Update on COVID19 Care Home Deaths Across the World – study

July 3rd, 2020

A study by the International Long Term Care Policy Network, hosted by the Care Policy and Evaluation Network at the London School of Economics updated the number of care home deaths across the world and came to the following conclusions:

  • Official data on the numbers of deaths among care home residents linked to COVID-19 is not available in many countries but an increasing number of countries are publishing data
  • International comparisons are difficult due to differences in testing availabilities and policies, different approaches to recording deaths, and differing definitions of what constitutes a “care home”.
  • There are three main approaches to quantifying deaths in relation to COVID-19: deaths of people who test positive(before or after their death), deaths of people suspected to have COVID-19 (based on symptoms or epidemiologically linked), and excess deaths (comparing total number of deaths with those in the same weeks in previous years).Another important distinction is whether the data covers deaths of care home residents or only deaths in the care home (as there are variations in the share of care home residents who are admitted to hospital and may die there)
  • This updated report contains data from a larger number of countries and this shows that earlier suggestions(when data were available for fewer countries) that the share of all COVID-19 deaths who were care residents increases with the total number of deaths may not be a robust finding, as New Zealand and Slovenia, despite having had relatively small numbers of total COVID deaths, have had a large share of those deaths among care home residents (72 and 81% respectively).
  • The impact of COVID-19 on care home residents has been very different internationally, with some countries reporting no deaths (or infections) in care homes, such as Hong Kong, Jordan and Malta, and two countries reporting that over 80% of COVID-19 deaths were of care home residents. Without including the three countries with zero deaths, and with the caveat that the definitions used vary, on average the share of all COVID-19 deaths that were care home residents is 47% (based on 26 countries).

Comments: This confirms our earlier commentaries on the profoundly disturbing fact that a large number of the total deaths of COVID19 were elderly people in care homes. Many of these people were not being adequately looked after, with evidence that in Spain and Italy, elderly people were left to die as workers didn’t come to work or simply left the country before lockdown. In New York, the UK and other countries, care homes were not protected well enough: elderly people were sent back to the care homes after hospitalization, without being tested for COVID19, care workers were not provided with sufficient information and the resources necessary to prevent the spread of the virus to the residents. In the UK, elders were isolated, pressured to sign Do Not Resuscitate notices and families were banned from visiting,

Elderly people, especially in winter were deficient of Vitamin D, essential for the immune system, and many were on ACE inhibitor drugs (for hypertension, diabetes, high cholesterol) that may have made them more susceptible to COVID19. The elderly are also prone to Zinc deficiency, which has been shown to increase the risk of poor outcomes to COVID19.

For otherwise healthy people, the chance of a serious infection is minimal. Walking outdoors carries little chance of infection, mask or not. The reality is that immune compromised people, especially the elderly, living in close quarters are the most vulnerable. It is therefore not surprising that the elderly in care homes have borne the brunt of COVID19. Rather than protect a group already identified as being at particular risk, they were, in the event, badly neglected.