Manuel Montero-Odasso, MD, PhD AGSF, FGSA, FRCPC1,2,3, S. Denise Goens, PhD, MPH2, Nellie Kamkar, MSc2, Robert Lam, MD4, Kenneth Madden, MD, MSc, FRCPC5, Frank Molnar, MSc, MD, FRCPC6, Mark Speechley, PhD3, Saverio Stranges, MD, PhD, FAHA31Schulich School of Medicine and Dentistry, Department of Medicine and Division of Geriatric Medicine, The University of Western Ontario, London, ON
2Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON
3Department of Epidemiology and Biostatistics, The University of Western Ontario, London, ON
4Department of Family Medicine, Toronto Western Hospital Family Practice Residency Program, The University of Toronto, Toronto ON
5Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, BC
6Division of Geriatric Medicine, Department of Medicine, University of Ottawa, Ottawa, ON
One of the goals of the Canadian Geriatrics Society (CGS) is to foster the health and well-being of older Canadians and older adults worldwide. Because there is currently no vaccine available to prevent COVID-19 and no specific antiviral medication to treat it, the best way to prevent illness is to avoid being exposed to the virus altogether.
We have perused information on the outbreaks in China, Italy, and Spain and recommendations from governmental sites including the Public Health Agency of Canada, Public Health Ontario, and the U.S Centers for Disease Control and Prevention (CDC), to provide the following guidance to older adults in Canada. We realize that our patients and their caregivers likely have many questions about COVID-19. As our health system faces this new challenge, we know these are difficult times and it might be harder than normal to address all concerns. This article is intended for physicians assisting older patients with a resource to be shared with them. A shorter version with infographic is available in the CGS website (www.candiangeriatrics.ca)
1. Who is high risk for severe illness from COVID-19?
Adults aged 60 and higher
People suffering from heart disease, respiratory disease, and diabetes
Being older and having existing conditions such as cardiovascular disease, lung disease, and diabetes, usually coexist; therefore, awareness is critical for older adults to take actions to reduce your risk of getting sick with COVID-19.
2. What should older adults do?
a. Take any illness seriously
Covid-19 may start like a common cold or mild flu; however, in older adults it may worsen quickly. Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you have mild symptoms or have had contact with someone who has tested positive for the virus, call your doctor, health unit or pharmacist. They will tell you if you need to be tested and where to go.
Go to the hospital immediately if you develop any of the symptoms below:
Difficulty breathing or shortness of breath
Persistent pain or pressure in the chest
New confusion or inability to arouse
Blue lips or face
b. Stay Informed
Your local Health Unit has the most up-to-date and accurate information. Many Health Units have social media accounts, which will be the fastest and most reliable information for your specific area, including how to stay safe and what to do if you think you may be infected.
Click here for links to health units by province:
check CBC and local news
3. What can you do to reduce your risk of becoming infected?
Take everyday precautions to maintain a physical distance between yourself and others, at least 2 meters (6 feet) if possible. See our 10 Recommendations.
Avoid crowds as much as possible.
When you go out in public, keep away from others who are sick and limit close contact with others, wash your hands thoroughly and often.
Wash your hands thoroughly and often. Avoid touching your face, especially the “T Zone” formed by your eyes, nose, and mouth.
Avoid any non-essential travel.
Stock up on supplies that you know you will need in case you need to stay home for at least 2 weeks.
During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed, and stay informed.
1. Take everyday preventive actions:
Wash your hands often and thoroughly with soap and water for at least 20 seconds, especially after having been in a public space and after blowing your nose, coughing, or sneezing. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol. Click here for the recommended method for hand washing.
Avoid touching high-touch surfaces in public places – these include elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something. Wash your hands after touching surfaces in public places.
Avoid touching your face, especially your mouth, eyes, and nose.
Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones).
2. Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick. Take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus.
Stay home as much as possible.
Consider ways of getting food brought to your house through family, social, or commercial networks
3. Avoid all non-essential travel (including plane trips and tourism and especially avoid embarking on any cruise ships), and non-essential in-person visits to your healthprovider (e.g., family physician checkups).
4. Have medical supplies handy
Contact your health-care provider to ask about obtaining extra necessary medications for 30 days to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time. Some physicians have access to virtual appointments; ask if this is an option.
Call your pharmacist before you run out and need more of any medication. Ask if they deliver. If you cannot get extra medications, consider using mail-order for medications.
Be sure to have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.
Have enough household items and groceries and non-perishable food on hand so that you will be prepared to stay at home or to minimize trip to stores.
5. If a COVID-19 outbreak happens in your community
It could last for a long time. (An outbreak is when a large number of people suddenly get sick). Depending on how severe the outbreak is, public health officials may recommend community actions to reduce people’s risk of being exposed to COVID-19. These actions can slow the spread and reduce the impact of the disease.
6. Have a plan in place in case you get sick
Consult with your health-care provider for more information about monitoring your health for symptoms, especially if they are suggestive of COVID-19.
Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, etc., if you become sick.
Determine who can care for you if your caregiver gets sick.
Watch for symptoms and emergency warning signs
Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call your doctor.
If you develop emergency warning signs for COVID-19 get medical attention immediately. In older adults, emergency warning signs include the following:
– Difficulty breathing or shortness of breath
– Persistent pain or pressure in the chest
– New confusion or inability to arouse
– Bluish lips or face
7. If you get sick
If you get sick, do the following:
Stay home and call your doctor and let them know about your symptoms. Tell them that you have or may have COVID-19. This will help them take care of you and keep other people from getting infected or exposed.
If you are not sick enough to be hospitalized, you can recover at home, and thus, staying home is the best option. We provide below some guidelines for how to take care of yourself at home.
Know when to get emergency help (emergency warning symptoms in Recommendation 6).
Get medical attention immediately if you have any of the emergency warning signs listed above.
8. Things you can do to support yourself and to minimize stress during the COVID 19 outbreak. Stress symptoms can include
Fear and worry about your own health and the health of your loved ones
Changes in sleep or eating patterns
Difficulty sleeping or concentrating
Worsening of chronic health problems
Increased use of alcohol, tobacco, or other drugs
Older adults with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms.
Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
Make time to unwind. Try to do some other activities you enjoy.
Connect with others. Talk with people you trust about your concerns and how you are feeling.
If you live alone, schedule daily telephone calls with your friend/family members/caregiver
9. What others can do to support older adults
Family and caregiver support. Below are some guidelines for those supporting older adults:
Know what medications your loved one is taking and see if you can help them have extra medication available on hand.
Monitor food and other medical supplies needed (oxygen, incontinence, dialysis, wound care) and create a back-up plan.
Stock up on non-perishable food to have on hand in your home in order to minimize trips to stores.
If you care for a loved one living in a care facility, monitor the situation, ask about the health of the other residents frequently, and know the outbreak protocol of that facility if there is an outbreak.
10. Where can I find out more information on COVID-19?
CGS is following Health Canada’s recommendations for COVID-19 and monitoring their ongoing information, as updates become available. To learn more, please view the following resources:
Health Canada: COVID-19
World Health Organization: COVID-19
World Health Organization COVID-19 F.A.Q.
Disclosure Statement: Drs. Montero-Odasso and Molnar are co-chairs of the Canadian Geriatrics Society COVID-10 working group. ( Return to Text )
Canadian Geriatrics Journal, Vol. 23, No. 1, March 2020