Mortality associated with COVID-19 outbreaks in care homes: early international evidence

Adelina Comas-Herrera (CPEC, LSE), Joseba Zalakain (SIIS), Charles Litwin (CPEC, LSE), Amy T Hsu (Bruyere Research Institute), Natasha Lane (University of British Columbia) and Jose-Luis Fernandez-Plotka (CPEC, LSE)

Last updated: 21st May, 2020

Key findings

  • 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
  • Due to differences in testing availabilities and policies, and to different approaches to recording deaths, international comparisons are difficult
  • 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), 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).
  • Trusted data from 19 countries suggests that the share of care home residents whose deaths are linked to COVID-19 tends to be lower in countries where there have been fewer deaths in total, although as the number of deaths grows the share seems to reach a plateau, for now.
  • There have been no infections or deaths in care homes in Hong Kong (only 4 deaths in total and 1,056 cases of infections in the total population).
  • In the other countries where there have been at least 100 deaths in total and we have official data, the % of COVID-related deaths among care home residents ranges from 24% in Hungary to 82% in Canada.
  • Data from England illustrates well the importance of paying attention to differences in definitions and methods used to estimate these percentages: the share of all probable COVID-19 deaths in care homes is 27%, whereas the share of probable deaths of care residents is 38%. The share of excess deaths in care homes during the pandemic has been 44% and the share of deaths of care home residents is 52% of all excess deaths. Also, in France, deaths in care homes are 34% of all COVID-19 deaths, whereas deaths of care home residents are 51%.
  • Data on the share of all care home residents whose deaths can be linked to COVID-19 may be a better indicator of the impact of COVID-19 on care home residents. We have been able to compile this for a few countries. The shares range from 0 in Hong Kong, 0.3% in Austria, 0.4% in Germany and 0.9% in Canada, to 2% in Sweden, 2.4% in France and 3.7% in Belgium. In the UK, if only deaths in care homes registered as linked to COVID-19, the figure would be 2.8, whereas if excess deaths of care home residents is used, it would be 6.7%[1].

1] This does not include deaths of Scottish care home residents in hospitals or deaths in care homes in Northern Ireland, so the share may be higher.

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9 thoughts on “Mortality associated with COVID-19 outbreaks in care homes: early international evidence”

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