Two new ONS analyses provide further insight on the impact of coronavirus (COVID-19) on care homes. While both help to improve understanding of this important subject, comparisons between the two should be made with caution. Becky Tinsley summarises the latest findings and gives an insight into future analysis the ONS is planning.
Today’s publications include the first results of a new large scale survey which look at how coronavirus has been affecting staff and residents of care homes. Alongside this we have also updated our earlier figures on deaths involving COVID-19 in the care sector.
The new survey is part of a cross-Government effort to understand the impact that COVID-19 is having on parts of the population that are not covered by the COVID-19 infection survey of private households.
The survey, part of the ‘Vivaldi’ study, covered 9,081 care homes in England who provide dementia care and care for older people. Care home managers were asked for information on their staff (that is, all staff working in care homes, including caterers, cleaners and managers) and residents, as well as information about the care homes to help understand the impact of the COVID-19 in these care homes and inform the public health response.
The results show that half (56%) of these care homes had at least one confirmed case of COVID-19, as reported by care home managers, since the start of the pandemic. Across those care homes where managers reported at least one case of coronavirus, we estimate that 20% of residents in those care homes have tested positive for COVID-19, while 7% of staff tested positive, as reported by care home managers, during the same period. The level of infections seen in care home residents could be affected by pre-existing underlying health conditions, which are likely to be more prevalent among care home residents.
The study also analysed which different factors may explain higher or lower levels of infection seen across these care homes. Key findings show that levels of infection in staff increases the likelihood of infection in residents, and vice versa. Care homes who use bank or agency nurses or carers regularly are more likely to have cases in staff and residents compared to those care homes who never use bank or agency staff. And care homes where staff regularly work elsewhere are more likely to have more cases in staff than those who have staff who never work elsewhere. Finally, care homes in which staff receive sick pay are less likely to have cases of COVID-19 in residents compared to those care homes where staff do not receive sick pay.
This shows that there are differences in practices across these care homes and in the levels of infection for both staff and residents.
We have also published separate figures on deaths involving the coronavirus within the care sector in England and Wales.
This shows that there were 66,112 deaths of care home residents (wherever the death occurred) since the start of the pandemic up to 12 June (registered up to 20 June). Of these, 19,394 involved COVID-19, which is 29.3% of all deaths of care home residents. Since mid-April 2020, we have seen a slowdown in both the total number of deaths and deaths involving COVID-19 in care home residents.
The publication shows that COVID-19 was the leading cause of death in male care home residents, accounting for 33.5% of all deaths, and the second leading cause of death in female care home residents, after Dementia and Alzheimer disease, accounting for 26.6% of all deaths.
While these two publications both relate to care homes, there are differences which mean that conclusions should not be drawn from putting them together.
The Vivaldi study only covers a sub-set of care homes in England (those providing dementia care and care for old people), while the term “care home residents” used in the Deaths involving COVID-19 in the care sector refers to all deaths in England and Wales where either (a) the death occurred in a care home, or (b) the death occurred elsewhere but the place of residence of the deceased was recorded as a care home.
Secondly, these publications report on different time periods. The Deaths involving COVID-19 in the care sector article includes provisional deaths data occurring up to 12 June 2020 and registered up to 20 June 2020. The reference period for the Vivaldi study was “since 1 March 2020”, and the survey took place between 26 May and 20 June 2020.
Finally, they have different sources of information. Data in the Deaths involving COVID-19 in the care sector article are based on death occurrence (date of death), not date of registration, and are obtained from details collected when deaths are certified and registered. In the Vivaldi study care home managers were asked to report the total number of confirmed cases of infection in their staff and residents since the start of the pandemic which may exclude anyone who had COVID-19 but hadn’t been tested at the time of reporting. Future publications will incorporate data from the results of swabs taken during the whole care home testing programme.
Understanding the impact of COVID-19 in care homes is a continually developing picture and the job of the ONS is to continue our providing more detailed data from the survey in the near future and continuing to monitor the deaths of care home residents over the coming months.
This is one of a suite of surveillance studies which are being conducted to understand how many people have the COVID-19, and how the virus spreads in non-household populations (such as care homes and prisons) and other settings (such as schools and hospitals). This is complementary to the COVID-19 Infection Survey which aims to find out more about how many people in residential private households have the coronavirus in the UK.
Becky Tinsley, Assistant Deputy Director for COVID-19 Surveillance Studies Analysis and Publication Co-ordinator