Older individuals and COVID-19


Coronaviruses, named for its crownlike shape, are a large family of viruses that are common in many species of animals. Several coronaviruses can infect people, according to the Center for Disease Control and Prevention. These strains mostly cause cold-like symptoms but can sometimes progress to more complicated lower respiratory tract illnesses, such as pneumonia or bronchitis.

On rare occasions, animal coronaviruses can evolve and spread among humans, as seen with MERS and SARS. The virus at the center of the latest outbreak is being referred to as a novel (new) coronavirus, since it’s something that health officials have not seen before.

Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more severe complications from COVID-19 illness.

Symptoms of COVID-19 can range from mild symptoms to severe illness and death. Symptoms may appear 2-14 days after exposure. Watch for fever, cough, and shortness of breath.

Dr. Sonja Rosen, MD, is chief of geriatric medicine at Cedars-Sinai in Beverly Hills, CA, and has been practicing for 19 years. AZJL reached out to Dr. Rosen and asked her questions specifically related to older individuals and COVID-19. Here are the questions and her responses:

 

AZJL: Other than underlying health conditions, what makes seniors so vulnerable to COVID-19?

Dr. Rosen: With aging, the body produces fewer immune cells, including white blood cells. Older people are essentially somewhat immunocompromised, as the fewer immune cells also don’t communicate as well with each other.

 

AZJL: If a person is healthy, but over 65, are they still at a higher risk of complications?

Dr. Rosen: Yes, because people over 65 have fewer immune cells, which means it takes longer to react to harmful germs, and healing can be slowed.

 

AZJL: What are some medical conditions that make contracting the virus more difficult to recover from?

Dr. Rosen: The most significant diseases are underlying lung diseases, disease that compromise the immune system (like lymphoma or leukemia), undergoing treatment that compromises the immune system (like chemotherapy), severe heart disease, dialysis patients and people with diabetes.

 

AZJL: What are the best precautions seniors can take to avoid getting COVID-19?

Dr. Rosen: The best way to prevent illness is to avoid being exposed to this virus by sheltering in place at home. Remember that some people without symptoms may be able to spread the virus.  Wash your hands often.

If you absolutely have to go out for essential things like groceries or for medications from the pharmacy, make sure to wear a mask and again, wash your hands frequently. If available, wear disposable gloves.

If possible, try to have food and medications delivered instead of going out, and ask the delivery person to leave it outside your door so you can avoid face-to-face, in-person contact.

 

AZJL: What should they do if a household member or caretaker gets COVID-19?

Dr. Rosen: It is important to isolate from that caretaker or household member, paying special attention to not use the same bathroom or food products.

 

AZJL: Any other advice for seniors during this time?

Dr. Rosen: Try to stay physically active at home. There are a lot of video and online activities, including exercise classes. Try also to stay socially connected from home, calling your friends and family and using a video chat or FaceTime if you can. There are several online programs that combine exercise and socializing – check with your local department of aging to find out more. Reach out to your city or county if you are food or other supply insecure – there are multiple efforts to feed and help supply older residents with essentials – reach out for help.

 

The CDC also recommends that seniors develop a care plan. During the COVID-19 pandemic, having a care plan is an essential part of emergency preparedness.

A care plan summarizes your health conditions, medications, healthcare providers, emergency contacts, and end-of-life care options (for example, advance directives). Complete your care plan in consultation with your doctor, and if needed, with help from a family member or home nurse aide.

Care plans can help reduce emergency room visits and hospitalizations, and improve overall medical management for people with a chronic health condition, resulting in a better quality of life.

It’s also important to stock up on over-the-counter medications to treat fever, cough and other symptoms, as well as tissues and standard medical supplies.

Major health insurers have pledged to relax prescription refill limits on “maintenance medications” in the wake of the coronavirus outbreak. Prescription refill limits are also being waived for many Medicare Advantage and Part D beneficiaries.

If you run into difficulty stocking up on your prescriptions at the pharmacy, consider refilling your medications with a mail-order service, the CDC says. You can also ask your physician to switch your prescription from a 30-day supply to a 90-day supply to make sure you have enough medication to get through a potential COVID-19 outbreak in your community.

 

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