New paper looks at early evidence of care home mortality in different countries. Provisionally concludes that about half (42% to 57%) of COVID-19 deaths are taking place in care homes. As a reminder, the 11,329 deaths announced by DHSC are hospitals only.https://t.co/t5Oesrkk8X pic.twitter.com/swStQkDphW

— stuart mcdonald (@ActuaryByDay) April 13, 2020

Tomorrow the ONS will publish its weekly numbers – which are likely to be a lot higher than the 11.329 because they will include those who died outside hospitals – in the community and care homes.

The daily number of deaths is an approximation of the true numbers. Take note, the true number of deaths is much greater. https://t.co/zRE0fzTUKf

— Dr Bharat Pankhania (@Doctorshaib) April 13, 2020

The ITC paper, mentioned by Stuart in his tweet is very alarming (though not sensational).

We may be getting immunised to numbers.

But the narrative of the report talks of something we’ve feared, but have had little evidence of.

The impact of COVID-19 on residents and staff has become apparent in two ways: distressing news reports of care homes becoming overwhelmed due to large number of deaths in a short amount of time and too many staff members being either sick or self-isolating, and, increasingly, estimates of deaths of care home residents. Very few countries appear to be testing people in care homes (staff and residents) systematically.

The most recent statistic given by the UK Government is that 13.5% of UK care homes have been infected. This equates to outbreaks at 2099  nursing homes

The Department of Health and Social Care have  confirmed 2,099 care homes in England have so far faced outbreaks of the virus., 92 of those cases were confirmed yesterday.

In Scotland – latest numbers are estimated at more than twice the rate of England at  31% – but this still lags European numbers

The Belgian study, with much greater testing , found that 90% of Belgian care homes had at least one case of COVID-19.

We are clearly at an early stage in knowing what is happening behind closed doors. Data from 3 epidemiological studies in the United States show that as many as half of people with COVID-19 infections in care homes were asymptomatic (or pre-symptomatic) at the time of testing.

If there is an elephant in UK’s care homes, the elephant is currently under sedation.

Alarming or alarmist

The reluctance of the Government to discuss care homes was obvious at today’s 5 O’clock press conference.

Tonight Channel 4 news has run a special on this issue.

Tonight on #c4news we concentrate on the hidden
Covid-19 epidemic in UK care homes

— Krishnan Guru-Murthy (@krishgm) April 13, 2020

The program shows alarming shortcomings in what is happening in care homes , with supply shortages of PPE.

Today we heard of 14 new deaths at the Stanley Park care home. A care home in Nottingham , where 9 residents have died, reported the staff felt they had been “broken inside”. 16 others have symptoms of the disease, hats off to Rebecca Mitchell who bravely faced going to the home this evening.

Wren Hall and Anita (right) in happier times

Anita Astell, owner of  Wren Hall care home spoke said that if her residents had gone to hospital “they’d probably have been sent back”. She said she was spending most of her time sourcing masks for her staff.

Is the elephant in the care home and if it is, is there anything we can do to stop it running amok?

Certainly the early prognosis for tomorrow’s ONS numbers looks quite like the elephant is beginning to trumpet.

This data is for England, a week further on from the ONS report that’s currently published (ie these figures will be reflected in tomorrow’s numbers) https://t.co/JHx3H9MsAx

— Matt Fletcher (@longevitymatt) April 13, 2020

But are even the ONS figures complete. Without accurate testing of those who have died, we may never know. Testing the cause of death , at this time of crisis, is simply not a priority.

The Channel 4 report suggested that as many people in the UK were dying of Covid19 in care homes as there are in the DHSC numbers, this will come as no surprise to the authors of the ITC paper.

Nor will it surprise Baroness Ros Altmann – who’s piece on this matter in the Mail is available here.