On 9 February, the Scottish Government published their long-awaited report entitled “Excess deaths from all causes, involving and with dementia as the underlying cause: Scotland 2020/2021”. The report paints a stark picture, showing the devastating effect of the COVID-19 pandemic on people with dementia, which was the main pre-existing medical condition in deaths involving COVID-19 during this period. The report is based on a secondary analysis of weekly statistics published by National Records of Scotland (NRS) on deaths involving dementia, or with dementia as an underlying cause. Looking at the period between 16 March to 31 December, 2020, figures show that 28% of all deaths involving COVID-19 had dementia mentioned on the death certificate. This makes dementia the leading pre-existing condition in all COVID-19 deaths. In comparison, 14% of deaths involving COVID-19 also mention ischaemic heart disease, the next most prevalent pre-existing condition.
The Scottish Government analysis also shows that residential setting had a huge impact on COVID-19 deaths of people with dementia. In 2020, there were 1,638 excess deaths involving dementia in care homes, 26% higher than previous years. The vast majority of these excess deaths involved COVID-19, highlighting the inadequacy of measures for reducing infection in the care home setting during the early months of the pandemic. Commenting on the report, Alzheimer Scotland called for re-evaluation of the large Care Home Model, where numerous people live together and are cared for by a small, dedicated team, as it presents a high risk of virus transmission for people with dementia: “We need to radically transform our approach, and develop a smaller scale approach to residential and nursing care. One that is not based on large scale but designed to meet the high care needs of individuals, and one which can withstand the ongoing threats of future pandemics without the unbearable consequences that those we have lost and their loved ones had to endure….We must have care environments which are not built on economies of scale but designed to tackle the rigours of a world learning to live with COVID-19 in as safe, humane and caring way as possible.”