Excess Deaths During the COVID-19 Pandemic in Alberta, Canada

•Examines excess mortality during COVID-19 by age group in a population of 4.4m.•Excess mortality follows waves of acute COVID-19 infection.•Younger age groups are over-represented in the mortality data.•Deaths from substance abuse are markedly higher in this time frame, particularly in young males. To determine if there was excess mortality in Alberta, Canada during the pandemic. We sought to confirm if excess mortality affected all age groups equally and determine what proportion of excess deaths is directly related to COVID-19, and non-pharmaceutical drug poisoning. The weekly all-cause data were used to estimate excess mortality were modeled against the pre-pandemic period (January 2015 to February 2020). Age-adjusted weekly mortality rates for March 2020 to Dec 2021 were compared to the previous 5 years. From March 2020 to Dec 2021 there was an 11% excess mortality corresponding to an average of 265 monthly excess deaths with a maximum of over 30%. COVID-19 related deaths (n=3202) account for 54.9 % of the total excess deaths (n=5833) that occurred in the 22 months. The increase in all cause -excess deaths was proportionately higher, and in significantly greater numbers, in the younger age groups. Statistically significant increases in monthly drug poisoning deaths occurred from March 2020 to April 2021 with a total of 1819 deaths. Excess 825 drug poisoning deaths representing 25.4 % of total all-cause excess mortality affected mostly those age 25-60. 54.9 % of all excess deaths is directly related to COVID-19 and 25.4% are drug poisoning related excess deaths. There was statistically significant increase in all-cause mortality. Although older adults are more likely to die of COVID-19, there was massive increase in non-COVID-19 related mortality among the youth. These should be factored in public policy decisions on epidemic/pandemic management. [Display omitted]