CG REPORT 6 Q3: What explains excess mortality in care homes?

Our report on care homes included three distinct questions and we’ve addressed each one individually. Follow the links for Question 1 and Question 2. You can also read and download the full report here.

After determining that there was significant excess mortality in care homes during the pandemic, we wanted to find out if and how that excess mortality could have been prevented. To do so, we looked at studies analyzing different measures implemented or not implemented in care homes during the first two waves of the COVID-19 pandemic to determine which had an impact on case rates and mortality.

As the table below shows, several reported interventions or factors suggest the potential to mitigate the risk in care homes substantially, including

• Improving the care home quality
• Increasing staffing levels
• Reducing the number of beds in the facility
• Employing staff confinement strategies with residents
• Improving clinical care, such as implementing daily examinations

Some care home solutions like US ‘Green House’ homes, which usually have fewer than 12 beds, may provide crucial insights into the care home problem compared with larger homes. Furthermore, care home residents faced barriers accessing emergency treatments during the pandemic waves. Finally, interventions targeting care homes should be subject to smaller trials given large effect sizes in some studies.

Overall, these studies point to the fact that there were a number of measures that, if implemented, could have drastically reduced mortality (both COVID and non-COVID related) in care homes during the course of the pandemic.