The challenges of the COVID-19 pandemic are different for various socio-demographic groups, and Medical News Today has zoomed in on the ways in which this crisis has affected the more vulnerable ones. In this Special Feature, we focus on how the pandemic has affected older adults.
As part of a new series of features, MNT has looked into how the pandemic affects women’s reproductive rights, people that may find themselves in an abusive relationship, as well as the mental health of people of color and those belonging to an ethnic minority group.
In this Special Feature, we examine the impact that the pandemic has had on another group that gets frequently overlooked: older adults.
From the likelihood of developing a more severe form of COVID-19 to the risks of isolation and mental health problems, this feature looks at ways in which older adults have taken the brunt of the pandemic.
The COVID-19 disease, in itself, has hit older adults harder than other age groups.
Older adults are more likely to already have underlying conditions such as cardiovascular disease, diabetes, or respiratory illness — comorbidities that we now know raise the risk of severe COVID-19 and COVID-19-related death. In addition, a likely weaker immune system makes it harder for older adults to fight off infection.
As a result, the impact on older adults is notable. According to World Health Organization (WHO) data from April 2020, more than 95% of COVID-19 deaths were among people over 60 years of age, and more than half of all deaths occurred in people of 80 years-plus.
In Sweden, for example, 90% of the deaths from COVID-19 were among people more than 70 years of age.
The Chinese Centers for Disease Control and Prevention offered data in March showing an average COVID-19 case fatality rate of 3.6% for adults in their 60s, 8% for those in their 70s, and 14.8% for people 80 years and above.
“Older adults are at a significantly increased risk of severe disease following infection from COVID-19,” said Dr. Hans Henri P. Kluge, WHO Regional Director for Europe in a WHO press briefing, who added:
“Supporting and protecting older people living alone in the community is everyone’s business.”
While the wider community should indeed be preoccupied with the health and well-being of older adults, there are epicenters to the current crisis, and nursing homes, alongside hospitals, are one such place.
The United States Centers for Disease Control and Prevention (CDC) warn that “nursing home populations are at the highest risk of being affected by COVID-19,” compounding not only the risk for older people but also placing care workers at risk.
The New York Times (NYT) gathered recent data showing that in the U.S., at least 28,100 residents and workers have died from a SARS-CoV-2 infection in a nursing home or in another long-term care facility for older people.
Overall, more than a third — that is, 35% — of all COVID-19 deaths in the U.S. occur in long-term care facilities, comprising residents and workers.
“While just 11 percent of the country’s cases have occurred in long-term care facilities,” say the authors of the NYT report, “deaths related to COVID-19 in these facilities account for more than a third of the country’s pandemic fatalities.”
In other parts of the world, the situation looks dire, too. Data collected by researchers at the London School of Economics (LSE), in the United Kingdom, suggest that the majority of COVID-19-related deaths occurred in nursing homes.
In Belgium, for example, 53% of the country’s entire number of COVID-19 deaths occurred in care homes.
- In Canada, this proportion was 62%.
- In France, the figure ranges from 39.2–51%.
- In Spain, 67% of all COVID19 deaths occurred in care homes.
- In the U.S., nearly 60% of all care home-related COVID-19 deaths occurred in the state of New York.
The danger of the new coronavirus spreading in care homes, and affecting workers as well as residents, is amplified by the fact that most of the cases doctors confirmed in these environments were asymptomatic.
In Belgium, for example, 72% of staff diagnosed with COVID-19 showed no symptoms at the time; neither did 74% of the residents who had tested positive for the new coronavirus.
Despite these alarming figures, the U.S. federal government are not keeping track of this data. Withholding key nuanced information about whom the pandemic is affecting hardest is in the way of directing resources where people need them the most.
“It’s impossible to fight and contain this virus if we don’t know where it’s located,” David Grabowski, a professor of healthcare policy at Harvard Medical School, told NBC News.
Prof. Grabowski added that knowing this information could help predict where the next outbreak will be; other NGO advocates agree that knowing which nursing homes have the highest number of cases can help states direct resources where the need is the greatest.
According to the CDC, at least half of the older adults living in these care facilities have Alzheimer’s disease or other forms of dementia, which makes it more difficult to contain possible infections with the new coronavirus.
One of the specific challenges for people living with dementia and similar forms of cognitive impairment is that they may have difficulty understanding the dangers of infection. Also, they may forget to follow safety precautions, such as washing their hands or practicing physical distancing.
Those who care for people with dementia and have contracted the virus may also avoid seeking treatment or being hospitalized because they cannot afford to leave their elders alone.
On the other hand, people with dementia themselves who have COVID-19 and need hospitalization may avoid it because they fear that, due to hospital triaging protocols, they may fall at the bottom of the ladder when it comes to receiving medical resources and attention.
Furthermore, people may be discouraged from seeking medical attention for dementia itself if they start to display symptoms; memory clinics are shutting, as seeing new patients is perceived to be riskier than for some people not to receive a dementia diagnosis.
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