Taking stock of COVID-19 policy measures to protect Europe’s elderly living in long-term care facilities

The current COVID-19 pandemic has come to impact all areas of life involving the health, psycho-social and economic wellbeing of individuals, as well as all stages of life from childhood to old age. Particularly, the frail elderly have had to face the gravest consequences of the disease; while reporting measures tend to differ between countries making direct comparisons difficult, national statistics worldwide point to a disproportionate and staggering share of COVID-19 related mortality coming from residential long-term care facilities (LTCFs). Still, the severity of the impact on the institutionalized elderly has not been uniform across countries. In an effort to better understand the disparities in impact on Europe’s elderly living in LTCFs, we review data on mortality outcomes seen during the first wave of the pandemic (months March to June 2020). We then set out to understand the role played by the following two factors: (1) the infection rate in the general population and (2) member state adherence to policy recommendations put forth by the European Centre for Disease Prevention and Control (ECDC) targeting the LTC sector. Regarding the latter, we compare the content of national policy measures in six countries – Austria, Denmark, Germany, Ireland, Spain and Sweden – with those of the ECDC. Our findings establish that infection rates in the general population accounted for most of the variation in mortality among member states, however adherence to EU policy helped to explain the residual variation between cases. This suggests that in order to best protect the institutionalized elderly from infectious disease of this kind, countries need to adopt a two-pronged approach to developing measures: one that aims at reducing transmission within the general population and one that specifically targets LTCFs.