Safeguarding senior citizens against coronavirus

Mamunur Rashid, a renowned actor, director and scriptwriter, has stopped going outside since the day the Bangladeshi government advised the public to maintain social distancing. 

He and his wife, along with a maid, have been staying indoors. No one is leaving the house and no one from outside is allowed inside.

This measure was taken as a precaution against coronavirus, which has killed more than 34,000 people across the globe and is proving especially deadly for the elderly. 

Aside from keeping himself and his family isolated, Mamunur is also maintaining the usual precautions, such as washing hands frequently and for at least 20 seconds. 

The illustrious artist has blood pressure issues and borderline diabetes, making him one of those who are vulnerable to the coronavirus. 

"The present situation in our country are very uncertain. But what can we do? We just need to stay cautious and follow the guidelines to stay safe. The elderly especially need to be taken care of," he said.  

The elderly and the unwell are more likely to die if they contract coronavirus. Its risk rises with age. 

Recent estimations from Imperial College London show that the death rate is almost 10 times higher than average for those over 80 and much lower for those under 40. 

As such, the authorities of countries struck with the pandemic are spreading awareness to safeguard their elderly population. 

Many cities across the world have shut down, while the younger people are being urged to avoid public places since they can carry the virus without knowing it and spread it among their elderly family members. 

In Italy, which now has the world's highest death count, the average age of those dying is 80, according to a study by the Italian national institute of health. 

In China, where the pandemic started, people aged 70 and older accounted for just 12 percent of all infections but more than half of all deaths, according to the Chinese Centre for Disease Control and Prevention. 

In the United States, people aged 65 and older have thus far accounted for 31 percent of cases, 53 percent of intensive care hospitalisations and 80 percent of deaths, according to the government data.

The Chinese government and relevant organisations rolled out a series of strict measures and humanitarian services to prevent vulnerable groups such as the elderly, orphans and handicapped from getting infected. 

They closed elderly care institutions when it was deemed necessary and suspended visits and the acceptance of new elderly residents. 

The remaining institutions keep functioning and are disinfected daily while the residents have their temperatures checked twice daily. 

The UK government advised the groups particularly vulnerable to coronavirus to stay at home for 12 weeks. 

In the meantime, those who are visiting their elderly relatives were asked to maintain distance and proper hygiene practices. 

Moreover, visits from younger relatives are discouraged. 

Addressing citizens in a video message, the State of Israel's Minister of Defence stated that the elderly being more vulnerable to coronavirus than the younger people was the single most important insight. 

He urged to keep old citizens separate from the young, and to take care of them from afar. 

The Business Standard contacted the Bangabandhu Sheikh Mujib Medical University to inquire about the measures they are taking to keep the elderly patients safe. 

According to Meherul Sopna Begum, the institution's deputy nursing superintendent, they are following the current recommendations of the WHO. 

"Our Outdoor Patient Department is functioning as usual, though we are urging people to maintain social distancing," she said. 

"In case of elderly patients, we are focusing more on checking their respiratory status. Mostly, we are checking for chronic obstructive pulmonary disease as well as cardiovascular diseases, since old people with these issues tend to have the worst outcome in case they become ill due to coronavirus infection.

"For patients who cannot move, we are keeping at least three to four empty beds between every two beds," she added.

Bangladesh's population consists of almost 1.5 crore senior citizens, said Professor ASM Atiqur Rahman, secretary general of Bangladesh Association for the Aged and Institute of Geriatric Medicine, also known as Probin Hitoishi Sangha. 

"Among this vast number of elderly people, at least 60-70 lakh suffer from housing issues. Across the country, a few establishments try to house the elderly who do not live with their families, but they can only accommodate about two two and a half thousand at best," he explained.

The concept of briddhasrom (old home) is not present in Bangladesh, the professor stated. 

"Briddhasrom is akin to an orphanage for the elderly. In Bangladesh, we have a few establishments such as the Probin Hitoishi Sangha who provide housing and community support at a government-subsidised rate. 

"There are some other facilities that provide such services but for a much higher price." 

Atiqur also said he does not trust most of the charity-based old homes.

When asked if Probin Hitoishi Sangha had adequate preparations for the pandemic, he exclaimed, "You are talking about preparations? Was Trump prepared? No one knew this would happen!" 

Probin Hitoishi Sangha accommodates 40 elderly men and women, some of whom have left to live with their families during the countrywide shutdown. 

But Atiqur is of the opinion that the residents staying here are better off as they can receive 24/7 medical care from the nearby hospital. 

As the Bidyanondo Foundation has launched several welfare programmes during this crisis, The Business Standard inquired whether they had any plans about the elderly who are living in various old homes across the country. 

Antara, a Bidyanondo volunteer and a pharmacy student, said they are focusing more on assisting people who are in quarantine and cannot go out for necessities.

She said the foundation is ensuring preventive measures in its own old home at Ramu in Bandarban. The facility is on lockdown and visitors are prohibited. 

There is also a resident doctor, Dr Asma Aktar, who is keeping a careful watch over the residents. 

In order to minimise the chance of the virus spreading, Bidyanondo Foundation has stopped recruiting new volunteers for the time being.

The Old Rehabilitation Centre (Boyoshko Punorbashon Kendra) in Gazipur's Hotapara has facilities to accommodate about 1,200 elderly people and are also taking measures against the pandemic. 

The residents are 60 years and above and for their safety, the authorities have stopped allowing visitors on the premises.

"Since we are away from the city and are under shutdown, we are hoping to stay safe from the coronavirus," said Jahangir Alam, manager of the centre.

As there are not many establishments in Bangladesh that accommodate the elderly, Professor Atiqur said we should not put too much focus there.

Do not just talk about the people in old homes, he said. 

"Talk about taking care of the elderly who are staying with their families. In every house, the elderly are abused and neglected," he claimed. 

"That is unimaginable. But this is the reality and this is why most elderly Muslim males spend most of their time in mosques to avoid the situation at home."

The professor suggested some measures for family members who are taking care of the elderly people. 

Firstly, the elderly must be persuaded to stay home. 

Secondly, they must be dissuaded from eating or drinking anything from refrigerator. 

The doorways and door knobs of their rooms must be cleaned with bleach regularly.

"Aside from the men who insist on going out, special care must also be given to elderly women and those who are disabled," Atiqur said. 

"The way things are going, it will be wise to keep the elderly at home until September for their own safety," added the professor.