Covid outbreaks 20 times more likely in large care homes

A new study has claimed that coronavirus outbreaks are up to 20 times more likely in large care homes, with the likelihood of infection getting into a home tripled with every additional 20 beds.

The study, by NHS Lothian and Edinburgh University, and seen by the Guardian, has prompted calls to divide care homes into ‘bubbles’ before any second wave hits.

Researchers examined infection patterns at 189 care homes in the NHS Lothian area where a total of more than 400 people died from coronavirus. In homes with fewer than 20 residents, the chance of an outbreak was five per cent, but in homes with 60 to 80 residents the likelihood soared to between 83 per cent and 100 per cent.

High footfall of staff – including agency workers, cooks and maintenance engineers, going in and out of the largest homes – is thought to be a key factor for infecting elderly residents.

The findings follow increasing pressure on ministers to draw up stricter guidelines to prevent further outbreaks in care homes. Of more than 55,500 people to have died with coronavirus in the UK according to their death certificates, nearly 40 per cent (21,600) were care home residents, despite ministers’ claims to have ‘thrown a protective ring’ around them.

At the height of the crisis, 25,000 people were discharged from hospitals into care homes without being tested for coronavirus, with many care leaders blaming the government for a lack of guidance and for not providing clear procedures.

Bruce Guthrie, the director of the Advanced Care Research Centre at Edinburgh University, said: “More footfall will give you more risk of infection. Although care home size cannot be altered without losing places for existing residents, there may be potential to create discrete units within care homes where smaller numbers of staff and residents are effectively cohorted to create self-contained units.”