Your coronavirus questions, answered: What seniors and caregivers need to know

March 2, 2020

As cases of the coronavirus spread across the U.S. and a growing number of countries, so does fear about the disease it causes, which is called COVID-19. The virus  — also referred to as a novel (new) coronavirus, or SARS-CoV-2 — was first detected in Wuhan, China at the end of 2019, and recently led to an outbreak at a Kirkland, Washington state nursing home. Four residents of the nursing center have died, while four other residents of the center, as well as a worker there, were diagnosed with the virus, according to The New York Times

As of Tuesday, March 3, the Centers for Disease Control (CDC) clocked the total number of cases in the U.S. at 60. Nine patients, all in Washington state, have died, reports NPR. The status of the remaining cases has not been reported. (The CDC says the latest numbers will be reported daily on their “situation summary” site.)

People concerned for senior loved ones’ safety have good reason to be on high alert, according to Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC), who said during a press briefing on Monday, March 2, “The data coming out of China continues to say that the people who are at higher risk for severe disease and death are those who are older and with underlying health conditions.” According to early information from China, the median age of deaths is 75 years old with an overall mortality rate of 2% of those infected. 

Here, what experts say senior caregivers need to know about coronavirus. 

What exactly is coronavirus?

Although we’re referring to this particular virus as coronavirus, the term generally refers to a family of seven viruses that cause a wide variety of illnesses ranging from the common cold to more serious conditions for humans, such as SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome), explains Dr. Rodney Rohde, Ph.D., Chair of the Clinical Laboratory Science Program and Associate Dean for Research for the College of Health Professions at Texas State University. The concern with the new coronavirus is that it is genetically related to MERS (which was first reported in Saudi Arabia in 2012) and SARS (which spread to 29 countries between 2002-2003), and during those previous global epidemics, the fatality rate was between 10 and 35%. 

Another worry, according to Dr. Gustavo Ferrer, MD FCCP, pulmonologist, founder of the Cleveland Clinic Florida Cough Clinic and a board member for the NCQA’s Geriatric Measurement Advisory Panel: SARS-CoV-2’s higher mortality rate than similar viruses. Seeing a virus that’s highly contagious mutate into one that’s potentially deadly is definitely concerning, he notes.

Why are seniors more vulnerable?

Infectious diseases, such as COVID-19, generally pose a greater risk to older people for multiple reasons:

A less effective immune system

Typically, the body mounts an immune response to an invading bacteria or virus. This might not be a problem for young patients as their body fights it off, but it can be devastating for older loved ones because our immune systems gradually become both weaker and slower as we age, Rohde notes. “Due to those weaker immune systems seen in the elderly — and other immunocompromised people — they can't mount a strong enough response to ‘clear’ their lungs or ‘catch up’ to neutralizing the virus,” says Rohde.

Chronic conditions

The elderly are also most at risk, because as we age, we have a higher chance of suffering a chronic condition that debilitates the immune system. “This includes diabetes, smoking addiction, chronic respiratory problems and cancer,” says Ferrer. 

Living arrangements

The elderly community is more likely to be in close contact with others who have infections, thanks to senior care living environments and frequent doctors’ appointments, he notes.

Certain prescriptions

A side effect of some prescriptions: hindering seniors’ immune systems. “There are many medicines that elderly patients take that might lower their defense mechanisms and the most notorious ones are going to be steroids — anti-inflammatory medications like prednisone, medrol and antirheumatic medications that people take for rheumatoid or severe arthritis, as well as medications that people take for cancer,” he says. Ferrer recommends touching base with the senior’s doctor to discuss the possibility of changing or lowering the dosage.

How seniors can reduce risk of coronavirus infection

While a vaccine is in development, at present, known medications are ineffective in preventing or treating COVID-19, which means that the best way to prevent the illness at this point is to avoid being in contact with it, according to the CDC. But instead of completely quarantining yourself and loved ones out of fear, Ferrer recommends that caregivers and the elderly take these 11 precautions to avoid the virus and stay healthy. 

1. Lean into disinfectants

SARS-CoV-2 spreads when an infected person is within 6 feet of another individual and a viral droplet becomes airborne when they cough or sneeze — or through contact with an infected surface, Ferrer notes. That said, senior caregivers should practice good hygiene.

The CDC recommends washing hands often with soap for at least 20 seconds, especially before eating and after using the restroom. If soap and water isn’t available, use a hand sanitizer that’s at least 60% alcohol.

2. Be aware of your surroundings and consider social distancing

If you or your senior loved one happens to be in the same space as someone with an infection, it’s important to monitor proximity to them. The CDC is also advising affected communities to consider social distancing, which is defined as “remaining out of congregate settings, avoiding local public transportation (e.g., bus, subway, taxi, ride share), and maintaining distance (approximately 6 feet) from others.” 

3. Reconsider doctor’s appointments 

If you’re the caregiver of a senior who has chronic conditions that could weaken their immune system, Ferrer advises avoiding visiting places that could increase their chances of coming into contact with an infected person. Especially in counties where cases of coronavirus have been identified, he advises that caregivers keep in touch with the senior’s doctors and discuss postponing unnecessary visits. 

4. Try nasal sprays

Ferrer highly encourages both caregivers and older loved ones to use over-the-counter saline nasal sprays with xylitol, which can help prevent bacteria from adhering to nasal passages, as a daily defense against the coronavirus. He recommends using multiple doses two to three times a day.

5. Support the immune system with hydration and nutrition 

Because our sense of thirst diminishes with age, Cleveland Clinic warns that dehydration is an often overlooked health risk in the senior community. According to Mayo Clinic, a general rule of thumb is 3.7 liters of fluids for men and 2.7 liters for women.

You’ll also do well to emphasize the maintenance of healthy diet, high in antioxidant-rich fruits and vegetables, which is also critical for keeping defenses up, notes Harvard Medical School

6. Maintain physical activity 

Instead of quarantining elderly loved ones to their room or home, encourage them to remain physically active, ideally outside. This will promote good circulation and encourage the body to clear mucus from the airways, lowering the probability of viruses sticking to the lungs, according to Harvard Medical School

There’s also a mental health benefit: “If we all just become attached to the TV, waiting for something bad to happen, we are not participating in daily life, and psychologically, there is a great likelihood for older people to become depressed or anxious,” Ferrer says.

7. Stop or curb smoking

Smokers and vapers may not realize  this habit can increase their chances for infection, Ferrer points out. “Smoking damages the lining of the lungs, which acts as the main defense when the virus first comes into contact with the respiratory system,” he notes. 

8. Rethink wearing a mask 

Masks are only truly effective for people who are already sick, as they help to decrease the spread of infection but do little to prevent a healthy person from catching it. What’s more, if you’re healthy, wearing a mask might elevate your risk of infection. “If any virus gets into that little space, you're going to have a direct inhalation process,” Ferrer explains. 

That said, the mask could be indicated for someone who is predisposed to respiratory illness and has to go to a doctor’s office or other locations where they’ll be in close proximity to individuals who are sick. 

9. Don’t overlook the flu shot

Ferrer explains that despite coronavirus fears, the flu is still the bug elderly patients have the greatest chance of coming into contact with. “We have a vaccine that has potential for benefiting patients, so it should be a no-brainer to take advantage of that,” says Ferrer.

10. Be aware of “high-touch” surfaces

“High-touch” areas, which include handrails and touch screens in public places should be avoided whenever possible. Rohde emphasizes being aware of contact with these areas so that you can deliberately avoid touching your face after if you do make contact. “I've even talked to others about using your key to touch elevator buttons instead of your fingers,” he says.

11. Curb panic with preparation 

“Panic will create more problems than solutions,” says Ferrer. “Instead, what we should be is prepared and look for information from trusted resources.” 

To that end, Rohde suggests taking a break from social media if it’s causing anxiety. “Remember, there are many types of microbes in our presence each and every day — common colds, flu, measles, which is sadly making a comeback, and whooping cough,” says Rohde. “Maintain context and perspective as you educate yourself and others.” 

Tips and stories from parents and caregivers who’ve been there.

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