As the COVID-19 pandemic—caused by the novel coronavirus—has spread, expert knowledge and guidance on the viral illness has evolved time and again as we learn more about it.
But one message has been clear throughout: Older adults, particularly those 65 and above, are at higher risk for severe disease.
We knew this early on: A study published online by the Journal of the American Medical Association in February looked at almost 45,000 people in China who had received a COVID-19 diagnosis. It found that almost 15 percent of those 80 and older, and 8 percent of those in their 70s, died after contracting the disease. The overall death rate was much lower.
Why Seniors Are Susceptible
The numbers are concerning but not surprising, experts say. Older adults are at an increased risk for severe effects from viral and bacterial infections, from flu to colds to shingles to pneumonia.
“We know immune systems change with age, making it harder for you to fight off diseases and infection, even if you’re otherwise fairly healthy,” says Michael Hochman, M.D., director of the Gehr Family Center for Health Systems Science and Innovation at Keck Medicine of USC in Los Angeles.
With age, the immune system becomes slower to respond to a threat like an infection, so you’re more likely to get sick and develop more severe symptoms. Because you have fewer immune cells, it may take longer to recover.
Older adults are also more likely to have health conditions, such as high blood pressure and type 2 diabetes, that seem to worsen outcomes from COVID-19, Hochman says.
But evidence suggests that certain precautions can significantly reduce your chances of catching COVID-19, as well as other infectious illnesses. Here are steps to keep you and your loved ones protected.
Stay Home as Much as You Can
If there’s any sort of outbreak in your community—whether it be COVID-19, the flu, or a bad bout of norovirus (sometimes incorrectly referred to as the stomach flu)—it’s best to stick to your home base unless it’s essential to go out. In fact, as coronavirus spreads in the U.S., many states and cities have “stay home” orders in place.
“Your home right now is probably the safest place to avoid COVID-19,” says Lee Lindquist, M.D., M.P.H., chief of geriatrics at Northwestern Medicine and associate professor of medicine at the Northwestern University Feinberg School of Medicine in Chicago.
This means more than avoiding travel and skipping meals out.
“We’re recommending now that all of our patients stock up on groceries for 30 days and have a 30-day supply of medications and other essentials, so they don’t even have to venture out to the supermarket,” says Sean Morrison, M.D., chair of the Brookdale Department of Geriatrics and Palliative Medicine at the Mount Sinai Health System in New York City. If possible, have groceries delivered, or ask a friend or family member to drop them off on your doorstep.
If you must run an errand, go at the least crowded times. Many stores, such as Stop & Shop, Target, and Walmart, have been offering “senior hours.”
Stay at least 6 feet away from other people. The CDC also recommends wearing a reusable mask when in public places such as food stores and pharmacies. This is thought to help prevent people who may have COVID-19—but are unaware of it—from spreading the disease to others.
And avoid contact with “high touch” surfaces—elevator buttons, door handles, handrails—as the Centers for Disease Control and Prevention recommends. Use a tissue or your sleeve instead, then wash your hands as soon as possible.
Wash Your Hands Well and Often
While COVID-19 fears have spurred people to practice good hand hygiene, it’s a habit that older adults should practice year-round to help reduce the risks of infection from all types of germs, including those that cause colds, the flu, and gastrointestinal bugs, such as norovirus, says Charles Gerba, Ph.D., professor of microbiology and immunology at the University of Arizona in Tucson.
When you touch an object that has germs on it, then touch your eyes, nose, or mouth, those germs can enter your body and make you sick.
The CDC advises washing your hands before, during, and after preparing food; before eating; after using the bathroom; after blowing your nose, coughing, or sneezing; after touching an animal, or its food or waste; and before and after taking care of someone who is sick.
In addition, “it’s important that the first thing everyone does when they walk back into their house from being outside is head to the sink and wash their hands,” Gerba says.
But you must wash thoroughly, he adds. Gerba advises using liquid soap, if you can, because bar soap can harbor germs from other people.
The CDC recommends this method: Wet your hands with clean, running water of any temperature, turn off the tap, and apply soap. Then wash for at least 20 seconds by rubbing soapy hands together, including the backs of your hands, between your fingers, and under your nails, to lift germs from your skin. Finish by rinsing hands—and residual germs—off. Dry your hands because the CDC says germs can be more easily transferred to and from wet hands. Use a clean cloth or paper towel each time.
And if soap and water are unavailable, the CDC advises using hand sanitizer with at least 60 percent alcohol.
Disinfect Key Areas Regularly
The CDC recommends cleaning and disinfecting high-touch areas—such as tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks—routinely, and daily if someone is ill or you think they may be.
Most regular household disinfectants, such as Clorox Disinfecting Wipes or those with at least 70 percent alcohol, are effective, according to the CDC.
You can make your own disinfecting solution by adding ⅓ cup bleach to a gallon of water. If possible, wear disposable gloves or designate a pair of latex or rubber gloves for cleaning only. As soon as you take them off, wash your hands.
Don’t forget your cell phone, Gerba adds. A study published online in 2017 in the journal Germs found that up to 80 percent harbor potentially harmful germs, such as staphylococci.
“Even if you use a headset, since most phones have touch screens, germs can easily spread from your phone to your hands, which can trigger infection if you touch your face,” Gerba says.
He recommends wiping your phone with 70 percent alcohol wipes several times a day, including each time you come in from outdoors. (A screen protector will prevent possible damage to your phone.)
Keep Guests to a Bare Minimum
During any outbreak of a bacterial or viral illness, try to limit access to your house to only the people who live with you. The flu, for instance, is thought to be infectious up to three to four days before people display symptoms.
This is especially important during the coronavirus pandemic. “People can be infected with COVID-19 and be without symptoms for 48 hours prior to becoming sick,” Lindquist says. (The CDC says it may take up to 14 days for symptoms to appear.) “This means people look and feel fine but actually have the potential to spread COVID-19 to others if they are close.”
If someone’s presence is essential—for example, a caregiver for a loved one—be clear that they must not come to work if they have any respiratory symptoms, or if they know that they’ve been exposed to a serious illness such as COVID-19 or the flu.
And “make it a rule that the first thing anyone does when they walk in your house is wash their hands,” says Sean Morrison, M.D., at Mount Sinai.
He also recommends that you maintain a distance of at least 6 feet from visitors, and after they leave, clean and disinfect any objects they may have touched, including tables, doorknobs, light switches, faucets, and even toilets.
Limit In-Person Doctor Visits
In March, Medicare began covering telemedicine for urgent and routine medical care. (Beforehand, it was available only in limited situations.)
This allows you to check in with your doctor for, say, a chronic condition—such as high blood pressure or type 2 diabetes—without being exposed to germs in the office. (If you experience a mild injury at home, you may be able to handle it yourself.)
“Whenever there’s some sort of outbreak going on, everyone should call before visiting their doctor,” Morrison says. Your doctor can tell you whether you should come in, and, if you have symptoms that need to be urgently addressed, where you should go for care.
Take Action If Illness Strikes
If you or a family member develops symptoms such as a fever, a dry cough, a runny or stuffy nose, and shortness of breath, call your doctor. He or she can decide whether a phone, virtual, or in-person office appointment is most appropriate, says Michael Hochman, M.D., at USC.
If your symptoms are mild, meaning you’re not having difficulty breathing, and you’re able to eat and drink enough to stay hydrated, you may be able to manage them at home.
While possible therapies for COVID-19 are being studied, home treatment focuses on resting, drinking plenty of fluids, and using an over-the-counter pain reliever (follow package directions).
The CDC recommends that the ill person spend most, if not all, of their time in a specific separate room, and use a separate bathroom.
In addition, anyone who is ill should not use the same dishes, towels, or bedding as the rest of the household. And make sure to clean and disinfect all the surfaces the sick person touches often, such as counters, tabletops, and doorknobs. The CDC says he or she should also wear a cloth mask when interacting with others.
Above all, be vigilant. Complications of COVID-19 include pneumonia; sepsis, which is when the body has an extreme response to infection, which can lead to tissue damage and organ failure; and acute respiratory distress syndrome, which is when fluid collects in the lungs.
It’s important to know that up to 70 percent of adults 85 and older, and 59 percent of those between ages 65 and 84, with COVID-19 end up being admitted to the hospital, the CDC estimates, and up to 31 percent of all adults 65 and older require admission to the intensive care unit.
So if your family member’s cough or fever worsens, call your physician immediately, Hochman says. And if your loved one develops symptoms that may signal an emergency, such as trouble breathing or chest pain, call 911 and tell the dispatcher he or she may have COVID-19. If you’re in doubt, call for help. Should You Get Vaccines Right Now?
A COVID-19 vaccine probably won’t be available for a year or longer. In the meantime, you can protect yourself against certain other infectious illnesses by making sure you’re up to date on the available recommended vaccines. For seniors, these include an annual flu shot, a shingles vaccine, the pneumococcal polysaccharide vaccine (PPSV23), and, for certain high-risk older adults, the pneumococcal conjugate vaccine (PCV13).
All adults should also get the Tdap vaccine once if they never received it, to protect against pertussis (whooping cough), then a Td (tetanus and diphtheria) booster shot every 10 years.
But should you get any of these vaccines right now? It’s appropriate to talk to your doctor if you’re not up to date on one or more vaccines. What your doctor recommends may depend on your health and the level of COVID-19 in your community.
If your doctor advises you to get a vaccine, ask where you should go for it. (Fewer sick people may be at a pharmacy than a doctor’s office, for instance.) And if you must get a needed vaccine, do so at off-hours, such as early in the morning, when fewer other people are likely to be around. When you do have to venture out to somewhere like a pharmacy, remember to wear a face covering and stay at least 6 feet away from others.