This report is yet another piece of statistical analysis into the pandemic and in so far as it goes it is both robust and evidential. It states a reality which we have known about for some time, namely that the population most at risk from Covid-19 are individuals with pre-existing and multiple comorbidities and those who are in the older age population. It is not surprising, therefore, that given a sizable number of those living with advanced dementia and in later age live in our residential and nursing homes that – as has been consistently said – they were a population most at risk of the pandemic and its threat to life. Sadly the lack of prioritisation of our care homes in the early stages of the pandemic was one factor which has led to the deaths reported in this research.
What the research, following a long line of analytical pieces of work, does not show is the human evidence of the impact of managing the pandemic in care homes. Questions remain as to whether or not the early clinical Guidance issued by Scottish Government clinicians, the level of transfer of residents to and from hospitals, the nature of isolation over lengthy periods of time, were, amongst other factors, one which contributed to the high death rates that this report describes. It is regretful that despite numerous requests from Scottish Care that bespoke and targeted independent academic work be undertaken to explore the experience of those with direct knowledge of what was happening in our care homes, especially, staff, residents, and their families, that such work has not to date been forthcoming or prioritised. The raw scientific data offers a partial picture, listening to the stories of those who matter the most would tell us a whole lot more.
One area which would also merit further exploration is the evidence in the report to show that there were higher number of excess deaths of those living with dementia in the community (both on the previous year and five-year average) and a lower number of deaths of individuals with dementia in our hospitals. Was this because those with dementia were being discouraged from or felt unable to go to hospital? Could some of these excess deaths have been prevented with alternative clinical prioritisation both in the community and in hospitals? Was there an impact of the speedy withdrawal of homecare and community supports in the early stage of the pandemic etc?