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Project #56:
Mortality among Care Home Residents in England


This study aimed to quantify the mortality risk among care home residents compared to residents of private homes during the first and second wave of the pandemic. We used a technique called standardisation to account for age differences between care home residents and residents of private homes, and described how the mortality risk changed between February 2019 and March 2021.

We found that care home residents had an approximately 10-fold higher risk of death compared to residents of private homes prior to the first pandemic wave; this increased to an approximately 17 times higher risk during the first wave. Despite absolute increases in the risk of death during the second wave, the relative mortality risk for care home residents remained stable at approximately 10-fold higher compared to residents of private homes.

These analyses were largely descriptive, and as such we cannot say why there was a spike in the risk of death for care home residents during the first but not the second wave. Plausible explanations include improved protections in care homes such as testing and better use of personal protective equipment (PPE), pre-existing immunity from the first wave among residents and staff, or an element of mortality displacement. The peak of the second wave occurred prior to the point where the UK vaccination program is anticipated to have an effect. This study quantifies the impact of the pandemic on care home residents in England, and suggests a number of important questions for future research to ensure that this vulnerable population is protected for the next pandemic.


  • Study leads: Anna Schultze
  • Organisation: University of Oxford and London School of Hygiene and Tropical Medicine