Jun 17, 2020 - Health

Saving the elderly from coronavirus

Illustration of a nurse pushing a senior citizen in a wheelchair with binary code lighting up in the background

Illustration: Annelise Capossela/Axios

As the elderly, especially those in nursing homes, bear the brunt of deaths from COVID-19, new approaches and tools to keep them safe are emerging.

Why it matters: Seniors are much more susceptible to the novel coronavirus, and the conditions in many long-term care homes facilitate the spread of COVID-19. Independent of the current pandemic, America and much of the world is aging rapidly and is in need of technologies to care for them.

Driving the news: More than 50,000 people in nursing homes and other long-term care facilities have died from COVID-19, according to a tally released on June 16 by the Wall Street Journal. That's nearly half of total U.S. deaths from the virus, and it doesn't count the many seniors living independently who succumbed to the disease.

  • The death toll in U.S. nursing homes since the beginning of the epidemic has been nothing short of horrific: 6% of New York state's more than 100,000 nursing home residents have died of COVID-19, while Michigan lost 5% and New Jersey 12%.
  • "COVID-19 has shown that we simply aren't prepared to care for the elderly," said Lily Parsey, the global policy and influencing manager at the International Longevity Centre, at a recent webinar.
"Nursing-home residents aren't getting half of our resources or half of our attention, yet they account for roughly half the deaths. We don't value their lives as much as other people's."
David Grabowski, health care policy professor at Harvard University

What's happening: There are steps that can be taken to protect seniors from both COVID-19 and the effects of the lockdown.

  • Regularly testing workers would be one of the most effective ways to stem outbreaks among the elderly, but testing all 3 million of the country's nursing home workers and residents just once would cost $672 million. While nursing homes received nearly $5 billion in stimulus money for coronavirus, facilities also need to cover additional expenses to protect against the virus, even as they lose residents and are largely unable to take in new ones during the pandemic.
  • Harvard's Grabowski, who advises Congress about Medicare, has proposed a federal effort to regularly test nursing home staff and residents and procure greater supplies of personal protective equipment (PPE). In an op-ed for USA Today, former Senate majority leader Bill Frist and Martha K. Presley of Vanderbilt University Medical Center suggest that pooling tests could reduce costs by as much as 80%.
  • Florida banned the transfer of COVID-19 patients from hospitals back to care facilities, which helped keep death rates among the state's nursing home residents much lower.

Technology could play an increasingly important role as well.

  • CarePredict sells a wearable device called Tempo that tracks indoor location, pulse rate, blood-oxygen levels and more. Originally targeted as a way for caregivers and family members to monitor the physical and mental health of seniors, Tempo is now being used to tackle COVID-19, including contact tracing.
  • "If an individual tests positive for COVID-19, [caregivers] can go into the software, select the individual and rewind the last 14 days to see who they made contact with and the duration and length of that contact," says Jerry Wilmink, CarePredict's chief business officer.

Context: Protecting the elderly from COVID-19 would be difficult enough in the best of conditions, given how much higher the fatality rate is for those over 75. But conditions in many of the U.S.'s 15,000 nursing homes are anything but ideal.

  • Too many facilities are understaffed, and pay is often so low that 42% of workers who care for older people are on some form of public assistance.
  • Especially early in the outbreak, many nursing homes struggled to source the PPE needed to prevent residents from spreading the virus between each other — and even more importantly, to keep younger staff who live in the community from bringing the virus into the facility.

As if the effect of the virus itself isn't enough, the lockdown policies instituted to stem the spread have had a major effect on the elderly, who already suffer disproportionately from loneliness and depression.

  • In-person visitors have been banned from nursing homes for months, while families have been advised to keep clear of seniors living independently to prevent spreading the virus to them.
  • The resulting loneliness and isolation, says York University psychology professor Gordon Flett, "is seen as a cause of mortality, not just a correlation."

The big picture: According to the UN, for the first time in history, people aged 65 or above now outnumber children under the age of 5 globally, and by 2050, the number of people 80 or above will triple to 426 million. The pandemic has exposed the vulnerability of an aging society and the need for new innovations to protect them.

The bottom line: COVID-19 has been a tragedy for the elderly, but if we're smart, it will be an opportunity to rethink how we approach a future — growing old — that nearly all of us will share.

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