The N.L. government has been downplaying COVID-19 deaths for months

On the afternoon of March 29, using what it calls the COVID-19 information dashboard, Newfoundland and Labrador's Public Health division proclaimed no one had died from COVID-19 in the most recent reporting period.

The update came as a large zero, prominently displayed under the heading "New Deaths" on one side of the dashboard.

Anyone who wanted to know the total death count could add up the numbers in the graphs on the other side of the screen breakdowns of deaths by age and region and come to a total of 339.

But that number was six people more not zero than the dashboard had totalled the day before.

Public Health had quietly changed the numbers. But in order to figure that out, anyone adding up the totals would need to have tallied the numbers from before the change and kept them, because the old numbers were no longer available online.

CBC News has been keeping track of that, and other, COVID-19 information since the pandemic began in March 2020, and found the government has been downplaying the number of coronavirus deaths for months.

How does the total number of deaths go up when there were no new deaths reported? The answer lies in a change the provincial government quietly made to its coronavirusupdates at the beginning of 2023.

Only source of public info

In March 2022, the Health Department unveiled its online COVID-19 dashboard, which was to be the public's sole source of pandemic data. Among other data, the dashboard announced the number of people in hospital, including the number of people in critical care, and the number of deaths since the previous update.

If you thought that really there haven't been that many people going to hospital or dying from COVID, maybe you would have a false sense of security.- Chris Kaposy

The dashboard was updated Mondays, Wednesdays and Fridays until mid-May, when the government reduced the frequency of updates to weekly, and toward the end of last year, the department said the province's COVID-19 situation was stable enough to reduce update frequency to every two weeks.

The first update of 2023 on Jan. 4, covering the final two weeks of 2022 also revealed an unannouncedchange in how Public Health was reporting numbers.

Instead of an up-to-the-day picture of the province's current pandemic situation, the data was now a summary of a two-week reporting period.

The 35 hospitalizations noted on the dashboard didn't meanthere were 35 people in hospital as of the update as previously would have been the casebut that a total of 35 people had been admitted to hospital over the course of two weeks, from Dec. 18-31. (The number of current hospitalizations would be lower than 35, with many of those people likely having since recovered and being discharged, as well as a handful of them possibly not recovering at all.)

On Jan. 4, the province's total deaths stood at 295. The dashboard doesn't include an overall total but does provide the number of deaths recorded in each regional health authority, as well as a breakdown by age range. Adding up either of the breakdowns will provide the total number of deaths.

With the next update, a discrepancy began to emerge. On Jan. 18, the dashboard announced two new deaths, but adding up the age and regional breakdowns revealed the number of total deathshad gone up by four. Two weeks later, the dashboard announced seven new deaths, but the total had gone up by eight.

After weeks of requests by clarification by CBC News, the Health Department explained there may be deaths within a two-week reporting period that aren't determined to be due to COVID-19 until after the reporting deadline. Those deaths aren't included under "New Deaths" in the next update but are included in the age and regional breakdowns.

A statement to CBC News from the Health Department last week states, "To obtain the total number of deaths that have occurred, one may compare the numbers from the previous version of the dashboard to the new version of the dashboard."

But once the dashboard has been updated, no "previous version of the dashboard" exists anywhere online for comparison; each biweekly update erases the previous update. (CBC News has been trackinggovernment COVID-19 data since the beginning of the pandemic.) And despite the Health Department's comparison to flu reporting, there are differences in how deaths, and other data, are reported:

• Each flu report displays the cumulative number of deaths with the same prominence as the new deaths. The most recent flu report, for example, notes zero deaths in the most recent two-week reporting period and 20 deaths overall for the season. The flu report also reports total cases and hospitalizations, something the COVID-19 dashboard does not.
• Flu reports are archived online, with all reports since 2012 available on the Department of Health's website. No such archive exists for the COVID-19 dashboard. The current information displayed is the only information available.
• Each flu report carries a disclaimer: "Fluctuations in data occur with each report and can be attributed to continuous reporting." No such disclaimer appears on the COVID-19 dashboard. The current dashboard displays zero deaths from March 26-April 8, with no indication that the actual number could be higher, as has been the case for almost all reports in 2023.

Asked why the province provides more information on the province's flu situation than it does for COVID-19 especially with the pandemic not yet over Dr. Janice Fitzgerald, the province's chief medical officer of health, said the flu report is a template that has been used for years.

"COVID-19, you know, we developed a dashboard so that we could give the latest and up-to-date information that was available to us, and so it just really is a result of two different methods of reporting to the public at this point," she said. "There's really nothing deeper about it at this point."

As the weeks have gone by, the gap between announced "new" deaths and the total number of deaths has widened. On March 11, the dashboard announced seven new deaths but the total number went up by 12. Two weeks later, the dashboard announced zero new deaths. It was the first time since July that an N.L. COVID-19 update announced there had been no new deaths, but the breakdowns revealed six deaths had been added to the total, which was now 339 and again, it's only possible to know that if one knows the previous total was 333. The dashboard maintains no record of it.

Fitzgerald said new deaths are announced for the most recent two-week period, rather than all deaths that have been attributed to COVID-19 since the last update, because that's the standard for epidemiological reporting.

"That's why we report by reporting period," she said. "From a risk perspective, I think people can certainly determine their risk based on what they see circulating in the community."

Fitzgerald said she's not sure the number of deaths is the most important factor for an individual to assess the pandemic risk.

"The real thing about what helps people determine their risk is the amount of circulating virus that we're seeing," she said. "So the number of cases, the number of hospitalizations, all of that will certainly give more information for people being able to assess their risk, right, than looking at deaths that may have happened three weeks prior."

There's no benefit to anybody if we aren't transparent about the amount of COVID that's out there.- Dr. Janice Fitzgerald

It's unclear how people can see how much COVID-19 is circulating the Health Department stopped providing an active caseload when it introduced the dashboard. At the time, the active caseload was more than 3,000 people and had been steadily rising for a month after the initial Omicron surge subsided.

The dashboard provides a daily count of new cases but those include only positive cases revealed through testing by a regional health authority, not rapid tests done by individuals.

And the Health Department stopped providing testing numbers in March 2022, making it impossible to determine the testing positivity rate, a better way to evaluate the prevalence of COVID-19 than the number of new cases.

There's "certainly no desire to downplay anything," said Fitzgerald.

"There's no benefit to anybody if we aren't transparent about the amount of COVID that's out there," she said. "It's simply a reporting lag that is contributing to that and the way that we do epidemiological reporting, that's what's contributing to the difference. That's simply it. There is no desire on anyone's part to not give the accurate information."

Chris Kaposy, an associate professor of bioethics at Memorial University, said he's willing to accept that Public Health didn't intend to make it more difficult to determine how many people are dying from COVID-19, but said the government has an obligation to be transparent about pandemic data.

"At some point, if it's recognized that there's a discrepancy between the numbers being reported versus the actual number of deaths in the province in a given reporting period," he said, "and it's pointed out to the government that this discrepancy is being noticed and the government doesn't actually take steps to fix that lack of transparency, at some point you have to assume that this is being done deliberately."

It would be easy to fix the problem, he said.

"Why not just announce the number of deaths that have occurred since the last update that haven't been announced, which would include those that fall within the current reporting period and those that happened before but weren't recognized as COVID deaths prior to the current reporting period, right? Seems like a simple fix."

Especially since the emergence of Omicron, the number of cases hasn't really been a meaningful measure of COVID-19's spread, he said, but other information is definitive and objective.

"Deaths, hospitalizations that's objective information, right? And that can also potentially be meaningful information, particularly, you know, imagine if you're an elderly person and you need to go to the grocery store and you're trying to decide whether you should wear a mask or not," he said.

"If you thought that really there haven't been that many people going to hospital or dying from COVID, maybe you would have a false sense of security and not wear your mask."

When the province is under a public health emergency, Kaposy noted, pandemic decisions are handed over to the provincial chief medical officer of health for good reason.

"It's actually a pretty good law, because when you have an emergency you want the people with the relevant expertise to be making the decisions," he said.

But when the emergency is over N.L.'s public health emergency was declared over in March 2022 management of the pandemic goes back to the political leadership, he said.

"And what that means is there's no longer a firewall between the experts and the politicians for making decisions about the pandemic," he said.

"Sowhat this could mean is that there's political motives, even if they're not acknowledged or even if they're not aware of these motives themselves to perhaps downplay the effect of the pandemic on the population."

I'm not going to interfere with how Public Health collect and report the data. I think they've earned our trust, and I trust the work that they do.- Tom Osborne

Health Minister Tom Osborne repeatedly told CBC News that Public Health is responsible for COVID-19 information, including what's on the dashboard, and said the division has proven its ability to deal with COVID-19 reporting.

"This province is a leader in North America, really, in responding to COVID," he said. "We had amongst the lowest COVID-19 rates in North America and some of the highest vaccination rates."

Asked why the dashboard doesn't provide the same level of information provided in flu updates, Osborne said Fitzgerald is the best person to ask.

"We don't sign off on the statistics or the reporting," he said. "We have put a great deal of confidence in Dr. Fitzgerald, and rightfully so. I think she has been a world leader in terms of managing COVID and the pandemic in this province."

He said the government continues to follow Public Health's pandemic recommendations, including information.

"I'm not going to interfere with how Public Health collect and report the data," he said. "I think they've earned our trust, and I trust the work that they do."

He added he'd be willing to sit down with Public Health and review the dashboard, but he trusts their reporting and he told CBC News that there's no desire on the government's part to downplay deaths.

"For some reason, you seem to think that the dashboard is politically motivated. I can assureyou that it's not," he said. "It's a Public Health dashboard. The data is collected and reported by Public Health."

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