Thought of the Day - August 3 - COVID Deaths in Canada Are All About Care Homes

On March 5, the first outbreak in a Canadian long-term care home was reported; it was a staff member at the Lynn Valley Care Centre. On March 8, a resident at the home became the first Canadian to die from COVID-19.

Since early March, Bonnie Henry has provided regular updates to the public on the number of cases and deaths in care homes. Similarly, many other provincial medical officers and premiers have provided updates on the spread of COVID-19 in care homes across the country. However, it took some time before reports, such as the ones produced by the BC CDC on March 23 and Public Health Ontario on March 31 concerning care homes became available; Quebec disclosed the number of cases and deaths of residents in care homes, as of April 13. Most other Canadian provinces and territories have had either no cases or too few cases in care homes to provide meaningful statistics.

Around 450 thousand Canadians live in long-term care or retirement homes as well as assisted living facilities. It is estimated that as of the end of May 4 between 17,246 of these residents (representing a little over 4%) had been infected with COVID-19, and 6,236 of them died as a result (1.5% of all care home residents). This number amounts to 85% of all COVID-19 deaths in Canada.

It is important to note that official sources have been reporting total counts of deaths in care homes, whether or not COVID-19 was determined to be a contributing or underlying cause of death. This may have inflated the estimates of the proportion of deaths due to COVID-19. Unfortunately, given the low rates of testing early on in the pandemic, some residents who died remain suspected rather than confirmed cases without post-mortem testing. Comparing the deaths during the COVID-19 pandemic to deaths during the same period in previous years (e.g., in the same weeks or months to determine the excess mortality) may prove to be the only way to improve the estimate of the mortality impact of COVID-19.

The graph below shows the total number of deaths linked to COVID-19 in the total population compared to the number of deaths among care home residents for a number of countries around the world:

As you can see, Canada has the highest percentage of the countries analysed.

The key message: Protecting our institutions, particularly care-homes, is the most important step in reducing the impact of SARS-CoV-2.

Cheers

Cliff