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Alberta's reporting of comorbidities questioned after boy, 14, removed from COVID-19 death count

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Nathanael Spitzer's family says he died of cancer, not COVID-19, as province reported

Wallis Snowdon · CBC News · Posted: Oct 15, 2021 11:19 AM MT | Last Updated: October 15Nathanael Spitzer, pictured above, died on Oct. 7, nine months after he was diagnosed with brain cancer. His death has renewed the debate surrounding how Alberta reports COVID-19 deaths. (Spitzer family/GoFundMe)          Nine months after being diagnosed with a Stage 4 brain tumour and two days after his family says he tested positive for COVID-19, Nathanael Spitzer of Ponoka, Alta., died in hospital.          When Dr. Deena Hinshaw told Albertans earlier this week that the 14-year-old had died of COVID-19, the province's chief medical officer of health triggered a wave of controversy over how coronavirus deaths are reported.                                                                                                                                                                                                                                                                                                                            Hinshaw told a news conference on Tuesday that the boy had complex, pre-existing medical conditions that contributed to his death. Her comments renewed a debate surrounding Alberta's practice of reporting on comorbiditie

The boy's family publicly called on Hinshaw to retract her statement, suggesting that Nathanael had died of cancer, not COVID-19.

'We just want the truth to come out'

Simone Spitzer accused the province of spreading "fake news" about her younger brother, who had been in hospital since August.

"We just want the truth to come out," she said in a message to CBC News on Tuesday.

On Thursday, at another news conference, Hinshaw apologized to the family. She said that while an initial report had indicated that COVID-19 was a secondary cause of the teen's death, a subsequent review determined that not to be the case.

Hinshaw announced the province will no longer report COVID-19 deaths of children until a review process has been completed to confirm the actual cause of death.

Nathanael, described by his family as an entertainer with a quick smile, has now been removed from the list of more than 2,900 Albertans who have died of COVID-19.

The case highlights the intricacies of reporting comorbidities — such as cancer, diabetes, hypertension and dementia — that can contribute to the dangers of COVID-19.

Alberta started reporting comorbidities linked to COVID-19 deaths in December 2020, but the data doesn't tell the whole story. Experts say discussing the statistics without nuance can minimize dangers of the disease.

WATCH | Hinshaw says Alberta has changed reporting for pediatric deaths:

Dr. Deena Hinshaw apologizes for mistake in cause of death of 14-year-old

4 days ago

3:44

'The pain of losing a child is terrible enough without having that loss compounded by a public debate about the circumstances,' Hinshaw said Thursday. On Tuesday, she had announced that COVID-19 was a contributing factor in the child's death. It was not. 3:44

Comorbidities are prevalent among all age groups, and the vast majority of Albertans who have died of COVID-19 will have at least one of these conditions listed on their death certificate.

Only 3.8 per cent of Alberta's COVID-19 deaths have involved no comorbidities. More than 74 per cent of all COVID-19 deaths in the province have involved three or more pre-existing conditions.

The most common comorbidities listed in Alberta are hypertension (82.9 per cent), cardiovascular diseases (52.2 per cent), renal diseases (49.7 per cent), diabetes (44.5 per cent), respiratory diseases (40.1 per cent) and dementia (40.1 per cent).

After a COVID-19 death is reported, each case is assessed to ensure the reporting is accurate. If fault is found, the case is removed from Alberta's COVID-19 statistics.

"If there is any question, the death certificate and file are reviewed by medical professionals post-mortem," Alberta Health spokesperson Tom McMillan said in a statement to CBC News.

"If the cause of death was unrelated to COVID — for a hypothetical example, if an individual who is a confirmed case of COVID-19 died in a car crash — the case would be subsequently removed from our death count."

An issue of classification

Dr. Noel Gibney, professor emeritus in the department of critical care medicine at the University of Alberta in Edmonton, says reporting on pandemic deaths is complex, and the data can easily be misunderstood.

Pre-existing conditions can range from severe to minor — and just because someone has a comorbidity does not mean they were likely to die before contracting COVID-19.

Gibney, who expressed sympathy for the Spitzer family, also noted that COVID-19 can trigger myriad lesser-known, potentially fatal health issues, such as a heart attack or stroke.

"The issue is: How does one classify, when they die, has someone died of COVID or with COVID?" Gibney said. "If you had COVID, would you have died on that day or could you have survived for another number of months or years?"

         Pediatric patients now excluded from Alberta's critical-care triage protocol

For example, he said, a terminal cancer patient who dies can still be categorized as a COVID-19 death if symptoms of COVID-19, such as pneumonia, are what ultimately proved fatal.

"If your condition was relatively stable and then you caught COVID and died, in most instances a doctor would fill out the death certificate as 'due to COVID' with your cancer as the underlying condition."

Gibney said tracking comorbidities can contribute to a broader understanding of the pandemic, but sharing the data publicly is problematic.

  • THE LATEST

         Everything you need to know about COVID-19 in Alberta on Friday, Oct. 15

Without context, the statistics may undermine the public's understanding of the disease, he said, noting that the data also stigmatizes those with underlying health conditions.

Ubaka Ogbogu, an associate professor in the faculty of law and the Katz Research Fellow in Health Law and Science Policy at U of A, said Alberta's comorbidities reporting system should be scrapped.

"This disclosure started a long time ago, and it started from the time that Premier [Jason] Kenney really wanted to minimize COVID in general, as well as COVID deaths," Ogbogu said.

"People who have these comorbidities are going to live in fear.... And that anxiety is not being matched by any action from these governments to actually show that they're trying to protect those who are especially vulnerable."

ABOUT THE AUTHOR

Wallis Snowdon

Journalist

Wallis Snowdon is a digital journalist with CBC Edmonton. Originally from New Brunswick, her journalism career has taken her from Nova Scotia to Fort McMurray. Share your stories with Wallis at wallis.snowdon@cbc.ca

CBC's Journalistic Standards and Practices|About CBC News                                                             

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Re: "Hinshaw announced the province will no longer report COVID-19 deaths of children until a review process has been completed to confirm the actual cause of death."



Why only with the deaths of children and not all deaths?

The family of the young lad saw the report on the news and that is how they realized it was incorrect. How many more are being missed?

Last edited by cain

This is kinda long but drives home the message.

The last paragraph summarizes the letter.

https://mounties4freedom.ca


( The last couple of paragraphs with my hilites.)

PUBLIC INTEREST

Lastly, we want to draw attention to the public safety issues that will arise if these COVID-19 mandates are upheld.
Pierre Elliot Trudeau once said, “There’s no place for the state in the bedrooms of the nation.35” How is it our federal government is now saying it will be mandatory for employees working from home to receive the COVID-19 treatment injections?36
Regardless of their vaccination statuses, there are RCMP members who feel the steps taken by the federal and provincial governments are too extreme and do not have the best interest of Canadian citizens. Forcing these mandates will cause several RCMP officers to lose faith in the federal government’s commitment to the Charter. These RCMP officers will not participate in actions they believe contradict their morals, ethics, and Canadian laws. These RCMP officers believe it is their responsibility to challenge the federal government in court if necessary.
The RCMP, which is already understaffed, will have additional gaps to fill across the country when these members are not working. Communities will have lost healthy and experienced officers, causing a decrease in available resources. There will also be an increase in taxpayers’ spending as the federal government attempts to fill these gaps. Being short-staffed will have a trickle-down effect causing fewer RCMP bodies to be available to properly recruit, assess, and conduct adequate background checks on potential cadets.
Our experience in law enforcement and as investigators have allowed us to see how crucial it is that professionals be allowed to speak openly and publicly. Without including their information in discussions, we believe the citizens of Canada (including RCMP members) are not receiving the information they need to make an informed decision. This is contrary to our laws and beliefs, and we do not support it.
We want to reiterate a point stated earlier in this letter, so it is remembered. If the people believe the government is continuing to censor experts, the country will fall into instability. We are experts in law enforcement and investigations. We are losing faith in the motives of our government, and we will not willingly participate in actions against people whose Charter rights and freedoms are being violated.

CALL TO ACTION

Commissioner Lucki, we ask that you represent the best image of the RCMP by remaining loyal to the Charter and Bill of Rights and not to any particular public figure. Our job as Mounties is to preserve the peace. If we continue down this road of segregation and discrimination, we risk repeating past mistakes. The divide in our society is quickly leaning toward a level of national security. We ask that you open an investigation to ensure no criminal acts were committed in the dissemination of information from federal and provincial health authorities or public figures in positions of trust. We ask you to send investigators to collect statements from medical professionals (and other reliable witnesses) who allege they had been silenced – putting lives at risk. Allow us to make this information publicly available to all so the public can scrutinize it and achieve informed consent. As Canada’s national police force, we are unique in our ability to conduct a large-scale cross-country investigation, which must be transparent to regain trust in the government.
We also ask that you challenge the Federal Government’s decision to send Mounties home without pay for decisions they’ve made on beliefs protected by Canadian laws. Neither the RCMP, nor the communities they serve, can endure the loss of experienced police officers.

We await your response and your plan of action.

Respectfully,

Mounties for Freedom

Last edited by cain

Just heard it's starting up in Alberta....court, here we come.

Also on the news, January 16, the Covid passport will not be needed for restaurant/ bar patrons. What's with the planned date... Covid leaving us for the winter?

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