Recommendations to address the integral health of older adults in times of total coronavirus quarantine
In our country, adults over the age of 65 represent the 11,4% of the total population (INE 2017) and are one of the risk groups with the highest mortality from coronavirus. Unfortunately, the lethality of COVID19 in Chile has so far affected only older adults. The severity of the disease caused by the virus in this age group is explained by the wear and tear of its immune system and the presence of multiple chronic-based diseases.
The combination of more than one chronic condition causes 90% of the Chilean population to have to consume at least 1 medicine on a regular basis, and almost 40% take 5 or more a day for their various treatments (ENS 2016/2017). The main comorability in patients infected with the virus is high blood pressure (approximately 17%), chronic condition affecting about 27,3% of Chile's population (Yang et al., 2020; GES Guide 2018).
COVID19 causes a decompensation of the existing pathology, and is mainly manifested by severe respiratory complications that require hospitalization and assistance of instruments such as artificial respirators. Older adults infected with this new coronavirus that consume antihypertensives from the Losartan and Enapril family, develop more severe breathing tables, Pneumonia, acute respiratory failure, kidney failure and can even lead to death (WHO, 2020).
That is why emphasis has been placed on the extreme prevention that older adults must adopt and their environment, especially if they have a chronic illness, which results in intensifying daily hygiene measures and calling to stay in their homes to avoid the likelihood of contagion. For the rapid advance of the virus in Chile, the government decreed on Wednesday, March 25, the total quarantine measure in 7 common in the metropolitan region, where the largest number of confirmed coVID19 cases have been concentrated.
In addition to the obligation of isolation, older adults being treated for a chronic illness are instructed not to give up their medication, as this could lead to even more serious consequences. Dr. Jorge E. Jalil, cardiologist specializing in Internal Medicine of the Pontifical Catholic University, and principal investigator at CENDHY (Center for New Drugs for Hypertension) He points out that: “In relation to hypertensive patients currently being treated with antihypertensive medications, the recommendation is to continue with the usual drugs". The academic explains that "there is no clinical evidence to advise a modification or discontinuation of these drugs in hypertensive patients against COVID19 infection".
The guidance of Dr.. Jalil is framed by the call of international scientific societies such as the European Hypertension Society, the Spanish Hypertension Society, the American Heart Association, the U.S. Heart Failure Society, the American College of Cardiology, the American College of Physicians, The Canadian Hypertension Society, The Cardiovascular Society of Canada, the International Society of Hypertension and the British Hypertension Society.
While it is very important that older adults remain physically healthy during the crisis period, mental health care is equally relevant. Tragic and alarmist news cluster on coronavirus in the media may affect total quarantined population in animica. The report of the deceased in Chile and the images of the parade of military vehicles loaded with coffins on the streets of Italy are a clear example of the type of content to which they are exposed daily.