Virus blamed for 10,000 extra care home deaths

Thousands of people who died before regular testing began were missed from official toll, study claims

THE care home death toll from the first wave of coronavirus may be 10,000 higher than reported, a study by the University of Manchester suggests.

The first independent analysis of deaths in English care homes up to August found that although the official death count for the period is around 19,000, the total may be closer to 29,000.

Researchers found there was a large number of non-covid excess deaths in care homes during the period, and the vast majority appeared in homes that had Covid cases.

It suggests that the majority of excess deaths occurred at a time when regular testing was not being carried out in care homes, and many deaths that should have been attributed to the disease were listed as a different cause.

“Thousands of people have died from Covid-19, but because many weren’t tested, some death certificates failed to attribute cause of death to the virus either directly or indirectly, especially at the beginning of the pandemic,” said Dr Marcello Morciano, a senior lecturer in health policy and economics at the University of Manchester.

“This study shows that in care homes, mortality figures attributable in some way to Covid-19 have been hugely underestimated: the figure could be as high as 10,000 people.

“But it also tells us where many of the people who died, in excess to what was expected based on historical trends, were living in care homes that experienced Covid-19-related fatalities and that has important policy implications in terms of prioritising resources.”

There are around 15,500 care homes operating in England, offering around 455,000 beds. The study used statistical analysis to compare overall trends in deaths between January 2017 and August 2020 with data from April to

August 2020 to calculate excess deaths in care homes during the pandemic.

The total excess deaths in care homes during the period was 29,542, equivalent to 6.5 per cent of all care home beds available in England.

Some 19,128 – 64.7 per cent – are recorded as coronavirus deaths, but the remaining 35.3 per cent have remained a mystery, with some experts suggesting that the extra deaths were caused because older people were not admitted to hospital or were asked to sign “do not resuscitate” orders.

But for the first time, researchers have looked at where the excess deaths occurred and found that most happened in the same care homes as coronavirus outbreaks.

If an extra 10,000 deaths were added to the official toll, Britain’s overall death count would be more than 60,000.

The team also found that the excess deaths were mainly concentrated among large care homes providing services to older people and people with dementia, affiliated to a branded chain of providers – where staff may be more likely to work in more than one place.

Prof Evan Kontopantelis from the University of Manchester said: “In care homes across Europe, at the beginning of the pandemic staff were left without PPE, testing regimes were poor, and care home residents who needed hospital treatment didn’t get it.

“And in mid-march, hospital trusts discharged medically fit patients to care homes with free capacity. Mandatory testing prior to discharge was only brought into effect a month later.

“These factors have all played their part in the higher figure of deaths we have described.

“We also believe that knowing the care home characteristics associated with Covid-19 outbreaks and excess deaths may help in designing rapid responses.”

‘Staff were left without PPE, testing was poor and residents who needed hospital treatment didn’t get it’