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What older people should do to protect themselves from coronavirus

CORONAVIRUS UPDATE: As experts learn more about the novel coronavirus, news and information changes. For the latest on the COVID-19 pandemic, please visit the Centers for Disease Control and Prevention.

Who is most susceptible to the coronavirus? Older adults, especially those age 65 and above, are at higher 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?

Two main factors contribute to increased COVID-19 risk among older adults: immune system changes and preexisting health conditions, according to Jeff Fortner, Pharm.D., a professor at Pacific University School of Pharmacy in Hillsboro, Oregon. 

“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.”

Data from the CDC shows that the death count for COVID-19 cases in the United States increases with each decade of life, with a noticeable difference after age 55.

RELATED: Who is at risk for coronavirus? People with chronic health conditions

What are some coronavirus prevention tips for older adults?

The four most important steps you can take are:

  1. Handwashing
  2. Physical distancing
  3. Mask wearing
  4. Disinfecting surfaces 

You should also avoid touching your nose, mouth, or eyes with unwashed hands.

Physical distancing means maintaining a distance of at least six feet from everyone you see out in public, says Melissa D. Hladek, Ph.D., CRNP, an assistant professor at the Johns Hopkins School of Nursing in Baltimore. She prefers the term “physical distancing” to “social distancing” because it is important for older adults to still socialize with friends and family members, but they need to maintain that physical space to stay safe from COVID-19.  

If eating in restaurants is an option in your area, Hladek recommends outdoor dining. Just make sure to bring disinfecting wipes so that you can clean any eating and commonly touched surfaces, and keep hand sanitizer with you so you can disinfect your hands even when handwashing isn’t possible. 

RELATED: The do’s and don’ts of preparing for coronavirus

Is it safe to go to indoor public places, like libraries, supermarkets, churches, and restaurants?

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,” Hladek says. 

Whether you’re inside or outside, everyone—including older adults—should wear a face mask (cloth face masks are best) when around others. Dr. Fortner also recommends checking local news for announcements from the state and local government leaders and their health departments. “These groups work to decide what safety restrictions, such as mask wearing, limiting group sizes, and how much social distancing, are necessary,” he says. 

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. 

“It depends on the outdoor space and how many people are there,” Hladek says. “If you are at a baseball game with a lot of spectators, and especially if your area has a high rate of infection, there is a greater risk of being exposed to the virus. But if you are out for a hike and there are very few people around, the risk is lower.”

Infectious disease experts believe that the virus is spread primarily through respiratory droplets from infected people. When an infected person speaks, sneezes, or coughs, they release microscopic droplets of the virus into the air. If an older adult is nearby, they can breathe in those droplets and become infected. There is also evidence that the virus can live on surfaces for many hours and can be spread that way, too.

“Outside, there is much more air to disperse any droplet particles, lowering the risk,” Hladek says. “But even if you are outside, you should still physically distance yourself from others, and wear a mask whenever you can’t stay at least six feet away. That will reduce your risk of both contracting the virus and spreading it to others.” 

In order to minimize the risk of coming into contact with the virus, older adults should also avoid touching shared surfaces like handrails and door handles. If they take these precautions, Dr. Fortner says, 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?

“People who are 65 or older, as well as people with chronic medical conditions, should be more cautious about meeting other people, including family members,” says Soma Mandal, MD, a board-certified internist and partner at Summit Medical Group in Berkeley Heights, New Jersey. “Ideally, meeting people outside with face masks is recommended.” 

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 COVID-19, or even be carriers of the disease with no symptoms at all, so they 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. 

Hladek agrees that it is important for older adults to avoid close contact with people they don’t live with whenever possible, but she stresses that it is very important that they continue to socialize and exercise, despite these precautions.

“We know that the stress of this pandemic is also exacerbating everyone’s coping abilities,” Hladek says. “Older adults predisposed to anxiety, depression, or loneliness may be feeling the effects more acutely. … Loneliness and despair are both really bad for your health.”

RELATED: Protecting your mental health while social distancing

What if you get sick?

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 infection, your healthcare provider may recommend that you stay home and monitor your symptoms or report to a medical care 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 degrees Fahrenheit—severe shortness of breath, new confusion, or persistent chest pain or pressure, go to the emergency room. Try to call ahead if you can. 

RELATED: How can healthcare workers protect themselves from coronavirus?

For preventive care and management of chronic illnesses, telehealth appointments may be available to you. Medicare Part B covers some online health services. Depending on where you live, Medicaid services may also include telemedicine.

In addition, the U.S. Centers for Disease Control and Prevention (CDC) recommend that you take measures to prevent the spread of COVID-19 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.