Report reviews global impact of COVID-19 in care homes

December 22, 2021

A new report published by Collateral Global has reviewed the impact of COVID-19 on care homes across the globe.

Collateral Global is a UK registered Charity dedicated to researching, understanding and communicating the effectiveness and collateral impacts of the Mandated Non-Pharmaceutical Interventions (MNPIs) taken by governments worldwide in response to the COVID-19 pandemic.

Analysis in the report, CG Report 6: Effects of COVID-19 in Care Homes – A Mixed Methods Review involved national datasets for 25 countries and reported that care home deaths were, on average, 30% of the total COVID-19 deaths (range: 9-64%). The 17 cohort studies also point to excess mortality worsening during the pandemic, with excess mortality being reported for both COVID-19 positive and negative patients.

Some of the report’s key observations include:

  • Care home residents comprised, on average, 30% of total COVID-19 deaths across 25 countries
    (range: 9-64%).
  • Up-to-date data on care homes deaths was scarce with only Australia, Belgium, Canada (British
    Columbia), Denmark, Hungary, the UK, and the US providing data through to September 2021.
  • Seven countries report more than 10,000 COVID care homes deaths: Canada, Belgium, France,
    Germany, Spain, the UK and the US.
  • In June 2020, Canada's national health data agency reported the highest worst record among wealthy
    nations for proportion of COVID-19-related deaths occurring in long-term care facilities among
    wealthy nations: approximately 80%.
  • In England and Wales, a higher proportion of deaths in care homes as were seen in wave two (25.7%)
    compared to wave one (23.1%), even though excess deaths were higher in wave one (27,079 excess
    deaths) compared with wave two (1,335 excess deaths).
  • In the US, 138,985 (18%) of 760,597 COVID-19 attributed deaths occurred in care homes as of 24 October 2021. US data include the Nursing Home COVID-19 Public File that reports to the CDC’s National
    Healthcare Safety Network (NHSN) Long Term Care Facility (LTCF) COVID-19 Module. The site
    ( provides data visualisation tools
    on resident cases and deaths by state.

According to the report authors, Carl Heneghan, Jon Brassey, Tom Jefferson: ‘several reported interventions or factors suggest the potential to mitigate the risk in care homes substantially. Interventions that could reduce mortality include improving the care home quality, increasing staffing levels, reducing the number of beds in the facility, employing staff confinement strategies with residents, and 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.’

Dawn Bunter, a Social Care Consultant/Interim Manager at the Umbrella Care Community told CMM in response to the report, ‘I was involved and discussed the impact of COVID-19 upon the care service I managed and the impact that had among deaths and to all staff.

‘To generate discussion surrounding the implementation of necessary co-production and cohesive working alongside the Social Care sector as a whole. The research underpins the underfunding and lack of awareness of the skills and professionalism associated with those that work in Social Care and how the reform is hugely welcomed and imperative.

To highlight this quote:

‘The pandemic highlighted and exacerbated a long-running problem: underfunding, poor structural layout, undertraining, under-skilling, under-equipping, and finally, lack of humanity in dealing with the most vulnerable members of society.’


Heneghan C, Dietrich M, Brassey J, Jefferson T. Effects of COVID-19 in Care Homes – A Mixed Method Review. Collateral Global

Visit the Collateral Global website to access the full report.

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