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Seniors more vulnerable likely due to lower immunity: Expert

Amrita Kaur on 12 Mar 2020

The Straits Times


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Nearly one in two confirmed coronavirus patients here is aged 50 and above.


This could likely be due to their "lower immunity and reduced physiological reserves", said Associate Professor Hsu Li Yang, infectious diseases programme leader at the National University of Singapore's Saw Swee Hock School of Public Health.


Physiological reserves refer to the capability of an organ to carry out its activity under stress.


Said Prof Hsu: "The elderly, as well as those with chronic medical conditions such as heart and lung disease, have generally been more vulnerable to infections, including other more common bacterial infections and even influenza."


In Singapore, out of 178 patients as of yesterday, 41 of them are in their 50s, 30 are in their 60s, and 10 are aged 70 and above.


Prof Hsu said it is plausible seniors are more likely to become very sick and are going to the hospitals. "Hence, they are more likely to be diagnosed as confirmed cases rather than young people who might recover when they stay at home."


Children, if infected, seem to have a mild form of the disease, known as Covid-19.


"This appears to be a special characteristic of such coronaviruses and has also been reported in Sars and Mers. Women appear to be less likely to die than men. We do not actually know why, at present," he said, referring to the severe acute respiratory syndrome and the Middle East respiratory syndrome.


The Health Ministry announced that all social activities for seniors held by government agencies will be suspended for two weeks from yesterday, as Singapore heightens measures to protect the vulnerable group from Covid-19.


This comes after an increasing number of infections was linked to a Chinese New Year dinner at Safra Jurong attended by many seniors. It is now the largest virus cluster in Singapore with 40 patients.


Prof Hsu said: "Mass activities where people mingle closely and for long periods of time - more than half an hour - generally favour the spread of viruses. In this case, the targeted social distancing is aimed at protecting a particular vulnerable segment of the population."


Senior consultant at the National University Hospital's Division of Infectious Diseases Nares Smitasin said the suspension of activities and social distancing measures are "reasonable".


He said: "One of the modes of transmissions of this virus is through droplet particle via close contact. The droplet particle consists of virus surrounded by fluid. This droplet particle size is usually more than five micrometers which will drop to the ground after infected patients cough.


"The usual range of transmission when one coughs is approximately 2m. Certain activities, especially singing, can generate more particles creating more droplet particles in the environment constantly."


The suspension of activities involving senior people will affect courses and activities at community centres and residents' committees in areas like music, drama, dance and exercise.


Senior assistant director at Fei Yue Community Services Aw Lay Hoon said social distancing measures will help to mitigate the transmission. "The close proximity of these activities, where seniors have conversations or are physically close to one another in a confined space may pose a threat to their safety during such an outbreak," she said.


While some may miss seeing their friends, seniors today are more IT-savvy and can always "see" their friends online, she said, adding: "They can also take the opportunity to spend more time with their family or go online to pick up new knowledge and keep themselves mentally engaged."


Clinical director at voluntary welfare organisation O'Joy Care Services Teo Puay Leng said the mindset of seniors may be more of a worry than the social activities.


She said: "They may brush off symptoms of illness as just the body being 'heaty' or they would see it as a minor ailment and instead of consulting a doctor, they may prefer to self-medicate. Some others may think, 'this is just a common flu, I cannot be that unlucky'. It could be this attitude that led many to continue to take part in social activities despite being unwell."


With the suspension of planned activities, senior director of the elderly group at Touch Community Services Kavin Seow said seniors may feel bored and lost.


"To pass time, I understand some seniors would still gather at the void deck to interact informally with neighbours and friends, as they normally do," he said.


Staff at Touch Senior Activity Centres have been visiting coffee shops and void decks to check on seniors, reminding them to practise good hygiene and be socially responsible.


Housewife Michelle Chan, who signed up last year for a course on aromatherapy, was disappointed that the first lesson scheduled yesterday was postponed.


However, the 56-year-old knows it is for the best. "I think the social distancing measures being put in place are good. The Government is doing this in the best interests of seniors and their health."


Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission.



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