Risks for seniors could linger for years
We already know life will not return to normal when Bay Area shelterinplace restrictions are lifted.
But for seniors, and other people who are at higher risk for developing more serious complications from COVID19 illness, things will be especially challenging.
“It is going to be a new way of life,” said Dr. Nima Afshar, who specializes in emergency and internal medicine at the San Francisco Veterans Affairs Medical Center. “It takes a minor risk, like high blood pressure, to make them more vulnerable to coronavirus.”
California is home to 5.3 million people who are 65 or older, an age group that makes up 8 out of 10 coronavirus-related deaths in the U.S., according to the Centers for Disease Control and Prevention.
Even when stayathome orders are relaxed and most people resume some semblance of everyday activities, seniors will need to continue to take extra precautions to avoid being exposed to the coronavirus.
That could likely mean no dining out, no public transportation, no travel.
“Those things will be out for a year or two, or until we have a vaccine or widespread herd immunity,” Afshar said.
In a bestcase scenario, the government will be able to provide enough testing, personal protective equipment and clear direction to keep seniors and people with underlying health conditions, including their families and caregivers, safe.
Until then, life will present a series of calculated risks for more vulnerable people when it comes to accessing essential services, socializing and going about their daily routines.
This is especially of concern if government leaders decide to hastily push back on sheltering in place and reopen the economy too soon, before basic protective measures for elders are in place.
“Older adults are going to have to be more conscious of assessing what public spaces they feel comfortable with,” said Dr. Stacy Torres, assistant professor of sociology at UCSF. “They’re going to have to decide whether it’s well ventilated, or if they need to go at a quieter time. They’re going to need to keep a circumference of space around them, which is going to be challenging in areas that are more dense.”
The state outbreak has been slowing down over the past few weeks, but the virus is still a threat. Last week was the deadliest in California, with more than 400 deaths recorded — including a oneday high of 115 on Wednesday.
With so little known about the coronavirus and how it spreads, reopening could make those numbers flare up.
The common view is that for the next year or two, life will become about the fundamentals and not much else: shelter, food and only necessary outings.
“I think it’s important to understand we’re in a time where we have to minimize the number of errands to do,” Torres said. “It’s about being smart about what you need to get done and having a purpose.”
Afshar echoed that sentiment.
“Seniors are going to need to avoid entering any nonhome setting that’s indoors,” he said. “They’re not going to be going to Target or Best Buy. I don’t see them taking public transportation. But they can still get fresh air, groceries delivered and FaceTime. People have survived longer than that with less.”
Beyond paying attention to recommendations from local public health departments — such as washing hands, wearing a mask outside and physical distancing — seniors will have other burdens to consider.
One of the biggest concerns is social isolation.
“I worry about the mental health effects of that,” Afshar said. “They’re already at the risk of loneliness and depression. There’s going to be a difference between those who live with someone and those who live alone. Especially men who live alone — they’re not going to do well. They tend to get higher rates of depression.”
Health officials offer several suggestions for helping older relatives stay in touch: Help them plug in, whether it’s providing them with internet connections or electronic tools such as iPads and smartphones, so they have access to friends and delivery services; help with their basic needs, such as taking out the trash or walking their dogs; and reduce their anxiety by encouraging them to turn off 24hour cable news networks and giving them clear facts about the virus.
“Pass along good information,” Torres said. “I would emphasize, ‘What is science telling us?’ ”
The most important thing is to stay in communication, at a distance, or set up virtual social groups in which people can check on each other.
“The opportunity to connect via videoconferencing is going to be important,” Afshar said. “That’s going to have to be a part of life.”
Doctors were initially concerned that the influx of coronavirus patients would overwhelm hospitals. Now they’re worried that older people are missing vital medical appointments — and sometimes even ignoring signs of a heart attack or stroke — because they either assume hospitals are overwhelmed, or they are worried about getting infected.
“We’re seeing a significant drop in patients with serious conditions,” Afshar said. “People should know that hospitals are now set up to separate respiratory patients from others. They have separate entrances. Everyone gets masks and hand sanitizer on arrival. There is a very low risk for acquiring COVID from going to the hospital right now.”
For those who still refuse, one alternative for noncoronavirus health care consultations is to do them remotely using telemedicine techniques.
“I would emphasize we need to be patient,” Torres said. “This is historic. Life is not going to go back to normal soon.”
Dining out and other public activities for seniors “will be out for a year or two.”
Dr. Nima Afshar, S.F. Veterans Affairs Medical Center
Aidin Vaziri is a San Francisco Chronicle staff writer. Email: avaziri@sfchronicle.com