Objectives
Care Homes faced crisis during the SARS-CoV2 pandemic with increased mortality and various corrective interventions were undertaken. The impact of current SARS-CoV2 B.1.617.2 (Delta variant) outbreak on COVID-19 deaths in Care Homes is not completely known.
Design
Observational study
Setting and Participants
We included nationwide data of deaths from all causes and COVID-19 in England and Wales during March 7, 2020-November 26, 2021.
Methods
Impact of COVID-19 deaths in Care Homes, Hospital and Homes relative to total deaths from all causes was investigated.
Results
During March 7-August 28,2020; 15,414 (29.8%) of the 51,740 COVID-19 deaths occurred in Care Homes. During August 29, 2020-May 28, 2021, there were significant decrease in COVID-19 deaths in Care Homes ([19.2%]; RR 0.64; 95%CI 0.63-0.65;p<0.0001], which significantly declined further ([8.9%]; RR 0.46; 95%CI 0.43-0.48;p<0.0001) during May 29-November 26, 2021. During the March 7-August 28, 2020; 20.0% (15,514/76,906) of all Care Home deaths were caused by COVID-19, which significantly declined to 18.5% (RR 0.92; 95%CI 0.90-0.93; p<0.0001) during August 29, 2020-May 28, 2021 and declined further to 2.5% (RR 0.13; 95% CI 0.12-0.14;p<0.0001) during May 29-November 26, 2021. Increased percentages of COVID-19 deaths occurred in Hospitals ([72.3%]; RR 1.14; 95% CI 1.1-1.15;p<0.0001) and Homes ([6.3%]; RR 1.33; 95% CI 1.27-1.40; p<0.0001) during August 29, 2020-May 28, 2021 and further increases in the Hospitals ([80.8%]; RR 1.11; 95% CI 1.10-1.12; p<0.0001) and Homes ([8.8%]; RR 1.39; 95% CI 1.31-1.47; p<0.0001) during May 29-November 26, 2021.
Conclusions and Implications
There was a significantly lower number of COVID-19 deaths occurred in Care Homes and a significantly lower number of Care Homes deaths caused by COVID-19 during the Delta variant surge in England and Wales than the prior surges. Care Home residents are at highest risk for mortality, continuous monitoring and research on COVID-19 preventive interventions are essential.
BackgroundTo assess the comprehensive dynamics of outcomes during the SARS-CoV2 B.1.617.2 (Delta variant) compared to the Alpha variant outbreak in the United Kingdom.MethodsIn this observational study of the cases reported by Public Health England for confirmed (sequencing and genotyping), SARS-CoV2 cases Delta variant (n=592,692) and Alpha variant (n=150,934) were used. Outcomes were analyzed by age groups and compared with all reported weekly cases in the UK.ResultsThe Delta variant surge is associated with a significantly lower case fatality rate (0.43% vs 1.07; RR 0.39; 95% CI 0.37-0.42; P<0.0001); lower odds of hospitalization (2.1% vs 3.0%; RR 0.70; 95% CI 0.68-0.73; P<0.0001) than the Alpha variant. During the Delta variant surge there were significant increased cases (11.3% to 21.1%, RR 1.87; 95% CI 1.84-1.89; P<0.0001), hospitalizations (40.2% to 56.5%; RR 1.40, 95% CI 1.3-1.46; P<0.0001) among confirmed Delta variant cases in the ≥50 years age group during the August 3-September 12, 2021 period compared to earlier reported cases. There was also a significant increase in total weekly COVID-19 deaths noted among ≥70 years old age group (71.4% to 75.1%; RR 1.05; 95% CI 1.01-1.08; P=0.0028) during August 6-October 8, 2021 compared to June 4-July 30, 2021 period.ConclusionsThe Delta variant surge is associated with significantly lower mortality and hospitalizations than the Alpha variant. As the Delta variant surge progressed, ≥50 years old had a significant increased percentage of cases, hospitalizations and a significant increased COVID-19 deaths occurred among ≥70 years old age group.
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