Independent report

Vivaldi 1: COVID-19 care homes study report

Published 3 July 2020

Applies to England

© Crown copyright 2020

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This publication is available at https://www.gov.uk/government/publications/vivaldi-1-coronavirus-covid-19-care-homes-study-report/vivaldi-1-covid-19-care-homes-study-report

Results

The results are based on analysis of the survey responses from 5,126 out of 9,081 care homes for the over 65s in England. Care home staff were asked to report on the total number of confirmed cases among staff and residents since the start of the pandemic.

The weighted period prevalence[footnote 1] of infection in:

  • residents was 10.5% (95% confidence interval: 9.9% to 11.1%)
  • staff was 3.8% (95% confidence interval: 3.4 to 4.2%)

Based on analysis of test results from the Whole Care Home Testing Programme (of all 9,081 homes tested via pillar 2 between 11 May and 7 June):[footnote 2]

  • 2.4% of all tests were positive (9,674 out of 397,197)
  • 3.9% of residents tested positive (6,747 out of 172,066)
  • 3.3% of asymptomatic residents tested positive (5,455 out of 163,945)
  • 80.9% of residents who tested positive were asymptomatic (5,455 out of 6,747)
  • 1.2% of asymptomatic staff tested positive (2,567 out of 210,620)

The survey provided data on denominators (staff and residents) as well as estimates of infections, mortality, and risk factors for infection since the start of the pandemic, to provide figures for prevalence.

Vivaldi then undertook multivariable analysis to identify characteristics of high-risk care homes, controlling for other factors (below).

Conclusions

Regular use of ‘bank’ staff (healthcare professionals who do temporary work in different settings as needed) is an important risk factor for infection in residents and staff.

Infections in staff are a risk factor for infection in residents and infections in residents are a risk factor for infection in staff. However, the magnitude of this effect suggests staff are more likely to transmit infections to residents than vice versa.

Emerging data suggests that the number of new admissions, and return of residents to the care home from hospital, may be important risk factors for infection in residents and staff. This has only been tested in unadjusted analysis due to a high proportion of missing data across these variables.

Region is an important risk factor for infection in staff and residents, but its effect is different in staff and residents. This may be due to temporal differences in the timing of testing between staff and residents.

Important transmission risk is now likely to focus on staff, who will now be tested weekly via the new whole home testing rollout.

  1. The number of confirmed cases reported to the care home since the start of the pandemic as a proportion of the total number of residents or staff in that care home. It is an unweighted estimate and does not reflect survey non-response ↩

  2. These figures are not representative and may contain duplicates. However, results for symptomatic staff are not available as they were not tested within the homes. ↩

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