The National Czech & Slovak Museum & Library (NCSML) hosted a webinar with geriatric experts from the Czech Republic, Poland, Hungary, and the US on June 11. The topic was Impact of COVID-19 on a Mature Population – Perspectives Across the Atlantic. Presenters were: Dr. Iva Holmerova, founder of the Czech Alzheimer's Society, President of Alzheimer's Europe, and professor at Charles University; Dr. Katarzyna Wieczorowska-Tobis, Head of the Department of Geriatrics at Poznan University, School of Medical Sciences, in Poznana, Poland, and President of the Polish Geriatric Association; Dr. Agnes Egarvari, a neurologist, geriatrician, and former head of the Hungarian Social Cluster; Dr. Siddarth Pandya, a radiologist from Jackson Hospital in Miami, FL; and Dr. Naushira Pandya, a geriatrician in Fort Lauderdale, FL, and Associate Professor and Head of Geriatrics at Nova Southeastern University and former National President of the American Medical Directors Association.
Dr. Holmerova spoke about the very low incidence of cases of COVID-19 in elder homes in the Czech Republic and the strong mandates that the people and the government took together to protect the country’s most vulnerable population. She noted that at first the media was rather negative about the maturing (elder) population and saying that the death rates will be going up; but, through enforced mask wearing, social distancing, and literally no travel, the country and its mature population were able to keep confirmed cases and the number of deaths down. She went on to say that the government and Ministry of Health developed safety principles for everyone to follow and they did. Both the Czech and Slovak Republics had among the lowest rates of COVID-19 of any nation in the European Union. Slovakia, with a population of 5.4 million, had only 28 total pandemic-related deaths as of June 15. The Czech Republic, with twice the population, had 330 deaths.
Dr. Katarzyna Wieczorowska-Tobis spoke on Poland’s attention to making sure that the mature population at home is safe. Elders were encouraged to go out and get fresh air as often as possible. Because the country focused on safety and prevention in the long term care facilities, the number of cases and deaths were much lower. The country made a targeted effort to protect its most vulnerable. Ongoing education was key to make sure that the elders ate well, had exercise, and did not get depressed.
Dr. Agnes Egarvari, a neurologist, geriatrician, and former head of the Hungarian Social Cluster, spoke on the care of mature adults in the care centers throughout Hungary. Dr. Egarvari herself is the head of a long term care facility that she founded near Budapest. She said that they did not require the residents in the long term care facilities to wear masks but they did of all staff. She said that masks did not show the elder’s smiles and how they were feeling. Overall, COVID-19 incidence rates were among the lowest ones in the EU with 4,076 cases and 563 deaths as of June 15. Attention was especially given to mature adults, encouraging them to spend a lot of time outside in their gardens. In the long term care facilities, residents started their individual flower gardens and were kept active. She said working with individuals who have Alzheimer’s was the most challenging.
Dr. Siddarth Pandya, a radiologist from Jackson Hospital in Miami, FL, presented an excellent medical overview of COVID-19 and how it affects the human body. He said that all the impacts to the body from the virus are still not known. Clearly, it is well established that the virus affects the lungs and the scars on the lungs may last a lifetime. This is an area of concern especially for younger persons who get the virus. In addition, there appears to be a fair amount of negative impact to the liver, stomach, and even kidneys. He reinforced the idea that there is still so much that is unknown and in the years to come we will find out all the damage and long term impacts that stay in the body after the virus attacks it.
Dr. Naushira Pandya, a geriatrician in Fort Lauderdale, FL, and Associate Professor and Head of Geriatrics at Nova Southeastern University and former National President of the American Medical Directors Association (a professional organization of long term care providers) talked about the high incidence of COVID-19 in US nursing homes and the ongoing need to monitor and really examine why the incidence was/is so high. Clearly, as we age, our immunes system is reduced. COVID-19 is transmitted from human contact, so people living close together like in long term care facilities are more prone to catch it. In addition, those in longer team care facilities are more likely to have compounding and underlying medical conditions, such as diabetes, heart diseases, or renal problems that also reduce one’s immune system.
It was clear that how the countries handled the COVID-19 pandemic was different and the outcomes were somewhat different too, for all ages in terms of both incidence and mortality. One stark difference is that the Czech Republic, Slovakia, Poland, and Hungary all required mask wearing very early on or suffer the very real consequences of a very large fine ($1000 or more). A big take home message was the need for more communication across the Atlantic and more consistence in data collection and overall sharing of best practices with a global population that is aging.
The NCSML is re-opening to the public at the time this article was written. Future events are planned. We encourage you to check out their website, www.ncsml.org, for more information.
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