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Improving care home responses to COVID-19

A carer with a patient in a care home

Economic and Social Research Council (ESRC) researchers say more COVID-19 testing is needed in the UK’s care homes.

Care homes are one of the principal battlegrounds of the COVID-19 pandemic in the UK. Care home residents are at high risk of COVID-19 infection and those who catch it risk severe outcomes.

The risks in care homes

Researchers led by Dr Laura Shallcross at University College London used active surveillance to estimate the incidence of COVID-19, the risk factors for infection and the number of care home residents dying as a result

They used electronic health records from 8,713 care home residents, and daily counts of infection for 9,339 residents and 11,604 staff, at 179 UK homes run by a major care home chain in the UK.

It was found that 22% of the residents developed COVID-19 symptoms, while lab tests showed that 10.2% of staff had the virus. Overall, 68% of homes had at least one COVID-19 infection or death.

The research shows that lower staffing ratios and higher care home occupancy rates were risk factors for infection. 1,694 of the residents died during the course of the project, 9% of all residents. Of these, 217 deaths occurred in 607 residents with confirmed infection.

One in five residents

Shallcross says:

Many of the excess deaths occurred in asymptomatic residents, in the context of limited testing for infection.

This suggests that more testing capacity is needed.

We think that one in five residents had symptoms of infection during the pandemic, but many cases were not tested.

Disease control measures should integrate active surveillance and testing with fundamental changes in staffing and care home occupancy, to protect staff and residents from infection.

The challenges to social care

ESRC is also supporting research on the effects of COVID-19 on users of adult social services outside care homes, led by Dr Juliette Malley at the London School of Economics.

A paper by Malley and colleagues from several UK universities points out that COVID-19 poses a significant challenge to social care services in England and describes responses to it.

People with social care needs have higher than average risks of death, or of deteriorating physical and mental health, from COVID-19. This is partly the result of social isolation introduced to reduce COVID-19 transmission.

And, while the pandemic increases the need for social care, the ability of families and social care staff to provide it is reduced by illness and quarantine.

Last updated: 28 October 2020

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