Care homes residents are 13 times more likely to die from coronavirus than elderly people in the community, a study suggests.
Canadian experts analysed Covid-19 deaths in more than 600 care homes in Ontario and compared them to victims of a similar age from the province.
They found care home residents were at a 13.1-fold greater risk of succumbing to the coronavirus than people of the same age who lived at home.
Elderly people normally end up in homes when they are too frail to live on their own or are suffering with health troubles — both of which drive up the risk of infection leading to severe illness.
The researchers behind the study pointed to overcrowding, staffing shortages and a lack of PPE and tests as being the main factors behind why the death risk is so much higher.
They say untested staff bringing the disease into the homes was another ‘strong’ driver behind the fatalities.
Yesterday, England’s chief medical officer admitted ministers and experts didn’t consider this ‘obvious’ risk in their plans to throw a protective ring around the sector.
This allowed the disease to race through the sector and kill more than 30,000 vulnerable residents, Professor Chris Whitty conceded.
Care homes residents are 13 times more likely to die from coronavirus than elderly people in the community, a study suggests. Pictured: Temple Grove in East Sussex is one of the only care homes in the UK not to experience a single case of Covid
The research, by academics from the University of Toronto, looked at the crises in 627 care homes in Ontario up until the first week of April.
Of the 627 care facilities, 272 (43 per cent) reported Covid-19 infections in residents or staff.
By this time, 83 care home residents had passed away from the virus out of a total of 79,498 (0.11 per cent).
The researchers compared this to the number of deaths involving people over the age of 69 in Ontario who didn’t live in homes.
RAPID COVID-19 TEST TO BE TRIALLED IN LONDON CARE HOMES
New Covid-19 swab tests that give a diagnosis in under an hour are being trialled in London care homes.
Queen Mary University researcherswill give the tests to up to 2,000 staff and residents in 50 care homes.
They want to see how effective rapid daily Covid-19 testing is at reducing rates of infection, hospitalisation and deaths in the sector.
At the moment, outbreak control in homes and communities is hindered by limitations in testing.
It can take days to swab a person suspected of having COVID-19, send the sample to a laboratory and receive the results.
The rapid PCR based testing system in this trial has been developed in the UK by Novacyt, and uses the Covid-19 PCR test already in use in NHS laboratories.
Residents, staff and visitors in 25 care homes will receive daily testing on the rapid testing machines which each have the capacity to process up to 100 samples a day.
Meanwhile the other 25 care homes will receive the standard central laboratory testing once a week to serve as a control group to compare the results to.
The trial team comprises researchers, medical students and laboratory experts from Queen Mary and Novacyt, who are also using a new and more convenient simple nose swab for daily testing, instead of the more common and invasive nasopharyngeal swab which involve throbbing deep at the back of the throat.
Professor Jo Martin from Queen Mary University of London who is leading the study said: ‘This work has the potential to bring a new rapid COVID-19 testing system to those at highest risk, and help interrupt community transmission.
‘If found to be successful in care homes, it could be very useful in a wide range of settings, helping to make a quick diagnosis and keep an environment free of COVID-19.
‘With rapid daily testing, we can report back to the care home on the same day, so that they can take action to reduce transmission in their care home and prevent outbreaks into the wider community. By undertaking this study in the diverse East London community, we’re hoping to protect one of the most vulnerable groups in the UK, and the frontline staff who are caring for them.’
Henry Black, chief finance officer, NHS North East London Commissioning Alliance said: ‘Working with our partners in East London we are at the forefront of detecting COVID-19 infections. Rapid testing is essential if we are to reduce transmission of the disease in social care settings.
‘The testing equipment is also portable enough to be used in community situations and we believe it will be a valuable tool in tackling any local outbreaks.’
By April 10, there had been 229 victims out of 1,731,315 individuals in that age group in the province (0.013 per cent).
The researchers said this amounted to a 13-fold greater risk of Covid-19 death for care homes residents — even though the raw data showed the difference was eight times greater.
The study also found the risk of dying from Covid-19 was seven times greater for care home residents compared to over-80s in the community.
People in that age group, regardless of where they live, are at a huge risk of dying from coronavirus, which explains why the difference is lower.
Most humans only live until they are in their eighties because the immune system, as well as vital organs, degrade over time.
They are also more prone to having deadly underlying health conditions – such as dementia and heart disease.
A vicious disease like Covid-19 is often too taxing on the body for people in this age group.
And, when comparing care home deaths to over-60s in the community – the risk of coronavirus to care home residents was 23.1 times greater.
Professor David Fisman, an epidemiologist at the university and lead researcher, wrote in the study: ‘In the context of Covid-19, this susceptibility has proven particularly deadly, with (as we demonstrate here) an incidence of mortality more than 13 times greater than that seen in community-living adults older than 69 years during a similar period, with relative risk of death rising sharply over time.
‘We also found documented infection in facility staff, as opposed to residents, is a strong identifiable risk factor for mortality in residents, with temporality suggesting that residents are infected by staff and not vice versa.’
The analysis – published in the journal JAMA Network Open – was completed in April, when the virus was just starting to peak.
But, as of June 10, at least 1,766 Covid-19–related deaths have occurred in care homes in Ontario, making up 71 per cent of all virus victims in the city.
Across Canada, it is estimated that more than 80 per cent of its near-9,000 Covid-19 deaths have occurred in care homes.
Professor Fisman added: ‘The prevention of such deaths requires strategic guidance from health regions and the provision of sufficient testing and personal protective equipment.
‘Provision of personal protective equipment (PPE) has benefits both in bidirectional prevention of SARS-CoV-2 transmission and in providing workers peace of mind to stay on the job.
‘Expanded testing, including testing of minimally symptomatic infection, will facilitate the early identification of infection and the implementation of effective infection control strategies.
‘Integrated regional approaches to LTC [long term care homes] facility human resource management, such as limiting workers to a single facility and ensuring that these workers earn a living wage to prevent the need for multiple jobs while at the same time maintaining adequate staffing levels, are also needed.’
Yesterday, England’s chief medical officer admitted ministers and experts didn’t consider care home residents were being put at risk of Covid-19 because of agency staff working across multiple homes.
Part-time carers and bank staff who were infected but showed no symptoms were able to move freely between care homes at the start of the crisis without being tested.
Staff on zero hours contracts also went to work despite feeling ill because they were not guaranteed sick pay, which helped the disease to race through the sector and kill more than 30,000 vulnerable residents.
In a virtual grilling by MPs, Professor Chris Whitty acknowledged the error seemed glaringly ‘obvious in retrospect’ but had not been recognised earlier on in the pandemic.
Speaking to the Commons Health and Social Care Committee, he said: ‘The fact that people working in multiple homes, people who were not paid sick leave, that is a clear risk… these were major risks in health and social care settings.
‘So I think there are a lot of things that we have learned that we will, we can now do a lot better in social care, and I don’t think any of us would look back on what has happened in social care and say the ideal advice was given.’
Boris Johnson provoked fury earlier this month by implying care homes were responsible for their virus death toll by failing to follow correct procedures.
But Professor Whitty told MPs today his ‘enthusiasm for blaming people for anything is zero, adding: ‘That is absolutely not the way we deal with any kind of situation in health and social care and that’s across the board. ‘
I think it’s clear that every country that has a care sector has not handled this well.
‘The UK is one country that has not handled this well in terms of issues in social care but the same is true, as previous speakers have said, the numbers are very similar or even higher in terms of proportions of deaths in almost every country where you look at this.
‘So this is across the board, this has been a major problem… I think there are a lot of things that we have learned that we will, we can now do a lot better in social care, and I don’t think any of us would look back on what has happened in social care and say the ideal advice was given and this is the fault of anyone. I personally would shy away from that.’