The coronavirus pandemic has disproportionately affected the aged, so much so that restrictions are still in place for persons over age 65 to remain in lockdown despite many aspects of life and the economy reopening. It was clear from the beginning that persons who mostly get severe symptoms are those within this age group, especially because they have a higher likelihood of having comorbidities such as non-communicable diseases. In China, for example, as at February 2020, cardiovascular disease was singled out as the condition that had the highest correlation with COVID-19 fatalities. Other illnesses, including diabetes, chronic respiratory disease, hypertension and cancer, were also to blame.
This was particularly demonstrated in Italy, which has one of the oldest populations in the world. Nearly 60 per cent of the population is over 40, with 23 per cent being over 65. COVID-19 disproportionately affected persons 60 years and older in terms of fatalities. The case-fatality rate painted a picture that clearly demonstrated why restrictions had been placed on persons in these age groups. According to ourworldindata.org, the COVID-19 fatality rate was as follows: 80+ – 20.2%; 70–79 – 12.8%; 60-69 – 3.5%. These were very different from figures for the age groups 50-59 (1%), 30-39 (0.3%), and 40-49 (0.4%). The younger age groups remained at zero.
For years, there has been a concern about the issue of ageing populations, where the number of persons over 55 is steadily increasing while the number of children born to families in reducing. The problem was seen as a consequence of the improvement in healthcare that resulted in better quality of life in some cases, but mostly, simply longer life. As the previous discussion shows, longer life does not necessarily equate to a healthier life or better quality of life. According to the World Factbook, 13.5 per cent of the Jamaican population is older than 55, as at 2018, and this is expected to increase in the coming years. The average life expectancy is 73.7 years, i.e. 72.1 years for males and 75.4 years for females.
COVID-19 has put back on the table the issue of healthcare for the elderly and the need for specific interventions for this group, especially in terms of finding remote-care solutions that would complement the need for less public interaction. Healthcare will have to catch up to this reality, and the best way to do this is through the use of technology. The World Health Organization has released a guideline document called the WHO Integrated Care for Older People (ICOPE), which include tools recommended to stakeholders to design, implement, and manage interventions for care for elderly persons as part of health-systems support ( WHO.int).
Aspects of the plan feature technology that can be used to diagnose and treat elderly patients remotely. For example, it is expected that the “implementation of the ICOPE App would mitigate the current gap between geriatricians and family physicians and those between the family physicians and the patients. Moreover, the decline in intrinsic capacity measured with the App may be useful to anticipate clinical adverse outcomes, such as prefrailty, missteps, falls, institutionalization, decreased quality of life, and death and to share professional advice to community-dwelling older adults” (Sanchez-Rodrigues, et al).
Jamaica is already within reach of fully implementing a full technology ecosystem in which holistic remote healthcare options would be available to persons at the community level, including the elderly. We have already witnessed the significant increase in the use of telemedicine, a direct result of the circumstances created by COVID-19. This, along with other elements such as emailed prescriptions that can then be used to deliver medication to the patients, could be used to provide the elderly with care for which they would not have to travel long distances or depend on a third party to see a physician or other caregiver.
I believe that we are firmly on the cusp of the era of technology-driven personalised medicine, and we are challenged to ensure that individual needs are fully met whether at the hospital level or via home care. The elderly, in particular, being primarily those who are plagued with non-communicable diseases, will need this type of specialised care.
Doug Halsall is chairman and CEO of Advanced Integrated Systems. Send feedback to firstname.lastname@example.org.
Published: Sunday | July 12, 2020 | 12:11 AM