According to a directive from Quebec’s Ministry of Health :
“If the presumed cause of death is Covid-19 (with or without a positive test) an autopsy should be avoided [emphasis in original document] and death should be attributed to Covid-19 as the probable cause of death. In addition, deaths whose probable cause is Covid-19 are considered natural, and are not subject to a coroner’s notice. “
The directive does not allow the counting of co-morbidities. And if the family of the deceased does not accept the Covid-19 categorization (which incidentally requires no PCR test), the autopsy request procedures are complex (almost impossible, two hospitals for the whole of Quebec, see document below).
This directive dated Thursday, April 16, 2020 was conducive to an immediate sharp increase in the number of deaths attributed to Covid-19: 44.9% of total deaths in Quebec are attributed to Covid-19 (week of 11-18 April 2020).
Read carefully the text of the directive sent to the managers of the OPTILAB clusters (the clinical-administrative and medical co-directors). (Les Grappes – OPTILAB are the medical biology laboratories)
The directive is issued on April 16, 2020.
Four days later, Monday April 21, 2020, La Presse (Montreal) reports that Covid-19 has become:
“… the main cause of death in Quebec, beating the daily average of deaths attributable to cancer and heart disease”
“The coronavirus, with 62 deaths recorded in the last 24 hours [20-21 April 2020], also claims more lives than the flu, alzheimer’s, road accidents and all the other causes of death listed by Health public.
According to La Presse, April  was the deadliest month . But did La Presse consult the directives of the Ministry of Health:
Similarly, Le Devoir confirms that COVID-19 had become deadly precisely in April 2020, at the very moment when the Ministry imposed its new guidelines concerning the Covid to the OPTILAB grappes labs.
And below is the (daily) mortality statement for Quebec corresponding to the week of April 12 to 18,