Special COVID-19 messaging for the elderly

EVEN AS they continue to communicate the risk of the COVID-19 virus to the general population, it is urgent that Jamaica’s health authorities begin to target specific messages to, and plan special interventions for, the most vulnerable cohort – the elderly, or people in the over-60 age group. The broad data on the virus, and the evidence from Italy, suggest that they should.

Up to yesterday, just shy of 175,700 cases of the virus had been reported in 162 countries, with 6,715 deaths, or a fatality rate of 3.8 per cent. This ratio, though, is likely to be exaggerated, given that limited testing, thus far, may be underestimating the prevalence of the virus.

What is known, however, although this may not as yet be the case in Jamaica, is that wherever COVID19 takes hold, it is older people who are at greatest risk of dying. The scientific data indicate that most people who contract the virus will come through it relatively unscarred, similar, perhaps, to having a bad case of the flu.

Indeed, up to yesterday, 44.3 per cent of the people who have had the disease had recovered, while of the just over 91,000 still active cases, 93 per cent was considered to be mild. Seven per cent (5,967 cases) were serious or critical. The problem for those with a serious, or critical, form of the disease is that the older they are, the greater the probability they could die. This danger is exacerbated for patients with underlying medical conditions, such as diabetes, or hypertension, whatever their ages.

For instance, when China – where nearly 81,000 have contracted COVID-19 and 3,213 have died – was still the epicentre of the virus, around 15 per cent of persons 80 or over, who contracted the disease, could be expected to die. That ratio nearly halved, to eight per cent, for persons in their 70s, and fell further, to 3.6 per cent, for those in their 60s. It was 1.3 per cent for people in the 50-plus age group and between 0.4 per cent and 0.2 per cent for younger age cohorts.

Italy, the new epicentre of the virus, with more than 24,700 cases and 1,809 deaths, appears to have confirmed the earlier observations. Their fatality rate, on the current numbers, is 7.3 per cent, or nearly twice the global average. Overwhelmingly, the persons who have contracted the virus in Italy are over 63, and during its first wave, the youngest was 55. Most of the deaths have been among people in their 80s, or older.

ITALY A GUIDE

The demographics of Italy seem to predispose it to COVID-19’s bias towards the elderly. With 60.4 million people, it has the oldest population in Europe with a median age of 47.3, compared to 40.5 in Britain and 38.2 in the United States. Further, 23 per cent of Italy’s population is 65 per cent or older.

This kind of information, it seems to us, should be a guide to Jamaica’s policy planners, and public health official, in fashioning the messages, and strategies, for combating the virus. We suspect that most of the island’s 15 reported cases are young people, but that might soon shift towards the global trend as community transmission takes hold.

Jamaica, of course, has a relatively young population, with a median age of 30.7. And, based on 2018 data, an estimated 13.2 per cent of its population is 65 or older, which is 10 percentage points below Italy’s. However, that represents more than 360,000 people, which, in the context of a small country, is a lot of people who could place a tremendous burden on a fragile health system.

Clearly, as the authorities have been doing, the emphasis of the public health messaging has to be on prevention. But there has to be, in this circumstance, information specifically targeted to the elderly, on how to avoid the virus, and for their immediate case, should they contract it.

The policies and programmes should also include psychological support for old persons who may be anxious about the disease and who may be asked to stay in isolation to protect their health.

Looking at the global impact, I believe this is a fitting time for our government to refocus on our agronomy effort. We need to urge our farmers to produce, produce, produce! We need to become self-sustainable.

The opinions on this page, except for The Editorial, do not necessarily reflect the opinions of The Gleaner.