The fight against COVID-19: a report from the Italian trenches
Diego De Leo, Marco Trabucchi
Abstract
Our senior citizens are the most exposed to the consequences of the COVID-19. Frailty caused by co-morbidities makes the advanced age of many people particularly vulnerable to the infection of this new coronavirus, the characteristics of which are still largely unknown to fellow scholars. What is clear is that older adults die more frequently than younger age groups, everywhere in the world. In the Veneto Region, 36.3% of individuals who died were 85+ years old, with the mean age of those who lost their life to coronavirus being 81 years (Regione Veneto, 2020). In the last days, Italian citizens were hugely impressed by watching on television a long series of military trucks transporting the coffins of dead people away from their home places, because there is no more room in the close cemeteries or opportunities for cremation. The mental health of our seniors is particularly challenged: they feel scared by the news and aware that, if infected, they would not receive the same attention (e.g., intubation; a bed in resuscitation unit, etc) of younger individuals. Older adults with mental health conditions feel more frail and vulnerable than before: contacts with carers are now reduced to the minum, with loneliness and abandonment becoming an excruciating reality. Checking on regular assumption of drug therapies may become problematic; eating properly and keeping with personal hygiene at a sufficient level can also be quite difficult. This may increase the sense of demoralisation and despair in people. A few cases of suicide have been signalled by media (Gazzettino, 2020), but in the present chaotic situation, it would not be surprising if similar fatalities would remain mostly undetected. Demented people are particularly exposed to the impact of COVID-19; there are anecdotal reports from domiciliary care nurses and staff in nursing homes that cases of delirium are on sharp increase. This could be justified by the positioning of the virus in the central nervous system (Li et al, 2020). On the other hand, in the present situation, caregivers of people with dementia are also exposed to extra stress: limited opportunities to offer the usual level of care; food and cleaning management more problematic; worries and concerns for the possibility of contaminating an older adult that would not survive the disease; and, in a situation like the Italian one, the many ‘badanti’ (carers from Eastern Europe) without a regular contract (Rugolotto, Larotonda & Van Der Geest, 2017), now impeded to reach the home of the older adults they take care of, because intercepted by police at check points.