The first set of data about Covid-19 deaths in nursing homes released from France’s most affected region has delivered a glimpse of a tragedy that is unfolding across Europe.

On Tuesday night, the health authority in the Grand Est region said two-thirds of its 620 old people’s homes had been affected by the coronavirus pandemic and 570 residents had died.
Those 570 people are not recorded in France’s official coronavirus death toll, which reached 4,503 on April 2, but so far counts only those who have died in hospital. Eastern France, which has had 1,112 hospital deaths, was the first region in the country to be badly hit by the pandemic.

Recent studies in Italy comparing recorded Covid-19 deaths with overall death rates in specific regions also suggest the country’s death toll is far higher than the official total of more than 13,000, already the world’s highest.
In an Italian retirement home in Mediglia, outside Milan, 52 of the 152 elderly staying there had died from Covid-19 infection by last week.
In the province of Bergamo, 2,060 deaths were attributed to the virus in March. However, L’Eco di Bergamo, a local newspaper, found that a total of 5,400 deaths occurred in the province in March, up from just 900 in the same month in 2019.

Some small towns in Lombardy have seen total deaths in March from all causes soar by more than 900 per cent year on year, according to analysis conducted by the polling and data analysis company YouTrend.


Covid-19’s mortality rate rises sharply in old age, and one of the first decisions taken by the French government to fight the pandemic in early March was to stop people from visiting their relatives in old people’s homes.
But for residents in dozens of such homes, especially in eastern France and the Paris area, it was already too late.

“The two main locations of deaths,” said Jérôme Salomon, France’s director-general of health, “are hospitals and Ehpads [an acronym for institutions to shelter the dependent elderly].” French officials say they are compiling new data from the community and old people’s homes on coronavirus.

On Thursday night, Mr Salomon said at least 884 people had died in nursing homes nationwide in addition to the official death toll, though the data are far from complete. The general mortality rate across France was 19 per cent above normal last week.

Nearly 700,000 elderly French people, many of them in their eighties or nineties and suffering from dementia, are cared for in 7,000 institutions run by both the public and private sectors. Each day brings news of fatalities: 16 at a home in central Paris; another 12 in Besançon in the east; seven more in Haute-Savoie.
A similar story is playing out in Spain, where 25 people, just under a sixth of the residents, died in just one northern Madrid care home.

Spain has around 5,400 public and private care homes, looking after 380,000 people and employing 190,000 staff. Cadena SER, a Spanish radio network, has estimated that more than a third of the people who had died after contracting coronavirus had been in care homes. At present, the official Spanish death toll from the virus is more than 10,000, which generally includes those dying in care homes only if they have previously been tested positive for Covid-19.

As part of its so-called Operation Balmis, the Spanish army has to date disinfected more than 1,800 old people’s homes throughout the country, and the state has assumed control over privately run residences. Margarita Robles, defence minister, said last week that the army had found dead bodies in “some visits” to such homes.

Even Germany, which has been able to do more coronavirus testing than most of its European neighbours, faces a possible crisis among the 800,000 elderly living in care homes. In Wolfsburg, west of Berlin, 22 people have died in the same nursing home. Forty-eight died in homes in North Rhine-Westphalia, Germany’s most populous state.
Infection and fatalities in German old people’s homes could have a marked effect on official statistics. Germany’s death rate was unusually low at the start of the pandemic, largely because the initial infections were among young, fit Germans returning from skiing holidays or taking part in carnival celebrations.

Patients groups have sharply criticised the government. “For too long the authorities have ignored care homes, when it came to the corona crisis — that’s negligence,” said Eugen Brysch of the German Patient Protection Foundation.

French managers, however, have warned against “catastrophism”, noting that thousands of France’s 7,000 Ehpads have yet to record infections, even if 50 or so have suffered multiple deaths and 500-1,000 have recorded coronavirus cases.

Ehpads across France are now introducing restrictions to isolate residents in their own rooms until the epidemic has passed (a measure not always possible with dementia patients). But the residences are in urgent need of more testing for the virus and many are seeking more safety equipment such as masks.

“We are in at the beginning of the wave. This week will be decisive,” says Florence Arnaiz-Maumé, executive director of Synerpa, which represents the private operators, some of which introduced tight controls on visits and disinfection in February because of their experiences in China and Italy. “And the next three weeks look to be pretty difficult.”