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Covid-19 statistics show that the coronavirus is most deadly among older people, with individuals in care homes dying in large numbers in the UK. In South Africa, a quarter of all Covid-19 deaths have been among people in the 50-60 age group and not far off the rest of the 2,500 people have been aged 60 and over. In Cape Town, two care homes have demonstrated how to reduce and even eliminate the presence of Covid-19. Dr Duncan Carmichael shares how Nazareth House and Highland House have become shining examples of protecting vulnerable people in the battle against the pandemic. – Editor
A tale of two care homes
By Dr Duncan Carmichael*
“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness…” Charles Dickens was writing about the French Revolution, but his lines could just as easily reflect the ongoing coronavirus crisis.
In this pandemic without a cure – yet – many readers will surely have wondered what might happen should they contract the virus. Businesses that should be open have closed, and many desperately hungry people stand in queues for food handouts.
If one were to take a positive from all of these challenges, it would be that nature has been given a breather. The skies over China haven’t been this clear in decades; dolphins have returned to the waterways of Venice; and leopards have been spotted roaming the towns of the Western Cape.
But as economies restart, even those silver linings will disappear. What will remain is the emotion that has been constant throughout – fear. The media is filled with news of the elderly and the vulnerable dying, leaving people scared. Older patients of mine who started 2020 active and happy are shadows of their former selves after months of gloomy news and indoor isolation.
Governments in many countries stand accused of failing to look after their elderly. In the UK, for example, one-third of coronavirus deaths have occurred in care homes. There are three reasons given for this. First, the elderly are more susceptible to infection. Second, they are in close contact in care homes, which makes social distancing difficult. And third, care workers who leave after their shift can introduce infections from the Community.
The question that comes to my mind is how South Africa is doing when it comes to caring for our most vulnerable. I’d like to share the tale of two care homes, both in Vredehoek in Cape Town, and both of which have been in the news lately.
The first is Nazareth House, which recorded its first coronavirus case in May. According to its press release, staff then tested all 24 residents in its dementia wing, of whom another three tested positive. Two of the four cases were terminally ill and passed away soon afterwards, while a third succumbed to Covid-19. Nazareth House has intensified its efforts to protect its residents – other than isolating residents in their rooms and sanitising extensively, staff are being accommodated on the premises to prevent them bringing in the virus. As a result, Nazareth House has not recorded another outbreak and the remaining residents remain free of Coronavirus.
The second care home is Highlands House, which has nearly 190 residents with an average age of 83. When one elderly resident tested positive, the care home’s doctor swabbed every resident, with 14 more testing positive. Highlands House lacks the space to accommodate its staff, but it did put in place strict isolation and cleaning policies. The result? It recorded just one death and 14 recoveries (many of whom were asymptomatic). Until now, it has recorded no new cases.
Nazareth House’s isolation policy protected four-fifths of its residents from contracting the virus. Highlands House not only prevented more than 170 residents from getting the virus; it recorded an impressive 93 percent recovery rate among those who did.
These are uplifting stories, not least because nearly 80 percent of South Africa’s coronavirus deaths were in people over 50. I am often asked why older people are more susceptible. These are still early days in the search for answers about Covid-19, but the following two factors appear to be highly relevant:
- Our immune system becomes compromised with age, which results in inflammation and a decreased ability to fight infections. What can we do about this? For most people, it’s a matter of following the basics: a good night’s sleep (eight hours, uninterrupted) along with vitamin D and zinc supplements. The most vulnerable might benefit from immune-booster injections from their doctor.
- Over 65 percent of people who died from coronavirus in South Africa had diabetes and nearly 60 percent had hypertension. The message is simple: cut out sugar and white carbohydrates as much as possible. It’s never too late to do this, and it’s wise to do so, because sugar drives the common form of diabetes and can worsen high blood pressure.
My wish for the elderly and the vulnerable during these challenging times is that they are freed from fear. The two care homes in Cape Town have shown that staying healthy and taking the necessary precautions are key, and mean that even those aged 80-plus can get through this crisis. To close with Dickens’s words, let this be “the spring of hope” and not “the winter of despair”.
- Duncan Carmichael is a medical doctor with 25 years of experience in the profession, and the author of ‘Younger for Longer: How You Can Slow the Ageing Process and Stay Healthy for Life’. He is a regular speaker at conferences on healthy ageing, and has written numerous articles on the subject. He founded and runs the Institute of Healthy Aging in Cape Town.
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