There’s a lot that the medical community is still learning about coronavirus, but one thing seems clear: Older adults, especially those with chronic health conditions, are at higher risk for infection.
We spoke with Dr. Manisha Juthani, an associate professor at the Yale School of Medicine, to learn more. She’s an expert on infectious diseases in older people.
Could you explain what we know about COVID-19 and older adults?
COVID-19 is caused by a virus that we’re finding is easily transmissible. For many younger people, it might just cause the common cold. But for older people whose immune systems are not as strong as when they were younger, or if they have other comorbid conditions which put them at more risk -- particularly lung conditions, which can make them at more risk for pneumonia -- that is what makes people more susceptible as they get older. And that is why there’s been a growing concern for patients that are older and have other conditions that could put them at high risk for infections.
What kind of preventive measures should assisted living facilities and nursing homes take to protect older adults?
Unfortunately, based on what we saw happen in Washington state, very quickly an entire nursing home was affected, and so this is our most vulnerable population. Obviously, they often are frail and older, and that’s why they’re there in the first place.
So what can nursing homes and assisted living facilities do? Number one is having hand sanitizer right in the front of the facility for anyone who’s visiting; even signs saying “please go to the restroom and wash your hands before you go visit a loved one.” Secondly, I think even symptoms such as common cold symptoms, sniffles, just a runny nose -- if you have a loved one who lives in a facility like that, this is not the time to visit.
We are so fortunate to have technology these days with things like video conferencing. You can still see a loved one if they are able to interact with you in that way, and that’s the way to do it right now.
What is your advice to older adults who want to go to the theater, to concerts, to a sporting event, or to church?
I think the major thing there is your own risk tolerance. We’re all going to have our own internal scale for what is most important. Is it very important to you to go to church and to be in front of your pastor or minister and be able to have solace in a time that is very stressful? Well, then, maybe that is the one thing that is very important for you to go to. However, if you could watch a movie on demand or on Netflix, maybe you opt out of that particular outing.
I think we really need to listen to our public health officials and listen to what guidance we’re getting. I don’t think there’s one answer for everybody. Everybody is going to have to make their own judgment calls. And that’s difficult. We’d all like to have somebody to tell us what to do. But I don’t think that that can happen. I think we all have to listen to guidance and try to make decisions accordingly.
It just seems like at times we’re hearing mixed messages.
A lot of people ask me, I don’t know what to think about this. On one hand, I hear people telling me not to panic. On the other hand, I have people on TV telling me this is something we have to be very concerned about. And the reality is, in some ways both are true.
People have to recognize that for those patients who get sick and who are vulnerable to begin with, this infection seems to be quite serious. The flip side is that the vast majority of patients -- out of some data that we got out of China -- 80% of people are having mild disease. That is the common cold, sniffles and cough. People will get over that.
So the only way the public health system can really deal with this is social isolation, hand hygiene, covering your mouth when you’re coughing, trying to maintain some distance. Try to heed the evidence and advice from our public health officials, because they’re the only ones that can really guide us in a sane way.
And at the end of the day, if we’re all a little bored hanging out at home alone, that is not a terrible thing! A little bit of social isolation is not going to hurt anybody. We are so lucky to have all these forms of entertainment at home. Why not take advantage of that? Get used to a little bit of boredom! It’s going to go a long way in the long run.