Exclusive: figures show Britain second only to Spain among major European countries
In England, 54% of all excess deaths were in care homes, the study found.
Booth Social affairs correspondent
Sun 28 Jun 2020 15.00 BST
Source: The Guardian
Reprinted for educational purposes and social benefit, not for profit.
Care home residents were more likely to die of Covid-19 in the UK than in any of the major European countries apart from Spain, analysis of global data has revealed. The proportion of residents dying in UK homes was a third higher than in Ireland and Italy, about double that in France and Sweden, and 13 times higher than Germany. The analysis of official statistics was carried out by academics at the London School of Economics as part of the International Long Term Care Policy Network. Of all the UK’s care home residents, 5.3% were confirmed or suspected to have died from Covid-19, compared with 0.4% in Germany, according to analysis of official statistics. About 3,500 people died in care homes in Germany compared with more than 16,000 in the UK, despite Germany having a care home population twice as large. Its test-and-trace system and 14-day quarantine for people leaving hospital have been credited with protecting homes from outbreaks.
The figures will increase pressure on the health secretary, Matt Hancock, to justify his claim in May to have “thrown a protective ring” around care homes right from the start of the pandemic. This week the operators of a Kettering care home, which had to be closed down last month when care standards collapsed and 12 residents died from Covid-19, said the virus had been introduced by people discharged from hospitals. Government guidance recommending that patients are tested before being sent from hospitals to care homes was introduced only on 16 April, by which time almost 1,000 homes had reported infections. Hancock is also facing legal action from the daughter of a man who died in an Oxfordshire care home in April. He became infected after a patient who tested positive for the virus was discharged from hospital into the home.
Labour’s shadow care minister, Liz Kendall, said: “These appalling figures raise serious concerns about the government’s handling of Covid-19 in care homes compared to other countries, and that they were too slow to act to keep older and disabled people safe. The government must learn from the mistakes so far. Care services must get the resources and support they need to deal with the pandemic, alongside the longer-term funding settlement for social care that is crucial to the country’s recovery.” The Department of Health and Social Care (DHSC) defended its record, with a spokesperson saying it had taken “swift action” to protect care home residents and staff. “This includes offering whole care home testing and providing additional funding for local services, which has resulted in almost 60% of our care homes [not having] an outbreak at all,” they said. However, whole home testing was only introduced on 15 May, well after the 8 April peak of Covid-19 deaths. And of the £3.2bn coronavirus funds announced in March and April, only £194m had been provided by councils to social care providers by the first half of May, according to a survey of council leaders.
The government also said variations in testing, recording deaths and definitions of care homes internationally meant it was not possible to make accurate comparisons. The study’s lead author, Adelina Comas-Herrera, said the research did not reach conclusions about the cause of the different patterns seen in care settings internationally, but noted different policies on testing and tracing outbreaks between the UK and Germany. “They were further ahead in understanding which staff and residents had contact with whom,” she said. “We think the main factor was that Covid was much less under control in the overall population [in the UK]. As a result, care homes were much more in danger.” A Public Health England study of six London care homes in April found that temporary workers moving between different facilities were partially responsible for transmitting the disease. Repeat testing of care home staff and residents is still not available in the UK. The care minister, Helen Whately, said three weeks ago she was “imminently” expecting scientific advice on retesting frequency. Last week the DHSC said: “We will update the sector shortly.”
The LSE study also found that the excess death toll in UK care homes during the pandemic was close to 32,000, almost twice the official number of confirmed or suspected fatalities from the virus. Excess deaths are those that would not have happened in an average year in the absence of the coronavirus crisis. The latest official figures from authorities in England, Wales, Scotland and Northern Ireland suggest confirmed or suspected deaths from the virus in care homes had reached 16,680. Excess deaths include other fatalities likely to be associated with the pandemic, through people not receiving normal levels of treatment for other illnesses, or which were in fact caused by Covid-19 but were not recorded as such.
In England, 54% of all excess deaths were in care homes, the study found.
Key findings (26th June)
- 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).
- To compare the relative impact of COVID-19 on care home residents in different countries it may be more useful to focus on the share of all care home residents whose deaths have been linked to COVID-19. We found that that, for the 18 countries for which have these data, the share of all care home residents who have died (linked to COVID-19) ranges from 0 to 6.1%. This is share is highly correlated to the total number of COVID-19 deaths in the whole population.
- It is also worth noting that whilst the focus of this report is on care homes, many older people receive care in the community. Currently, there is limited evidence from anywhere in the world on how those individuals have been directly or indirectly affected by COVID-19.