Recycling the myth of Scottish care home deaths with basic errors

Guardian 19th July

In a piece broadly sympathetic to the First Minister and Scotland’s covid strategy, the Guardian writers seem to feel the need for ‘balance’ and use anything they can find even if it’s wrong. Truth, fairness and accuracy are what readers need. You wouldn’t expect to have balance on a piece about the health risks of smoking so why would you need it for a piece on a health strategy which has reduced covid cases and deaths to almost elimination levels?

Here are the offending bits. First:

On the downside, Scotland has the highest death rate for coronavirus in care homes in the UK. Some 47% of all Covid-19 deaths have been in care homes in Scotland, while in England the figure is about 27%.

This is plain daft. Those stats tell you that the percentage of all covid deaths in Scotland which were in care homes was higher than in England, not that there was a higher rate in those homes.

More important than the percentage of all covid deaths that were in care homes is, surely, the overall, per head of population death toll in care homes, ie did Scotland or England have more care home deaths as a percentage of their overall populations?

Data from research by LSE, reported on May 14th in Care Home Professional:

More than 22 000 care home residents in England and Wales have died during the coronavirus pandemic, according to new research. In a new paper, the LSE said data on deaths had underestimated the impact of the pandemic on care home residents as it did not take into account the indirect mortality effects of the pandemic and/or because of problems with the identification of the disease as the cause of death. The paper said current data only accounted for an estimated 41.6% of all excess deaths in care homes.

https://www.carehomeprofessional.com/research-estimates-put-real-care-home-covid-19-death-toll-at-over-22000/

In Scotland, up to 17th May, there were 1 623 deaths in care homes where Covid-19 was mentioned on the death certificate.

https://www.nrscotland.gov.uk/covid19stats

The population of England and Wales is 59 million, 10.7 times that of Scotland at 5.5 million so, all things being equal you might expect the death rate there to be 10.7 times 1 623 or 17 366.

So, the actual care home death rate in Scotland by mid-May, based on the LSE research was 21% lower than in England & Wales.

Second:

There are tentative signs that Sturgeon’s handling of the crisis may be bolstering support for the nationalist cause. One recent poll showed 55% of Scots now favour independence.

Tentative? One?

Third:

In a move that led her political opponents to criticise her for political posturing, Sturgeon threatened recently to close the England-Scotland border, while Johnson has claimed no such border exists.

This is, of course totally untrue. The FM made no move and has made no move. The move was by the media to push the FM on something, leading her to then say that she ruled nothing out. Not quite the same thing?

8 thoughts on “Recycling the myth of Scottish care home deaths with basic errors”

  1. It might be useful to add some context to the stuff around care homes and hospital discharges in England and Scotland. Here are extracts from an article by Professor David Bell and others about the discharge of older patients from Scottish hospitals.

    “Delayed discharges occur when a hospital patient considered well enough to return to the wider community continues to occupy a hospital bed because of difficulties in accessing the necessary care, support or accommodation. Such delays are generally not in patients’ best interest since most would prefer to leave hospital – extended stays in hospital are generally harmful to patient wellbeing. Delays are not in the interest of the healthcare system either because they reduce patient throughput……

    …. Each delayed discharge is now assessed and categorised. Delays fall into three main categories – those associated with health and social arrangements, those caused by arrangements relating to the patient, family or carer and more complex reasons relating to the specific care needs of the person……

    ……Public Health Scotland has recently released monthly data covering the period up to and including March 2020. These show a remarkable turnaround between February and March 2020. The number of delayed discharges fell from 1627 to 1171 during this period, an overall reduction of 28%. The principal reason for reductions in delayed discharge, accounting for 98% of the total, was “health and social care reasons”, suggesting that Scottish Health and Social Partnerships increased the volume of assessments, placements and care arrangements so that a substantial number of older people whose discharge had been delayed, could be moved into the community or care homes. This was likely associated with a desire to remove patients who were potentially vulnerable to COVID19 away from hospital settings….

    …..These data provide clear evidence of the imperative to clear hospitals prior to the pandemic. Those moved away from hospital will have been accommodated in care homes or in a domestic setting. It is likely that these arrangements were made in haste with probably the laudable motive of protecting patients from the virus. Whether this process has caused more problems by placing some people with COVID infections in settings where they could infect others or by exposing frail individuals to more risk than they would have faced in hospital must await further research. This should be feasible, given that all delayed discharge records can be attached to the Scottish Community Health Index data spine….”

    https://ltccovid.org/2020/05/28/delayed-hospital-discharges-in-scotland-what-happened-in-march-2020/

    If you read the piece at the link you will see that one of the sources is David Oliver. Oliver talks in the context of discharges in English hospitals. He suggests that decisions to move older patients out of hospital in Feb/March(with the mistakes that went with that) were made by clinicians, not politicians. He has a twitter thread about it. Here is the link to that.

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  2. Re deaths of care home residents. England and Wales data from ONS

    IN PARTICULAR up to 20th June -19,394 care home resident deaths, total confirmed and suspected to 20th June 46,120, care home residents – 42%..

    ”Our definition of deaths involving COVID-19 includes cases where the certifying doctor suspected the death involved COVID-19 but was not certain, for example, because a test was not undertaken. Of the 19,394 deaths involving COVID-19 of care home residents, 16,305 (84.1%) were classified as “confirmed” COVID-19 and 3,089 (15.9%) were classified as “suspected” COVID-19”

    https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathsinvolvingcovid19inthecaresectorenglandandwales/deathsoccurringupto12june2020andregisteredupto20june2020provisional#deaths-involving-covid-19-among-care-home-residents

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  3. If I may add a little more context to what happened in English care homes. The information provided here is from the same source to which John links. The suggestion here is that the deaths have been significantly understated. The number of “excess” deaths in care homes in England related to covid19 is likely to be much larger in reality and possibly accounts for all such deaths in 2020.

    “Key findings:
    Data on deaths in care homes directly attributed to COVID-19 underestimate the impact of the pandemic on care home residents, as they do not take account of indirect mortality effects of the pandemic and/or because of problems with the identification of the disease as the cause of death.

    Not all care home residents die in care homes. According to ONS data, 13% of all deaths of care home residents took place in hospitals (28% of residents whose deaths were linked to COVID died in hospitals).

    The number of registered COVID-19 deaths among care home residents in England only accounts for an estimated 54% of all excess deaths in care homes (compared to same period in 2019).

    Total excess mortality taking place in care homes since 28th December is estimated to be 19,319 (48% of all excess mortality in England), and excess mortality among care home residents was 22,231, 55% of all excess mortality in England.

    This short report has been updated since the first version of the 12th of May, as the ONS published more detailed data on care home residents on the 15th May. A more detailed analysis of the new data published by ONS will be added soon.

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  4. Pretendy lefty Guardian, cannot abide that rag. How dare they even make comment on Scotland at all really, a nasty English rag, sowing seeds of division to boot.

    That nasty rag had my pals in England become very anti SNP in 2014, ‘I don’t like that Alex Salmond mind’, ( they couldn’t say why though) ‘what will yous do without the oil’, ‘wieye but the Scots fought with the English against Ireland’ (way back when), such claptrap and with an ounce of hatred/jealousy mixed in. The whole message being that Scotland was anti English by wanting to ‘seperate’ as well. Rags like the Guardian touted that sentiment, disgraceful.

    It’s a lying Britnat establishment rag posing as somehow lefty, the worst kind of propaganda in fact.

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  5. At the 2011 census – 291,000 were living in care homes in England and Wales –
    https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/articles/changesintheolderresidentcarehomepopulationbetween2001and2011/2014-08-01

    At the same time, there were 36,000 in care homes in Scotland and a further 6,000 were in other medical and care establishments –
    https://www.scotlandscensus.gov.uk/news/census-2011-release-2a

    The population ratio is 10.9, so pro-rata to England & Wales there should be 26,730 in Scotland. As stated above, there are at least 36,000 in Scotland. From other sources, the numbers don’t seem to change much with time.

    There are other details such as – how many are older people care homes – but I assume the data above are on the same basis and that the proportions of older people will be similar. I am a bit surprised about how high the Scotland number is, so it would be useful if someone else could have a look at this.

    As it stands, using your data on deaths, this means 22,000 died in England & Wales out of 291,000 residents, which is 7.5%. In Scotland, the figure is 1,623 out of (say) 36,000, which is only 4.5%.

    However, the 22,000 figure is for all deaths I think. More up-to-date data where Covid-19 is mentioned on the death certificate has England & Wales at 19,394 deaths, and Scotland at 1,947. This would mean 6.7% of care home residents died of Covid-19 in England & Wales and 5.4% in Scotland.

    It has also been suggested (by the FM and others) that there’s something fishy about the reporting down south. The percentage of excess deaths attributed to Covid-19 seems to be lower in England & Wales than in Scotland – which may mean that GP’s in Scotland are more liberal with Covid-19 as a contributory factor on death certificates. If this is true, the per-resident data for England & Wales would be higher than 6.7%.

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