Wendy Jones considers the challenges of lockdown in the UK, especially for older people
The response in the UK and other developed countries to the covid-19 pandemic has, in part, been to recommend isolation of the elderly, i.e those over 70, as well as those who have underlying health conditions. It should be clear that those in these two groups, in contrast to what has been stated in some publicity material, are not necessarily at more risk of contracting the virus, but that the consequences of those over 70 and those with underlying health conditions contracting the virus are likely to be more severe in a significant proportion of cases. This would put significant strain on the capacity of the NHS to provide intensive therapeutic support, resulting in a higher proportion of fatalities in those groups.
The rationale behind the isolation of vulnerable groups to reduce, or at least spread out, the demands on the intensive respiratory care facilities is not without consequences. It is at present intended that this period should be for 12 weeks, but reading between the lines of interviews and reports it is clear that the requirement for further periods of lockdown or isolation for the identified vulnerable groups may have to be continued for many months ahead.
As a recently qualified and active “over 70” I see some difficulties ahead as a result of this necessary policy. In the population of over 70s there is admittedly a high proportion who have underlying health conditions, and therefore might be categorised as vulnerable, but there is also a proportion who are in reasonable health and might therefore be considered to be merely “venerable.” These include many who would normally be providing childcare for working parents, volunteering at day centres for other elderly or disabled individuals, and organising or actively participating in sports clubs and self-help groups which enable their members to keep fit, active and socialised. During this period of lockdown, these activities are not able to take part at any level except via the internet. We can at present only speculate on how many of the parents previously relying on grandparental support will still have jobs to go back to after the crisis has passed, and as to whether facilities for sports, social and voluntary activities will still be in existence. If not, the purposefulness of the “elderly active” will be reduced or minimised.
It is clear from conversations by phone and on social media that many of those in the designated groups are frustrated by being unable to continue in the roles that they normally carry out, whether with families or with social networks. Lack of purpose does nothing for morale. The ability to keep positive through what may well be an extended period is challenging even those with the most robust outlook on life. On the positive side, there is some opportunity (albeit somewhat limited) for those (probably only about 70% of this age group) who have facility with social media and online activity to support children’s learning. This could be by involvement with distance learning programmes, devising and sharing quizzes, or sharing knowledge on new subjects, such as how to grow vegetables. There is also the possibility to become involved in other online activities with friends, such as bridge, to replace existing face-to-face contacts and maybe even make new friends.
Keeping active is a challenge for all who cannot go out as often as they are used to, and the maintenance of good general physical and mental health is likely to be impacted in those who are confined by self-isolation. Recovery of these competences (muscle strength, bone density, social interaction skills) may not be fully recoverable, resulting in increased frailty and greater or earlier dependence on others by those who would until recently have been active, independent and supportive community members.
I suggest it could be argued that those who normally keep themselves fit and active present a lower resource demand on the NHS, both in terms of mental and physical health. As we get older, our ability to recover physical strength and fitness following periods of inactivity decreases. Socialisation by providing interpersonal support prevents calls on mental health/advocacy services. While the requirement to avoid overwhelming the NHS at the present time is real and necessary, future governments will need to understand and respond to the unintended consequences of this policy which will impact on the healthcare requirements of the nation for many years to come.
Wendy Jones is a grandmother and scientist, also active in sports groups and still working part-time as an associate hospital manager (Mental Health Act) and as an operations manager in Changing Streams.
Competing interests: None declared.