A bloodthirsty but important question

So, what’s the death rate in a care home anyway?

The number of care home residents who have died of suspected coronavirus may have reached 7,500, according to the latest estimate, The Telegraph has learned.

New data collated by Care England, the country’s largest representative body for care homes, suggests the number of deaths from Covid-19 is far higher than its previous estimate of 1,400 from earlier this week.

The number is also far in advance of the official figure from the Office for National Statistics (ONS), which has recorded 217 care home deaths from the virus up to April 3 – the most recent date for which official data is available.

The actual important thing we want to know being “Are extra people dying or not?”

Or, in other phrasings, is the death rate higher than normal? Would those dying of – note of, not just with – covid-19 have died of whatever influenza or pneumonia was passing by this year anyway?

My best guess – my guesses not being a guide to policy – is that yes, more deaths, death rate is up, it’s not just those who would have died soon anyway. But some of it is. And that is important for policy purposes. For what matters to decision making is what is the extra amount of deaths that can be avoided by lockdowns etc.

Thus to know about care homes we need, at least, to know how many die in a normal winter/spring and deduct that from our total deaths to see what the specific effect is.

My guess being that 7,000 care home deaths from ‘flu over a winter is pretty normal. Perhaps a bad season then.

23 thoughts on “A bloodthirsty but important question”

  1. The death rate in care homes is by definition 100%.

    The pertinant question is something like: how sooner are carehome residents dying because of Corvid-19 than they would be otherwise. Is the resident who would have died in December 2020 dying this week because of Corvid-19, or is it residents who would have died in 2025 dying this week?

    Most dispassionate observation has concluded that Corvid-19 is taking off the last few weeks/months of life from residents, not the last few years. Granny is dying of Corvid-19 this week when otherwise she would have gone from something else next month.

  2. Doing the research, apparently we had a Flu Pandemic in 2009. I don’t remember noticing it, though 457 people died out of 28,000 cases.

  3. What jgh says.

    Added to that: all the usual nasties that kill the elderly haven’t disappeared, so Covid comes on top of that. With the added “bonus” that it seems the elderly do not develop any resistance at all to Covid, so they are really easily re-infected.
    So once it’s loose in a care home.. welll…..

  4. Bloke in North Dorset

    Its amazing how many people aren’t aware that we already put a value on a life or even that we have NICE. My MP said something on Twitter and I asked him to justify why we aren’t following Sweden’s route and that a government Danish economist admitted they had gone in to lock down too early.

    Judging by the responses (not from him, he’s a twat who doesn’t engage) I’m the new Yorkshire Ripper.

    I’ve just pointed out that people will die because of the lock down and it is essentially a life v life decision. Presumable I’m now going to be a holocaust prison guard, if not literally Hitler.

  5. Bloke in North Dorset

    it seems the elderly do not develop any resistance at all to Covid,

    Do you have a link for that?

  6. ” Presumable I’m now going to be a holocaust prison guard, if not literally Hitler.”

    Could be worse, you could move to an end terrace in Ely.

  7. I suppose we won’t really know until this time next year. If lots of people are dying right now who would have ordinarily died anyway sometime this year then we would see lower death rates later in the year. The usual death rate in the UK is a little north of 600,000 a year. If 2020 sees similar numbers then meh. But even if 2020 sees, say, 650,000 we still won’t really know until we see 2021. If that were (say) 575,000 then we’ve trashed the economy for a 2 year statistical blip.

    Sad that some people who die this year would otherwise have died next year but a trashed economy would be a high price to pay for an extra year for 0.04% of the population

  8. BiND: if people are slagging you off, you might be able to counter them with
    this story, the gist of which is “Sorry, Mr Byrom, we could cure your cancer, but we’re not going to.”

  9. how sooner are carehome residents dying because of Corvid-19 than they would be otherwise. Is the resident who would have died in December 2020 dying this week because of Corvid-19, or is it residents who would have died in 2025 dying this week?

    I suspect – regardless of COVID-19 – that 90% of people in care homes today will not be alive in 2025. You always have a few old dears who seem to plough on for ever and one or two who go in when in reasonable health but most are there for their final few years.

  10. Bloke in North Dorset

    Thanks CJ, added to my list.

    Allthegoodname,

    Thanks, but I was more interested in this bit:

    that it seems the elderly do not develop any resistance at all to Covid

  11. I think we had two mild years for flu deaths before this, so people who hung on through those years may be dying now. Who knows.

  12. So yes, bloodthirsty questions, but interesting none the less…

    Given that almost all those who’re dying are already fairly ill, I wonder if, finally, the NHS will be seen to have benefited financially from COVID? The chancellor too, that’s a lot of prescription, pension and disability benefit payments that’re not going to be paid over the next 20+ years…

  13. The most recent full year stats seem to be 2018
    https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/deathsregisteredinenglandandwalesseriesdrreferencetables

    Extracting from ‘Table 10: Deaths, place of occurrence’
    Home 128,388 24%
    Care Homes 119,629 22%
    Hospices 30,396 6%
    Hospitals 249,735 46%
    Other communal 1,804 0%
    Elsewhere 11,637 2%

    From the ONS week 14 2020 ‘Deaths registered from 29 December 2019 to the 3 April 2020.’

    England and Wales
    Number of deaths Number of COVID-19 deaths
    All deaths 166436 4122
    Home 40238 24% 136 3%
    Hospital 76769 46% 3716 90%
    Hospice 8002 5% 33 1%
    Care Home 37386 22% 217 5%
    Other communal establishment 617 0% 3 0%
    Elsewhere 3424 2% 17 0%

  14. @ BiND “that it seems the elderly do not develop any resistance at all to Covid”

    That was in thursdays’ daily live briefing by the RIVM ( dutch center for disease control https://rivm.nl/en ) regarding questions about the serology tests they’ve been doing on blood donors as part of a hunt for the true infection rate over here.

    The results of that are being prepared for pre-publishment currently, but the spokesman stated that it was clear that , “although the preliminary results have to be treated with care, and still need statistic evaluation” , there was a “trend of significant reduction in resistance development with increasing age”.
    It’s rare for that lot to proclaim anything that hasn’t been double-checked and peer-reviewed. Especially about stuff with the impact Covid has.

    So yeah, it seems that there’s serious indication that as you get older ( that’s 55+ older and up ) you tend to not develop/get a significantly reduced immunity to Covid.
    Which does put a bit of a damper on the vaccination-eradication route as this, if confirmed, leaves the most vulnerable group of people wide open even if there is a vaccine.

  15. “My best guess – my guesses not being a guide to policy – is that yes, more deaths, death rate is up, it’s not just those who would have died soon anyway. But some of it is. And that is important for policy purposes. For what matters to decision making is what is the extra amount of deaths that can be avoided by lockdowns etc.”

    Actually, no. I’m far more interested in the extra deaths that might occur compared to taking the “non-Nazi” route of “information, persuasion, testing, etc”, that Boris was sort of trying to follow before he bottled it, and that Sweden and others have continued to follow.

    Those that aren’t natural authoritarians I suspect had little problem with the earlier approach, based on a more liberal informative approach. Hence, for me, that’s the true comparable. If the fascist style lock downs ultimately are going to have very little extra effect, then fuck Boris and all those who sail in her.

  16. Pre the Wuhan virus, what was the median length of stay in a Care Home.

    USA: “The average length of stay before death was 13.7 months, while the median was five months. Fifty-three percent of nursing home residents in the study died within six months. Men died after a median stay of three months, while women died after a median stay of eight months.” (24 Aug 2010)

    UK: “The median length of stay in residential care homes is 462 days from time of admission until death (Forder & Fernandez, 2011)”

    More recent:
    https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-019-0973-0

    A good point is made in this: the figures typically cover the last care home the deceased stayed in: if they’d already spent time in another home that wouldn’t usually be recorded.
    https://www.parliament.uk/business/publications/written-questions-answers-statements/written-question/Commons/2017-09-05/8937

    This has oodles of data but only for Scotland.
    https://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Publications/2018-09-11/2018-09-11-CHCensus-Report.pdf

  17. Locally it was in the care homes before the lockdown, the first 10 deaths were in a single care home, that care home still accounts for a quarter of all deaths and so far it’s been identified in over 20 care homes and 90% of deaths were in care homes.
    It doesn’t strike me as this is a highly infectious killer taking out all and sundry or that the lockdown was worthwhile. Social distancing, ban large events, stop the cruise ships to kee tourism down and reduced capacity for restraunts etc and let everyone else get on with life

  18. “The route of “information, persuasion, testing, etc””.

    When trying to get the figures for Tim, I found the government review of the 2009 Flu Pandemic, which recommended exactly that in any future pandemic, along with saying that locking the public up would be counter-productive. linky

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