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The double risk that vulnerable populations face during COVID-19 quarantines
Published 23 April 2020
Beyond the most evident victims of the coronavirus crisis – those who become seriously ill and those who die from the disease – a less-visible but increasingly at-risk population suffers as global quarantines and social distancing remain in place. The elderly, those with mental diseases and other vulnerable people are the largely silent and sometimes overlooked victims of the pandemic.
Isolation and lack of social contact can be challenging and even unhealthy for all of us, says pathologist and Alzheimer’s disease expert Antonella Santuccione Chadha. But for those who are most vulnerable, it can be “absolutely detrimental,” she says.
“For those who are living with mental diseases, such as Alzheimer’s, this crisis is one of the worst things that can happen,” says Antonella, the Global Medical Lead Partnerships Alzheimer’s Disease at Roche.
People living with Alzheimer's, for example, already belong to a high-risk group. They are typically older, and elderly people are the highest mortality group for COVID-19. But the situation is compounded because elderly people are also frail, and because of their comorbidities – coexisting chronic diseases such as diabetes, heart disease, or depression, for example.
“We know that staying engaged within a society as well as with nature is highly protective for our cognitive function,” Antonella says. “So for these people living with Alzheimer’s, this situation we are in just doesn't do them any good.”
Over and over, experts have said that social distancing is one of the best ways to prevent spread of the disease.
“That’s why it’s so important that the rest of us maintain social distance as much as possible, helping to keep the pandemic phase as short as possible, with the greatest possible outcome,” Antonella says.
At the end of the day, it’s an appeal, a call to all humans, to really do the best that they can to comply with the guidance of governments so we can keep this quarantine as short as possible, and to help those people who in many cases suffer the most. This is something which is very dear to my heart.”
When we consider the effect of social distancing and quarantine on women, the news gets worse.
“Twice as many women suffer from Alzheimer’s disease than men,” says Antonella, who co-founded the Women’s Brain Project, an international organisation advocating and researching women’s brain and mental health. “And depression and anxiety, too, are gendered situations; it’s twice as high in women, generally. So it’s really a big group of people out there. These are people who are already vulnerable, and this situation makes it even harder.”
In the first few weeks of the lockdown in Italy, emergency call centers for reports of family violence saw a disturbing trend. The phones stopped ringing. Highly likely, it wasn’t that the violence stopped, Antonella says. In fact, around the globe family violence is spiking. The too-close quarters of quarantine, financial worries and increased stress can make an already-bad situation worse. A story in The Guardiansays activists see a pattern of increasing abuse in countries from Brazil to Germany, China and Greece.
The Andalucian Women’s Institute partnered with more than 3,800 pharmacies to launch the “Mascarilla 19” programme to help women who are isolated with their abusers. Women can use the code word “Mask 19” to signal abuse or violence during a visit to the pharmacy, and get help. The programme has since spread throughout Europe and beyond.
“Of course, if you’re quarantined with your spouse or partner and you’re a victim of domestic violence, you can’t safely take the chance from home to talk with someone who can help you,” Antonella says. “And it’s the same for children. It seems that lots of aggressivity may go towards children. Vulnerable people pay the highest price. And certainly as I said, social isolation doesn’t do any good.”
The coronavirus crisis underscores the need for strategies that identify people who are at higher risk or vulnerable – like the elderly, or people with other conditions – and to have systems in place to protect them, Antonella says. “And it’s our responsibility as a society to do that.”
Personalised healthcare, sex and gender
Watch an extended interview with Dr. Antonella Santuccione Chadha from the Women’s Brain Project. She discussed her current research, the current unknowns when it comes to sex and gender, how these factors influencing brain and mental health and also how personalised healthcare can bring new insights.