When Nadine Dorries, UK’s health minister, tested positive for coronavirus, the 62-year-old tweeted that she was more worried about her 84-year-old mother who was staying with her and had begun a cough.
It’s a sentiment many of us across continents can relate with, including 16-year-old Jaspreet Sidhu from Mohali, Punjab. Sidhu studies in an international school where many of the students have just returned from places such as Italy and the UK for the new academic session. Her grandparents, who normally stay in Delhi, have come to Punjab for a while because of the COVID-19 outbreak.
“They are quite old and suffering from various geriatric ailments. They cannot bear any more viral load like corona. I cannot hug them the way I used to do earlier and need to change my uniform and take bath before entering their room. They need to be protected,” Sidhu told HuffPost India.
Her mother is also worried about their health. She works in a private bank and meets hundreds of people every day, including many NRIs in Punjab.
“Some of them have arrived from Corona-affected countries. After arriving in India, they feel safe and hence do not take many precautions. This has put the health of my colleagues and family in jeopardy,” she said, adding that her bank has not taken any preventive measures except issuing an advisory.
How serious is the scare?
A study, the largest published so far on the outbreak of coronavirus, by the Chinese Centre For Disease Control and Prevention and published in The Journal of the American Medical Association (JAMA) in February this year said that the Case Fatality Rate (CFR), which is reported at 8% in people between the age group 70-79 years, has jumped to 14.8% in people above 80 years. The CFR was reported to be as high as 49% for people under critical care.
These numbers are of concern to anyone worried about their elderly relatives, especially Indians who live in large families that include people across age groups. This is especially so if the old people suffer from chronic medical conditions including heart disease, eye disorders or diabetes
Geriatric care (healthcare for elderly people) facilities are still underdeveloped in India.
“The threat from Coronavirus is much more in elderly people than a young individual due to medical complications due to their age. In countries like India, where there is a joint family culture, utmost precautions are required to keep them away from mass gatherings,” said Dr. Manoj Goel, director and head, Pulmonology, Critical Care, Fortis Memorial Research Institute, Gurugram.
He added that elderly people should stay in clean, well-ventilated rooms and the household items they use, such as light switches, toilets, taps, cellphones and doorknobs, should be regularly disinfected.
Soon after China first reported that people were getting infected with COVID-19, Chinese researchers identified the etiological agent now known as 2019-nCoV and published a viral sequence. The study pointed out that modelling the 2019-nCoV epidemic remains challenging as many questions are still unanswered.
Dr. Kamal Bandhu, a geriatrician at AIIMS, Delhi, said it is still unknown how the virus gets transmitted and under what conditions it will subside.
“If we look at the Case Fatality Rate (CFR) of CoronaVirus cases, it is reported that 8 out of 100 people who are less than 60 years of age have died but in people above 80 years of age, the rate is reported to be over 14%. Various studies conducted on the virus so far have claimed that more than 40% of people affected by Corona were above 60 years, said Dr. Bandhu.
He also added that due to the prevalence of immunosenescence (gradual deterioration of the immune system as one ages), an elderly person is more at risk.
Don’t stop the love
While staying in joint families and small houses can pose a risk, it should not be a deterrent in spreading love and affection among family members.
Dr. O.P. Sharma, senior consultant of geriatric medicine at Indraprastha Apollo Hospitals and general secretary of Geriatric Society of India, said that regular handwashing is helpful, and that infected people should wear proper masks and maintain a distance from immunocompromised people, young children and pregnant women. He also added that it may be indirectly helpful to consult a doctor on providing immunoboosters to elderly people.
Things to do if you have grandparents at home
These are the precautions recommended by experts.
1. In India where geriatric care is not that developed, one must be ready to face any exigency.
2. It is advisable to stock adequate material required to survive a quarantine or isolation period. For elderly people, this includes medicines, processed food and toiletries. While the situation in India is not as alarming as many other countries, some stock should be readily available at home.
3. Elderly people should be given clean and properly ventilated rooms. The household items they use, such as light switches, toilets, taps, cellphones and doorknobs, should be regularly disinfected..
4. They should avoid going to crowded areas such as markets, religious places, restaurants, shopping malls and movie theatres. This may be the best time to introduce them to technology such as FaceTime, WhatsApp or Skype by which they can stay connected with their friends and extended family members.
5. Yes, you can still hug them but before that ensure you take all possible measures to keep them safe and healthy.