FIRTPA is the acronym of Foreign Investment in Real Property Tax Act. Purpose of the act is to address the concern that it would be extremely difficult, if not impossible, to collect income tax from a taxpayer who resides abroad especially if – after the sale – he or she does not own real estate property in the United States anymore.
Who is subject to FIRPTA?
The seller of real estate property in the United States is a subject to FIRPTA when he is not a US person but a foreign person for tax purposes. The buyer can rely on the affidavit provided by the seller to determine what is the seller’s status, unless the seller has reason to believe that the affidavit is false. A foreign person is a nonresident alien individual, a foreign corporation not treated as a domestic corporation, or a foreign partnership, trust, or estate. Each of those categories need to be examined separately:
Individuals:
A seller who is a US citizen or a US permanent resident/green card holder is exempt from FIRPTA withholding.
If the seller does not have US citizenship or a green card, he can still be considered a US person for tax purposes if he passes the substantial presence test, which consider whether the individual has spent sufficient time in the United States to make him subject to taxation. But how does the substantial presence test work?
The substantial presence test is met when the individual has been in the United States:
For at least 31 days during the current year (so that the individual cannot pass the test for the current year if applied in January); and
For at least 183 days in the year period that include the year being tested (the current year, if it is the one being tested) and the two years before the year being tested. The days should be pondered as follow:
The total amount of days of the year being tested;
1/3 of the days of presence for the year before the year being tested; and
1/6 of the days of presence for the year before the year being tested.
Finally, the substantial presence test has its own exceptions. For example, if the person is present in the United States under a F Visa (student visa) he or she will be considered non-US persons for tax purposes and so subject to FIRTPA.
Entities:
US entities are not subject to FIRTPA. Once again, it will be necessary to determine who is considered to be a US entity.
Corporations incorporated in the United States or proving that they elected to be taxed as a domestic corporation under I.R.S. § 897(i) are US persons for tax purposes. Exception: a US corporation that is not publicly traded and has more than the 50% of its assets in real estate interests (a real estate holding entity) is considered a foreign entity.
Partnerships organized in the United States, which are always multi-members, are US persons for tax purposes; the withholding will not affect the sale of the real estate interest, but the taxable income of the partnership.
Limited Liability Companies do not exist for tax purposes: if single-member, a limited liability company is transparent and so considered as an individual for tax purposes; if multi-member, a limited liability company is a fiscal entity taxed as a partnership. However, limited liability companies can elect to be treated as corporations for tax purposes.
Trusts:
To be considered as a US person for FIRTPA purposes, a trust needs to pass a two prong test:
The “court test”:whether a court within the US can exercise primary supervision over the administration of the trust, which is determined by where the administration is located and by whether a US court would be heard in case of dispute over the administration of the trust.
The “control test”: whether the trustees qualifying as US persons have the authority to control all substantial decisions of the trust, and are in no way subject to the decisions of trustees who are not US persons.
FIRTPA is the acronym of Foreign Investment in Real Property Tax Act. Purpose of the act is to address the concern that it would be extremely difficult, if not impossible, to collect income tax from a taxpayer who resides abroad especially if – after the sale – he or she does not own real estate property in the United States anymore.
Why FIRTPA creates a burden to the Buyer?
A question you may ask yourself is: why Buyer is involved in a tax matter that regards Seller? The answer is: because the solution that the IRS created to secure payment of taxes related to the capital gain on the transaction is to make the Buyer a withholding agent of Seller.
In fact, by definition Buyer has FIRTPA puts Buyer in charge of withholding and paying a portion of the purchase price to the IRS at closing, to cover the anticipated tax liability Seller will have as a consequence of the sale.
The final taxable amount is determined when the tax return is filed in the year following the transaction: at that time the IRS will directly refund Seller of any credit he or she may have (or, in the rare case in which an additional income tax is due, Seller will have to pay the difference to the IRS).
How much needs to be withheld?
Seller shall withhold the 15% of the purchase price and pay it to the IRS within twenty (20) days after the date of the closing; the amount is considered as paid when the forms to be sent to the IRS are postmarked. The closing agent will perform this operation on behalf of Buyer; typically, the withholding appears as a debit on the Seller’s side of the closing statement.
The closing agent will cooperate with Seller’s tax lawyer or accountant for the preparation and the submission of the required documents to the IRS.
If Seller has never filed taxes in the United States and so he or she does not have a Social Security Number, an ITIN number can be requested simultaneously with the payment of the withholding to the IRS. Typically, Seller will need to provide a certified and apostilled copy of the passport.
There are special circumstances in which a reduced withholding, or no withholding, is required. Those circumstances will be better explained in another article.
Who is subject to FIRPTA?
Seller of real estate property in the United States is a subject to FIRPTA when he or she is not a US person but a foreign person for tax purposes. A foreign person is a nonresident alien individual, a foreign corporation not treated as a domestic corporation, or a foreign partnership, trust, or estate. However, Buyer can rely on anaffidavit provided by Seller to determine what is Seller’s status, unless Seller has reason to believe that the affidavit is false.
Paola Pucci è nata a Benidorm (Alicante), ha studiato in una British School dall’età di 6 anni e si è laureata in Giurisprudenza presso l’Università di Alicante con voto 7/10. Ha studiato la laurea in un gruppo speciale ad alte prestazioni e bilingue in inglese. Durante il periodo universitario Paola Pucci ha soggiornato un anno all’estero presso l’Università Alma Mater di Bologna ed è riuscita a fare una seconda mobilità internazionale a Santiago del Cile presso l’Università di San Sebastian. è stata recentemente ammessa come avvocato in Spagna.
Paola Pucci, ha realizzato uno stage presso Escobar abogados di Benidorm, effettuando la traduzione di documenti legali, scrivendo corrispondenza in inglese e italiano e redigendo documenti legali dove ha maturato esperienza nella redazione di documenti legali specialmente nell’area del diritto civile e penale.
In particolare Paola Pucci, parla correntemente inglese, spagnolo e italiano, ed ha una conoscenza informale del tedesco. Mostrare un lavoro di squadra responsabile, organizzato, di squadra, capacità di leadership quando deve arrivare a una soluzione.
Paola Pucci, è attualmente un membro attivo dell’associazione di beneficenza internazionale Lions, dove ha partecipato a scambi culturali con l’Australia e l’India per migrare la povertà.
English
Paola Pucci was born in Benidorm (Alicante), Studied in a British School since the age of 6 and graduated in Law at the University of Alicante with a final grade 7/10. She studied the degree in a High performance special group and bilingual in English. During the university period Paola Pucci, stayed one year abroad in the University of Bologna Alma Mater and managed to make a second international mobility to Santiago de Chile in the university of San Sebastian. She has been recently admitted as a lawyer in Spain.
Paola Pucci, realized an internship at Escobar abogados in Benidorm, making the translation of legal documentos, writing correspondence in English and Italian and drafting legal documentes where si gained experience in the drafting of legal documents specially in the area of civil and criminal law.
In particular Paola Pucci, is fluent in English, Spanish and Italian, and has the informal knowledge of German. Showing a responsable, organized, team work, leadership skills when she has to come to a solution.
Paola Pucci, is currently an active member of the Lions international charity association, where she participated in cultural exchanges with Australia and India to migrate poverty.
Español
La abogada Paola Pucci nació en Benidorm (Alicante), estudió en un Colegio Británico desde los 6 años y se licenció en Derecho en la Universidad de Alicante con nota final 7/10. Estudió la carrera en un grupo especial de alto rendimiento y bilingüe en inglés. Durante el período universitario Paola Pucci, estuvo durante un año en el extranjero, en la Universidad de Bolonia Alma Mater y estuvo también a nivel internacional en Santiago de Chile, en la universidad de San Sebastián. Se ha colegiado recientemente en España como abogada.
Paola Pucci, estuvo trabajando en el despacho de Escobar abogados en Benidorm, realizando traducciones de documentos legales, redactando correspondencia en inglés e italiano y redactando documentos legales, adquiriendo con ello experiencia en la redacción de documentos legales, especialmente en las áreas del derecho civil y del penal.
En particular, Paola Pucci, habla inglés diariamente, español e italiano con fluidez y tiene conocimientos básicos de alemán. Demostrando una capacidad de liderazgo, responsabilidad, organización y trabajo en equipo cuando tiene que llegar a una solución.
Paola Pucci, actualmente es miembro activo de la asociación benéfica internacional Lions, en la que participó en intercambios culturales con Australia e India para erradicar la pobreza.
Si è discussa davanti al Giudice del lavoro del Tribunale di Paola, la causa tra Alina Vlad e la struttura di Belvedere
PAOLA Si è discussa questa mattina davanti al Giudice della sezione lavoro del Tribunale di Paola, Antonio Dinatolo, la causa tra Alina Vlad, infermiera licenziata dalla Tirrenia Hospital s.r.l. di Belvedere e la stessa struttura ospedaliera, difesa dall’avvocato Vincenzo Maradei. I legali difensori della Vlad, gli avvocati Romolo Reboa e Roberta Verginelli, hanno depositato una nota scritta relativa ai documenti prodotti dalla struttura del tirreno cosentino. Il giudice ha fornito i tempi relativi allo scambio di memorie e rinviato il procedimento al 27 aprile quando si terrà la nuova udienza. Il giudice Dinatolo potrebbe decidere di prendersi altri 30 giorni di tempo prima di pronunciare il verdetto sul procedimento.
Il Reboa Law Firm è specializzato nella tutela delle vittime di grandi tragedie sociali, sanitarie, e naturali, oltre che le vittime del dovere e del terrorismo, per le quali lo stato italiano riserva una tutela speciale.
La maggioranza di vittime del dovere sono agenti di polizia, Carabinieri o militari caduti nell’esercizio delle proprie funzioni, mentre tra le vittime del terrorismo il Reboa Law Firm ha ottenuto i risarcimenti per molte persone che subirono attentati negli anni di piombo in Italia a causa delle loro idee politiche.
Non tutti sanno che, sia in caso di sopravvivenza che in caso di morte, sia le vittime che i superstiti hanno diritto ad ottenere vari benefici.
Elenchiamo qui i benefici a cui le vittime del dovere e del terrorismo e i loro familiari hanno diritto in caso di morte, riservandoci di fornire informazioni più specifiche qualora fossimo direttamente contattati dai beneficiari:
L’esenzione dal pagamento di ticket per ogni tipo di prestazione sanitaria(L. 30 Ottobre 1990 e D.P.R. n. 243/2006, art. 4, comma 1, lett. a), n. 2).
Il diritto al collocamento obbligatorio (art. 1, co. 2, della L. 407/1998).
Il diritto a ricevere due assegni vitalizi per ogni familiare superstite, compresi i figli maggiorenni, di € 258,23 mensili, soggetto a perequazione annua (L. n. 407/98, art. 2, co. 1) e un altro di € 1.033,00 mensili (art. 5, co. 3 L. 206/2004).
Il diritto a ricevere una speciale elargizione pari, in caso di decesso, all’importo di € 200.000,00 (art. 5, co. 5 L. 206/2004).
La corresponsione una tantum di due annualità, comprensive della tredicesima mensilità, del trattamento pensionistico al coniuge superstite, ai figli minori, ai figli maggiorenni, ai genitori, ed ai fratelli e alle sorelle, se conviventi e a carico (art. 5, co. 4 L. 206/2004).
L’Avv. Francesco Lodise, nostro partner con la propria struttura territoriale in 00049 Velletri, via Roma 156, è iscritto all’Ordine degli Avvocati di Velletri (Roma), esercita la professione di avvocato penalista in processi in tutta Italia e, talvolta, all’ Estero.
Conseguita la laurea in giurisprudenza presso l’Università “La Sapienza” di Roma, fatto il prescritto periodo di pratica, si abilita all’esercizio della professione in Roma.
Per un periodo dal 1987 al 1996 presta servizio, come cancelliere dirigente, presso la Pretura Circondariale di Velletri. Ha frequentato la Scuola Superiore della Pubblica Amministrazione a Caserta.
Ha lavorato come giornalista negli anni 1981 e 1982 presso il settimanale “Guerin Sportivo” di Bologna e presso il quotidiano “Corriere dello Sport” in Roma.
Contemporaneamente all’attività forense dal 1996 si è dedicato all’insegnamento negli istituti di istruzione superiori come professore di discipline giuridiche ed economiche.
È stato altresì docente di diritto e procedura penale presso la Scuola Allievi Marescialli e Brigadieri dell’Arma dei Carabinieri in Velletri.
È socio fondatore della Camera Penale di Velletri. Da sempre è impegnato nel Sociale in Italia e in Africa (Burundi) per sostenere, con due associazioni, gli studenti bisognosi e svantaggiati e per incentivare progetti di microcredito.
È coniugato ed ha due figli: uno medico e l’altro avvocato.
Ama i viaggi e la musica blues e rock anni ’70 ed ’80.
Ha una buona conoscenza, parlata e scritta, della lingua francese, ed una parziale di quella tedesca.
English
Francesco Lodise, our partner with its own territorial structure in 00049 Velletri, via Roma 156 and a member of the Velletri Bar Association (Rome), practices as a criminal lawyer in trials throughout Italy and, sometimes, abroad.
After graduating in law from the “La Sapienza” University of Rome, he completed the prescribed period of practice has then been admitted to practice law in Rome.
For the period from 1987 to 1996 he served as executive clerk at the District Court of Velletri. He attended the Higher School of Public Administration in Caserta.
He worked as a journalist in 1981 and 1982 at the weekly “Guerin Sportivo” in Bologna and at the newspaper “Corriere dello Sport” in Rome.
At the same time as his forensic activity since 1996, he has devoted himself to teaching in higher education institutions as a professor of legal and economic disciplines.
He was also a professor of criminal law and criminal procedure at the School of Marshals and Brigaders of the Carabinieri in Velletri.
He is a founding member of the Criminal Chamber of Velletri. He has always been involved in Social in Italy and in Africa (Burundi) to support, with two associations, students in need and disadvantaged and to encourage micro-credit projects.
He is married and has two children: one a doctor and the other a lawyer.
He loves travel and blues and rock music from the 70s and 80s.
He has a good knowledge, spoken and written, of the French language, and a partial knowledge of the German one.
Español
El Abogado, Francesco Lodise es nuestro socio con estructura territorial propia en 00049- Velletri, en la calle Vía Roma 156. Es miembro del Colegio de Abogados de Velletri (Roma), ejerce la profesión como abogado penalista en procedimientos en toda Italia y, a veces, en el extranjero.
Tras licenciarse en Derecho en la Universidad “La Sapienza” de Roma, completó el período prescrito de práctica, habilitándose para ejercer la abogacía en Roma.
Entre los años 1987 a 1996, trabajó como secretario ejecutivo en el Tribunal del Distrito de Velletri. Asistió a la Escuela Superior de la Administración Pública en Caserta.
Trabajó como periodista entre 1981 y 1982 en el semanario “Guerin Sportivo” de Bolonia y en el diario “Corriere dello Sport” en Roma.
Paralelamente a su actividad forense desde 1996, se ha dedicado a la docencia en instituciones de educación superior como profesor de disciplinas jurídicas y económicas.
También ha sido profesor de derecho penal y procesal penal en la Escuela de Alumnos Mariscales y Brigadieres de los Carabineros en Velletri.
Es miembro fundador de la Sala Penal de Velletri. Siempre ha estado involucrado en el ámbito social en Italia y en África (Burundi) para apoyar, con dos asociaciones, a estudiantes necesitados y desfavorecidos y para fomentar proyectos de microcrédito.
Está casado y tiene dos hijos: uno médico y el otro abogado.
Le encanta viajar y la música blues y la música rock de los años 70 y 80.
Posee un buen conocimiento, hablado y escrito del idioma francés y un conocimiento discreto del alemán.
L’Avv. Angelina Santoro pratica la libera professione nel foro di Latina, dove è titolare di un suo studio.
Da venti anni svolge la professione di avvocato nell’ambito civilistico, occupandosi di diritto d’impresa e societario con una particolare attenzione al diritto dell’ambiente e delle energie rinnovabili.
In tale ambito, ha svolto numerose consulenze per aziende specializzate nell’efficientamento dell’utilizzo delle risorse energetiche e per la realizzazione di impianti di produzione di energia da fonte rinnovabile, seguendo gli aspetti autorizzativi e contrattualistici.
È iscritta all’Albo degli avvocati abilitati al patrocinio avanti alle giurisdizioni superiori.
English
Attorney Angelina Santoro practices freelance in the Latina bar, where she owns her own studio.
For twenty years she has been practicing as a lawyer in the civil field, dealing with business and corporate law with particular attention to environmental law and renewable energy.
In this context, she has carried out numerous consultancy services for companies specialized in the efficiency of the use of energy resources and for the construction of energy production plants from renewable sources, following the authorization and contractual aspects.
She is registered in the Register of lawyers authorized to practice before the highest courts.
Español
La abogada Angelina Santoro ejerce en la ciudad de Latina donde tiene su propio despacho.
Desde hace más de veinte años, trabaja como abogada en el ámbito civil, ocupándose de derecho empresarial y societario con especial atención al derecho medioambiental y al de las energías renovables.
En este ámbito, ha realizado numerosas consultas para empresas especializadas en la eficiencia del uso de los recursos energéticos y para la realización de instalaciones de producción de energía a partir de fuentes renovables, siguiendo las cuestiones de autorizaciones y contractuales.
Está inscrita en el Colegio de abogados como habilitada para ejercer ante las magistraturas superiores.
A lawsuit by a nursing home employee in Italy will test whether health care professionals are paying a price for pointing out dangerous conditions at medical facilities.
By Emma Bubola
July 13, 2020
MILAN — In February, he said the directors of the nursing home where he worked kept him from wearing a mask, fearing it would scare patients and their families. In March, he became infected and spoke out about the coronavirus spreading through the home. In May, he was fired amid claims that he had “damaged the company’s image.”
Hamala Diop, a 25-year-old medical assistant, challenged the decision in a lawsuit that was first heard in court on Monday. The proceedings will raise the issue of whether whistle-blowers have paid a price in raising alarms about dangerous conditions at medical facilities.
After successfully lowering the curve of new cases after a devastating initial outbreak, Italy is now bracing for a potential second wave.
The country, with the oldest population in Europe, was affected especially deeply by the coronavirus, and nearly half the infections reported in April happened in nursing homes, according to the Italian National Institute of Health. The breadth of the outbreak put the management of nursing homes under judicial and media scrutiny.
As the country fears the emergence of new clusters, some worry that Mr. Diop’s experience could have a chilling effect on those seeking to raise early warnings about potentially dangerous behaviors.
“Nobody protected us from catching the virus,” Mr. Diop said, “and nobody protected us from getting fired.”
On Feb. 26, as officials had already sealed off towns in the northern region of Lombardy, a director at the Palazzolo Institute of the Don Gnocchi Foundation, a nursing home in Milan where Mr. Diop worked, walked to the ward where Mr. Diop and his colleagues were tidying up the dining room. Mr. Diop said in an interview the director told them not to wear masks, that the building was safe and that they should not scare the residents. When presented with this account, the foundation said that they had always rejected any accusation that the employees were kept from using masks as “serious and baseless.”
For more than two weeks, while the coronavirus epidemic was exploding in the region, Mr. Diop said that he and his colleagues washed, changed and fed the residents without wearing masks or other protection. More than 150 residents would die in March and April, according to Milan’s prosecutors investigating the case. Asked if that figure was accurate, nursing home officials declined to comment.
“They watched TV and saw what was going on outside,” he said of the residents, “but I had to reassure them and tell them that the virus will never come into our safe place.”
Hamala Diop, a medical assistant, lost his job at a nursing home in May amid claims that he had “damaged the company’s image.” Hamala Diop
The human resources director encouraged managers to place on leave employees who “polemicized” or insisted on wearing protective gear “even when they are not required to,” according to an email submitted as evidence. Mr. Diop said that he received his first mask on March 12, when more than 15,000 people in the country had already been infected and days after the government had imposed nationwide restrictions on movement and work.
That same day, Mr. Diop fell ill. A week later, his swab test came back positive for the virus. His mother, who also works at the home, was infected, too.
Eleven days after becoming sick, he filed his complaint along with 17 colleagues, most of whom also had the virus. In it, they argued that management had covered up the first coronavirus cases among the staff and prevented them from using the necessary protective gear, contributing to the spread in the nursing home.
“We are their arms and their legs and they all become like our grandpas and grandmas,” Mr. Diop said of the residents. “And they kept us from protecting them,” he said in reference to the management.
In a statement, the foundation’s lawyers said the home had followed the instructions of the Italian National Institute of Health on the use of masks, and that communications about the infections among workers took place according to privacy laws.
After news of the lawsuit was published by Italian newspapers, dozens of victims’ families filed similar complaints. Milanese prosecutors opened a criminal investigation into the home’s management. On May 7, Mr. Diop was fired by the cooperative that employed him, a subcontractor for the foundation, for talking to reporters about the lawsuit, and many of his colleagues have also been transferred or dismissed.
Mr. Diop challenged the decision, and his lawyer, Romolo Reboa, argues in court filings that Italian and European laws on whistle-blowers should protect workers who raise alarms about situations that put lives at risk. Mr. Reboa cited a similar case of a nurse in Rome who was fired after anonymously speaking on the radio about the lack of masks in his hospital.
“In nursing homes, the politics of Covid was if you speak, you get sanctioned,” Mr. Reboa said. “And this created a climate of intimidation that had a direct impact on the number of deaths.”
Mr. Diop, originally from Mali, lives with his parents and two siblings in Cormano, a small town north of Milan. He said that losing his job was a serious financial setback and that he was worried he would not find new work given his record.
While he had expected to face some consequences for his actions, he said he did not think he would lose his job, since the government had imposed a freeze on layoffs during the emergency and health care workers were particularly in demand.
Wherever the virus spread uncontrolled, elderly care homes were left unprotected
By Naomi O’Leary, Europe Correspondent – Tue, May 19, 2020, 01:00
Felisa Gonzalez looks at her mother, Maria Maillo, through the window during a visit to a nursing home in Barcelona, Spain. Photograph: David Ramos/Getty Images
Across Europe, coronavirus has ravaged homes for the elderly, raising questions about why the part of society most vulnerable to the disease was overlooked in planning for the pandemic.
Though healthcare systems and policy reactions to the pandemic varied widely, one thing is consistent: in countries where national authorities lost sight of where the virus was spreading, it found its way into care homes and left devastation in its wake.
Roughly half of deaths from the virus across Italy, France, Spain, and Belgium have taken place in nursing homes, according to figures collected by academics at the London School of Economics. In many countries the true figures are only just coming to light, as unlike in Ireland, deaths in care homes were not reported in national figures.
Behind the numbers are individual stories of tragedy. Far from killing people who would have died anyway, the disease stole an average of 13 years of expected life from men, and 11 from women, according to a study of hundreds of victims by University of Glasgow researchers.
Many of their deaths were lonely. Infection risk kept loved ones away or behind panes of glass. The sheer numbers of people who were dying at once overwhelmed staff, and meant people did not always have access to palliative care such as sedatives, to ease their pain as they passed away.
Bad conditions
There were errors. In the United Kingdom, patients diagnosed with coronavirus were discharged into nursing homes to free up hospital beds, putting the disease right beside the people most vulnerable to it. In Spain, soldiers sent in to disinfect nursing homes found abandoned elderly people lying dead in their beds.
But across Europe, the toll of the disease was worsened by structural weaknesses in elderly care, which was revealed to be a fragmented and peripheral sector that was overlooked in the initial scramble to procure equipment and prepare hospitals.
From Italy to Sweden, working conditions in care homes made it hard to stop the spread of the disease.
As enclosed spaces where people work in close proximity to the age group most vulnerable to the virus, care homes were always going to be high-risk.
But this was heightened by a rotating roster of staff who often worked more than one job, lacked adequate training and equipment, and had casual contracts that meant they were not paid if they took a sick day.
“Across the European region, long-term care has often been notoriously neglected,” the World Health Organisation’s regional director for Europe, Dr Hans Henri P Kluge, said last month. “The way that such care facilities operate, how residents receive care, is providing pathways for the virus to spread.”
The hardest hit
At the height of Italy’s disaster, local media ran photographs of a chapel in a home for the elderly filled with coffins instead of pews.
Since then, police have raided care facilities across the country as they investigate accusations by employees and grieving family members of mistakes, corner-cutting and reliance on black market labour.
Romolo Reboa is the lawyer representing a group of care home workers who were suspended from their employment after they accused management of preventing them from being able to protect those in their care, including forbidding them to wear face masks in case it frightened residents.
“Families sent their loved ones into long-term care facilities because they thought they would be safe there,” Reboa told The Irish Times. “These were para-hospital institutions. They needed staff who were able to handle the situation . . . In reality, standards were much lower.”
He argues that the novelty of Covid-19 as an illness should not be an excuse for care home management, because they should be experts in infection control as the elderly in their care are vulnerable to many infectious diseases, from seasonal influenza, to nonovirus, to antibiotic resistant bacteria.
In Spain, the government is still collecting national data on how many of the more than 27,500 people lost to the coronavirus lived in care homes. But in the Madrid region, 42 per cent of deaths were in care homes, according to figures from the regional government.
The extent of the disaster in care homes was revealed when soldiers sent in to disinfect them discovered dead elderly people who had been abandoned in their beds.
The liberals
Sweden and the Netherlands opted for some of the EU’s most liberal pandemic responses, choosing not to try to contain the virus but to try to allow it to spread in a controlled manner.
Like in Britain, this policy was justified by a claim that the most vulnerable people in society such as the elderly would be “cocooned” or protected from the disease as it spread.
This did not translate into reality on the ground.
Though family visits to care homes were restricted in the Netherlands, another infection route was left wide open. Workers were advised that they could go to work if they had a cough or cold symptoms, but did not have a fever, according to official advice to care groups seen by The Irish Times.
Availability of protective equipment was limited, and hospitals took priority. By April, Covid-19 cases had been found in 36 per cent of nursing homes, according to the Dutch public health agency.
A harrowing video by a care home worker went viral on Dutch-language social media in April. “All the people here died of corona,” he says as he walks from room to empty room of a care facility. “This whole corridor is dead. Dead.”
Zero hours contracts
Swedish authorities said the vulnerable would be protected as they allowed the virus to spread in the hopes it would increase immunity in the population. This didn’t happen: about half of Swedens 3,680 coronavirus deaths occurred in care homes.
The government was forced to apologise; health minister Lena Hallengren called it “a failure for society as a whole”.
Working conditions in care homes were key to their vulnerability, according to Ulf Bjerregaard, who is head of the nursing home division in Sweden’s largest union for municipal employees Kommunal. Even in a country of strong social protections, elderly care sticks out for its underpaid and casualised labour force.
About 40 per cent of nursing home workers are thought to be on zero-hours contracts, meaning they often work in several locations, and are not paid if they stay at home when they are sick. They receive little training, and are often let go after they gain experience as employers wish to avoid the legal obligation to offer them a permanent work contract.
“Too few care about elderly care. It’s not important for the politicians. It’s underfunded, it’s low status,” Bjerregaard said. “It’s obvious that we have failed to protect the elderly.”
Professor Devi Sridhar, who is chair of global public health at the University of Edinburgh, believes that mathematical modelling that suggested the vulnerable could be “cocooned” while the strong are exposed to the virus is faulty.
“Shielding doesn’t really work in real life because healthy and vulnerable people interact,” Sridhar told The Irish Times.
“It works well in models, not in complex systems especially in care homes, multi-generational families and those living on their own relying on the community for support.”
Greek model
Available data is still partial, and the pandemic is far from over. But lessons could be learned from the experiences of countries that did handle the initial outbreaks well, such as Greece.
Greece sticks out in Europe as a country that kept a lid on infections with limited resources, as its public services and healthcare system had been ravaged by long years of crisis and austerity.
An awareness of this vulnerability made the Greek government react early to events in Italy, according to Dr Stella Ladi, assistant professor in public management at Queen Mary University of London and Panteion University, Athens.
Authorities started banning public events in February, a fortnight before Ireland, helping it keep infections to a low enough level to be carefully tracked. Schools and gathering places began to be closed down before the virus spread widely. With one of the oldest populations in the world, the government wanted to take no chances.
“The most significant event was that the measures were taken very early,” Ladi said. “There was a concern that the health system really wouldn’t be able to cope, so the government didn’t want to take any risks”.
When a case was discovered in a home for the elderly in the town of Nea Makri, the institution was put into quarantine. Staff and residents were tested, the ill were moved to hospital, strict hygiene restrictons were put into place and the contacts of those infected were traced.
Greece’s daily death toll never rose above single digits. As the country eases out of lockdown, the number of dead stands at 147.
Case studies: How four European countries fared with care homes
The Sunrise care home in Bagshot, England. At the beginning of the epidemic it was not understood within the UK health system that people with the virus who were asymptomatic could infect others. Photograph: Warren Little/Getty Images
UK – Some discharged from hospital with virus
At the start of the coronavirus epidemic in Britain, Boris Johnson promised the National Health Service (NHS) “anything it needs” to deal with the crisis. By the middle of March, sweeping changes saw non-urgent elective procedures cancelled while new emergency Nightingale hospitals were built, most of which have been largely empty.
But until March 12th, the official guidance on care homes said there was little risk of infection there and it was not until the middle of April that the government published an action plan for the sector. By May 17th, 5889 care homes in England had reported a suspected outbreak of symptomatic or confirmed coronavirus, 38 per cent of the total.
The Office of National Statistics said last week that there were 12,526 registered deaths from coronavirus in care homes between March 2nd and May 1st, more than a third of the total. But the number could be much higher, as the number of people dying in care homes from all causes is three times higher than the average for this time of year over the past three years.
A study from the London School of Economics last week suggested that about 22,000 people in care homes have died directly or indirectly from the pandemic.
Some of those who have died in care homes were discharged from hospital after being infected with coronavirus and returned to homes without testing.
Downing Street said on Monday that the number of such cases has been falling. At the beginning of the epidemic it was not understood within the health system that people with the virus who were asymptomatic could infect others.
Local authorities are responsible for social care in England and access to publicly funded care is determined by needs and means tests, although care homes are mostly run by private organisations. The government last week announced a £600 million Infection Control Fund to help local authorities to cover the cost of measures to halt the spread of coronavirus in care homes.
Throughout the epidemic, care home staff have reported shortages of personal protective equipment (PPE) and until recently often had to travel great distances for testing. The government’s action plan promised to recruit 20,000 new staff for the sector, where low pay and poor working conditions have meant that staff shortages have long been endemic.
The government has asked care homes to restrict staff, many of whom are employed by agencies, to working in only one home if possible.
Denis Staunton
Emergency services outside Etienne Marie de la Hante retirement home in Crepy-en-Valois, France. Photograph: Francois Nascimbeni/AFP via Getty Images
FRANCE – Staff badly short of protective equipment
Approximately 50 per cent of Covid-19 fatalities in France have been residents of care homes for the elderly, known by the acronym Ehpad (Établissements d’hébergement pour personnes âgées dépendantes).
According to the French public health organisation Santé publique, 28,108 people have died of Covid-19 as of May 17th. Of those, 10,642 died in care homes.
This figure does not include more than 3,300 patients who died after being transferred from care homes to hospitals. When that figure is factored in, care home residents account for about 50 per cent of Covid-19 deaths.
Two-thirds of all Ehpads in France have declared at least one Covid-19 case, and the proportion of elderly victims seems to have grown. Of the 483 deaths registered in France over the 24 hours from May 16th to 17th, 429 perished in care homes, 54 in hospitals.
Of the 28,108 deaths reported on May 17th, 58 per cent were over the age of 60. But other factors have contributed to the high excess mortality rate in French care homes. Medical professional organisations accuse the government of giving priority to hospitals over Ehpads. The shortage of surgical masks and tests, which has been nationwide, intensified the vulnerability of care-home residents.
“The needs of Ehpads were initially under-estimated because official attention was focused solely on what was going on in intensive care units,” Marc Bourquin of the French hospital federation FHF told Le Monde.
Visits to care homes were banned on March 6th, 10 days before the national lockdown started. But medical personnel and caregivers are believed to have transmitted the virus to residents because they lacked personal protective equipment.
The government requisitioned all masks on French territory until March 21st, so care homes could not even purchase them on the market. When distribution of masks finally started, on March 22nd, Ehpads were allotted only two per resident.
The health ministry initially advised care homes to stop testing once three residents of an Ehpad had tested positive for Covid-19. At that point, the entire care home was assumed to be infected. An unknown number of patients are believed to have been needlessly infected because the lack of testing meant positive cases were not isolated.
Several families of deceased care-home residents have filed lawsuits against Ehpads for manslaughter, endangering life and non-assistance to persons in danger.
Lara Marlowe
An employee prays with a woman at the Las Praderas care home for the elderly in Pozuelo de Alarcon near Madrid. Photograph: Pierre-Philippe Marcou/AFP via Getty Images
SPAIN – Residents in care homes found abandoned
In Spain, the handling of care homes and their role in the Covid-19 crisis has been under scrutiny almost since the virus began to spread across the country.
Until recently, Spain was the second-hardest hit country in Europe behind Italy and its current death toll, nearly 28,000, has been attributed in great part to the virus’s presence in homes for the elderly.
However, the leftist government has not yet released figures showing how many care home residents have died, citing the fact that different regional administrations have varying methodologies for collating the information. Europa Press news agency has reported that the national total is “at least” 17,253 – close to two-thirds of total deaths.
A string of care home-related scandals has put the sector firmly under the spotlight. Early on in the crisis, members of the military who had been deployed to disinfect homes found elderly residents in some of them abandoned by staff. There were even reports of the bodies of dead residents having been left in homes in some of these cases.
The state prosecutor is now investigating these as part of a probe into about 150 care homes across Spain, for their alleged failure to respond adequately to the emergency.
In one Madrid home, 17 residents reportedly died from the virus without receiving any medical attention.
Last week, the Las Camelias care home, also in the Madrid region, sparked outrage after members of its staff posted on Facebook photographs of a recent party they had held in the building, complete with suckling pig and flamenco dancing. The event seemed to flout lockdown rules and was seen as distasteful given that about 80 of a total 226 residents of the home have died of coronavirus, according to El País newspaper.
The central government published guidelines for all care homes in early March, asking them to restrict visits and isolate those who appeared to be suffering symptoms. However, as the overall death toll escalated, the government appealed, two weeks later, for regional authorities to ensure those guidelines were being followed.
Spain has both privately- and publicly-run care homes. Pablo Iglesias, leader of the leftist Podemos party and a senior minister in the coalition government, has blamed the increasing involvement of private finance for the sector’s failings in this crisis.
“The privatisation of care homes, handing them over to the corrupt, to vulture funds, has placed our elderly in a position of vulnerability,” he said on Sunday.
Guy Hedgecoe
Care worker Marine Lehmberg helps Marlene Schulz (85) who has dementia, dance to a singer’s live performance at the Hermann Radtke Haus nursing home in Berlin. Photograph: Sean Gallup/Getty Images
GERMANY – Strong focus now on care home sector
Germany has been held up as an example in the Covid-19 pandemic, with early and widespread testing and rapid contact tracing helping to contain the virus’s spread.
A lesser-reported story is how, like many of its neighbours, its first coronavirus scare involved outbreaks in care homes in half a dozen federal states.
About 800,000 Germans live in retirement and nursing homes, most of which are privately run, often by charitable foundations. Until now, no official statistics have been collated on confirmed coronavirus cases and, beyond sporadic news reports, it is difficult to get an overview of the situation.
In late March, a care home in Wolfsburg with 165 residents living with dementia registered 12 deaths within days and 72 Covid-19 infections.
Just before Easter a home in Bonn run by Catholic charity Caritas registered that 70 of its 337 residents, and 38 care staff, had tested positive.
Mid-April saw another outbreak in the western city of Duisburg with three residents dead and 21 out of a total of 104 residents and 15 staff infected. Meanwhile the northern Bavarian city of Würzburg reported 44 deaths in two homes. Public sector broadcaster WDR reported on April 29th the death of 23 people from the virus in Cologne.
AWO, a leading care home operator, has conceded shortages of protective equipment is the greatest challenge in containing the spread of the virus.
On the other hand, statistics from Germany’s Robert Koch Institute, the disease control body, show the largest age-group affected by Covid-19 is not older people but the middle-aged 35-59 age group.
Given it has one of Europe’s oldest populations, Germany has made care homes – both residents and staff – a focus as it adapts its Covid-19 regulations for the second phase of the pandemic.
Last Thursday the Bundestag passed the Infections Protection Act, with a special focus on care homes and hospitals.
The new regime ramps up testing among care home residents and hospitals patients, including people with no symptoms. All tests results – even negative ones – will be logged to help map the virus spread.
Nurses and care workers will be entitled to a €1,000 tax-free bonus, a move to help counter sectors where labour shortages reflect low pay.
After a six-week lockdown, Germany’s 16 federal states have in the last week begun allowing
