Are elderly people at greater risk from COVID-19?

Both the Virus and the Disease have recently been officially named. Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) causes Coronavirus disease (COVID-19) just as the HIV (Human Immunodeficiency Virus) can lead to AIDS (Acquired Immuno Deficiency Syndrome)

Different viruses can strike down some more than others more severely than another. The “Spanish” influenza pandemic of 1918–1919, which caused approximately 50 million deaths worldwide, particularly affected young adults. The Zika outbreak that raged through Brazil in 2015-2016 had an especially devastating effect on the central nervous system of the fetuses of pregnant women. Severe Acute Respiratory Syndrome (SARS), a similar virus that started in China in 2002, affected the over 60s disproportionately. There were 8,098 reported cases and 774 deaths an approximately 10% mortality rate.

SARS-CoV-2 is the virus that causes COVID-19, the Corona Virus mediated disease that originated in China appears to get more dangerous with age. So far children aged 1-9 account for just 1% of all Chinese infections, and none of the deaths. Those aged 10-19 also account for only 1% of infections. Below age 35 there are exceedingly few cases but as age increases from the 40s to 80s mortality also increases markedly.

SARS-CoV-2 is likely to have come from a Wuhan seafood market where wild animals, including marmots, birds, rabbits, bats and snakes are known to be traded illegally. Corona Viruses are known to jump from animals to humans, so it’s thought that the first people infected with the disease, a group primarily made up of stallholders from the seafood market contracted it from contact with animals.

In China about 80% of the cases are reported to be mild, however 20% of those diagnosed had moderate, severe, or critical symptoms, such as difficulty breathing, pneumonia and multiple organ failure. About 2.3% of overall infections have been fatal.

Italy has an elderly population, actually much older than the China’s. There measures have slowed the spread but there are still major concerns about the burden on the health care system and the threat it poses, especially to older people. Measures recently introduced have the aim of avoiding a large epidemic wave with precautions including nationwide school closures which will stay in place until at least March 15th.

Many of those who have died in Italy suffered from serious pre-existing conditions as well as being elderly, such as Cancer, Chronic Obstructive Pulmonary Disease (COPD), Coronary Heart Disease )CHD) and Diabetes. This with the relatively mild and under-reported symptoms in the younger population makes it extremely difficult to calculate the true mortality rate but best estimates are that Italy’s mortality rate is currently about 3.5 percent which is not much above the global average of 3.4 percent reported by the World Health Organization. But the COVID-19 is taking a disproportionate toll on the elderly in Italy, which has the oldest population in Europe, and the second-oldest in the world after Japan.

In Italy 23 percent of the population is 65 or older and so far of those infected in their 70s,  8% have died and nearly 15% of those 80 and older died with COVID-19.

So the older you are the likelier you are to contract a SARS-CoV-2 and develop COVID-19 infection and also suffer more morbidity and even death. Recent research in China has found that the average age of COVID-19 patients who developed Acute Respiratory Distress Syndrome (ARDS) where fluid builds up in the lungs causing marked shortness of breath is 61. In January, Chinese health authorities were already reporting that the median age range for people who died of the disease was 75.

Early data suggested that men were more vulnerable, as they accounted for just more than half the cases and died twice as often as infected women possibly because men are more likely to be smokers than women.  A World Health Organisation study from 2019 found that 47.6% of Chinese men smoke, compared to only 1.8% of Chinese women. This compares to only about 15% of the US/UK population. Women are also thought to mount stronger immune responses.

People with heart problems, diabetes, or lung issues like Chronic Obstructive Pulmonary Disease are also at a higher risk for severe disease and death.

To be prepared keep up with news about where the virus is spreading and take the usual precautions to keep healthy as possible by getting enough rest, exercising, eating well, and having the flu vaccine. Those that follow this advice are the people who tend to be less likely to contract COVID-19 and if they do, recover faster.

The  UK government has announced funding for a simple home-based test, like a pregnancy test, where people can tell if they’re infected in 20 minutes or so rather than the 24-48 hours it needs now.

 

Simple advice to keep the doctor away!

  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. It is also suggested that you wash hands as soon as you come into the house or office.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If you haven’t a tissue. Cough into the crook of your elbow not your hand.

Surgical masks

Surgical masks help keep pathogens from the doctor’s nose and mouth from entering the surgical field and infecting patients.

In  Japan and China, it’s common to see people wearing surgical masks in public in an attempt to protect themselves from pathogens and pollution. However the evidence is that these masks will not help much as they are not designed to keep out viral particles and they do not fit tightly enough around your nose and cheeks allowing unfiltered air to enter from the sides. Even those masks that are well fitting may not help much as they force the wearer to breathe in more deeply.

People sick with COVID-19, however, should wear face masks to reduce the risk of infection to people around them.

It’s also important to remember that we are still in the middle of the seasonal flu season, which impacts older adults every year and it is estimated that 70-85% of seasonal flu-related deaths occurred in people aged 65+. Although there is no vaccine for COVID-19 yet, estimates vary but it is expected to take at least a year of research and development, it is not too late to benefit from your annual flu shot.

 

Are elderly people at greater risk from coronavirus and what should you do if they are told to self-isolate?

Your guide to helping elderly relatives lower the risk of falling ill

Are elderly people at greater risk from coronavirus?

Yes. The mortality rate for the general population is thought to be between 1 and 2 per cent. But this rises to 8 per cent to those in their 70s, and to 15 per cent for over-80s. People with underlying conditions are at even greater risk.

How can we protect the elderly?

Make sure they do not come into contact with the virus. That means anyone visiting them should be very careful about hygiene – by washing their hands and perhaps staying away if they have a cold. But don’t avoid all contact – experts believe this will do more harm than good. It could mean they become isolated, exacerbating loneliness.

Should they avoid crowds?

The World Health Organisation said anyone over the age of 60 – or those with existing health conditions – should ‘try to avoid crowded areas. Public Health England, however, says this advice is overly cautious until there is ‘evidence of sustained and widespread transmission within the community’, and the Government is keen for everyone to carry on their normal day-to-day routine.

Should relatives stay away?

No – unless anyone has been specifically told to self-isolate. But parents should be especially careful about the hygiene of young children, who should wash their hands at least four times a day.

What should you do if an elderly person is told to self-isolate?

Age UK advises that people stay in touch over the phone, by post or online – for example, by using video chat services. See if people need any shopping or help by running errands. It is important to encourage people to stay active around the house.

What if an elderly person becomes ill?

In the UK call NHS 111. They should not go to their GP without phoning first. If a GP believes they may have COVID-19 they will be tested by arrangement at home or a nominated centre. The results take 24 to 48 hours to arrive.

How will they be treated?

Most patients are taken to hospital and treated in isolation until the virus has passed. In some cases this can be very quick – only 5 per cent of patients are sick enough to require intensive care. In more severe cases treatment includes life support and can take some days.

Isn’t the risk of infection higher in hospital?

No. Hospitals are safe because infection control has been so thorough since the beginning of the outbreak.

How might the advice for the elderly change?

During an epidemic, the elderly could be told to have minimal contact with the outside world because they are at such high risk – but only during the peak of the disease, which may last for three weeks.

….and this from Dr Abdu Sharkawy from an  Infectious Diseases Specialist at the University Health Network, Toronto Ontario. I guess this is the best information we’re likely to get direct from the horses mouth!

I’m a doctor and an Infectious Diseases Specialist. I’ve been at this for more than 20 years seeing sick patients on a daily basis. I have worked in inner city hospitals and in the poorest slums of Africa. HIV-AIDS, Hepatitis,TB, SARS, Measles, Shingles, Whooping cough, Diphtheria…there is little I haven’t been exposed to in my profession. And with notable exception of SARS, very little has left me feeling vulnerable, overwhelmed or downright scared.

I am not scared of COVID-19. I am concerned about the implications of a novel infectious agent that has spread the world over and continues to find new footholds in different soil.  I am rightly concerned for the welfare of those who are elderly, in frail health or disenfranchised who stand to suffer mostly, and disproportionately, at the hands of this new scourge. But I am not scared of COVID-19.

What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world. I am scared of the N95 masks that are stolen from hospitals and urgent care clinics where they are actually needed for front line healthcare providers and instead are being donned in airports, malls, and coffee lounges, perpetuating even more fear and suspicion of others. I am scared that our hospitals will be overwhelmed with anyone who thinks they ” probably don’t have it but may as well get checked out no matter what because you just never know…” and those with heart failure, emphysema, pneumonia and  strokes will pay the price for overfilled ER waiting rooms with only so many doctors and nurses to assess.

I am scared that travel restrictions will become so far reaching that weddings will be cancelled, graduations missed and family reunions will not materialise. And well, even that big party called the Olympic Games…that could be kyboshed too. Can you even imagine?

 

I’m scared those same epidemic fears will limit trade, harm partnerships in multiple sectors, business and otherwise and ultimately culminate in a global recession.

 

But mostly, I’m scared about what message we are telling our kids when faced with a threat. Instead of reason, rationality, openmindedness and altruism, we are telling them to panic, be fearful, suspicious, reactionary and self-interested.

 

Covid-19 is nowhere near over. It will be coming to a city, a hospital, a friend, even a family member near you at some point. Expect it.  Stop waiting to be surprised further. The fact is the virus itself will not likely do much harm when it arrives. But our own behaviors and “fight for yourself above all else” attitude could prove disastrous.

 

I implore you all. Temper fear with reason, panic with patience and uncertainty with education. We have an opportunity to learn a great deal about health hygiene and limiting the spread of innumerable transmissible diseases in our society. Let’s meet this challenge together in the best spirit of compassion for others, patience, and above all, an unfailing effort to seek truth, facts and knowledge as opposed to conjecture, speculation and catastrophizing.

 

Facts not fear. Clean hands. Open hearts.

Our children will thank us for it.

#washurhands #geturflushot #respect #patiencenotpanic

Elderly people who contract coronavirus are “not a goner” and the “great majority” of patients as old as 80 will recover, England’s top doctor has said.

Professor Chris Whitty, the country’s chief medical officer, sought to reassure the public that over-60s have a good chance of surviving Covid-19 if infected.

Health chiefs have warned that older people and those with pre-exisiting medical conditions such as asthma, diabetes and heath disease are more likely to fall seriously ill from the virus.

Coronavirus: Elderly people ‘not a goner’ and great majority will recover from disease, UK medical chief says

‘It’s easy to get a perception that if you are older and you get this virus then you’re a goner,’ says Professor Chief Whitty – Videos and an excellent article by Chiara Giordano

But Prof Witty said: “Even in the most vulnerable, oldest groups, in a very stressed health service – which Hubei was at the point when most of the data came out – the great majority of people who caught this virus – and not everybody will – survived it. The great majority, over 90 per cent.

“I think it’s easy to get a perception that if you are older and you get this virus then you’re a goner – absolutely not, the great majority of people will recover from this virus, even if they are in their 80s.”

He added: “We intend to do what we can to make sure that they are the group that is least affected as far as we can.”

Prof Whitty’s comments came in response to a question from MP Jeremy Hunt, chair of the Health and Social Care committee, who said the Chinese government had declared “80 per cent of the fatalities have been people over the age of 60”.

The chief medic was grilled by the committee as the number of coronavirus cases in the UK rose to 90 on Thursday.

Earlier, Prof Whitty said Britain had moved mainly into the “delay” phase of its four-stage battle plan for tackling coronavirus.

He said new measures will be considered to try to reduce the spread of the outbreak in this second phase.

SARS-CoV-2 is spreading around the world although at the epicentre in Wuhan, China they have had at least one day of NO new cases! Keep up with the news and Keep up with the LATEST advice which may change when there is new information. 

When the Facts Change, I Change My Mind. What Do You Do, Sir?

John Maynard Keynes? Paul Samuelson? Winston Churchill? Joan Robinson? Apocryphal?

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