Posted on Apr 20, 2020, 6 p.m.
Although we are seeing an unprecedented increase in COVID-19 cases across age groups, the risks faced by our elderly loved ones are particularly acute. In America alone, there are an approximate 49.2 million individuals that are 65 and older. To give you a better idea of who is greatly at risk when it comes to COVID-19, that’s about 1 in every 7 Americans.
Over the last few months, the focus of the COVID-19 infections shifted from East Asia to Europe, and now to North America. With a confirmed infection rate in the United States steadily climbing throughout the month of March and continuing into early April, the window to “flatten the curve” is closing. We’re also seeing reported case fatality rates for those over 80 years old hovering around 15 percent, so it is essential to protect the most vulnerable by taking extra precautions.
As information about the virus floods social media and news outlets, it’s important to remember that accurate information is the best information. To help “flatten the curve,” society is navigating uncharted territory with increases in telehealth and other remote-methods of clinical evaluation. It remains important to make sure that you are maintaining your health, including regular doctor checkups and routine vaccines, both for your own immune health and for the sake of your community. Make sure to touch base with your doctors and other healthcare providers to determine if they are changing their protocols for appointments.
To ensure that we are slowing the rate of infection to avoid overwhelming our already-taxed healthcare workers, we need to recognize the symptoms of COVID-19, what to do when they present, and which precautions to take to protect ourselves and our communities. Taking necessary precautions, even if you feel perfectly fine, is an important part of helping reduce the spread of infection. COVID-19 takes, on average, five days to begin to show symptoms and there’s increasing evidence that people can transmit the infection well before they become symptomatic. Practicing social distancing and staying in as much as possible is crucial to limiting the spread. If you must go out in public, only go for things like groceries when absolutely necessary. Be sure to keep a reasonable distance (in many parts of the US, the current recommendation is 6 feet (1.83 meters) apart. Wash your hands for at least 20 seconds if you’ve been out. Avoid touching your face, especially your “T-zone” (the central part of your face—including your forehead, nose, chin, and area around your mouth).
If you fall into a group that’s considered lower risk, your best bet is to keep a close eye on symptoms. Track your temperature, keep a count of how often you’re coughing, and watch out for signs of breathing difficulty. If you notice symptoms start to worsen, it’s time to reach out to a healthcare professional, most likely via a phone call first. In any case, stay home even if you feel fine and know when and who to get in touch with if you start to feel sick!
If you fall into a group considered higher risk, including elderly and/or having other health conditions, then it helps to develop a plan of action. Many grocery stores have implemented “senior only” hours (often early in the day when the store has most recently been cleaned). Stocking up of non-perishable food and needed medication is a good idea, as it’ll help limit the need to be around other people and crowds. Signing up for a food delivery service may also be a helpful way of having fresh produce delivered to your door. Many delivery services have developed “no contact” protocols so there is no physical touching between the delivery person and intended recipient. In addition to the things you do to stay healthy outside the healthcare system, if you start to experience new symptoms or your current symptoms get worse, stay in close communication with your health providers and keep them apprised of your condition.
Social distancing, self-isolation and quarantine can be tough in the best of circumstances, so keeping in touch with friends and family over the phone or via letters can be an effective way to bridge the physical divide. If you have access to appropriate technologies (e.g. computers and internet), video chat and/or video conferencing is also a great way to remain connected with loved ones. Similarly, taking a walk alone in an uncrowded area can be a great way to get some fresh air and refresh. Of course you need to balance the benefits of physical activities outside with your local risks. It’s important to follow your local leadership’s recommended guidelines about physical activity outdoors.
While staying more than six feet away from others is ideal, it can be especially difficult for people living in assisted-care residences and nursing homes. It’s important to always maintain a clean home, but as the virus can remain active on certain surfaces like plastic for up to three days it’s even more important to diligently clean and disinfect surfaces to help ensure that opportunities for transmission are reduced. High-contact, hard surfaces such as countertops, phones, remotes, and taps/faucets should be cleaned regularly. With state lockdowns and social distancing, we’re all spending a lot more time in our homes. It’s imperative that our spaces remain clean, especially when vulnerable populations are sharing space closely. There are even some uncommon considerations that you may want to take to ensure that your space remains clean. For instance, check your plumbing system for leaks or other potential issues to ensure that surprise problems don’t pop up and cause discomfort or even unsanitary conditions.
Lastly, it’s just as important to take care of one’s mental and emotional well-being too. Social distancing does not have to mean social isolation! Do all that you can to maximize social connectedness even while minimizing physical contact. Be attuned to your own body’s signs of stress. Do you carry worry/anxiety in your lower back? Headaches? Gritting your teeth? Watch for those signs assertively and do everything you can to mitigate those physical manifestations of heightened distress. Expressing love and caring through words does not spread the virus!
Although COVID-19 infections are increasing at unprecedented rates and life has taken on a altered current reality, we can maximize the health of elderly individuals by communicating with healthcare practitioners on routine appointments and potential virus symptoms, practicing social distancing while keeping communication up to boost mental health, and ensuring that homes are clean and sanitary to limit virus spread. It is up to us as a collective to flatten the curve of COVID-19.
About Amin Azzam, M.D., M.A.
Additionally, Dr. Azzam is currently a professor at three San Francisco bay area universities -- UCSF, UC Berkeley, and Samuel Merritt University. He has dedicated his career to providing innovations in health professional schools, including Problem Based Learning (PBL), Simulation Based Learning (SBL), and Open Educational Pedagogy (OEP). He remains clinically active, running long-term psychotherapy groups for patients with chronic illnesses.
He lives in Oakland with his wife (June) and children (Remy and Margo). They enjoy camping, board games, and international travel.
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