The next coronavirus tragedy: care homes
Deaths because of coronavirus among the elderly living in Britain’s care homes could be up to nearly 20 times greater than the figures which have been reported.
Mike Padgham, of the Independent Care Group which represents the care home industry, claims the actual number of deaths are as high as 4,000. This compares to the 217 deaths which have been reported by the Office of National Statistics.
Concerns over the growing number of deaths has prompted the government to promise to improve the gathering of information as well as step up testing and increase the availability of protective clothing for care home staff on the frontline.
Speaking at the government’s daily coronavirus briefing on Tuesday, Professor Yvonne Doyle, chief medical director of Public Health England, said the government is working flat out to collect information more rapidly but emphasised the big challenges in gathering statistics from the thousands of care homes across the country.
Britain’s care sector is both large and fragmented. According to a report by the Competition and Markets Authority in 2017, there were approximately 410,00 elderly persons living in 11,300 separate care homes which were managed by 5,500 different providers.
This fragmentation contributes to the slow release of figures about deaths in care homes. The ONS says its weekly totals are 11 days behind because of the time taken to register, process, and publish them.
As such, the apparent disparity between the current official figures and the estimates by industry figures may simply be a function of this time lag.
Furthermore, in counting the number of deaths due to coronavirus the ONS includes any death where Covid-19 is mentioned on the death certificate.
As a result some of the deaths recorded may not have been directly due to coronavirus if another major ailment was present, or coronavirus may have been one factor of many in contributing to a death.
The difficulty of making the fine distinction between someone dying from coronavirus and someone dying with coronavirus is therefore muddling the causes of death of those living in care homes.
However, there is no doubt the care home sector is under immense strain. The average annual number of deaths in care homes in the period running from 2014-2018 stands at 114,259. If the industry estimate of 4,000 of deaths due to the virus is accurate, that would mean that the number of deaths in care homes due to coronavirus is already equal to 3.5% of the average yearly total number of deaths.
The problem is compounded by the fact that only 500 care home staff have been tested for coronavirus so far, and many care homes are already running short of PPE.
While the government has promised to ramp up testing and provide more PPE to care homes, this may prove difficult to achieve as it is already struggling to hit its own testing targets and some hospitals are also facing PPE shortages.
Protecting elderly residents of care homes has proved a tough challenge across Europe. A report by LSE academics drawing on data from Italy, Spain, France, Ireland, and Belgium shows that 42-57% of all deaths in those countries have occurred in care homes.
Hospices are also likely at risk to the virus due to their large number of vulnerable residents. While official ONS figures have so far only recorded 33 cases due to coronavirus in hospices one fears the true numbers could be much higher.
Sadly, care homes and hospices alike are easy targets for the virus as they house multiple elderly persons who are particularly vulnerable to the disease in a single area. Care staff coming in to help them are themselves possible vectors to carry the virus in from the outside. The potential for tragedy is all too clear.