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1/18One of a series older parents, relatives, friends & #Coronavirus.
THEY SHOULD BE IN QUARANTINE - READ ON
3 reasons to talk about this:
1. A critical group, yet quarantine rules are all over the place
2. They will suffer most if we get lockdown exit wrong...
2/183. The support network for older people, often family reliant, has been particularly disrupted
Disclaimer - I've done some pro bono work on #covidγΌ19 for the wonderful people at http://wisetribes.com who got me aware of issue 3. If there's some overlap that's why.
3/18So let's get into it.
TOPIC - QUARANTINE RULES
I hoped that all older people were in quarantine. http://wisetribes.com helped me understand they're not.
The reason is once again UKGov being too slow and IMHO too cautious with their advice. CONSISTENTly so.
4/18I'm not going to contradict UKGov advice, I'm going to suggest applying it tighter.
IF YOU ARE 60 OR OLDER you should make every effort to QUARANTINE - that means NO FACE TO FACE contact, applying Shield Rules.
https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
5/18The next tweets justify this statement because once that's done, there's guidance for the rest.
You may not know what UKGov advice is. Recently they upgraded it to say, "People 70 or older should be particularly stringent in applying Social Distancing"
Clear as mud
6/18The issues with UkGov guidance:
1. For weeks they forgot to follow up guidance to older people
2. "Particularly Stringent" is undefined, does it mean washing hands for 10 more seconds? or outside even less than "absolutely necessary (HOW?)"
3. Asia/Aus BEST PRACTICE
7/181. FORGETTING OLDER PEOPLE (AND CHRONIC CONDITIONS)
I don't know why UKGov forgot to follow up on advice but I do know the implications. In the first hurried weeks of social distancing, older people were not the focus. Subsequent advice got much less publicity.
8/18And there was another disrupting effect. The Media initially set an expectation that only old people needed to worry about C-19. So when younger people and kids started dying that got blanket coverage.
68% of 70 and older pass away in UK Intensive Care
9/18Excluding any additional vulnerabilities the average fatality by age is:
50s: 1.3%
60s 4.6%
70s 9.8%
80s 18.0%
10/18Plot this and see there's another less talked about exponential of #coronavirus #COVIDγΌ19. I've added the much-discussed 1918 flu data to show just how much Covid-19 affects Older People. It was correctly reported. it's a LOT worse.
You see why over 60s data too?
11/182. PARTICULARLY STRINGENT SOCIAL DISTANCING
So what do you think that means? Here's Google page 1
1. China level tracking
2. Do it a lot
3. Definitely quarantine
4. Definitely not quarantine
5. Work from home
6. Almost quarantine
7. NHS 404 error
Who could know?
12/18IMHO ambiguity kills. My parents were quarantined from early March using the SHIELD rules above. Read them, and there's a practical guide with downloadable reminders
Don't go out
Don't open the door
Someone else delivers food
Decontaminate https://www.wisetribes.com/post/staying-home-safe-mum-and-dad-parents
13/18I can't think why we wouldn't simply tell the 60s and above to quarantine - what are we protecting?
Over 60s still in employment who can't work from home?
More pressure on supermarket delivery slots?
Societal Fear?
Those horses have bolted
Save political face?
14/183. ASIAN COUNTRIES KNOW BETTER
Of all the criticisms that will be made of UKGov in the future, high on the list will be institutional behaviours that refused to look at or listen to best practice from Asia / Australia in dealing with MERS and SARS
15/18I can't even call this institutional racism, because in common with the rest of Aisa, Australia concludes 60 and above
They even identified minority vulnerable communities more affected - something we haven't started to do (big fuss coming).
https://www.health.gov.au/sites/default/files/documents/2020/03/coronavirus-covid-19-information-for-older-australians_1.pdf
16/18So that concludes the 3 reasons, why I (and other virologists and all of Asia, and most experience medics in this area) think the UKGov advice fails on age range, and on strict no face to face quarantine advice.
For clarity of guidance, do this:
17/18Five important caveats.
1. Very elderly people may be unable to cope in complete isolation, you can modify by following shield hygiene guidelines
2. Same for Care
3. Same for those living alone
4. Cost
5. They live with you already
Happy to take questions on those.
18/18At the start, I said this was one of a series. I plan also to cover:
Lockdown planning - also an unnecessary shambles and a refusal to learn from Asia
Family network planning - in case we have another one
Practicalities at home
Pls reply with any additions
Thanks to everyone who answered the poll that selected this topic, and particularly to @AlisonKMurray @SusanChubb1 for great suggestions.
I'll add future threads in this series next as I complete them.
I'll add future threads in this series next as I complete them.
Always forget!
Older men
Older women
Safely locked into quarantine.
Older menOlder womenSafely locked into quarantine.
