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For the elderly, there is the real pain of being isolated, vulnerable to COVID-19

By Mona Sabalones Gonzalez Published Oct 05, 2020 6:28 pm

COVID-19’s capacity to hit the brain may cause a dementia-like syndrome, psychosis and strokes in the elderly. It’s worse if they have two or more comorbidities. 

“How are you handling the stress from COVID?” a friend asked me recently. 

 I am 66 years old, which puts me in the second most affected age group by death from COVID-19 in the Philippines (age 60-69, 29.2%), a WHO report on the Philippines says. The most affected age group from death by COVID is 70 and older, at 34.7%.

I initially dealt with COVID by denying it. I avoided the news and just read what I needed to know to keep safe, which was mainly to stay indoors.

They came outside to say goodbye, wearing masks and physically distant. My brave friend shed a few tears, saying: I couldn’t hug my grandchild.

My husband got me some masks and a face shield, which I used at home because I’m allergic to dog hair, and my dogs were shedding. 

But when you’re a writer, you can’t avoid writing about the things that matter most. My first COVID-19 article was about the pangolin which, at the time, was being blamed as the intermediary animal between bats and humans. 

 My second article was about bats, which carry a lot of coronaviruses, including the virus SARS-CoV-2, which leads to COVID-19.

Humans don’t get COVID-19 from bats. An intermediary animal is needed, through which the virus can transform to a structure that can latch onto human cells. 

We are learning new things about COVID every day. For example, in the past it was believed to attack only the lungs. Now, there is the growing belief that it can also attack the brain, kidneys, blood, and heart. There may also be long-term effects such as lung scarring, and poorer ability to exercise, which are called “post-COVID lung disease.” 

This is the first time that an article I am working on really scares me, because it’s about the possibility of elderly people getting the virus even if they stay at home.

So far, I haven’t come across stories of that, but the same can’t be said about elderly people who live in nursing homes.

There are many stories of COVID-19 spreading through people living in these care homes all across the world.

The most heartbreaking story is in Belgium, a rich country that denied care to people from nursing homes who had COVID-19, even though the country has 1,100 hospitals. At the peak of COVID-19, 2,400 free beds were available in the ICUs of these hospitals. 

A July report from Doctors Without Borders said that Belgian hospitals ordered their paramedics not to accept patients aged 75 and older, and in some cases, aged 65 and older.

Instead, they were given morphine to ease the elderly into death. 

Belgium, on a per capita basis, has among the largest nursing-home populations in the world.

In the Philippines we have a sizable number of nursing homes but the general perception of Filipinos is that we should take care of our elderly. 

The elderly are vulnerable because our immune systems are more susceptible to pathogens, and our ability to respond to novel antigens is compromised, as is our memory response.

It seems that the US is starting to think similarly because there is the heightened possibility that elderly people who are living in nursing homes are more vulnerable to COVID.

Because of this, some families have pulled loved ones out of nursing homes so they can live comfortably in the family dwelling.   

Why senior citizens are at the greatest risk

According to the Center for Disease Control, the older you are, the greater your risk of getting a severe bout of COVID-19 that can lead to death.

The elderly (60 and up) are vulnerable because our immune systems are more susceptible to pathogens, and our ability to respond to novel antigens is compromised, as is our memory response.

 We also have higher autoimmunity (an overactive immune system that attacks healthy cells). Inflammation normally occurs when a healthy immune system is fighting off pathogens and/or damaged cells.

But if an elderly person has autoimmunity, plus prolonged periods of inflammation, it only lends more time for one’s autoimmunity system to kill more healthy cells. 

Adding to this unhealthy mixture is the presence of comorbidities with age, such as hypertension, diabetes, obesity, bronchial asthma, chronic kidney disease, and/or cardiac disease, to name a few.

It’s worse if we have two or more comorbidities. 

For example, my 70-year-old friend in the US is a two-time cancer survivor who smoked for 35 years before she kicked the habit. Despite having always led an active lifestyle, she has been staying at home because she wants to live.

I initially dealt with COVID by denying it. I avoided the news and just read what I needed to know to keep safe, which was mainly to stay indoors.

Grandchildren are a great reason to live and my friend’s days are brightened by their online visits. When her grandchild had a birthday, everyone stayed inside the house so that she could decorate their garden and leave a gift behind.

They came outside to say goodbye wearing masks and physically distant. My brave friend shed a few tears saying, “I couldn’t hug my grandchild”.

Symptoms of COVID among the elderly 

The normal early warning signs according to the CDC are fever, constant coughs, shortness of breath, muscle aches, and loss of smell and taste.

However, among the elderly there are more eclectic symptoms. This is because geriatrics have a wider range of incidents that affect their normal reflex actions. 

For example, strokes and/or mental decline, among others, affect our reflex action. The weakened reflexes may make some of us unable to cough, and a compromised immune response may leave us fever free—two warning signs of COVID.  

Instead, one should look for symptoms that are more pronounced in senior citizens such as:

  1. Disorientation, confusion
  2. Imbalance
  3. A tendency to tire more easily
  4. Lethargy
  5. Collapse  

Real pain

Every day, something new is learned about COVID -19. We recently learned, for example, that there may be long-term effects post-COVID-19, including mental and neurological effects such as deep cognitive impairment, dizziness, headaches, and loss of taste and/or smell.

Wes Ely, at pulmonologist at Vanderbilt University Medical Center, told STAT  “The problem for these people is not over when they leave the hospital.”

I have also just learned that COVID-19’s capacity to hit the brain may cause a dementia-like syndrome, psychosis, and strokes, according to a study that was featured in The Lancet.

COVID is physically painful even for young people, and the hospital bill can wipe up your retirement savings.

In the Philippines, the youngest person who died from COVID was about a month old. On top of the experience of genuine pain and the high cost of hospitalization, there is the very real possibility of death.

These are three exceptionally good reasons why we should isolate ourselves, wear masks outdoors, and practice distancing. We should do everything it takes to prevent ourselves from catching the virus.