Older adults, especially those age 80 and above, are at increased risk for complications and poor health outcomes if they are infected with the novel coronavirus (COVID-19). We know that you have questions about how best to protect yourselves and your loved ones from this disease. Below are some answers to our most frequently asked questions about coronavirus prevention for high-risk patients.
Why are older adults considered high-risk patients for COVID-19? What age group are we talking about?
There are a number of factors that contribute to increased COVID-19 risk among older adults. According to an associate professor at Pacific University School of Pharmacy in Hillsboro, Oregon, these include weakening immune systems and other chronic diseases which are more common as people age.
“Our immune systems become weaker in the last few decades of life, with a significant decrease in function around age 80, as the immune cells in our body decrease in both number and effectiveness,” says Dr. Fortner, who is also a member of the SingleCare Medical Review Board. “At the same time chronic diseases become more common, and COVID-19 seems to be especially harmful to people with diabetes, heart disease, kidney disease, or lung conditions.”
Dr. Fortner also pointed to a study, published Mar. 11, showing that the death rate for COVID-19 cases in China increases with each decade of life, with a noticeable difference after age 50. For patients under 50, the death rate was less than 0.5%, but increased to 1.3% for people in their 50s, then 4.6%, 9.8%, and 18% for those in their 60s, 70s, and over 80 respectively.
What are some coronavirus prevention tips for older adults to stay safe and healthy and avoid exposure?
“Handwashing, disinfecting surfaces, and social distancing are the most important tools we have to mitigate the spread of COVID-19 right now,” says Melissa D. Hladek, Ph.D., CRNP, an assistant professor at the Johns Hopkins School of Nursing in Baltimore.
According to Soma Mandal, MD, a board-certified internist and partner at Summit Medical Group in Berkeley Heights, New Jersey, social distancing is a term public health officials use to mean limiting one’s exposure to other people who might be carrying the virus. The goal is to slow down or stop coronavirus transmission by staying away from crowded places.
“Since we are at least one year out from a vaccine and we need more testing available, this is the best way to slow down the spread of the coronavirus,” Dr. Mandal says. “During the influenza pandemic of 1957-1958, the spread of the illness occurred after public gatherings.”
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Is it safe to go to indoor public places, like libraries, supermarkets, churches, and restaurants?
Dr. Hladek says that the risk of going to indoor places depends a lot on where you live. “If an older adult lives in an area with an active community-acquired outbreak, then there is increased risk of exposure in public places.”
Dr. Fortner agrees, and recommends that older adults check their local news for announcements from the state and local government leaders and their health departments. “These groups work to decide if safety restrictions such as social distancing are necessary, which means to cancel large events, limit gatherings of people in public, or closing public spaces.”
What about outdoor spaces like parks and walking trails?
If your community is experiencing active cases of COVID-19, you may still be exposed to the virus in outdoor public spaces, but the risk will be lower than it would in an indoor area.
“I think again it depends on the outdoor space,” says Dr. Hladek. “How many surfaces, who else is there, how big is the space and is it in an area with an active outbreak? At this point, we think the COVID-19 virus is spread through physical contact with the virus, but it might also be present in small microscopic droplets in the air even after an infected person has left the area. We do not know for sure. So outside, there is much more air to disperse any droplet particles, lowering the risk.”
Dr. Fortner says that in order to minimize the risk of coming into contact with the virus, older adults should stay at least six feet away from other people, and they should not touch shared surfaces like handrails and door handles. If they take these precautions, it might be okay to enjoy the parks and walking trails in the community, especially if there are no active cases in your area.
Do elderly people need to avoid their own children and grandchildren?
Dr. Mandal recommends that older adults stay home, even if that means not visiting with their families. “They should clearly avoid visibly ill people,” she says. “Limiting interactions with children and grandchildren would be recommended at this time, but since we are now in a digital age, make sure to Skype or FaceTime with them every day.”
Dr. Fortner says that the decision of whether or not to avoid family members depends on their health status, but he warns that younger and healthier people tend to have mild or moderate symptoms of this disease, so you might not know that they pose a risk. “The older you are, or the worse your health is, the more important it is to maintain space from younger people who can carry and transmit the virus, whether or not they have symptoms themselves,” he says.
How long will these precautions be necessary?
There is no way to know for sure how long these precautions will be necessary. It could be as long as a few months, or perhaps a little shorter or longer. It’s really difficult to say.
“I do think the answer is also dependent on the current status of the outbreak in one’s community,” says Dr. Hladek. “For example, some places with more community acquired infection are shutting down schools for six weeks. Others are choosing two weeks for now. Churches are suspending services. The short answer is that we don’t know. The hope is that our efforts at handwashing, disinfecting, and social distancing will mitigate the spread. And given the long incubation period, we may need to engage in social distancing for longer than we anticipate right now.”
What if you get sick?
Dr. Amy L. Darter, medical director for the Oklahoma Institute of Allergy, Asthma & Immunology in Oklahoma City recommends using the internet to take care of some tasks that would normally require you to go out. “If you’re sick, try to do a doctor’s visit online. It’s important to stay home and stay isolated, so try to order necessities online, too. Definitely avoid crowds and medical facilities unless you are very ill or it’s a necessity.”
If you have respiratory symptoms and a fever, and you think you might have COVID-19, you should call your healthcare provider first before going to the office. They will ask you questions to determine whether or not you are at risk, and whether your illness is severe enough to be seen.
Based on your risk for COVID-19, your healthcare provider may recommend that you stay home and monitor your symptoms or report to a medical facility for evaluation and treatment. If you do have to go in, don’t bring children or anyone else unless you need their assistance. And if you have severe symptoms, such as a higher fever—above 103°F—or severe shortness of breath, go to the emergency room. Try to call ahead if you can.
In addition, the U.S. Centers for Disease Control and Prevention (CDC) recommend that you take measures to prevent the spread of the novel coronavirus to others, such as practicing the good hygiene practices listed above, staying away from other people and pets, not sharing “high touch” items, disinfecting surfaces frequently, and wearing face masks when you’re sick.