The Provincial COVID Misery Index (PCMI) is a comprehensive tool designed to compare the impacts of the pandemic and governments’ responses to it on Canadians’ wellbeing. It captures the health impacts wrought by the disease itself such as cases and deaths (Disease Misery), the efficiency of provinces’ responses such as vaccination and testing programs (Response Misery), and the economic toll endured in terms of lost jobs, rising debt levels and lost economic growth (Economic Misery).
By Richard Audas, July 19, 2021
Update since May 5
As COVID caseloads decline across Canada, vaccinations escalate, and travel between provinces opens up, we are starting to imagine life returning to something that looks like normal. Alberta appears to be largely there, with large crowds attending the Stampede and with most pandemic measures removed. Conversely, in Ontario, the opening has been extremely slow and deliberate, with the province only moving into “phase 3” of its plan on Friday, with many restrictions still in place.
These variations in moving beyond lockdown are captured in the “stringency” scores for each province in the updated Provincial COVID Misery Index (PCMI), which captures data since the initial launch of the PCMI on May 5.
The Ontario paradox
The arrival and proliferation of the new ‘delta’ variant had been a cause of concern due to its higher rate of contagion, but early evidence shows that the currently approved vaccines offer good protection. For those rare few vaccinated individuals who do become infected with COVID-19, the symptoms are much less severe. In short, vaccines are working, and the high vaccination rates in Canadian provinces offer an opportunity for increased personal freedoms.
However, one of the most striking findings in the data over the last few months is that while Ontario is just about at the top of the rankings for its vaccine rollout, it is paradoxically a stark outlier on “stringency”, which measures the severity of public health measures and restrictions on movement, including school and business closings, curfews, quarantines, stay at home orders, and limits on gatherings. Higher levels of stringency result in a worse grade for the Response Misery category on the Index, since citizens suffer greatly during lockdowns from lost incomes, the mental health toll of isolation and stress, the impact on physical health of a hobbled medical system, and, for children, serious repercussions for learning and social development.
Ontario, along with Manitoba and New Brunswick, has seen an incredible surge in the rate of vaccinations. Yet only in the last few days are the most rigorous public health restrictions being lifted in the country’s most populous province. Though larger gatherings and indoor dining are now permitted, some capacity limits still remain, resulting in the province’s outlier status in terms of stringency response measures compared to other parts of the country.
Atlantic Canada continues to lead
In our first Provincial COVID-19 Misery Index, released in May, the data painted a clear picture of Atlantic Canada coming through the pandemic with the least degree of misery compared to other regions in the country. There has been considerable speculation as to why this has been the case. The data, however, is very clear-cut: Atlantic provinces fared far better than everywhere else in Canada, and continue to do so. Even the recent outbreak in Nova Scotia has had a limited impact on the overall level of misery experienced in the region.
In the weeks since our first Provincial Misery Index, we have seen a fall in cases across the country, with especially low case counts on the east coast, and in particular in Newfoundland and Labrador, Prince Edward Island and New Brunswick. Fewer cases result in fewer deaths (and Prince Edward Island has still recorded no COVID-19 deaths) and lower rates of excess deaths (a measure of deaths from all causes, which could be an indicator of the cost in lives of public health choices made to combat the virus). In fact, Prince Edward Island and Nova Scotia have had negative rates of excess deaths; the rate is near zero for Newfoundland and Labrador although positive still for New Brunswick, suggesting that while the province has done a good job preparing for and grappling with COVID-19, this may have come with the trade-off of less attention being provided to other health conditions.
The lower case counts have allowed these provinces to enjoy more relaxed public health measures. But the relaxed need for stringency has resulted in correspondingly lower rates of vaccination in Newfoundland and Labrador and Prince Edward Island. Vaccination rates have been somewhat higher in Nova Scotia and New Brunswick.
In Quebec, falling caseloads and a relatively light third wave allowed officials to lift some of the public health restrictions, although Quebec’s vaccination rate has been comparatively slower than other provinces. Given their relatively higher caseloads earlier in the pandemic, they have struggled to keep up with other provinces in terms of tests per case, and their early failure to contain the disease and particularly to protect the elderly continues to harm Quebec’s rankings.
The Western provinces – especially Alberta – continue to receive lower grades. Caseloads, deaths attributed to COVID-19, and excess deaths are generally above the Canadian average. While the most stringent of public health measures are being relaxed, vaccination rates in Saskatchewan, Alberta and British Columbia remain below the Canadian average. However, it should be noted that Manitoba stands out as having the highest vaccination rate of any province.
Alberta’s ambitious reopening will begin to pay off as its stringency rate continues to fall and the economic benefits become more apparent, as long as there isn’t a major resurgence in the virus. As commodities recover, Alberta’s economic misery is expected to improve further.
The economic data has not been updated in this edition as there is little change in the available economic data from month-to-month. But we intend to update the economic measures after the summer, by which time we hope vaccination rates will be very high, new cases will be very low, and life will be returning to its pre-pandemic course for all Canadians.
Richard Audas, Professor of Health Statistics and Economics Faculty of Medicine, Memorial University of Newfoundland. Senior Research Fellow, Macdonald-Laurier Institute.