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Covid-19: risk of death in UK care homes 13 times higher than in Germany

Care home residents were more likely to die of Covid-19 in the UK than in any of the major European countries apart from Spain, analysis of global data has revealed.

The proportion of residents dying in UK homes was a third higher than in Ireland and Italy, about double that in France and Sweden and 13 times higher than Germany. The analysis of official statistics was carried out by academics at the London School of Economics as part of the International Long Term Care Policy Network.

Of all the UK’s care home residents, 5.3% were confirmed or suspected to have died from Covid-19, compared with 0.4% in Germany, according to analysis of official statistics.

About 3,500 people died in care homes in Germany compared with more than 16,000 in the UK, despite Germany having a care home population twice as large. Its test-and-trace system and 14-day quarantine for people leaving hospital have been credited with protecting homes from outbreaks.

Care home deaths in Europe – graph

The figures will increase pressure on the health secretary, Matt Hancock, to justify his claim in May to have “thrown a protective ring” around care homes right from the start of the pandemic. This week the operators of a Kettering care home, which had to be closed down last month when care standards collapsed and 12 residents died from Covid-19, said the virus had been introduced by people discharged from hospitals.

Government guidance recommending patients are tested before being sent from hospitals to care homes was only introduced on 16 April, by which time almost 1,000 homes had infections.

Hancock is also facing legal action from the daughter of a man who died in an Oxfordshire care home in April. He became infected after a patient who tested positive for the virus was discharged from hospital into the home.

Labour’s shadow care minister, Liz Kendall, said: “These appalling figures raise serious concerns about the government’s handling of Covid-19 in care homes compared to other countries, and that they were too slow to act to keep older and disabled people safe. The government must learn from the mistakes so far. Care services must get the resources and support they need to deal with the pandemic, alongside the longer-term funding settlement for social care that is crucial to the country’s recovery.”

The Department of Health and Social Care (DHSC) defended its record, with a spokesperson saying it had taken “swift action” to protect care home residents and staff.

“This includes offering whole care home testing and providing additional funding for local services, which has resulted in almost 60% of our care homes have not had an outbreak at all,” they said.

However, whole home testing was only introduced on 15 May, well after the 8 April peak of Covid-19 deaths. And of the £3.2bn coronavirus funds announced in March and April, only £194m had been provided by councils to social care providers by the first half of May, according to a survey of council leaders.

Timeline

The crisis in care homes

Public Health England issues guidance stating that it was “very unlikely” care homes would become infected. The guidance was not withdrawn until 12 March.

Despite a lack of official statistics about fatalities, care homes warn that they are at “breaking point” and MHA, the country’s biggest charitable provider, says it has suspected cases in more than half of its facilities.

The Department of Health and Social are guidelines on discharging hospital patients into care homes states: “Negative tests are not required prior to transfers/admissions into the care home.”

Chief medical adviser Chris Whitty says that more than one in ten care homes (13.5%) now has at least one case of Covid-19. Whitty says: “Care homes are one of the areas where there are large numbers of vulnerable people and that is an area of risk and therefore we would very much like to have much more extensive testing.”

Testing is expanded into care homes but only for people with symptoms.

Five of the largest care home providers say they have now recorded a total of at least 1,052 deaths

Care home deaths are included alongside deaths in hospitals after a sharp rise of more than 4,300 deaths over a fortnight in England and Wales. Testing is extended to staff and residents without symptoms.

Launch of a national delivery system for personal protective equipment to care homes is hit by a delay of up to three weeks

Academics report that more than 22,000 care home residents in England and Wales may have died as a direct or indirect result of Covid-19 – more than double the number stated in official figures.

An unpublished government study which used genome tracking to investigate outbreaks revealed that temporary care workers transmitted Covid-19 between care homes as cases surged. In evidence raising further questions about ministers’ claims to have “thrown a protective ring around care homes”, it emerged that agency workers – often employed on zero-hours contracts – unwittingly spread the infection as the pandemic grew, according to the study by Public Health England.

The government also said variations in testing, recording deaths and definitions of care homes internationally meant it was not possible to make accurate comparisons.

The study’s lead author, Adelina Comas-Herrera, said the research did not reach conclusions about the cause of the different patterns seen in care settings internationally, but she noted different policies on testing and tracing outbreaks between the UK and Germany.

“They were further ahead in understanding which staff and residents had contact with whom,” she said. “We think the main factor was that Covid was much less under control in the overall population [in the UK]. As a result, care homes were much more in danger.”

A Public Health England study of six London care homes in April found that temporary workers moving between different facilities were partially responsible for transmitting the disease. Repeat testing of care home staff and residents is still not available in the UK. The care minister, Helen Whately, said three weeks ago she was “imminently” expecting scientific advice on retesting frequency. Last week the DHSC said: “We will update the sector shortly.”

The LSE study also found that the excess death toll in UK care homes during the pandemic is now close to 32,000, almost twice the official number of confirmed or suspected fatalities from the virus.

Excess deaths are those that would not have happened in an average year without the coronavirus crisis. The latest official figures from authorities in England, Wales, Scotland and Northern Ireland suggest confirmed or suspected deaths from the virus in care homes have reached 16,680. Excess deaths include other fatalities likely to be associated with the pandemic, through people not receiving normal levels of treatment for other illnesses, or which were in fact caused by Covid-19 but were not recorded as such.

In England 54% of all excess deaths were in care homes, the study found.

Read the original article at The Guardian

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