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Novel methods for estimating the instantaneous and overall COVID-19 case fatality ratio among care home residents in England

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The COVID -19 pandemic has had high mortality rates in the elderly and frail worldwide, particularly in care homes. This is driven by the difficulty of isolating care homes from the wider community and the large population sizes within care facilities (relative to typical households). To quantify the mortality risk posed by disease, case fatality ratios are an important tool. This quantifies the proportion of cases that result in death, and is related to infection fatality ratio, which quantifies the proportion of infections that result in death. Whilst the IFR may be a better indicator of the risk posed by infection, from an operational perspective the CFR is more informative, since we only observe cases rather than infections. Throughout the pandemic, CFR amongst care home residents in England has been monitored closely. To estimate CFR , we apply both novel and existing methods to data on deaths in care homes provided by Public Health England and the Care Quality Commission. We compare these different methods, evaluating their relative strengths and weaknesses. Using these methods, we estimate temporal trends in the instantaneous CFR (at both daily and weekly resolutions) and the overall CFR across the whole of England, and dis-aggregated at regional level. We also investigate how the CFR varies based on the type of care required, dis-aggregating by whether care homes include nursing staff.

This talk is part of the Worms and Bugs series.

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