Coronavirus in Scotland: Care home deaths now average one every 30 minutes

The cumulative total for Covid-19 deaths in care homes rose from 548 to 886 last week, an increase of 62%.

Since the pandemic claimed its first Scottish victim in mid-March, around of 39% people have died from Covid-19 in care homes, compared to 52% in hospitals and 9% at home or other non-institutional settings.

However after rising relentlessly, care home deaths accounted for more than half the total in the week to Sunday, while deaths in hospitals fell for a second week. 

Of the 656 fatalities in which Covid-19 was recorded as a factor last week, 338 or 52% were in care homes, while 276 or 42% were in hospitals.

This averaged one Covid-19 care home death every half hour last week.

Deaths in care homes from all causes also exceeded those in hospitals for the first time, with 684 in homes last week against 633 in hospitals.

Microbiologist Professor Hugh Pennington yesterday told MSPs that Covid-19 was “on the rampage” in care homes, with a transmission rate 10 times higher than in the community.

The ratio of Covid-19 deaths in homes to deaths in hospitals has been doubling each week, from 1-to-8 in the week ending March 29, then 1-to-4, 1-to-2, 1-to-1 and is now 1.22-to-1.   

Over the same period, the number of deaths in Scottish hospitals from all causes has risen by 19%, but has soared by 157% in care homes. 

The accumulated total for care home deaths has risen from 243 on April 12 to 548 on April 19 and is now 886 as of April 26.

The NRS tally includes cases where suspected Covid-19 was recorded as a factor on the death certificate.

It is considered more accurate than the daily running total produced by Health Protection Scotland (HPS), which only counts laboratory-confirmed cases of Covid-19.

The NRS cumulative figure was 80 per cent higher than the 1,262 deaths recorded by HPS as of April 26.

The total number of deaths from all causes registered over the week to April 26 was 1830, a drop of 81 from the previous week, but still 743, or 68%, above the five-year average.

Of the 743 above average, or ‘excess deaths’, 85% involved confirmed or suspected Covid-19. 

NHS Greater Glasgow and Clyde remains the health board with the highest number of Covid-19 deaths, with 741 registered so far, compared to 513 by April 19.

The health board’s mortality rate rose from 4.4 per 10,0000 to 6.3 per 10,000 last week.

At the Scottish Government daily briefing, Nicola Sturgeon said the number of excess deaths in Scotland is "far too high", but is proportionately lower than similar figures seen in England and Wales.

She said the high number of care deaths was sadly comparable with the picture in other countries, where up to 60% of deaths have been in homes.

She said said those in residential homes are "very, very vulnerable" to the virus.

She said close proximity between older people in care homes who may already have other conditions increases the likelihood of the spread of the virus.

She added: "The steps that we've taken so far are designed to ensure that they're as safe as they possibly can be. We will continue to take whatever steps are necessary and appropriate to ensure that is the case."

Questioned by the media, Ms Sturgeon denied the Government and NHS were under-prepared for the care home crisis.

She said: “There has been no complacency at any stage of dealing with this crisis. 

“Does that mean we haven’t made mistakes along the way, talking in general? Of course we’ll have made mistakes. All governments are dealing with an unprecedented situation.”

Asked if she was concerned about the situation in care homes getting a lot worse before it got better, Ms Sturgeon said: “I have never been as concerned about anything in my time in my government career as I am about this, and that applies to care homes as well as to everything else.

“I’m not going to stand here and predict that we may not have much more difficult news ahead of us before we feel we’ve turned a corner on this virus.

“Even when we feel we’ve turned a corner in this phase, we know it’s going to be with us for a long time to come.

“So I will continue to try to urge caution but also take the careful steps we need to take to get it under control.”

Asked why so many care home residents were dying in situ rather than being transferred to spare ICU beds, the First Minister said: “Often intensive care will not be the best place for somebody who is old and frail. Certainly, ventilation will not be best because of the impact that has on your body.

“So these have to be very person-centred decisions. Somebody at the very end stage of their life, it may be clinically the best thing for them not to be moved to hospital.

“I think everybody can understand that in terms of their own experiences. But if it is right they should be in intensive care, that’s where they should be. That’s really important.”

Care homes deaths have also become more prominent in data for England and Wales compiled by the Office of National Statistics, which lags a week behind the NRS data.

The latest ONS figures showed 2000 care home deaths south of the border last week, more than doubling the cumulative total to 3096. 

Statistician Sir David Spiegelhalter, of the University of Cambridge, said he thought the number of deaths in care homes and the community could now equal those in hospitals.

The number of UK deaths in hospitals alone from coronavirus so far is 21,678.

The opposition parties called for a step up in testing of care home staff and residents.

Scottish Tory leader Jackson Carlaw said: "This grim landmark was expected, but still the SNP’s support of care homes is falling well short.

“Scores of elderly people are dying every day in care homes – they need action now, not merely a suggestion that things are being monitored and considered.

“And the First Minister should cease this rhetoric about independent care homes being privately-run businesses, as if that somehow means the wellbeing of residents isn’t the responsibility of government.

“These homes play a key part in the health system at all times, easing strain on councils and the NHS, and helping ease bed-blocking.

“Now they need Scottish Government support more than ever.

“The residents and staff need access to testing – they deserve absolutely no less.”

Scottish Labour Leader Richard Leonard said: "There has been progress made in recent days on testing and PPE, but today’s awful news is the result of government failure weeks ago.

“Both the UK and Scottish Governments have failed our care home population and have put the most vulnerable in our society and those who care for them at risk.

“Yesterday Professor Pennington called the UK and Scottish Government’s decision to ignore the WHO testing advice a 'policy error'. Today we have the grim confirmation that he was correct.

“Everything must now be done to rapidly expand testing and the availability of PPE: with the social care sector the top priority.”

Liberal Deomcrat MSP Alex Cole-Hamilton added: "Care staff are demonstrating incredible resilience and commitment to safeguard the most vulnerable in our society against this horrible disease. 

"They urgently need a massive increase in care home testing so that when a Covid-19 case is diagnosed in any care home all residents and staff are immediately tested." 

Scottish care home owner Robert Kilgour, who founded Four Seasons Health Care 30 years ago, said the sector was “on the critical list” and needed more support from government.

He said: “We really are in the 'last chance saloon' if we want to save our social care sector.

“If our social care collapses with its 1,000 care homes, 35,000 residents and 50,000 staff - what happens to our NHS? 

“Without proper and fair financial support from the Scottish Government, I fear that many Scottish care homes will close, and we will face bed blocking within Scottish hospitals at an unprecedented level.

“After this Covid-19 crisis is over, we must devise and implement a new social contract. We need to look after the key workers who will have saved this country during this crisis so much better than we currently do. We owe them nothing less.”

Pete Whitehouse, NRS Director of Statistical Services, said: “Every death from this virus is a tragedy. These statistics, alongside the other important evidence being made available by the Scottish Government and Health Protection Scotland (HPS), are valuable to the understanding of the progress and impact of the COVID-19 virus across Scotland.

“Our aim is to ensure that our statistical publication provides information that is as useful as possible and adds value to the understanding of how the virus is spreading throughout the country. We will continue to review and develop these statistics as new information is made available.”

Green MSP Alison Johnstone said the figures were a "stark warning that there is a long way to go in the fight against Covid-19".

She said: "It’s clear that the introduction of routine testing for care staff and hospital workers, regardless of whether they are showing symptoms, will help to detect cases early, reduce the spread of the virus and give those dedicated workers and the people they are caring for the extra protection that they deserve.

“The Scottish Government has yet to explain why it won’t accept my proposal to introduce the routine testing of health and care workers, and it continues to underuse its testing capacity. It’s time for ministers to get serious about testing.”