Diamantis S, Noel C, Vignier N, Gallien S, SARS-cov-2 related deaths in French long-term care facilities: the “confinement disease” is probably more deleterious than the COVID-19 itself, Journal of the American Medical Directors Association (2020), doi: https:// doi.org/10.1016/j.jamda.2020.04.023.
This brief research letter reports on the circumstances and causes of deaths related to COVID-19 among residents of a French long-term care facility. The 140 resident-care home in the Southern Ile-de-France region had registered more than 24 COVID-19-related deaths of residents over a 5-day period.
- Deaths among long-term care facility residents were mainly due to hypovolemic shock, a result of significant loss of blood and body fluids. No acute respiratory distress syndrome was observed.
- Care home residents with COVID-19 had been confined to their rooms for several days, without assistance for eating and drinking.
- Care provision was limited due to care home staff not having access to protective masks; staff shortages due to a 40% absenteeism rate; and visits of general practitioner having been replaced by tele consultations.
- Interventions by a task force established in response to the high number of deaths included providing infusions to restore body fluid levels as well as oxygen therapy, as per WHO guidelines, and led to a “rapid improvement of this high mortality trend”, according to the study authors.
- In this French care home, leaving dependent care home residents to themselves and without assistance for food and drink intake accounted for more deaths than the infectious disease itself. The authors of the research letter labelled this the “disease linked to confinement” of COVID-19 cases.
- An excess number of deaths in care homes can be prevented by providing basic care.
- This is a research letter lacking detail about the number of cases and cause-specific deaths, as well as the methods to diagnose cases, ascertain causes of deaths, and circumstances of the deaths of residents.
- This research letter reported about the experience in a single care home in France.
Summary by Max Salcher (CPEC, LSE)