Why do those over 70 have to cocoon during Covid-19? Public health doctors explain all
The benefits of cocooning for the over 70s outweigh adverse effects, says Prof Emer Shelley, Dean of the Faculty of Public Health Medicine at the Royal College of Physicians of Ireland.
Early data on this new disease show that up to 20% of people diagnosed with Coronavirus may develop severe illness and that disease severity increases with age. While most people recover from the illness, one in eight over 60 may be hospitalised and that rises to one in five in the over 80 age group.
Every one of us has been asked by the Government to restrict our movements to only essential trips, but those over 70 and a number of other at risk groups have been asked to stay indoors, to avoid contact with others and to have their food, medications and other essential items delivered to them. This is what is meant by cocooning.
“Cocooning not only reduces our own individual risk of catching the coronavirus, which is circulating in the community, it also reduces the risk of passing it on to others. If we do get ill, it increases the risk to healthcare workers and reduces the capacity of the health services to care for others,” Prof Shelley said.
“It is easy for people to understand why those taking medication which affects their immune system, such as those who have had an organ transplant, are being asked to stay at home. However, the capacity of the immune system to respond to threats such as a virus also decreases steadily as we age. This is due to a steady reduction in the number of cells in the body’s defence system to tackle and disarm invading bacteria or viruses.”
“Immunologists who are studying the course of the Covid-19 illness have found that several days into the illness an imbalance may develop in the immune response causing excessive inflammation. This can result in acute respiratory distress syndrome and can damage other organs such as the kidney. It is not known why this occurs in some people and not in others but it is more likely to occur in older people.
In addition, Prof Shelley said, “The Irish Longitudinal Study on Ageing, TILDA, found a high prevalence of diseases such as diabetes, chronic lung disease and heart disease. A high percentage of the over 50s are taking several medications on a daily basis. While most are feeling well, these diseases can also reduce the effectiveness of their immune system.”
“It is very important that those who are cocooning try to get some daily physical exercise. That might be walking outside, around your house or garden or doing some light exercises, which can be done in a small space. Being sedentary for long periods causes muscle mass to go down and it also increases risk of heart disease, stroke and other diseases. Striking a balance is important while we are confined.”
“It is important to remember that the restrictions do not apply if anyone needs urgent medical help for any reason, such as a suspected heart attack, stroke or problems with diabetes. In that event, they should call 999 in the usual way. Emergency departments have made arrangements to separate patients who might have Covid-19 from those with other needs for acute care,” Prof Shelley said.
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