Adelina Comas-Herrera, Elizabeth C. Ashcroft and Klara Lorenz-Dant (Care Policy and Evaluation Centre, London School of Economics and Political Science)

11th May 2020

The full updated report is available here.

Key findings:

• While both the characteristics of the population in care homes and the difficulties of physical distancing in communal living mean that care home residents are at high risk of dying from COVID-19, these deaths are not inevitable.
• Countries with low-levels of infection in the population typically also have low shares of infections in care homes.
• The response to COVID-19 in care homes needs to be coordinated across all relevant government departments and levels, and with the acute health sector response.
• Timely data on the impact of COVID-19 in care homes is essential to ensure that opportunities for preventing large numbers of deaths are not missed.
• Evidence of asymptomatic transmission and atypical presentation of COVID-19 in geriatric populations should be reflected in guidance documents and testing policies.
• While there are infections local to care homes, regular testing of residents and staff will be essential, ideally followed by contact tracing and effective isolation.
• Most countries have restricted visitors but this policy alone has not protected care homes from infection, countries are increasingly considering how to make visits safer, recognizing their impact on wellbeing.
• Staff pay and living conditions may be an important barrier to effective infection controls, particularly if staff do not have access to sick pay or need to work in more multiple facilities (or live in crowded accommodation).
• Access to healthcare and palliative care (in terms of personnel, medicines and equipment) needs to be guaranteed, particularly for homes without nursing or medical staff.
• Not all care homes are suitable as isolation facilities, technical support and alternative accommodation may be required in some cases.
• Measures to address the psychological impact of the pandemic on both staff and residents need to be put in place, particularly as many staff and residents will have experienced trauma and grief. For some residents, particularly those with dementia, the disruption in their normal lives by the measures may have significant negative impacts.