As the coronavirus pandemic continues to dominate headlines, we’ve been hearing that one particular population may be vulnerable: those aged 60 and older. But what puts that group at a higher risk of complications from Covid-19? And for those over 60, or who have a loved one in that age group, what should we be doing to keep ourselves and each other safe?
We turned to physician and longevity expert Dr. Peter Attia for his thoughts on the subject. Here’s what he had to say…
Wake Up Call: Why is the 60+ age group particularly vulnerable to this virus?
Dr. Peter Attia: Different populations are susceptible to different viruses. In the case of the SARS-CoV-2 virus (the coronavirus responsible for COVID-19) it’s been clearly observed that the risk of death rises sharply for people older than 60, and especially for people over the age of 75. This does not mean people younger than 50 are safe, but their risk is much lower.
There are probably a few reasons for this observation. First, age is a strong proxy for other conditions that increase risk — most notably high blood pressure, heart disease, type 2 diabetes, and lung disease. Second, as people age, their immune responses change, and there is typically a diminished adaptive response. Finally, as people age their “physiologic reserve” (how much physiological stress they can tolerate) goes down, so they have less buffer to combat severe illness.
What would you say to people in the 60+ age group who are not practicing social distancing?
The best option to help protect oneself and those around them from infection is social isolation. From the most recent March 18 CDC report of U.S. cases by age group, ~32% of positive cases for ages 65–74 were hospitalized, ~11% of those cases required intensive care and there was a 3% death rate reported for the age class. And in other countries, such as Italy, the numbers are worse.
Moreover, delaying the onset of illness — referred to as “flattening the curve” — is particularly important to ensure that the healthcare system can support the number of hospitalization cases at any given time.
Is there anything people in this age group can be doing to help boost their immune systems right now?
Sleep may be the most important behavior we can control to maintain a strong immune system. But even sleep or another immune system supporter will not do very much without social distancing, given how infectious this virus is. There is probably little harm in supplementing with zinc and vitamin D, but these measures should not at all be viewed as “protection” from more extreme measures to avoid infection.
If someone over 60 needs to leave their home — say to walk the dog or go to the grocery store — how should they best protect themselves?
If you need to leave an isolated environment, it is best to do so at a time when there is the least chance of exposure to other people. Going for a walk where there is low foot traffic or going to the grocery store when it is the least busy will limit person-to-person interaction. You should also take special precautions not to touch your face and to wash your hands well after any outing. That means scrubbing your hands for 20 to 30 seconds with soap and water.
If someone in this age group appears to be exhibiting symptoms, should they go to the hospital?
It is important to call a healthcare professional as soon as possible, if you think you have been exposed and begin to develop symptoms. Although a diagnosis cannot be made over the phone, a hospital setting increases risk of viral exposure and should be avoided if possible. If symptoms progressively worsen you must contact your primary care physician as soon as possible. Your symptoms should be monitored by phone with your physician in order to evaluate if and when you should get tested and seek in-person care. Telemedicine is also emerging as a suggested resource to monitor and confer about symptoms without having to leave social isolation.
Should people in this age group do anything to prepare, just in case they fall ill?
Noting that testing protocols vary from state to state, older individuals and persons at risk for serious illness are generally given testing priority. Please make sure that you have made contact with your primary care physician so that you have a point of contact prior to your symptoms getting worse. It is also a good idea to have nearby clinic information on hand to consult upon symptom onset to understand the location-specific instructions to get tested. A medical professional can help you by phone to evaluate when you should leave isolation to get tested.
The most concerning symptoms to monitor are fever, cough and shortness of breath. More generally, it is always a good idea to be in touch with a family member or caretaker who can be involved and support monitoring of symptom progression and providing transportation if and when necessary.