COVID-19 prevention tips for older people and those living with chronic illnesses

Your immune system is naturally weak during two stages of life - during early childhood and after the age of 55-60 years. The older you get, the greater your chances of having a weakened immunity coupled with diseases like high cholesterol, high blood pressure, diabetes, etc. The result is that the immune system is weak in general, and the onslaught of a new disease can exacerbate the situation.

This is the primary reason why older people are more likely to experience complications and more severe symptoms if they contract COVID-19. If an older person catches COVID-19 right now, their immune response would be slow and the existence of other conditions may make fighting the new virus next to impossible for their bodies. It’s therefore very important to care for the elderly during the spread of the COVID-19 infection.

The symptoms of COVID-19 include mainly:

• Fever
• Cough
• Shortness of breath

Other symptoms of COVID-19 infection include:

• Headaches
• Sore throat
• Sneezing
• Fatigue
• Muscle pain
• Runny nose and congestion
• Gastrointestinal symptoms like stomach cramps, diarrhoea, vomiting and nausea.
• Pneumonia
• Wheezing 
• Central cyanosis (bluish discolouration of the tongue and lips)
• Shock
• Multi-organ failure and death

Though researchers are revising what we know about this disease as new data come in, an early study published in The Lancet Infectious Diseases journal on 30 March 2020 shows:

• Case fatality ratio, or what percentage of patients dies, of COVID-19 was around 1·38% in China.
• The death rate was, however, substantially higher in older age groups: while 0·32% of patients under 60 years of age in China died due to COVID-19, the percentage of older patients who died was:
  • 6·4% of those aged 60 or less
  • up to 13·4% of patients who were 80 or older
• Outside China, the study found, 1·4% of patients under 60 years died and 4·5% of those over 60 years passed away after contracting COVID-19.

Being immunocompromised is something that can happen, no matter what your age. This is because diseases like diabetes, high blood pressure, high cholesterol, obesity, etc., are lifestyle diseases - their onset doesn't just depend on age, genes, diet, lack of exercise and environmental factors also play a part.

Cancer, be it any type, also has a similar chance of showing up at any age. Autoimmune diseases can be genetically passed on, and sexually transmitted diseases (STDs) can also be contracted at a young age.

No matter what the name of the chronic illness or disease, if you have an underlying condition, it means that your immune system is compromised and is not capable of responding to the sudden attack of a highly contagious infection like COVID-19.

If you or a loved one suffers from such an immunocompromising disease, you (or they) are likely to be at an increased risk of contracting COVID-19. This is the reason why no matter what your age, if you have an underlying condition, you should immediately self-isolate and follow all the precautions needed to avoid COVID-19.

If you’re in your 60s, and also have a pre-existing medical condition like heart disease, lung diseases such as chronic obstructive pulmonary disorder (COPD), diabetes or cancer, you’re at an increased risk of getting COVID-19 due to your compromised immune system. This is the reason why you and your loved ones should be taking proper steps to avoid contracting this disease. Here are a few things you must ensure.

• Maintain proper hand hygiene. Wash your hands with soap and water regularly, or use an alcohol-based hand sanitizer.
• Maintain good respiratory hygiene. Use your elbow or a tissue to cover your nose and mouth while coughing or sneezing.
• Stay at home and avoid going out. Ask a healthy young person to shop for your essentials instead. This could be your own children, neighbours, or anybody else you know.
• Clean and disinfect surfaces that you touch regularly.
• Avoid travelling and physical interaction with people who have travelled abroad recently.
• Eat well and get proper nutrition to be able to stay active.
• Exercise at home (while taking ample safety precautions so as to avoid injuries) to stay active and fit. Practice yoga and meditation to maintain physical and mental balance. (Read more: Intense bodyweight exercises you can do at home.)
• Take breaks from watching the news or social media, because worrying about the spread of a pandemic like COVID-19 can be stressful, and stress can compromise your health further.
• Practice social distancing but do not socially isolate yourself. Talk to your neighbours while at your own home, call up people and stay connected. 
• If you feel unwell or are worried that you have symptoms of COVID-19 already, do consult your doctor and call emergency services if you stay alone.

According to the World Health Organization (WHO) and the Chinese government’s Joint Mission on Coronavirus Disease 2019 (COVID-19), heart patients who got infected in China - where COVID-19 originated - had the highest mortality rate: 13.2%. This data can be quite alarming, which is why heart patients need to be very cautious and take every necessary precaution during the spread of COVID-19. The risk is much higher for people above 65 years with heart conditions, but heart patients of every age should take all the necessary precautions. 

The American Heart Association says that a diseased heart has to work much harder to supply oxygenated blood to the entire body, which is why any more stress on the system - especially due to a disease that affects the lungs as COVID-19 does - can have extremely adverse effects. This is why every heart patient needs to take the following steps to ensure they are not infected by COVID-19. 

• Follow all the safety precautions, including self-isolation, washing hands regularly with soap and water, respiratory hygiene, cleaning and disinfecting all surfaces, etc. Be as stringent as you can be about these precautions.
• Stay at home and ensure that people who live with you are also following all the safety and hygiene precautions.
• Consult with your doctor on a call, and figure out emergency protocols for your health. 
• You should also talk to your pharmacist about your stock of medications and if the supply will be regular or not. 
• Take proper nutrition and get proper exercise to ensure you are fit and active.
• If you’re afraid you might already have symptoms of COVID-19, contact your doctor immediately and ask if you need to be hospitalised.

Read more: Why heart patients may be more prone to COVID-19

Depending on your age and medical conditions, you are at an increased risk of contracting the COVID-19 infection if you are HIV-positive, and especially if you already have AIDS. While not much is yet known about how this disease specifically targets or impacts people with HIV/AIDS, according to the US Centers for Disease Control and Prevention (CDC), you are at a much higher risk of getting COVID-19 if you have:

• A low CD4 cell count
• Are not on HIV treatment, i.e. antiretroviral therapy (ART)

Since there is, as of now, no vaccine for COVID-19. This means that if you have HIV/AIDS, you will have to take every precaution you can to avoid getting infected. The following are a few steps you must take.

• Take all the preventive measures everybody else is recommended to take, like handwashing, respiratory hygiene, regular cleaning and disinfecting of surfaces, social distancing, etc.
• Eat right and get enough exercise to stay active and fit.
• Stay at home and avoid coming in contact with visitors or people who have recently travelled.
• Get at least eight hours of sleep every day.
• Reduce stress as much as possible.
• Continue your HIV treatment and stay in touch with your doctor over the phone. This will help your immune system.
• Make sure you have at least a 30-day supply of HIV medications, and you’ve taken all the vaccinations needed - especially those for influenza and bacterial pneumonia.
• Stay connected with medical professionals and providers as well as your friends and family if you’re staying at home or quarantining for a period of time. This will help you keep stress at bay and help your mental health too.
• If you think you have symptoms of COVID-19, call emergency health services as well as your doctor immediately.

People who suffer from asthma are at a much higher risk of contracting COVID-19 and getting seriously sick with it. This is because, as the CDC reveals, COVID-19 can affect the respiratory tract (nose, throat, lungs) and cause an asthma attack. These in turn can lead to pneumonia and acute respiratory disease, which are critical conditions requiring hospitalisation. 

This is the reason why, if you have asthma, you should take every precaution needed to avoid contracting COVID-19. The following are some steps that you should immediately take.

• Follow all the preventive measures and precautions recommended to the public, including social distancing, handwashing, hand hygiene, etc. 
• Stay at home and avoid going out and visits from people.
• Take your asthma medications exactly as prescribed by your doctor.
• Talk to your doctor, pharmacist and insurer about emergency scenarios and ensure there’s a supply of inhalers, etc.
• Avoid triggers that lead to your asthma attack.
• Clean and disinfect all surfaces you come in contact with, but use a disinfectant that doesn’t trigger your asthma.
• If any symptoms of COVID-19 show up, contact your doctor and emergency healthcare services immediately.

Read more: How useful are masks for preventing COVID-19 and how to use them

Cancer patients are inevitably on the list of those who are immunocompromised and at a greater risk of getting severely sick if they contract the COVID-19 infection. This is because their immune systems are weakened by the cancer and cancer treatment.

According to the American Cancer Society, those who have received treatment for cancer before and haven’t had a relapse since might have normal immune function - but they shouldn’t take their immunity for granted and practise proper hygiene and take all precautions.

Current cancer patients who have to go for chemotherapy and continue gruelling treatment regimens are at more risk, but all cancer patients (past or current) should take all the necessary precautions, consult their doctors and come up with a plan in case they get infected with COVID-19. The following are some steps you should definitely take:

• Take all the preventive measures recommended to the public to avoid the spread of COVID-19, including washing your hands with soap and water regularly, respiratory hygiene, etc.
• Stay at home and avoid meeting with visitors or going to crowded places.
• Clean and disinfect all surfaces you come in contact with.
• Ensure that you have a stock of all the medications you need, and talk to your pharmacist about supplies.
• Consult with your doctor about emergencies, hospitalisation, chemotherapy appointments, etc. Discuss any delays in elective surgeries you might be in need of.

According to the WHO and the Chinese government’s Joint Mission on Coronavirus Disease 2019 (COVID-19), diabetes patients who got infected in China had a mortality rate of 9.2% - second only to mortality rates among those with heart diseases. This clearly indicates that while diabetics might not be at an increased risk of contracting the disease, they're surely at a higher risk of the infection taking a turn for the worse and claiming more lives. 

It’s therefore of the utmost importance that diabetes patients should take every precaution necessary - no matter how stringent they might seem - to avoid getting infected in the first place. This means taking all the necessary precautions, from regularly washing hands, following respiratory hygiene to maintaining social distancing.

This apart, diabetes patients should also consult their doctors about checkups, precautions and supplies of insulin and other medications. If diabetes patients show any symptoms of COVID-19, they should immediately refer to emergency health services.

You might also be interested in: Who can get tested for COVID-19 infection?

People with chronic kidney disease, those who have suffered kidney failure, those who’ve had or are going to need a kidney transplant and those who need to get dialysis done frequently are at an increased risk of contracting and suffering from COVID-19. This is not just because kidney patients are immunocompromised, but also because kidney disease patients need frequent access to medical services, which are under immense pressure during a pandemic like COVID-19. 

Therefore, kidney patients should not only take every precaution to avoid getting infected with SARS-CoV-2 - the virus that causes COVID-19 - but also make sure that everyone around them does so too. What’s more, kidney patients should consult their doctors, dialysis units, etc., to ensure they will be able to avail emergency services if required. Stocking up on medications, food, etc., is also a good idea. 

It’s very important for kidney patients with symptoms of COVID-19 to consult doctors at the earliest possible. Immediate isolation is also recommended for such patients.

Read more: Mental health tips for those who are self-quarantined