in learning online at home one out of two days. In this thread, I'll examine this measure.
2) Legault held his news conference at 5 p.m. after the Education Ministry released its latest statistics revealing 52 more #COVID19 cases in schools since Friday, 11 more shuttered classes and three more schools with confirmed infections. See the chart below.
3) For its part, covidecolesquebec.org reported Monday night 32 more schools with at least one positive case among students or staff since Sunday. After the number of #COVID19 cases in schools dropped a week ago, the latest figures appear to indicate an upswing.
Read 10 tweets
26 Oct
1) Has Montreal already experienced the worst of the second wave? Is it even fair to ask this question with #COVID19 still surging in the Capitale-Nationale and Chaudière-Appalaches? In this thread, I will nonetheless attempt to provide a nuanced response.
2) Montreal on Sunday posted its lowest daily tally in 33 days, 146 new #COVID19 cases, as the descending orange line in the chart below shows. The city’s seven-day average was down to 112.48 cases per million population compared with a rate of 126.32 a week ago.
3) At the neighborhood level, Montreal’s #COVID19 hotspot in the second wave — the centre of the city, including Côte-des-Neiges, downtown and Parc-Extension — posted fewer than eight cases, while the West Island health district of Pierrefonds-Lac Saint-Louis identified far more.
Read 10 tweets
25 Oct
1) With less than a week left before the month's end, Quebec posted on Saturday more #COVID19 deaths in October (259) than the previous three months combined (229), underscoring the lethality of the #pandemic’s second wave. In this thread, I'll examine fatalities by age group.
2) First, let me emphasize that any life cut short because of #COVID19 — whatever the age — is a death that should have been prevented and is therefore tragic. But in my analysis of the data I’ve come across some noteworthy findings, which I believe are worth sharing.
3) There’s an age group that is gaining in its share of the total number of #pandemic deaths: people in their 70s. Two months ago, the 70-to-79 demographic comprised 17.9% of all such deaths. On Saturday, that share crept up to 18.2% — or 15 more deaths and 1,115 in total.
Read 9 tweets

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