(Mark Grabowsky, Volunteer advisor at Fundación Comunitaria de Puerto Rico, is also author of this op-ed.)
At this point in the coronavirus outbreak, everyone is aware that the elderly are at higher risk of dying from it. The actual numbers are striking: A recent review of cases in China showed that the risk of death among infected 70-year-olds is about 50 times higher than the risk of death among infected 30-year-olds. And while the death rate from an infection for those in their 70s is extremely high, it is twice as high for those in their 80s.
This needs to be taken much more seriously than the flu. Seventy-year-olds are ten times more likely to die if they have the coronavirus than if they have the flu. Infections in a long-term care facility can be especially devastating - half of all deaths in the US are among the elderly in one nursing home. However, most cases will occur through community transmission and one in five community members in Puerto Rico are elderly.
While we may feel powerless in the face of the growing outbreak, a science-based approach that empowers the best in Puerto Rican communities can have a major impact on protecting the elderly. In fact, we believe that Puerto Rico should set a goal of zero coronavirus deaths in the elderly in each of our communities. Non-governmental organizations in partnership with communities have played a critical role in responding to recent challenges and we believe they can play an essential role in achieving this goal.
The key insight is to understand how the elderly get coronavirus infection. Quite simply, they get it from people like you and us. Every chain of coronavirus transmission that ends with an older person’s death links to a younger person’s mild infection. Reducing deaths in the elderly depends critically on reducing infections in young people and subsequent interactions between the elderly and the infected – what epidemiologists call the contact rate.
If we have half as many contacts for half as long, we have lowered the contact rate by 75%. The goal should be to support people around their essential needs while limiting the number and duration of contacts. This requires a degree of sensitivity, expertise and organization which NGOs have developed over recent crises.
The challenge is to practice both social distancing and social responsibility. The rules of social distancing are widely publicized and becoming widely practiced. However, the rules for social responsibility during an outbreak are far less clear and confounded by fear. As a society, we need to assure that we do not let our desire for personal safety cause us to reduce our responsibilities to others.
Social responsibility can include supporting health aides to assure they can stay home when sick, delivering food and medicine to support social distancing, and putting in place a social support system for those who have none and are isolated. However, each community needs a different plan of action. The actions will need to be creative, self-sacrificing, and sometimes heroic. This is where NGOs excel.
In the past few days, the Governor and the Mayor of San Juan have taken decisive actions; yet, for communities, there is no need to wait any longer for improved testing for coronavirus. At this point, it would be prudent for communities to begin to put these measures in place as if community spread is already here.
It is a worthy goal and our community responsibility to prevent deaths in the elderly in each of our communities. With a great sense of urgency, the Fundación Comunitaria de Puerto Rico will be contacting non-governmental organizations and partners to implement science-based community actions to achieve it. We hope that all sectors in PR will join us in supporting this goal.