Novel methods for estimating the instantaneous and overall COVID-19 case fatality risk among care home residents in England

The COVID-19 pandemic has had high mortality rates in the elderly and frail worldwide, particularly in care homes. This is driven by the difficulty of isolating care homes from the wider community, the large population sizes within care facilities (relative to typical households), and the age/frailt...

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Published in:PLoS computational biology 2022-10, Vol.18 (10), p.e1010554-e1010554
Main Authors: Overton, Christoper E, Webb, Luke, Datta, Uma, Fursman, Mike, Hardstaff, Jo, Hiironen, Iina, Paranthaman, Karthik, Riley, Heather, Sedgwick, James, Verne, Julia, Wilner, Steve, Pellis, Lorenzo, Hall, Ian
Format: Article
Language:English
Subjects:
Age
Analysis
Biology and Life Sciences
Casualties
China
Coronaviruses
COVID-19
Epidemics
Estimates
Fatalities
Health risks
Households
Infections
Medicine and Health Sciences
Mortality
Mortality risk
Nursing homes
Pandemics
People and Places
Public health
Regions
Risk
Statistical methods
Time series
Trends
United Kingdom
Viral diseases
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Summary:The COVID-19 pandemic has had high mortality rates in the elderly and frail worldwide, particularly in care homes. This is driven by the difficulty of isolating care homes from the wider community, the large population sizes within care facilities (relative to typical households), and the age/frailty of the residents. To quantify the mortality risk posed by disease, the case fatality risk (CFR) is an important tool. This quantifies the proportion of cases that result in death. Throughout the pandemic, CFR amongst care home residents in England has been monitored closely. To estimate CFR, we apply both novel and existing methods to data on deaths in care homes, collected by Public Health England and the Care Quality Commission. We compare these different methods, evaluating their relative strengths and weaknesses. Using these methods, we estimate temporal trends in the instantaneous CFR (at both daily and weekly resolutions) and the overall CFR across the whole of England, and dis-aggregated at regional level. We also investigate how the CFR varies based on age and on the type of care required, dis-aggregating by whether care homes include nursing staff and by age of residents. This work has contributed to the summary of measures used for monitoring the UK epidemic.
ISSN:1553-7358
1553-734X
1553-7358
DOI:10.1371/journal.pcbi.1010554