Coronavirus: real care home death toll double official figure, study says

More than 22,000 care home residents in England and Wales may have died as a direct or indirect result of Covid-19, academics have calculated – more than double the number stated as passing away from the disease in official figures.

Robert Booth 

Academics at the London School of Economics found that data on deaths in care homes directly attributed to the virus published by the Office for National Statistics significantly underestimated the impact of the pandemic on care home residents and accounted for only about four out of 10 of the excess deaths in care settings recorded in recent weeks in England and Wales.

ONS statisticians said on Tuesday that 8,314 people had died from confirmed or suspected Covid-19 in English care homes up to 8 May.

The figures suggest the impact of the virus in care homes is finally reducing. They are based on reports filed directly from care home operators to the regulator, the Care Quality Commission. Care Inspectorate Wales has said Covid was confirmed or suspected in a further 504 cases in homes up to the 8 May in Wales.

But academics at the care policy and evaluation centre at the LSE found that when excess deaths of other care residents and the deaths of care home residents from Covid-19 in hospitals are taken into account, the toll that can be directly and indirectly linked to the virus pandemic is likely to be more than double the current official count.

They said these additional fatalities may have been caused by residents who did not seek or receive medical care for other health conditions for fear of contracting Covid-19 or over-burdening the NHS as well a lack of access to normal care.

Care homes have been running at 10% to 20% staff absence rates and many homes have been trying to isolate residents in their rooms to reduce infection spread, but this can also make their normal care more difficult and residents’ needs less visible.

The academics, who have been tracking virus death tolls in care homes globally since the start of the pandemic, cited concerns raised internationally about deaths being linked to the consequences of residents being isolated in their rooms, without adequate eating, drinking or medical support, and not to the virus itself.

They said that from 13 March to 1 May, there were 19,938 “excess deaths” in care homes – that is above the average number of deaths for the same weeks in the previous five years. Only 8,310 of these were specifically linked to Covid-19 by the ONS – reflecting the declarations of care homes, rather than on death certificates. The researchers added that deaths of care home residents in hospitals are not currently accounted for in the ONS figures and that around 15% of deaths of care home residents happen in hospitals, and that this figure could even be higher.

“Data on deaths in care homes directly attributed to Covid-19 underestimate the impact of the pandemic on care home residents, as they do not take account of indirect mortality effects of the pandemic and/or because of problems with the identification of the disease as the cause of death,” said the report authors, Adelina Comas-Herrera and Jose-Luis Fernandez.

“Data on registered Covid-19 deaths in care homes in England and Wales only accounts for an estimated 41.6% of all excess deaths in care homes. Not all care home residents die in care homes … Calculating total excess mortality in care homes since 28 December and adjusting this by the assumption that 15% of care home residents die in hospital, suggests that by 1 May there had been in excess of 22,000 deaths of care home residents during the Covid-19 pandemic – 54% of all excess mortality – in England and Wales.”

Asked to comment on the estimates, a spokesperson for the ONS said: “ONS is undertaking further analysis on all deaths of care home residents which will be published in the coming days.”

The figures came as the Alzheimer’s Society said care homes have been “left to fend for themselves” amid continuing shortage of personal protective equipment and testing for residents and difficulties isolating infected residents.

It said that of more than 100 homes surveyed last week, 43% were still not confident of their PPE supply, with one home resorting to taping bags around carers’ arms, feet and hair. Fifty-eight percent of homes said they were unable to isolate residents and a third said they have taken in Covid-19 positive patients discharged from hospital.