A geriatrician talks about the COVID-19 pandemic and what it means for seniors

The World Health Organization has officially labelled the coronavirus outbreak a pandemic.

There are no cases in Nova Scotia yet, but New Brunswick reported its first presumptive case on Wednesday.

So far, COVID-19 has most seriously affected the elderly.

Dr. Ken Rockwood, a professor of geriatric medicine and a geriatrician at the QEII Health Sciences Centre in Halifax, spoke with Diane Paquette of CBC's Mainstreet about keeping senior citizens safe. The interview has been edited for length and clarity.

As we know, older people are more at risk. As we head into March Break, what are some of your tips for keeping the elderly people in our lives safe?

Right now, it doesn't look like there's an effective treatment, so everything has to do with prevention. 

The virus gets in through the eyes, nose and mouth, so you have to keep your hands away from your face, and you've got to do hand washing in a very fastidious way.

Do we know why the elderly are more at risk?

No. In terms of speculation, it presumably has something to do with the immune system in some way. Yet at the same time, children, who often will be at risk for things that older people are at risk of, appear not to be at the same level of risk. 

What we do know is about 10 to 15 per cent of people who develop mild cases go on to get severe cases. That seems to be higher in nursing homes, where, for the most part, they're frailer than older people who are not there.

So everyone needs to take care, but we particularly need to take care with older people who are frail, who have got a lot of illnesses, who are in and out of the hospital, who are in long-term care.

Do you know if enough is being done in Nova Scotia to make sure ill people are not going into nursing homes?

I can't comment on that. Generally, though, I expect the desire to want to go see someone would need to be really carefully balanced against the risk that we pose to them and other people. 

Some of the discussion that's going on is about using teleconferencing and such as a way to interact. Not quite as satisfactory, but clearly much less risky.

We know that COVID-19 seems to be marching ahead, and we're not even really sure where it is and how far it's spread yet because some places don't really have adequate testing. As a doctor who deals with the elderly, what goes through your mind as you contemplate this disease?

A few things come to mind. One is how very dependent we are on science, and particularly the science out of the U.S., because they're the people who have the resources and the attitude to see this as a fixable problem that they want to be at the centre of. 

Right now, the development of the vaccine, which appears to be quite a ways off, seems to be our best bet. 

And it's likely, too, that one thing they'll have to figure out is who gets sick and when, so we're not overwhelmed by a very large number of people who are ill all showing up at the same time. 

So I'm concerned about this because it seems to me that this could be a very substantial challenge to the way we provide health care with the resources that we have at present.

You mentioned looking to the U.S. for some guidance in this outbreak, but there has been a fair bit of criticism in the way the Centers for Disease Control and Prevention in the U.S. has failed to respond adequately or quickly enough. Do you think Canada has done a better job?

Some independent observations may suggest Canada has done a good job with the resources that we have. But obviously the scale that's needed is going to be a scale the U.S. can provide. They have a much larger infrastructure and they have some large volumes of labs who are very excellent at this.

Presumably, Canada can be part of a worldwide co-ordinated effort, but it's at times like this where I think we need to understand how very much dependent we are on the state of science in the United States. It's easy sometimes to make fun of what goes on in the U.S., but this, I think, really exposes how very much we depend on American scientists.

So if someone does have a senior citizen in the family and this person's health is not great, what can they do to keep them safe?

We've got to be really meticulous about visiting and about being sure that anyone who goes in employs good handwashing techniques. It's not like this is going to go away any time soon, by all of the estimates, so this is something we're going to have to really take seriously and adapt to. 

And if there's one thing that societies have shown they can do, it's adapt to large challenges. We've just got to make sure that we're up to it as well.

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