Should seniors, even doctors, be going to work?
My plan was to stroll El Matador Beach in Malibu, then drive to Griffith Park for a hike, both of which could be done while maintaining a safe distance from anyone.
But I’ve had a Medicare card in my wallet for a year and a half, and on Sunday, Gov. Gavin Newsom told me along with the state’s other 6 million seniors to self-isolate at home until further notice.
The coronavirus, of course, carries a higher danger for older folks. “We are prioritizing their safety,” Newsom said. I’m still getting used to being called a “senior,” or “elderly,” which can mean anything from 65 to 105. It stings a bit to be singled out by age, but putting ego aside and public health front and center, is it my civic duty to stay home?
And if so, what exactly does that mean? Should I use a fishing pole to reel the newspaper in from my driveway?
I wasn’t the only one with questions. Even medical professionals and agencies on the front line of the epidemic are grappling with how to respond, reluctant to pull back and leave patients, clients and colleagues in the lurch.
My dentist, David Kitada, who is in his mid-60s and still working for now, is one of
them. But he told me he’s taking extra precautions and only seeing patients who need procedures completed or who have acute problems. He shared recommended protocols from a colleague that included postponing treatment of patients 65 and older.
David Aftergood, a 68year-old Beverly Hills endocrinologist, said he’s still on the job too, but exercising as much caution as possible and seeing a limited number of patients.
“I look at myself and don’t want to tempt fate, but I feel like I’m a relatively healthy and kind of a young 68,” said Aftergood, who told me he considered the governor’s call for seniors to stay home a recommendation rather than an edict.
Santa Clarita geriatrician Gene Dorio, 68, has closed his office, and he and his staff will be doctoring by phone with non-emergency patients.
But Dorio said he will still make the occasional house call if patients are severely ill, and he sent a letter to Newsom explaining his reasoning and asking for special dispensation.
After explaining that he was in excellent health, he got to the heart of the matter.
“My medical practice is mainly house calls, serving those seniors and disabled who cannot leave their homes. Some of them live in chronic pain or have multiple medical problems. They cannot get to a doctor’s office, and haven’t been able to go for years.
“Other doctors,” Dorio noted, “do not do house calls, and the health and welfare of my patients will be in jeopardy. Therefore, I request an exemption to your recent directive to self-isolate.”
Dorio, president of the L.A. County Commission for Older Adults, had not heard back from the governor’s office as of Tuesday afternoon.
A psychologist named Jamie, who asked that I not use her last name, emailed me about her own desire to keep working despite her age.
When I called her, Jamie said her agency’s staff is seeing a heightened level of anxiety among clients, some of whom are homeless. She didn’t feel right about not serving their needs. She stayed home Monday but by Tuesday had set up a video conferencing program so she could work from home and still supervise frontline staff.
“It’s hard enough being an older adult in this country without all of a sudden feeling stigmatized,” Jamie said.
Dr. Jon Sherin, director of the L.A. County Department of Mental Health, told me he has quite a few frontline employees who are 65 and older. He said he is trying to find ways for them to stay on the job but not in contact with others, even though some have argued that they’re in perfectly good health.
“It’s all about risk factors,” Sherin said. “I think we’re sophisticated enough to say that if you’re over 65 and in great health, OK ... but by definition you’re at risk, and I’m suggesting that they don’t come in, and stay at home where there are things they can do whether it’s service-related or clinical.”
His fear, Sherin said, is that many of the department’s clients — especially those who are homeless — are vulnerable and pose higher health risks, and he’s trying to avoid a significant spread of the coronavirus through both staff and patient populations.
Better to reduce risk now than regret not doing so later, Sherin said, adding that he’s already trying to plan ahead for the possibility of having fewer employees available to handle a mental health crisis that was already overwhelming before the coronavirus threat.
“This is serious and there could be a lot of tragedy, but we’ve got to figure out a way to get through it,” Sherin said, “and build better systems for future stresses.”
On Monday and Tuesday, I checked with two senior centers that are trying their best to cope with high anxiety among the populations that rely on them for essential services like meal programs.
David MacDonald of the Santa Clarita Senior Center said the switch has been made from in-house meals to drive-through pickups, and 130 seniors took advantage of the new program on Monday.
His staff was also stepping up phone contact with clients to make sure they’re OK.
“Isolation can be a dangerous thing,” said MacDonald, citing depression and fear of access to needed resources as potential issues. “We want to keep in touch with our seniors.”
Akila Gibbs, director of the Pasadena Senior Center, said classes have been canceled and the fitness center closed, but limited services were still being offered to people who have no one to look after them.
Gibbs said the combination of lost revenue from canceled classes and a hit on the center’s investment fund because of the stock market collapse will create big financial challenges, and said she and her staff are adapting to service recommendations from doctors and public agencies that change daily.
“We’re going to try to get food to” those who have stopped coming to the center, Gibbs said, “and we’re calling 2,000 people at home to find out how they’re doing.”
One of the scariest things about the coronavirus is that it’s invisible. We don’t know who, or what, is virus-free, and we don’t know whether we’ve only just begun to see the worst of the hell it could wreak.
But we all do have a responsibility, to ourselves and each other, to limit the spread.
I may go ahead and take that walk on the beach or hike in the hills, but as much as possible, I’m going to avoid face-to-face human contact and play it safe.
And hope we soon turn the corner.
steve.lopez@latimes.com
‘I’m suggesting that they ... stay at home where there are things they can do whether it’s service-related or clinical.’
— Dr. Jon Sherin, director of the L.A. County Department of Mental Health, on advice he’s given to his older employees