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

Adelina Comas-Herrera, Joseba Zalakaín, Elizabeth Lemmon, David Henderson, Charles Litwin, Amy T. Hsu, Andrea E. Schmidt, Greg Arling, Florien Kruse and Jose-Luis Fernández

Last updated: 1st February, 2021

Key findings (1st February 2021)

  • Not all countries publish data on the numbers of deaths among care home residents linked to COVID-19 and international comparisons of the data available are difficult due to differences in testing capabilities and policies (particularly in the earlier part of the pandemic), 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).
  • Despite the difficulties arising from differences in definitions, in almost all countries where there have been deaths linked to COVID-19, a substantial proportion of those deaths were among care home residents.
  • Based on the data gathered for this report, up to the 26th January, the current average of the share of all COVID-19 deaths that were care home residents is 41% (based on 22 countries), this is lower than in previous phases in the pandemic.
  • Adding up all the deaths of care home residents counted in the data available for the 22 countries covered in this report amounts to just over 325,000 deaths of care home residents attributed to COVID-19 since the beginning of the pandemic, this would be equivalent to the entire population of Thessaloniki (Greece) or Cordoba (Spain).
  • To compare the relative impact of COVID-19 on care home residents in different countries it is useful to focus on the share of all care home residents whose deaths have been linked to COVID-19. For the countries where data is available, the share of all care home residents who have died (linked to COVID-19) ranges from 0.02% in Singapore and 0.04% in New Zealand to over 5% (which would mean that over one in 20 care home residents have died linked to COVID-19) in Belgium, France, the Netherlands, Slovenia, Spain, Sweden, the UK and the USA.
  • The share of all care home residents who have died (linked to COVID-19) is highly correlated to the total number of COVID-19 deaths in the population who live outside care homes.
  • 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.
  • Although the rollout of COVID-19 vaccinations has started in many countries covered in this report, the data up to 26th January 2021 is unlikely to capture the impact of vaccination programmes on the care home resident population. At this stage it is also difficult to monitor the potential impact of vaccinations, given the difficulties associated with obtaining disaggregated data on vaccines this early on in the rollout. Attempts to gather international data on vaccinations in care homes and among care home residents are underway.

Comparison of COVID-19 related deaths per 100 care home population with COVID-19 related deaths per 100,000 community-based (non-care home) population
Data sources are in the report (see file above)

Suggested citation:

Comas-Herrera A, Zalakaín J, Lemmon E, Henderson D, Litwin C, Hsu AT, Schmidt AE, Arling G, Kruse F and Fernández J-L (2020) Mortality associated with COVID-19 in care homes: international evidence. Article in LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 1st February 2021.

Previous versions of this report are available here:

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

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