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

Adelina Comas-Herrera, Joseba Zalakaín, Charles Litwin, Amy T. Hsu, Elizabeth Lemmon, David Henderson and Jose-Luis Fernández

Last updated: 26th June, 2020

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.

Previous versions of this report are available here:

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

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