Practical and serious coronavirus advice for older adults, please!
March 8, 2020 4:34 PM   Subscribe

I freely admit that I'm concerned. While we are physically fit and active, I just turned 65 and Mr. DrGail is 75. We are being especially careful about washing our hands and using hand sanitizer both at home and away from home. So what other changes should we make to our lifestyle in order to minimize our chances of contracting, or serving as a transmission point for, the coronavirus?

We both have hypertension (well-controlled with medication) but he has sleep apnea (for which he uses a CPAP) and DMII (with a A1C last month of 6.5, so well-controlled). We are physically fit and active; we work out at our gym five days a week, and are resistant to modifying that schedule. But we also have a habit of dining out at least once a week, engaging in recreational as well as necessary shopping, attending (small) theater events, and taking overnight or weekend trips by car. We're kind of stuck between resolving to isolate ourselves by staying home (which is admittedly much harder for me than for him) and determining that living our lives as normal is the best strategy. What do you say?
posted by DrGail to Health & Fitness (25 answers total) 15 users marked this as a favorite
Some easy things that you should do without sacrificing much:

- Adopt public habits that make you less likely to contract and transmit anything, like pushing buttons with your elbow.
- Try to get in a habit of sanitizing shared surfaces, like the things you use at the gym.
- Consider covering common shared surfaces that you might touch with dirty hands (e.g. sink handle, doorknobs, light switch) with copper tape, which almost definitely kills coronavirus quickly.
- Check to see if you are vitamin D deficient and supplement if so. Most people are deficient, so it's a good idea in general, and there's some evidence that being vitamin D deficient increases the likelihood that you will get a cold.
- Same but weaker case for vitamin C, which seems to modestly decrease cold duration if supplemented prior to catching one.
posted by value of information at 4:50 PM on March 8, 2020 [3 favorites]

According to the Associated Press:
On Friday, the CDC quietly updated its website to tell older adults and people with severe medical conditions such as heart, lung or kidney disease to “stay home as much as possible” and avoid crowds. It urges those people to “take actions to reduce your risk of exposure,” but it doesn’t specifically address flying.

[...] Some experts this week said clearer and louder guidance should be made to vulnerable people, so they take every possible step to avoid settings where they might more easily become infected. “The clear message to people who fit into those categories is; ‘You ought to become a semi-hermit. You’ve got to really get serious in your personal life about social distancing, and in particular avoiding crowds of any kind,’” said Dr. William Schaffner, a Vanderbilt University expert on infectious diseases.
The CDC guidance for People at Risk for Serious Illness from COVID-19 includes:
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.
Also, from the NYT: Gyms and Coronavirus: What Are the Risks?
Sweat cannot transmit the virus but high-contact surfaces, such as barbells, can pose a problem, a doctor said.
posted by katra at 4:53 PM on March 8, 2020 [5 favorites]

This conversation is a couple of days old now, but is supremely level-headed:

Direct from the NIH: Dr. Anthony Fauci on the Coronavirus – what we face and what we can do (this includes both the audio and a written transcript).
posted by mandolin conspiracy at 5:00 PM on March 8, 2020 [2 favorites]

What kind of working out do you do at the gym, and could you modify your routine so you work out together at home?
posted by freethefeet at 5:06 PM on March 8, 2020 [2 favorites]

As a follow up about surfaces (Vancouver Sun / MSN), which may be helpful to consider when developing a strategy:
The U.S. Center for Disease Control also found that similar coronaviruses can last up to nine days on inanimate surfaces at room temperature but that they are quickly rendered inactive with common disinfectants. On surfaces like copper and steel, similar coronaviruses last about two hours.
posted by katra at 5:09 PM on March 8, 2020 [1 favorite]

Best resource so far I've read. Bit for med professionals but useful broadly also.
posted by skepticallypleased at 5:30 PM on March 8, 2020 [10 favorites]

I'm mid-60s and having an asthma flare-up. I read that CDC warning. I went to a meeting today that was important to me, elbow-bumped instead of shaking hands because it's good practice. I have been reading the Coronavirus threads on MetaTalk, and some articles and tweets that strongly suggest that there isn't nearly enough testing happening to give a clear picture of the spread of the virus. There are no reported cases in Maine. So, I'm reducing going out, especially crowded places, practicing mild social distancing, but not self-quarantining. Not only do I not want to get sick; I don't want to carry the virus to anyone else.

Every state has a public health dept. IL Dept. Public Health. I think it makes sense to follow the US CDC and state/local Public Health Depts. as much as possible.
posted by theora55 at 6:08 PM on March 8, 2020 [2 favorites]

I think it's rational to assume that the US CDC is at least partially compromised. Consider the dance the NOAA had to do around the Alabama Hurricane fiasco. It's probably better to trust your state public health department, unless your state government is deeply ideologically Republican, in which case people at the top may be holding back to support the current political leaders. If this is the case, you may want to pay some attention to nearby states that may have a deeper commitment to factual reality (for instance, if you are in North Carolina, you may also monitor the Virginia public health department).

If you're far from any reported cases, you may want to hold off on going full hermit while you gradually ramp up social distancing as you wait for more information. But you won't know when it comes to your area until it's already been there a while. Don't panic, but don't take unnecessary risks.
posted by rikschell at 6:54 PM on March 8, 2020 [6 favorites]

Your husband in particular is at high risk if infected.

You should be minimizing all forms of activity that put you within six feet of any other people, or of touching things that other people have been spending time near, or touching themselves, as much as possible. It is time to stop going to the gym, dining out and engaging in cultural activities.

The only reason to go out should be to do needed shopping, in as few trips as possible, and when you do this, being extremely disciplined about not touching your face until you have washed your hands with soap and water for 20 seconds. Watch a video of the correct way to wash your hands. Spritzing things with rubbing alcohol will not help, and you may not be able to get more rubbing alcohol once you run out. Alcohol-based hand sanitizer will work if you have some, but watch a video of the correct way to apply it, and it's also going to be very hard to get that for quite some time. Buy soap and disposable gloves, you can still get those in lots of places.

Get some equipment to work out at home, or if you have stairs in your house and are in condition to do so, do laps on your stairs. Get some multivitamins. He should be absolutely rigorous in cleaning his CPAP.

New clusters of community spread are popping up in new locations every day. This is not the time for half-measures, or for waiting and seeing. Best case, it burns itself out quickly, or we discover an antiviral that works, and you've inconvenienced yourself for a while.

posted by strangely stunted trees at 7:19 PM on March 8, 2020 [27 favorites]

Considering that you're both, for multiple reasons, in a demographic where a COVID-19 infection could prove catastrophic if not fatal, and in a major city... can you consider altering your routine for a month or so? Can you work out at home together, go for jogs or long walks with each other, etc., for the next month?

If you decide you must continue your gym routine, wipe down your equipment with Lysol wipes or similar, and then wait a few minutes before touching it. Do not touch your face with your hands (use a clean, dry towel each time you need to touch or wipe your face while at the gym -- single use, then get a new one). Wash your hands thoroughly with soap and water after contacting shared surfaces. Consider not using any gym facilities (saunas, whirlpools, showers, hand dryers, etc) for a while. Train yourselves to recognize when you're touching a "shared surface" and thoroughly wash any part of your body that contacts it. Practice "social distancing," staying 6 feet away from people as much as you can.
posted by erst at 8:35 PM on March 8, 2020

I'm in between you and your husband age-wise. I'm very healthy but will not be going to the gym for the foreseeable future. Eating out, nope, theater nope.
posted by mareli at 8:42 PM on March 8, 2020

We're kind of stuck between resolving to isolate ourselves by staying home (which is admittedly much harder for me than for him) and determining that living our lives as normal is the best strategy.

Here in very dense Hong Kong normal life has changed dramatically, but it hasn't stopped. I think it's probably possible for you to maintain a lot of your routines, but in the very virus-aware way that strangely stunted trees mentions; the level of lifestyle change is of that magnitude. When they say "it is time to stop going to the gym, dining out and engaging in cultural activities", they are correct.

I think you can manage the risk by planning your day in limiting your social contact to the extent possible:

- do your shopping in fewer trips, at times when there aren't a lot of people around

- work out at home; replace your gym routine with something like yard work or gardening for now

- ramp up your cleaning routines

- do more cooking at home and less eating out

- connect with the important people in your life digitally

- if you're in a healthcare setting like being at a doctor's appointment, take extra precautions

- keep an eye on your mental health and keep up the routines that keep your soul happy: if you dance around to showtunes every evening or write romance novels or greet the dawn with tai chi, keep doing these things!

Finally, here's Hong Kong's official Centre for Health Protection (our CDC) advice.
posted by mdonley at 8:43 PM on March 8, 2020 [7 favorites]

No, there is no "if you decide you must continue your gym routine" for a 75-year old male with diabetes, high blood pressure, and sleep apnea. Neither you nor your husband can continue to go to the gym. Nobody should be wasting Lysol wipes right now on wiping down a fucking elliptical in any case.

This thing is moving very quickly, it's already in a lot of places in the US we don't know about yet, and the number of cases is doubling every five to seven days.

I know that everybody wants to feel helpful right now, and erst, this isn't directed at just you, but giving half-assed advice on this topic is risking human lives.
posted by strangely stunted trees at 8:49 PM on March 8, 2020 [19 favorites]

I have a suppressed immune system and despite having four housemates, at least one of whom is sick at all times, I haven't been sick with a cold/flu all year.

This is what I do at home:
When someone is sick I wipe the doorknobs, light switches, sink handles, refrigerator handles, drawer handles, and stove knobs daily, as well as the bathtub taps and the toilet seat. In your case you're not worried about someone at home, but you might inadvertently bring something home. So keep it as clean as makes you comfortable. It's good practice to take off your shoes upon arriving home and even if you don't do any of the rest of this, wash your hands the second you step inside. I also wipe down phone, keys and cash card with 70% alcohol and let it sit dry. If the air is dry when I go out, I apply a bit of Vaseline to the inside of my nose with a q-tip, and for the love of God, stay hydrated. It makes a difference. The normal stuff all applies. Don't touch your face or your mouth, and wipe down your grocery cart with those wipes. As someone above suggested, hit elevators with your elbow, or tissues in your purse, ditto for opening doors. Bring your own pen--never use a public one. I wipe my hands with wet wipes when I get back to my car after using a terminal, and I always shower as soon as I get back from the gym.

If you haven't had your flu shot, get it. It'll amp up your immune system.

If you're in a restaurant and the server seems even slightly sick, talk to the manager, then leave. Don't ask to be transferred to another table, because I guarantee you one of the coworkers already has it and isn't showing symptoms. My housemate has been sick with an upper respiratory thing this month and still went to work. She is a waiter and doesn't have sick leave and can't afford to not work. So keep that in mind when you eat out. Not only your server, but line cooks as well are probably sick. Never underestimate desperate, cavalier, or stupid.

And finally, remember, if you go to the gym five times a week, statistics say you're less likely to get sick. And most people who get Covad survive, with only mild-moderate symptoms.

If everyone were careful and could afford time off we would have wiped out the flu long ago. :(

Try not to worry too much. These precautions may seem exhausting, but I promise they become second nature quickly. This is how I've had to live for years. It's slightly annoying, but not that big of a deal, and as a result I've gotten sick far less than I did years ago with a normal immune system. These precautions do make a difference in the long run.
posted by liminal_shadows at 10:08 PM on March 8, 2020 [7 favorites]

I want to add that the above precautions should add less than fifteen minutes to your day--it seems like a long list, but the only real burden is in remembering to do it until it becomes habit--and convincing your brain you're doing fifteen minutes or less of tedious work for a reason that doesn't have an immediate payoff.
posted by liminal_shadows at 10:16 PM on March 8, 2020

As a practical matter, it may be worthwhile to note that there are real challenges right now for the American health care system (WaPo), and one of the apparent benefits from "social distancing" is referred to as "flattening the curve," (WSJ) which is considered "valuable because it prevents a surge of patients from overwhelming clinics and hospitals."

And statistically (MarketWatch/MSN, Mar. 6, 2020):
The medical journal JAMA released this paper analyzing data from the Chinese Center for Disease Control and Prevention on 72,314 coronavirus cases in mainland China, the figure as of Feb. 11, the largest such sample in a study of this kind.

The sample’s overall case-fatality rate was 2.3%, in line with the earlier global estimates for the virus. No deaths occurred in those aged 9 years and younger, but cases in those aged 70 to 79 years had an 8% fatality rate and those aged 80 years and older had a fatality rate of 14.8%.

No deaths were reported among mild and severe cases. The fatality rate was 49% among critical cases, and elevated among those with preexisting conditions: 10.5% for people with cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6% for hypertension, and 5.6% for cancer.
Covid-19 is also being described by experts as the ‘most daunting virus’ in half a century (Stat News), so responding to it as more than the flu (Guardian) seems warranted based on what is currently known.
posted by katra at 11:54 PM on March 8, 2020 [5 favorites]

Consider boosting the temperature and humidity in your house and pulling open the curtains. (Twitter thread with citations) Might not make any difference but can't really hurt.
posted by salvia at 11:56 PM on March 8, 2020 [1 favorite]

Dr John Campbell's youtube channel is a good place for level headed info on the outbreak. Here is one of his videos with info on practice for caring for yourself/a sick person.
posted by Balthamos at 1:07 AM on March 9, 2020

Giving up things that give you pleasure for a few weeks won't kill you. Avoiding the gym for a few weeks won't instantly make you out of shape. Eating at home won't kill you. Avoiding the theater won't kill you. And if you do decide you just can't live with those luxuries remember that you can have the virus without knowing it and you can spread it to people who don't have the great luxury of being able to stay home for a few weeks, like the cleaners in the gym, the workers there and every other place you want to go. I'm 70, semi-retired and seriously thinking about giving up my part-time job even though I really need the income for, like, essential things. The mods will probably delete this but if you were my sister I'd tell you the same thing. And this is what my sister, an MD, is telling me. Stay the fuck home!
posted by mareli at 6:13 AM on March 9, 2020 [9 favorites]

This paper estimates a 20% death rate for people in the 70-79 age bracket in Hubei. Linear interpolation from the previous bracket implies an approximate death rate for a 75 year old around 16% even before accounting for any extra risk factors. Diabetes is a known risk factor for death from Covid-19. Individuals with diabetes have been estimated at somewhere around triple the death rate of the background population according to the figures I’ve seen, although how that plays out across age groupings I don’t know.

What do you say?

I say: Your partner is 75, has sleep apnoea & type II diabetes. You are putting his life at risk if you do not both self-isolate, starting right now.
posted by pharm at 6:45 AM on March 9, 2020 [13 favorites]

I mean, I get you. I, too, am resistant to the idea that I jettison the very thing that's supposed to be buttressing my health. But my mother is over 70 and has asthma, and the below just showed up in the WAPO breaking news deal (I added some emphasis to the parts of it that have convinced me that you, I, and your husband need to stay out of the gym right now):

"CDC: Elderly Americans with underlying conditions should avoid travel, stockpile essentials

Elderly Americans with underlying health conditions such as heart disease, lung disease and diabetes should refrain from traveling and should stockpile essential supplies and medicines as the coronavirus continues to spread, a top official with the Centers for Disease Control and Prevention said Monday.

'The reason to stock up now is so that you can kind of stick close to home,' said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.

She personalized the message: 'My parents are in their 80s. They’re not in an area where there is currently community transmission. But I’ve asked them to stick close to home.'

The nation’s top health officials have steadily ratcheted up their warnings as the covid-19 disease caused by the coronavirus continues to spread. Messonnier’s guidance Monday was the most direct statement yet targeting the actions and movements of people who, based on evidence coming out of China, are most vulnerable to having a serious outcome if they become infected with the virus.

'We are recommending avoiding crowds,' she said."

If my mother needs to avoid crowds of potential carriers so as not to contract a virus that could kill her, then I, who have frequent contact with my mother, also need to avoid crowds of potential carriers so as not to contract a virus that could kill my mother. I need to do everything possible not to become a carrier, myself. I am not myself vulnerable. I am not in a high-risk group. I would probably just feel a bit under the weather for a week. But my mother is vulnerable. My mother is in a high-risk group. My mother could die. So now is the time to exercise an abundance of caution, avoid the gym, and exercise at home, instead. The chance that I could harm my mother is ittybitty. But the outcome is so very terrible, I'm still not taking the ittybitty chance.
posted by Don Pepino at 10:51 AM on March 9, 2020 [4 favorites]

If there is a provider doing telehealth in your area, download that app...these visits are often inexpensive even if insurance doesn't cover them (typically around $35 to see a provider), and they keep you out of medical offices.

If I were you, I'd stay home for a while and see how things go. If things are well contained, as mentioned above, you haven't really lost anything for this; you can eat at home for a few weeks, find alternate workout options (tons of video options on the internet!), and watch films instead of going to the theater. If anything, you'll come out a few bucks ahead since you won't have spent as much as usual.

If things are not well contained in that time, you may have gained significantly. The risk is currently largely unknown; there are no vaccines or known treatments for COVID-19. The pace of decompensation appears to be rapid in people with multiple risk factors. Only you can decide what risk is tolerable to you. Some people like to climb icy peaks, jump from cliffs into the oceans, run 100 km races, some like to gamble.

There are ~29,000 hospital beds in IL for a population of ~13 million. If 15% of your population gets ill in the coming weeks, that's a couple million people. If just 10% of those require hospitalization, that's 195,000 hospital beds if my math is correct. Some of those hospital beds are for deliveries of children, people with cardiology concerns, people who've had strokes, and people who have other conditions, so the effective number is much lower.
posted by OneSmartMonkey at 11:34 AM on March 9, 2020 [2 favorites]

That you feel that you "are resistant to modifying that schedule" for a few weeks or months for the health of others is the most disturbing idea to me in terms of the movement of the virus. Staying healthy does not go down the drain with modification for a bit. You will absolutely be ok with a bit of change in your schedule.
posted by MountainDaisy at 5:56 PM on March 10, 2020 [1 favorite]

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