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Why cocooning elders from COVID-19 infections is key

 


As the number of cases and deaths related to COVID-19 rise in the State, the percentage of the elderly among these tallies is constantly growing and, as expected, the case fatality rate is relatively higher among the above-60 age group.

Over 55% of the total deaths (397) occurred among the elderly population, and within that subset, elderly males accounted for an unusually high percentage – 73.5. Paying attention to the elderly, as epidemiologists and experts have been saying since the relatively early stages of the pandemic, has clear advantages in reducing the fatality rate in a State or a region.

“The case fatality rate (CFR) seems to be age-dependent, with a higher percentage among the elderly, especially men, and an overall interim CFR of approximately 1% – 3%,” according to ‘SARS-CoV-2 Vaccines: Status Report’ by Amanat and Krammer, published in the journal Science Direct. In Tamil Nadu, the percentage of people over 60 years of age among the total number of positive cases has been increasing over the months. While this is to be expected as the testing base widens, what is worrisome is that among the elderly, the CFR is 4.45% — even higher than the 1%-3% reported across the world. In comparison, the CFR among the general population is 0.9%.

Other global studies have also showed that people who are older and those who have co-morbidities are more susceptible to the infection and are at a higher risk of developing complications. “Epidemic management must be place- and people-specific,” said P. Kuganantham, former Corporation Health Officer. “This is to say that we need to look at the areas that need to be addressed for every area and for groups of people. So, now, because of the risks of transmission of this virus, we need to focus on the group of elderly citizens in our community,” he added. While acknowledging the need for more testing, he made a case for focused testing of high-risk groups, including senior citizens. “If you take care of the vulnerable population — making sure they do not catch the infection or [ensure that they] have their health parameters under control — then the bulk of the work is done.”

Epidemiologically, the elderly population also bears the heaviest burden of non-communicable diseases, leading to heightened vulnerability in the COVID-19 scenario. While reverse-quarantining or sequestering elderly people who have not yet tested positive is being tried in some places, a great deal of mental health issues have to be handled as well, a State health official said.

Health secretary J. Radhakrishnan said the government was conscious of the need to take care of this group of people. In Chennai alone, 1.50 lakh elderly people are registered with the Corporation. “Volunteers call them regularly to check their health status, whether they are getting/taking their pills regularly, and if they have any symptoms. We also help them get tested. This is our ‘Cocooning the elders’ project. There is also a proposal to use the 500-bed facility at National Institute of Ageing, Guindy, as a unit to specifically take care of the elderly who test positive.

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