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As the reach of coronavirus grows in the U.S., seniors are particularly at risk.
No state has a higher share of residents who are in their 70s, 80s or older than Florida.
Though it is difficult to estimate the virus’ exact fatality rate, early data indicates older people who catch it are at a higher risk of dying. In a study of more than 44,000 confirmed cases in mainland China, the overall fatality rate was 2.3 percent. But in patients 80 years and older, the death rate was more than six times as high.
For patients in their 70s, the rate was 8 percent, four times as high as the overall rate. Another study this week estimated a lower overall death rate but still found fatality rates were higher for older patients.
In Florida, where officials had announced three cases of the virus as of Tuesday — a woman in her 20s and a traveling companion who have been quarantined in Hillsborough County, and a Manatee County man in his 60s — AARP Florida called for protecting the the state’s elderly residents.
“Florida is the grayest state in the nation, tied with Maine," said AARP Florida spokesman David Bruns. "If there’s any place for public agencies and industry to be watching very carefully, this is the place.”
Elderly patients are more likely to suffer the most severe coronavirus symptoms, including death, said Jay Wolfson, a professor of public health, medicine and pharmacy at the University of South Florida. But there are also particular challenges in providing care for them.
“Placing persons in isolation requires systems of care available to support at least 14 days of quarantine. And the higher rate of severe impact among the elderly would also mean that our hospitals would be faced with an increased census of very sick, highly contagious people.”
Wolfson warned of a combination of health risks in Florida.
“We are in the midst of a flu season, a high pollen season that is causing allergic reactions, the winter influx of people from all over the U.S. and the world, and the invasion by a new virus about which we are learning as we go, but for which we do not yet have a vaccine.”
Bruns, the AARP spokesman, said elder care facilities are of particular concern because they cluster older patients together in a communal setting, overseen by staff who are constantly moving from patient to patient.
In Kirkland, Wa., an outbreak of the virus has killed four people at a nursing home, among the first coronavirus-related deaths counted in the U.S. Four other residents and a health care worker also have contracted the virus.
In Florida, there are more than 3,000 assisted-living facilities, including about 700 nursing care centers. Though none have counted a case of coronavirus, “those all should be areas that are receiving extra attention," Bruns said.
In 2017, the state learned what happens when those facilities are unprepared for an emergency: A dozen residents of the Rehabilitation Center at Hollywood Hills died of heat-related illnesses after Hurricane Irma knocked out the air conditioning.
Another concern is senior centers, where the elderly gather for meals and other social activities, then return home. More than two dozen executives from Miami-Dade senior centers, nursing homes and other providers held a two-hour meeting Monday with Mayor Carlos Gimenez to address coronavirus, reported the Miami Herald.
The mayor said senior centers worry him more than nursing homes because they don’t have medical personnel and seniors rely on them for food and other needs. Who will feed them if they have to stay home? “If it gets to be that extreme, how do we provide services to those folks at their domiciles?” the mayor told the Miami Herald.
The Centers for Disease Control and Prevention has a pandemic planning checklist for long-term care and residential health facilities. It recommends designating staff members and teams to coordinate decisions, advises on strategies for isolating residents with symptoms and suggests ways to address potential staff absences.
The Florida Healthcare Association, which represents 550 nursing care facilities, is also trying to ensure prevention is top-of-mind. The association was to hold a joint phone call on Tuesday with the Florida Surgeon General and the secretary for the Florida Agency for Healthcare Administration to advise nursing care facilities on best practices in case of a pandemic.
The association has recommended hygiene measures like cleaning surfaces with Environmental Protection Agency-registered hospital grade disinfectant daily and re-educating health care staff about best hygiene practices. It also advises facilities to use surveillance programs to identify outbreaks and their causes and to restrict visits by the sick.
“There is no directive that says you can’t allow visitors, but we are encouraging centers to use common sense, and visitors to use common sense,” said Florida Healthcare Association spokeswoman Kristen Knapp. “If you are sick, don’t visit the building. If health care professionals are sick, stay home." She said nursing care staff can work with residents to contact loved ones through phone and video calls.
The protocols are similar to what nursing care facilities routinely do to prepare for flu season, Knapp said, though there is more uncertainty because of how easily coronavirus spreads and the higher fatality rate.
The Centers for Disease Control and Prevention and state agencies have not released any guidance directed particularly to senior citizens, though the World Health Organization recommends people over 60 avoid crowded areas. Otherwise, they should do what everyone else does — wash hands frequently, sanitize spaces, get a flu shot, cover coughs and sneezes with a tissue and contact the health department if they experience respiratory symptoms.
Bruns hopes state and local agencies will check that proper training is implemented at long-term residential facilities like nursing homes.
“We want in an abundance of caution to make sure these issues are being closely watched," he said.
The Florida Department of Health has launched a call center for coronavirus surveillance. If you or someone you know is experiencing symptoms or has questions related to the illness, known technically as COVID-19, call (866) 779-6121 or email: COVIDfirstname.lastname@example.org. The center is available from 8 a.m. to 5 p.m. Monday through Friday.
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