Measuring COVID-19 Deaths Among the Elderly in the OECD

coronavirus

new analysis by the Canadian Institute for Health Information looks at one key aspect of the COVID-19 pandemic that has received some coverage from the mainstream media; deaths among the world's most elderly and vulnerable population.  In the study, the authors examined statistics for 16 of the world's most advanced economies (i.e. the OECD nations), focussing on three key areas; cases and deaths, baseline health system characteristics and policy responses.  The authors note that there are some limitations to the study when it comes to international comparisons due to differences in COVID-19 testing regimes and reporting practices as well as how each nation defines long-term care (LTC).  Here are the key findings with statistics being current to May 25, 2020.

Let's open this posting with this table showing both the number of COVID-19 deaths per million population and the number of COVID-19-related deaths in long-term care per million population:

Here is a list of nations showing the number of COVID-19 cases and deaths among long-term care residents that occurred in each nation:

Australia – 67 cases, 28 deaths

Austria – 788 cases, 119 deaths

Belgium – 8,746 cases, 4,616 deaths 

Canada – 15,063 cases, 5,324 deaths

France – 73,435 cases,  13,539 deaths

Germany – 14, 128 cases, 2,835 deaths

Hungary – 172 cases, 33 deaths

Ireland – 5,698 cases, 897 deaths

Israel – 407 cases, 163 deaths

Italy – 30,012 cases, 10,629 deaths (data from 52 percent of LTC facilities in Italy)

Netherlands – 3,543 cases, 853 deaths

Norway – 163 cases, 136 deaths

Portugal – 658 cases, 327 deaths

Slovenia – 276 cases, 10 deaths

Spain – 29,516 cases, 17,730 deaths

United Kingdom – 191,138 cases, 10,102 deaths

United States – 150,000 cases, 30,000 deaths

Here is a list of nations with the percentage of COVID-19 deaths among long-term care residents as a percentage of all COVID 19 deaths for each nation:

Australia – 27.5 percent

Austria – 18.6 percent

Belgium – 49.6 percent 

Canada – 81.1 percent

France – 47.7 percent

Germany – 34.1 percent

Hungary – 6.6 percent

Ireland – 55.9 percent

Israel – 58.2 percent

Italy – 32.3 percent

Netherlands – 14.6 percent

Norway – 57.9 percent

OECD Average – 42 percent

Portugal – 24.65 percent

Slovenia – 9.4 percent

Spain – 66.1 percent

United Kingdom – 27.4 percent

United States – 31.0 percent

As you can see, Canada had, by a wide margin, the highest proportion of COVID-19 deaths occurring in long-term care.  This is significantly higher than its OECD peers which had an average of 42 percent of COVID-19 deaths occurring in long-term care residences.  In part, Canada's elevated level of deaths in its long-term care residences is due to the fact that Canada's LTC population tends to be older than other nations with 74 percent of residents being over the age of 80 years.

Let's look at two other interesting aspects of long-term care which partially explains why certain nations have such a high percentage of LTC deaths:

1.) Nursing aides, personal support workers per 100 LTC residents aged 65 and older and the type of funding in LTC:

Australia – 4.9 – private – user fees

Austria – N/A – public – insurance

Belgium – N/A – public – insurance

Canada – 2.3 – mixed public/private

France – N/A – private – user fees

Germany – 2.4 – public – insurance

Hungary – 0.2 – public – insurance

Ireland – 2.9 – mixed public/private

Israel – 9.7 – mixed public/private

Italy – N/A – mixed public/private

Netherlands – 5.6 – public – insurance

Norway – 8.6 – mixed public/private

Portugal – 0.5 – mixed public/private

Slovenia – 1.1 – public – insurance

Spain – N/A – mixed public/private

United Kingdom – 1.2 – private – user fees

United States – 4.0 – private – user fees

In general, nations with a higher number of nursing and support staff and centralized regulation and organization of long-term care had lower numbers of COVID-19 cases and related deaths.

Another aspect that influenced COVID-19 infection and COVID-19-associated death rates in long-term care facilities was the date on which there was enforced restriction of visitors to LTC:

Australia – March 18

Austria – March 5

Belgium – N/A 

Canada – March 17

France – March 11

Germany – April 2

Hungary – N/A

Ireland – March 27

Israel – March 10

Italy – N/A

Netherlands – March 19

Norway – N/A

Portugal – March 20

Slovenia – March 10

Spain – March 20

United Kingdom – N/A

United States – N/A

These statistics, particularly in the case of Canada, point to systemic problems of understaffing issues, particularly in the nation's private sector long-term care facilities.  Rather than focussing on the raw numbers of COVID-infections and deaths, it would appear that the world's media would be better serving the public need by pointing out the obvious flaws in the model of care that is provided to each nation's oldest citizens.

Click HERE to read more from this author.


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