Coronavirus Outbreak is Pandemic - Why Older People are at Higher Risk? - Seeker's Thoughts

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Coronavirus Outbreak is Pandemic - Why Older People are at Higher Risk?


The world health organization declared the novel coronavirus outbreak a pandemic. There are 118,000 cases, more than 4,000 deaths caused by this deadly virus.


A pandemic is defined as the “worldwide spread” of a new disease. Whereas, an outbreak in the occurrence of disease cases in excess of what’s normally expected and an epidemic is more than a normal number of cases of an illness, specific health-related behavior or other health-related events in a community or region.

The last pandemic reported in the world was the H1N1 flu pandemic n 2009, which killed hundreds of thousands globally.

According to the CDC, Pandemic has been a part of human history for centuries, with one of the earliest ever reported dating back to 1580. Since then, at least four pandemics of influenza occurred in the 19th century and three occurred in the 20th century.

The most severe pandemic in recent history was the 1918 influenza pandemic, sometimes referred to as the “Spanish flu.” 


The pandemic was estimated to have infected about 500 million people or one-third of the world’s population and killed some 50 million worldwide.

Scientists have found that the H1N1 flu virus had genes of avian origin. In other words, it had a connection to birds.

Then in 1957, novel influenza A H2N2 virus emerged in east Asia, triggering a pandemic that is estimated to have killed 1.1 million worldwide and 116,000 in the USA. 

The virus was comprised of genes that could link to avian influenza a virus, it had a connection to birds too.

     Also read - Global impact of Deadly Coronavirus


In 1968, a pandemic caused by an influenza A H3N2 that originated in China swept the world. That virus was comprised of two genes from avian influenza a virus.

The virus first noted in the USA in September 1968 and led to about 100,000 deaths nationwide and 1 million worldwide. Most excess deaths were in adults 65 and older, according to the CDC.

In the spring if 2009, novel influenza A H1N1 virus emerged, and then spread quickly across the world. It was found to be of Swine origin.

The CDC estimated during the H1N1 pandemic somewhere between 151,700 and 575,499 people died worldwide during the first year the virus circulated globally, 80% of the deaths were estimated to have occurred in people younger than 65.

                                        

Why coronavirus is so dangerous for older adults?

Even before the Covid-19 Coronavirus reached more than 100 countries around the world, early data from China – where the outbreak started suggested that older adults were the most vulnerable to the worst effects of the disease.

Now the current data, along with emerging research from Italy – the second most affected country in the world – are showing just how dangerous Covid-19 is for older people, particularly for those with heart, lung, and immunological conditions.

In a late February report, researchers looked at the first 72,314 patients with confirmed or suspected Covid-19 and discovered a huge variation in the case fatality rate by age group. In short, the disease appears to be deadlier in people with each passing decade.

Age, however, doesn’t tell the whole story about who is at risk of severe disease. In fact, it reveals the underlying vulnerabilities in the wider population to an illness like Covid-19. Many of these factors are concentrated among older adults, but younger people with certain underlying health problems are also at risk. The lessons we learn from older patients could help us treat and prevent the spread. That makes it all the more important to understand the variables that put older adults at greatest risk so we can develop a strategy to protect society as a whole.


Immune function declines with age. That makes us more susceptible to more severe illness.

As we age, the systems our bodies use to fight disease wear down. Not only does the body have a harder time fighting off new infections like Covid-19; it’s also more likely to be afflicted by chronic diseases that make the immune system weaker.

Let’s walk through the first part: how our bodies get worse at fighting foreign invaders, including viruses like SARS-Cov-2, which causes Covid-19.

In older adults, the number of white blood cells that find and help eliminate infections can decline. The cells also become less adept at identifying new pathogens to fight. In the case of Covid-19, the virus can also damage the immune cells that might otherwise overcome the virus. If there are fewer of these cells, to begin with, and they’re also weaker than they once were, an illness can do more damage.

“Immune function is not as robust as it is in younger people,” according to Sean Leng, a geriatrician and a professor of medicine at the Johns Hopkins University School of Medicine. “Studies over the years have shown that in most people, their immune function is pretty OK in their 60s, or even in their 70s. The immune functions go down rather quickly after age 75 or 80.”



When a response to infection kicks in, an older person’s immune system faces a higher chance of a dangerous overreaction known as a cytokine storm. Cytokines are proteins that serve as signals to the body to ramp up its infection-fighting machinery.

But during a storm, these cytokines are overproduced, which causes severe inflammation, high fever, and organ failure. In other words, it’s not just a sluggish response to infections that can harm older adults; the immune system’s overreaction to an invader can also kill. “The cause of death of this virus is, No. 1, respiratory failure, and then No. 2, probably the cytokine storm.” The good news, as two doctors at the University of Alabama at Birmingham wrote for Vox, is that we have treatments for cytokine storm syndromes, which could help save a significant number of lives in this outbreak.

Why older people have a higher prevalence of chronic disease?

The longer we live, the more likely our cells are to replicate in dangerous ways, the more damage they accumulate, and the more likely our organs are to stop functioning normally. This puts us at a heightened risk of chronic health conditions, like cancer or diabetes. Along with already weakened immune systems, these underlying diseases can also make it harder for the body to ward off infections. The takeaway: It’s not just age alone that endangers people; it’s being older with one or more chronic diseases.

Among the 105 patients who had died in Italy as of March 4, two-thirds had three or more pre-existing conditions. The most common was hypertension, followed by ischemic heart disease and diabetes mellitus. These chronic illnesses can leave organs degraded and more vulnerable to infection. Additionally, the treatments for these conditions can suppress the immune system, leaving the body susceptible to pathogens.

In a World Health Organization report on China’s outbreak, the case fatality rate in people who reported no chronic diseases was 1.4% but it shot up in groups with these conditions: “13.2% for those with cardiovascular disease, 9.2% for diabetes, 8.4% for hypertension, 8.0% for chronic respiratory disease, and 7.6% for cancer.”



Different groups of people, though, are more likely to fall into the severe or critical categories than others:

The elderly: People who are over the age of 60 are at a higher risk of developing a severe case of COVID-19, according to data collected by the WHO. The highest death rate is in people above the age of 80. Around 15 percent of people in that age group died from the disease in one set of Chinese patients. The Centers for Disease Control and Prevention (CDC) recommends that people who are older stay away from crowds and avoid nonessential travel.

Children: Children, on the other hand, don’t appear to get as sick. Very few develop the disease in the first place, and if they do, only a small group develop the severe or critical disease. No young children have died from the virus in China.



People with chronic conditions: People who have underlying health conditions like high blood pressure, kidney disease, cancer, or diabetes are also more likely to get very sick or die from COVID-19. Around 9 percent of people with diabetes who contracted the virus died, for example, as did around 8 percent of people with high blood pressure. The CDC also recommends that people in this group avoid crowds, stick close to home, and stock up on medication for their condition if they’re able to.

Everyone else: Most people who are young or healthy and who contract the virus don’t get severely ill. But if you have the virus, even if you don’t get that sick, you might come into contact with people who are more at risk — and pass the virus to them.

 That’s why it’s so important to stay home if you’re not feeling well. Minimizing the number of people each sick person infects is low-tech, but it’s the best way to slow the spread of a disease like COVID-19. It’s the goal of policies like school closures and event cancellations and why people who might have been exposed to the illness are asked to isolate themselves.
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