The impact of COVID‐19 on residents of long‐term care facilities with learning disabilities and/or autism

Abstract

Background The COVID‐19 pandemic has had disproportionate impact on vulnerable populations including those with learning disabilities. Assessing the incidence and risk of death in such settings can improve the prevention of COVID‐19. We describe individuals who tested positive for SARS‐CoV‐2 while residing in care homes for learning disabilities and/or autism and investigate the risk of death compared with individuals living in their own homes. Methods Surveillance records for COVID‐19 infections in England from 02 February 2020 to 31 March 2022 were extracted. Data on property type, variant wave, vaccination, hospitalisation and death were derived through data linkage and enrichment. Care home residents with learning disabilities and/or autism and diagnosed with COVID‐19 were identified and analysed, and logistic regression analyses compared the risk of death of individuals living in private residence. We assessed interaction parameters by post‐estimation analyses. Results A total of 3501 individuals were identified as diagnosed with SARS‐CoV‐2 whilst living in 632 care home properties for learning disabilities and/or autism. Of the 3686 episodes of infection, 80.4% were part of an outbreak. The crude case fatality rate was 2.6% and 0.6% among care home residents with autism and/or learning disabilities and their counterparts in households, respectively. The post‐estimation analyses found over eight times the odds of death among care home residents in 60 years old compared with their counterparts living in private homes. Conclusions Care home residents with learning disabilities and/or autism have a greater risk of death from COVID‐19. Optimising guidance to meet their needs is of great importance.

Time-varying reproduction number estimation: Fusing compartmental models with generalised additive models

“…Care Quality Commission (CQC) IDs for care homes and their accompanying UPRN information were also linked to the cases line list to identify registered care providers not identified through the address matching process. Finally, properties with 'care home', 'rest home', 'senior living', 'elderly', 'retirement' were also searched to determine whether there were any additional addresses that might have been care homes [37,38]. The total number of care homes for older people is about 14,500, with a total of about 450,000 beds associated with these settings [39].…”