COVID-19 hospitalizations due to Omicron are vastly underreported: grassroots organization

With provinces releasing less frequent data on COVID-19 three years into the pandemic, a group of volunteer experts has been releasing their own analysis of cases, highlighting a vast underreporting of hospitalizations and deaths in Canada due to the Omicron variant.

Recent figures based on this analysis show that expected hospitalizations from Omicron could be 70 per cent higher on average than what has been reported since Dec. 2, 2021, if the rest of the country reported as Quebec did.

"If each province reported in a similar fashion as Quebec, which is the gold standard in Canada for complete and timely reporting of severe COVID outcomes, then these numbers would look very different from those that have been reported," Tara Moriarty, an infectious disease expert at the University of Toronto and the co-founder of COVID-19 Resources Canada, told CTVNews.ca on Tuesday.

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The difference is also significant for Omicron deaths, which are expected to be 51 per cent higher than reported, according to the data.

"It became critical to provide this information to the public," said Moriarty.

Founded in March 2020, the grassroots initiative – made up of scientists, healthcare professionals, and web developers – collates data from different sources including information from provincial databases and Statistics Canada, and gets its funding from the Public Health Agency of Canada.

EXPECTED OMICRON CASES ACROSS CANADA ARE UNDERREPORTED

Since Dec. 2, 2021, the total expected hospitalizations from Omicron in Canada were roughly 162,000 - a huge jump of 70 per cent from the reported 95,000 hospitalization cases, according to the information provided on the dashboard.

Moriarty said even with reporting delays, the difference in hospitalizations, ICU admissions, and deaths from Omicron alone is huge.

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Expected deaths from Omicron are 51 per cent higher than what has been reported. An earlier report by the 2021 Royal Society of Canada—in which Moriarty was involved– showed that on average, provinces outside Quebec likely under-reported COVID deaths by 1.4 fold, and that the country as a whole underreported by 1.3 fold.

Moriarty said outside of Quebec, the gap in reported and expected deaths has been growing during Omicron.

As in hospitalizations and deaths from Omicron, ICU admissions from the variant are also being underreported. ICU admissions are most likely 29 per cent higher than what is being reported— an expected 22,200 ICU admissions in comparison to 14,750 reported ones, according to the data analysis by COVID-19 Resources Canada.

53 PER CENT OF CANADIANS INFECTED WITH OMICRON - ESTIMATES

According to Moriarty’s estimates, 53 per cent of all Canadians have been infected with Omicron since December 2021, equaling 20.3 million people.

A breakdown by age shows that an estimated 59 per cent of those infected are below the age of 40.

Data shows that per capita infections remained high in Atlantic Canada compared with most other regions from mid-February onward. While cases across Canada are coming down, the total estimated Omicron infections per capita have been the highest for Nova Scotia.

Nova Scotia also has the highest hazard index while the rest of the country is either rated elevated or high. The hazard index designed by COVID-19 Resources Canada is measured by four equally weighted scores: vaccine protection, current infection and spread, healthcare system impact, and mortality.

In early January of this year, Nova Scotia had a high hazard risk while most provinces were under the severe category of the index. But the picture is reversed now.

The test positivity rates estimated infections and wastewater is high in Nova Scotia while they’re down in other provinces. Moriarty says part of the reason is that the percentage of Nova Scotians infected was low for several months of 2022 and even last December.

"They certainly kept up some public health measures, like masking for example, and had a very proactive public health system," Moriarty said. "One big thing was that Nova Scotia was testing a lot more per capita than any other province until recently."

Now with public health measures gone, the province has the highest hazard index.

The surge in hospitalizations, and deaths started happening when Nova Scotia started testing as little as the rest of the country. Another reason, Moriarty said, is that they have a lot more people who hadn’t been infected before so the cases started seeing an uptick.

RISING OMICRON HOSPITALIZATION COSTS

The dashboard also analyzes the rising costs associated with Omicron hospitalizations and compares them with the non-COVID hospitalization costs.

Based on the analysis, COVID-19 Resources Canada reduced the CIHI-estimated COVID-19 hospitalization costs by 27 per cent, to account for the shorter average duration of hospitalizations from Omicron.

The Canadian Institute for Health Information (CIHI) estimates show that the average cost of a COVID-19 hospital stay is $23,000— about 3 times more than for a heart attack ($7,000) or pneumonia ($8,000), four times more than the cost of a stay for influenza (approximately $5,000) and almost as much as a kidney transplant ($27,000).

People with COVID-19 remained in the hospital for about twice as long as an average pneumonia patient—roughly 15 days in comparison to seven days from pneumonia— and a larger proportion of them were admitted to the ICU and ventilated, according to the CIHI data.