The gradual reopening of the Rochester-Finger Lakes region necessitates a balancing act for the region’s oldest residents, say doctors who specialize in geriatrics at the University of Rochester Medical Center.
Mortality from COVID-19 increases with age. To avoid transmission of the virus that causes the disease, older adults should take extra care to avoid situations where they are physically close to other people, said Dr. Annette Medina-Walpole, the chief of URMC’s geriatrics and aging division.
Many of the region’s oldest residents have been staying home for the past few months, she said. Now, as businesses start to reopen and restrictions on gatherings relax, she and other doctors are advising them on how to weigh the risks of going out.
“Your risk is associated with time and dose,” said Dr. Daniel Mendelson, Highland Hospital's associate chief of medicine. “It’s the amount of viral particles you’re getting into your body over a length of time, so the longer you’re in a closed environment with the virus, the more likely it is that you’re going to get infected.”
Mendelson said an outdoor visit to grandparents where everyone wears masks and stays at least 6 feet apart is likely quite safe.
Eating dinner in a crowded restaurant, however, “is a horrible idea,” he said. “You’re in close quarters, with no masks, for an extended period of time.”
Dr. Ciandra D’Souza, a geriatrician at Highland Hospital, said she’s been fielding questions from patients wondering how to balance mental health with physical safety.
“It’s really hard,” she said. “Grandkids want to see their grandparents, and vice versa.”
Ideally, everyone visiting someone older than 65 would quarantine for two weeks before the visit, D’Souza said.
Illness of any kind should be a disqualifier for a visit to grandparents, she said. “If anyone is sick, you should stay away.”
The doctors said nursing home residents need to be especially careful.
“Once you live in a concentrated community, the risk of transmitting to each other becomes much higher,” said Mendelson.
He said the measures that nursing homes and their residents are taking to prevent the spread of the novel coronavirus are necessary to protect physical health, but they do come with mental health costs.
“You also have to protect the people around you, and that’s hard. It leads to some of the social isolation that I think is really devastating to folks,” Mendelson said.
To counteract the effects of isolation, Mendelson said his patients have been playing online bridge games and reaching family members through video calls.
“That’s a really big help,” he said, but it can’t make up for the loss of physical contact.
Mendelson counts himself among the people having a hard time with physical distancing.
“I do my job for the hugs,” he said. “I’m really missing the hugs, but I know that we’re making that sacrifice in order to keep everybody safe.”