The risk of severe illness increases with age, with older adults at highest risk. Over 95% of fatalities due to COVID-19 in Europe and 80% in China have included people older than 60 years old. In the USA, 80% of deaths were among adults 65 and above. Decreasing social interactions due to ‘social distancing’ has had a negative impact on mental and physical health in older people. Elderly face greater risk of financial hardship due to chronic nature of ailment and comorbidities, which require long term treatment and care. An Indian Institute of Technology Madras study has called for greater Government investment in public healthcare to mitigate the impact of COVID-19 on the elderly.
Based on the 75th round of the National Sample Survey (NSS) 2017-18, the study, published in the prestigious international journal Globalization and Health, found that only 18.9% of the elderly had health insurance and therefore they may not be able to bear large expenditures on health; and further, 27.5% of people whose age is 80 years or above are immobile and 70% of elders are partially or wholly financially dependent on others.
The study was undertaken by Prof. V.R. Muraleedharan, Department of Humanities and Social Sciences, IIT Madras, and Dr. Alok Ranjan, the first author who was a post-doctoral student at IIT Madras and is currently an Assistant Professor in the Department of Humanities and Social Sciences at IIT Jodhpur.
The NSS survey covered 113,823 households and 555,115 individuals from randomly selected 8077 villages and 6181 urban areas. The results showed that disparities exist in health status as well as healthcare access of elderly people across the country.
“Our research highlights ways in which the elderly may have suffered even due to COVID-19 control measures, such as social/physical distancing that could increase depression, and lead to a higher chance of inflammatory response in the elderly. There are several such ailments specific to the vulnerable elderly population. These are highlighted empirically, supported by other studies carried out in other country settings during the current pandemic”, Prof. V.R. Muraleedharan said.
The vulnerability of India’s elderly increases across economic levels, and other dimensions such as the place of residence, gender, social group (caste), marital status, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may cause detrimental health impact. Missed treatments, unavailability of drugs also pose a major health challenge to elders.
Diabetes, blood pressure, cardiovascular issues are the grim realities of old age. Most of the elderly have either one or more of these underlying conditions, apart from a weak immune system they are likely to have. The COVID-19 pandemic made access to healthcare facilities more difficult and unlike the young, the elderly may have also struggled to adapt to tele-consultations and online shopping.
Speaking about the relevance of the study to tackling future pandemics, IIT Madras Alum Dr. Alok Ranjan, Assistant Professor, Department of Humanities and Social Sciences, IIT Jodhpur, said, “The future is uncertain and we may experience such pandemics and adversaries in coming years and therefore it is important that we take lessons from the current pandemic to ensure that such disasters in the future are less detrimental to the physical and mental health of the elderly.”
The poor among the elderly would suffer more than others. As a result, their access to regular primary healthcare services, and continuity of care that is essential for those suffering from non-communicable diseases, given their dependency and lack of mobility, may have worsened further during this pandemic.
Overall, given the evidence on the possible hardships that the elderly may have already gone through during the pandemic and hardships that they may face in the future, the importance of strengthening the public health care system cannot be over-emphasized, researchers opine.
Prof. V.R. Muraleedharan (L) and Dr. Alok Ranjan (R)