It is no secret that the spread of COVID-19 within the care sector has been the subject of significant media attention and cause for concern amongst those involved with care. But how hard can it be to answer the question: ‘How many deaths on care has there actually been?’ The answer is: it’s all in the detail. Continue reading “How many deaths in care have there actually been?”
“We are facing a secondary pandemic of neurological disease.”
Robert Stevens Associate Professor of Anaesthesiology and Critical Care Medicine at Johns Hopkins Medicine, US.
With medical science struggling to keep up with coronavirus and its consequences, it will be several years at least before more conclusive studies as to the long term impacts of the pandemic can be produced. The law lags even further behind.
Whilst COVID-19 has largely been considered to be a respiratory disease, more than 300 studies from around the world report a significant number of COVID-19 patients are displaying neurological abnormalities ranging from mild symptoms, such as headaches and loss of smell, to more severe variants commonly associated with mild to moderate brain injury.
Care homes have undoubtedly been significantly affected by Covid-19 and the manner in which cases have both spread and been controlled has been criticised across national media outlets. The Office for National Statistics, reported on 3 July that for deaths registered up to 9 May 2020, 12,536 involved Covid-19. The number may of course be significantly higher as testing has not been undertaken in every death.
A recent study by NHS Lothian and Edinburgh University , looking at care-home outbreaks in a large Scottish health board has been undertaken. The study considered 189 care homes in the Lothian area where more than 400 people died from Corona.
The study identified that 37% of care homes considered within the sample group had experienced an outbreak of Covid-19 and significantly the larger the care home, the larger the associated outbreaks. NHS Lothian and Edinburgh University found the likelihood of the infection spreading increased three fold with every increase of around 20 beds. Homes with less than 20 residents had a 5% chance of outbreak, compared with a figure between 83% and 100% for homes with 60 to 80 residents.
The concerns with how the virus was controlled in care homes is still relevant considering the potential for a second wave. Lessons can and should be learned to prevent such significant numbers of deaths occurring again and actions taken to lessen the impact of a second wave. The study found that many of the deaths were due to outbreaks in only a few locations. This essentially means there is a wide pool of care homes that Covid-19 has not broken into, and thus a wide pool of potentially vulnerable residents that will need further protection ahead of any second wave.
The possibility of creating ‘bubbles’ within care homes has been suggested. These ‘bubbles’ in a care home setting could be created from sectioning larger Homes into smaller units. Residents would be assigned to a small sub-unit and particular staff would also be assigned to those units. This way interactions between residents, staff, and the general footfall through the home could be limited, reducing the potential spread. Staff could be assigned to certain areas, and more scheduling of bubbled staff could be introduced for the running of the care home, such as cooking, cleaning and maintenance.
This in theory sounds like a possible way to reduce the outbreaks within care homes, however this will of course take considerable planning, resources, and staffing which will in turn increase the funding required to support the care homes. Consideration will need to be given to individual set ups of care homes, and the possibility to create small units within them, especially for homes with residents who may be prone to wandering, such as those suffering with dementia.
Pressure will likely continue to mount on the government, requiring clearer advice, and forward planning for a potential second wave and to ensure steps are in place to prevent the impact of any second wave.
Written by Holly Paterson at BLM
At the government’s daily COVID-19 briefing yesterday, the Health Secretary Matt Hancock announced a further expansion of its testing programme for COVID-19 in care settings. Previously the focus had been on care homes providing care for over 65s and for those with dementia. Testing will now be available for all residents and staff in England whether or not they have symptoms of COVID-19. Testing will also be extended to under 65s and to encompass for example adults with a learning disability or with mental health problems.
In the past few months, one of the dominant news stories has been that of the effect of the COVID-19 pandemic on the social care sector. This has mostly focused upon the issues surrounding elderly care.
However, the Care Quality Commission (CQC) has this week published an analysis regarding deaths of persons with a learning disability and/or autism. The analysis is based upon notifications from providers registered with the CQC where the death certificate indicates the deceased had a learning disability. This shows in the period 10 April to 15 May there was a 134% increase in deaths in comparison to the same period in 2019.
Our recent blogs have consistently focused on this developing saga as COVID-19 continues and as we as a nation compare ourselves to our counterparts, we are increasingly coming up short. There is a stark message coming through that our most vulnerable have been forgotten: the elderly in care homes, the detained in mental health units and those with learning disabilities.
In the last few weeks, the COVID-19 related issues concerning care homes have become increasingly more apparent and a light has been shone on the pressures homes have faced. There has been suggestion that care providers have somewhat been missed by the Government, in respect of PPE, testing of staff and residents, or those returning from hospital. Sadly, since the beginning of April, the number of COVID-19 related deaths which took place in homes among residents overtook the number of care home resident deaths within hospitals. Many have suggested the main factor in respect of this has been the lack of testing of those with COVID-19 symptoms, when they have been returning to their care homes, having been receiving treatment externally.
The COVID-19 pandemic has shone a light on the resourcing of care homes that is long overdue.
Following exchanges in the commons and a study by LSE it appears that 22,000 care home residents have died in England and Wales to date as a result of COVID-19 but statistics will no doubt continue to be debated with the lack of testing being a stumbling block for absolute clarity.
On 6 May it was announced that five residents had died at a care home on the Scottish island of Skye at the centre of a COVID-19 (C-19) outbreak on the island. 57 residents and staff at this care home have tested positive for C-19. Ten deaths have also recently been reported at a care home in East Dunbartonshire.
Statistics from the National Records of Scotland show that by Sunday 3 May there had been 2,795 deaths in Scotland where C-19 is mentioned on a death certificate. More than four in ten of those deaths (42.8%) have been in care homes. The proportion of deaths in care homes has also been growing, accounting for almost 60% of C-19 deaths between 27 April and 3 May.
We have all seen the headlines reporting on the heavy toll that the COVID-19 pandemic is taking upon the care home sector, and figures published yesterday by the Office of National Statistics confirm that over one fifth of deaths in England and Wales in the period up to 24 April 2020 occurred in care homes
The latest ONS statistics do not include information on COVID-19 deaths from those who rely on domiciliary care, as they only confirm how many deaths occurred in hospitals, care homes, hospices and at home. So it’s difficult to know how domiciliary care is affected – but no doubt some of those deaths that took place in hospitals or at home will include domiciliary care service users.