The coronavirus pandemic has created many doubts in the members of the Vincentian Family. During this time of social distancing, how can we ensure that the poor whom we assist will be provided for in a safe environment. In addition to the measures that have been recommended by health professionals and government authorities, what can be done to provide for the elderly who reside in homes and are cared for by members of the various branches of the Vincentian Family? In order to respond to these and other questions, the members of the communications team responsible for the webpage of the Society of Saint Vincent de Paul in Brazil spoke with Dr. Karla Giacomin, a specialist in geriatrics.

Doctor Karla Giacomin is a consultant with the World Health Organization. Photo credit: Manuela Antunes.

Dr. Karla specialized in Geriatric Medicine in France and has a master’s degree in Public Health and received a doctorate in Health Science. Currently she works in the municipal health care network in Belo Horizonte (Minas Gerais, Brazil) and is a university professor. She is also a consultant with the World Health Organization and with the International Longevity Centre.

Below you can read the guidance that was offered by Dr. Karla:

SSVPBRASIL – Some people classify the new coronavirus as a common cold. As a medical professional and a doctor, how would you define Covid-19?

Dr. Karla Giacomin – Covid-19 is an infection caused by a virus (coronavirus-19) that, in 80% of the cases, leads to respiratory symptoms. Therefore, initially this can appear to be a cold (fever, sore throat, cough). The cough, however, is a dry cough and the fever is high. We still know very little about this virus and are discovering new forms in which this virus manifests itself: changes in the skin, abdominal pain, fatigue, nausea, diarrhea. The problem is that 20% of those infected suffer severe consequences and some 5% needed treatment in an ICU center. In developed countries this virus seems to afflict primarily those persons who are elderly.

SSVPBRASIL – There are statistics that tells us about the presence of other diseases and illnesses that have a higher mortality rate that the present coronavirus. Therefore, at this present time is there any foundation for the measures that are being taken and recommended to the public at large?

Dr. Karla Giacomin – Yes. Other diseases, with a high mortality rate (like Ebola), claim the lives of many people but do not spread easily to others. The rabies virus, for example, has a mortality rate of 100% (when untreated) but is not transmitted from one person to another. This virus, in contrast to the dengue virus which is transmitted by a mosquito, circulates among people and one person who is infected can transmit the virus to two or three others persons … these two or three infects six or nine and then these six to nine, thirty-six to eighty one … and so on in an exponential manner. Thus there is a need to avoid contact with other people in order to reduce the number of individuals who become infected with the virus.

SSVPBRASIL – One of the ministries of the Vincentian Family, especially the members of the Society of Saint Vincent de Paul, is to visit the poor in their homes. As a result of social distancing and “stay at home” orders, many services have been closed. The poor, however, need food to survive. How should our food baskets be distributed so that the health of our members and the health of the families that we visit is protected?

Dr. Karla Giacomin – It is important to continue the various forms of humanitarian work. Food should be prepared by people who have cleaned their hands and hands should be washed immediately before beginning such preparation. It is good to have small groups organize and prepare the food baskets … social distancing should be maintained and use proper hygiene when coughing or sneezing (protect the mouth and nose by coughing or sneezing into one’s elbow). If an individual should present symptoms, then that person should not engage in such activity for at least 14 days (that person should be cared for and avoid contact with other persons). Such assistance with regard to food should be done in an organized manner so that the amount of time in which people are outside their homes is kept to a minimum. The food basket should be left in front of the door of the people who are to receive this assistance (do not enter the house of these individuals).

SSVPBRASIL – Geriatrics is your field of specialization and this gives you a certain authority when speaking about the health of the elderly … why are the elderly more prone to the effects of this virus?

Dr. Karla Giacomin – There are various reasons: (a) a immunity of individuals decreases as one grows older; (b) persons are more vulnerable to the coronavirus if they have other underlying conditions (hypertension, heart disease, diabetes, cancer, kidney or liver disease); (c) diseases in the elderly can present themselves as a form of mental confusion or drowsiness … such an individual might have a cold without a fever, pneumonia without a cough and all of this can confuse family members and professionals who might think that all those conditions are a sign of being old … and they are not.

SSVPBRASIL – Speaking about the elderly, what form of contact with them is advisable and what is the best way to do this?

Dr. Karla Giacomin – Maintain contact through the use of the telephone (if the individual has one) or if necessary by speaking at the window (if the person is a neighbor). Ask the individual(s) if they need something (people are often embarrassed to ask for assistance).

SSVPBRASIL – This present crisis involves isolation; nevertheless, the elderly often experience a profound loneliness. What can be done at this time to reduce this feeling of loneliness?

Dra. Karla Giacomin – Much advise is being offered in this regard. For example, one can utilize that material that we (the International Longevity Centre in Brazil), have developed. One can establish a time when people will pray together for the well-being of the community and for an end to this pandemic. It is most important to support the elderly who live alone (in Brazil, this group is composed mostly of women). Many elderly people care for other elderly persons and at this time they are burdened physically and psychologically … preserving their life is not only a humanitarian act but it is also a form a preserving the culture of the care giver and that has repercussions on their family members and the communities in which they live.

SSVPBRASIL – There are people who work in the homes of the elderly who are now experiencing stress and are fearful of becoming infected. Professionals cannot tell these individuals to stop working since the elderly are in need of their assistance.  What advice would you give these individuals?

Dra. Karla Giacomin – Follow all the hygienic recommendations, especially with regard to washing one’s hands. Prepare a place in your home to isolate those members who become symptomatic. Those persons should be isolated from others in a well-ventilated room. If available, use masks around such individuals. Let the health providers and professionals assign and define tasks. Divide the group so that no one person feels overwhelmed in caring for others. Collect funds to support the people involved in these activities (many professionals, because they are elderly, symptomatic or pregnant, have to be absent from their work).

SSVPBRASIL – Can the use of propolis, lemon, orange and other vitamin loaded food prevent one from being infected with Covid-19?

Dra. Karla Giacomin – Such a statement could not be affirmed. The only things that could be said is that perhaps the use of these will serve as a complement and will strengthen one’s immunity.

SSVPBRASIL – Would you recommend the use of hydroquinone for those individuals who are suspected of being infected or who have been confirmed as being infected?

Dra. Karla Giacomin – Absolutely no. Those medicines should be used with a medical prescription. They are being used in an experimental manner on patients who are seriously ill as a result of the covid-19 infection.

SSVPBRASIL – What suggestions would you offer to the members of the worldwide Vincentian Family?

Dra. Karla Giacomin – Social isolation among the elderly is a serious public health problem, one that can increase the risk of cardiovascular problems as well as mental health problems such as anxiety and depression. When the elderly are ordered to stay in place, it becomes necessary to take measures to reduce the physical and mental pressures on their health. Therefore, is it urgent to ensure them that they will receive the food and the medicines that they need (even though they will have no contact with their family or friends). This form of confinement affects especially those elderly persons who live alone and whose only social contact is outside the home, for example, when they shop or go to church or spend time at a community center. There are people who have no family member or friend who lives near to them and who depend on the services of volunteers (such as the people who are served by the members of various branches of the worldwide Vincentian Family). This is when online technology is very helpful (social networks, skype, zoom) and yet we know that many members do not know how to use this technology and many of the elderly do not have a mobile phone. More frequent telephone conversations with the elderly can by very helpful. Isolating the elderly can also reduce the transmission of the Covid-19 virus which is most important if we want to bend the curve of the pandemic and minimize the spread of this virus to groups of high-risk people. Nevertheless, fidelity to such strategies will have to diminish with the passing of time. Thus, the importance of reinforcing the restrictions with regard to direct contact … we must be careful here of not abandoning the elderly. These persons have to be visited (while maintaining the stipulated distance and the prescribed hygiene when returning home) so that they can feel that they are important in the life of someone else. The members of the Vincentian Family have an important role in strengthening the bonds of solidarity and respect among those persons who are elderly and most in need.

Source: Society of St. Vincent de Paul in Brazil
https://www.ssvpbrasil.org.br/