Updated international report on COVID-19 related mortality in care homes

Adelina Comas-Herrera (Care Policy and Evaluation Centre, London School of Economics and Political Science), Joseba Zalakaín (SiiS),  Elizabeth Lemmon (Edinburgh Health Economics, University of Edinburgh), David Henderson (Edinburgh Napier University, Scottish Centre for Administrative Data Research), Charles Litwin (Care Policy and Evaluation Centre, London School of Economics and Political Science), Amy T. Hsu PhD (University of Ottawa Brain and Mind Research—Bruyère Research Institute Chair in Primary Health Care Dementia Research),  Andrea E. Schmidt (Austrian National Public Health Institute), Greg Arling (School of Nursing, Purdue University, US), Jose-Luis Fernández (Care Policy and Evaluation Centre, London School of Economics and Political Science)

This report was updated on the 26th January 2021:

The full report is available here:

Key findings:

  • Official publicly available data on the numbers of deaths among care home residents linked to COVID-19 is not available in many countries.
  • International comparisons are difficult due to differences in testing capabilities 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).
  • 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, the current average of the share of all COVID-19 deaths that were care home residents is 46% (based on 21 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 countries where this data is available, the share of all care home residents who have died (linked to COVID-19) ranges from 0.01% in South Korea to over 4% (which would mean that over one in 25 care home residents have died linked to COVID-19) in Belgium, Ireland, Spain, the UK and the US. This share is highly correlated to the total number of COVID-19 deaths in the population who live outside care homes.
  • 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.
Figure: 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 described in:

Comas-Herrera A, Zalakaín J, Lemmon E, Henderson D, Litwin C, Hsu AT, Schmidt AE, Arling G and Fernández J-L (2020) Mortality associated with COVID-19 in care homes: international evidence. LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 14 October.

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