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Long-Term Care and the Impact of COVID-19: A First Look at Comparative Cross-National Statistics

Publication Date
Pamela Doty, PhD, and Martin Blanco, MA, MPH

U.S. Department of Health and Human Services
Office of the Assistant Secretary for Planning and Evaluation

December 2020

Link to HTML Version (12 PDF pages)

ABSTRACT: Policymakers and care providers all over the world recognize that the risk of infection and of death from COVID-19 increases with age and among individuals with pre-existing conditions, especially diabetes and heart disease. Because many younger adults and children with physical or intellectual disabilities also have these and other medical conditions, they are also at higher risk of becoming seriously ill and dying from COVID-19 infections. Most highly developed countries as well as some countries with emerging economies are tracking rates of infection and deaths from COVID-19 among high-risk subsets of their populations. Due to the concern over infection rates in congregate settings, as of October 2020 most of the focus has been on rates of infection and death in residential long-term care (LTC) facilities serving the elderly (persons 65 and older) exclusively or predominantly. However, despite the dearth of comparable statistics about rates of COVID-19 infections and deaths among LTC users not residing in nursing homes or related residential care facilities, the available evidence suggests that COVID-19 infection rates are likely to be lower among the elderly and people of all ages with disabilities and chronic medical conditions who reside and receive assistance "at home." In this brief, we summarize the available data and literature on the cross-national impact of COVID-19 in LTC settings as of October 2020 and the changes in reported death rates since June 2020.

This brief was prepared through intramural research by the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Behavioral Health, Disability, and Aging Policy. For additional information about this subject, visit the BHDAP home page at or contact the authors at HHS/ASPE/BHDAP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201;,

DISCLAIMER: The opinions and views expressed in this brief are those of the authors. They do not reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. This brief was completed and submitted on November 17, 2020.

Product Type
ASPE Issue Brief
Location- & Geography-Based Data
International Data