Efforts to contain and slow down the corona pandemic in Germany are becoming ever more intense. Since yesterday, the Robert Koch Institute has rated the risk to the population as high.
With many of the protective measures that have been taken, the actors responsible for public health have a particular eye on the elderly and the elderly. Because if they get sick, the likelihood of a severe course of the new lung disease Covid-19 is particularly high.
According to the Robert Koch Institute, the infection with the novel coronavirus Sars-CoV-2 is mild in 80 percent of those affected, sometimes even asymptomatic. In 20 percent of the cases, however, it is not ticked off with a sore throat, cough, mild runny nose and a little fever.
Weak immune system
Data from China show that almost 15 percent of those infected have severe courses – i.e. pneumonia, shortness of breath and lack of oxygen in the blood. And a good 5 percent of the cases are critical to life-threatening: they suffer from lung failure, so-called septic shock like blood poisoning, and the failure of several organs.
Certain sections of the population are at increased risk for these difficult courses. In addition to smokers and people with previous illnesses – such as the heart and lungs – this primarily includes old people.
“The risk increases gradually from the mid-50s, increases again significantly from the age of 75 and is extremely increased in people over 80,” says Hans Jürgen Heppner, President of the German Society for Geriatrics (DGG) and Chief Physician of the Clinic for Geriatrics on Helios Klinikum Schwelm and holder of the chair for geriatrics at the University of Witten / Herdecke.
He makes this clear by the case mortality parameter, which indicates what percentage of diagnosed Covid 19 cases are fatal. “The estimated mortality rate in Germany is currently 3.5 percent on average. It is more than 4 percent in patients between the ages of 55 and 70, and increases to 14.8 percent from the age of 80, ”says the geriatrician.
At the same time, he points out that these figures should be viewed with extreme caution. Depending on the development of the wave of infection, they are subject to a very dynamic process.
A weak heart puts the illness away worse
As the expert explains, the most important thing is of course the individual state of health, which can still be fabulous even for 80-year-olds. Still, age is a risk factor in itself. “Over time, so-called immune senescence occurs. The infection defense then works slower and weaker than in younger patients. Basically, seniors are more susceptible to infections, especially acute respiratory infections, ”says Heppner.
In addition, many older people are chronically ill – and that makes them even more at risk. “Above all, respiratory diseases such as asthma and the lung disease COPD, but also diseases of the cardiovascular system increase the risk of a severe course of Covid-19,” says the geriatrician. This is because shortness of breath and pneumonia often mean stress for the heart and circulation. “An already weak heart or one with defective heart valves is worse off,” says Heppner.
Other risk factors are severe kidney diseases – because then the detoxification works less well and medication must be dosed more carefully. It is very important for diabetics how well their blood sugar level is treated and what other diseases they have.
First until Easter
So there is no question that seniors and the very elderly need to protect themselves particularly well during these times. But what does that mean specifically? When it comes to grandma’s upcoming birthday or a long-planned family celebration, it is difficult to make decisions.
At the end of last week, the German Geriatric Society issued a press release that said “Grandma and Grandpa may continue to be visited” and “Nobody will be locked away”. In view of the dynamics of the epidemic in Germany, Heppner is now correcting this announcement. “In the next few weeks, grandma and grandpa should only be visited when it is absolutely necessary,” he says.
Initially for the time until Easter, he now considers it necessary to be very distant (see notes). It is difficult to foresee whether this waiting period should be extended again. Heppner: “At best, the measures now taken will already be effective and life can gradually return to normal after Easter.”
The most important information for the near future
· Visit: Seniors should severely limit the number of people who come to visit them – so that everyone can keep a distance of two meters from each other. The visit time should not be too long, for example not exceeding 45 minutes.
· Homes: Elderly and care facilities have already made rules for visits or have completely prohibited visits. Relatives should inquire about this and adhere to it. Especially with cold symptoms you should not enter these facilities.
· Communication: Other communication channels can now be tried out within the family – such as video calls using a tablet computer or smartphone.
· Celebrations: Up until and including Easter, family celebrations should be canceled and any church services should be avoided.
· Household: In the case of elderly people in need of care who are cared for by family members in the home, protective measures should be carefully taken, such as hand hygiene and regular ventilation.
· Physiotherapy appointmentsthat are not absolutely necessary should be canceled for the next two weeks. For medically urgent treatments, it is advisable to consult the practice by phone and ask for appointments when the waiting room is not full. The same applies to dentist and other postponed doctor’s appointments.
· purchases let neighbors or relatives take care of it – in case of doubt, only have the bag brought to the door. Seniors who want to go shopping themselves should avoid rush hours, keep their distance from others and wash their hands thoroughly after contact with shopping carts etc. or treat them with disinfectant gel while on the go.
· Public transportation: Limit routes with buses and trains as far as possible, avoid rush hours, keep your distance.
· Outpatient care services: Seniors who are cared for by outpatient care services should make sure that the staff wear protective equipment such as gloves and abide by the hygiene rules.
· Pneumococcal vaccination: Protection against pneumococci should be essential. It is important because pneumonia with vaccinated patients has significantly milder symptoms than those who are not vaccinated. As with influenza, the coronavirus is not always the virus itself, but the resulting additional pneumonia in the end is fatal. Pneumococci very often play a role here.
· The flu shot can now be made up for. However, the wave of this season will soon be over and in many places there will be no vaccine. Make a reservation for autumn!
· walks in the fresh air are good. You train the immune system.
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