Nursing homes linked to up to half of coronavirus deaths in Europe, WHO says
BRUSSELS - Up to half of coronavirus-related deaths in Europe are taking place in long-term care facilities such as nursing homes, the World Health Organization said Thursday, an assessment that suggests public health authorities may have allowed the pandemic to rage among some of their most vulnerable populations as they focused on hospitals and other aspects of their response.
A "deeply concerning picture" is emerging about residents of homes for the elderly, Hans Kluge, the WHO's top official for Europe, told reporters at a news conference Thursday. According to countries' estimates, he said, "up to half of those who have died from covid-19 were resident in long-term care facilities. This is an unimaginable human tragedy."
Kluge's warning focused on Europe, but the United States has also struggled with the pandemic at homes for the elderly. A Washington Post analysis this week found that nearly 1 in 10 nursing homes in the United States have reported cases of the coronavirus, with a death count that has reached the thousands.
Many countries in Europe have banned family visits to nursing homes, an attempt to shelter the facilities from the spread of the disease, since it is far more fatal among older people and those with pre-existing conditions. Those bans, though well-intentioned, may have deprived the elderly of advocates as conditions swiftly deteriorated.
"This pandemic has shown a spotlight on the overlooked and undervalued corners of our society," Kluge said.
He and other WHO officials who spoke Thursday said they did not have enough data to say conclusively that people in nursing homes were being transferred to hospitals less often than they should be, or that they were being discharged from hospitals prematurely - fears raised by advocates in Britain and elsewhere. But the WHO officials hinted strongly that those factors might be contributing to the high death rates.
"It is important that the decisions, the very tough decisions that have to be made, are not based on a single criteria like age," said Manfred Huber, a WHO long-term care specialist.
Measuring and comparing coronavirus death rates can be difficult, since some nations are testing more suspected coronvirus cases than others are and each country is using different accounting methods as they record cases and deaths.
Many countries in Europe have essentially ignored coronavirus testing in nursing homes to focus their testing capacity on hospital patients and hospital staffers. In Italy, for instance, a recent national health service report indicated that people dying in nursing homes were overwhelmingly unlikely to have been tested for the virus.
And many countries have not been carefully tracking deaths outside of hospitals.
"The challenge is we don't have very good information for people in care homes," said Adelina Comas-Herrera, a researcher at the London School of Economics.
Comas-Herrera and colleagues reported last week that coronavirus deaths in nursing facilities in Belgium, Canada, France, Ireland and Norway might account for half of those countries' deaths from covid-19, the disease caused by the novel coronavirus.
She noted that most elderly care homes were never designed to serve as acute care hospitals. Many do not even have a nurse on duty.
A first grim glimpse of Europe's nursing home situation came on March 23, when soldiers sent to disinfect nursing homes in Madrid discovered dozens of elderly people dead in their beds. Spain's defense minister pledged that the government would be "unrelenting and forceful" in finding those responsible. As of this week, public prosecutors are investigating some 86 nursing homes throughout Spain for hundreds of elderly deaths, including 40 facilities in the region of Madrid, which has outpaced the rest of the country in death toll.
Spain has not included deaths in nursing homes in its official counts, although authorities say 10% to 20% of residents might be infected.
British Health Secretary Matt Hancock on Wednesday told Parliament that nursing home residents might represent 20% of all deaths in that country. That corresponds to an estimate by the nonprofit National Care Forum, which says elderly and disabled people in residential and nursing homes account for 4,000 of Britain's nearly 19,000 coronavirus-related deaths. But some researchers in Britain have put the number as high as 40% for deaths in care homes - a staggering number, considering that such facilities house less than 1% of the country's population.
In Belgium, where officials have included suspected cases in their overall death count since early this month, more than half of the 6,450 recorded deaths were in long-term care facilities, not hospitals. And of those nursing-home deaths, 95% are "suspected" cases, meaning that patients displayed some of the symptoms of covid-19 but were never tested for the disease.