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Although no official figures have been provided, it is estimated that in Spain around 8,400 elderly people have died from Covid-19 in Spanish residences. In other words, just over 50% of all deaths from this coronavirus. Without a doubt, "this percentage puts on the table a deficit that would have to be addressed in some of these centers that probably did not have the appropriate level of qualification," explains Cristina Alonso Bouzón, president of the Spanish Society of Geriatric Medicine (Semeg).

First of all, it would be necessary to begin to consider the reinforcement of these institutions. In the words of this expert, "having a doctor, nursing staff and assistants who can facilitate some treatments (paracetamol and intravenous antibiotics, oxygen, palliative symptoms ...) would help people with higher levels of dependency do not have to be transferred to be well cared for. " This, without preventing, on the other hand, that those who are "more independent and require specific treatments can access a hospital and there have the same options as other younger people."

There are robust over-70s (24% of them) whose 10-year mortality is only 23% and others in worse conditions with a lethality of 75% at 10 years. Not all elders are the same just because of their age. This part of the population has a great diversity between those who are better and those who are more affected by different diseases. The variability is enormous and for this reason, Semeg doctors insist on remembering this idea to avoid violating rights.

The truth is that "the elderly are the most affected and worst treated in this crisis," says Alonso Bouzón. Precisely because of taking into account only their age, and given the overload of health services and the limitation of available resources, there is a real risk of "discrimination that is never tolerable", the geriatricians emphasize in a statement.

As the president of Semeg explains, "it has been raised in certain forums how to prioritize if there are not enough resources (such as respirators) and age has been discussed as a justification criterion." In this sense, "the Ministry of Health published a document on ethical aspects to emphasize that access to treatment cannot be denied due to age ." Before falling into "denial of aid, all possible options must be burned: in private hospitals or in other autonomous communities, for example."

But above all, the key is to evaluate each patient individually, taking into account their conditions, other possible diseases, what they do in their normal lives and from there, "choose the most appropriate treatment and offer it to them," says the expert. Sometimes, the most recommended will be a less aggressive treatment in the residence itself and others, more aggressive in a hospital.

For this, it is necessary to coordinate properly and bet on giving more medical support to the residences. In the specialist's words, "the union between health and social needs to be increased." Let's not forget that in Spain there are more than nine million people over 65 years old , and almost three million over 80 years old. According to the latest data available in our country, around 32% of COVID-19 cases occur in those over 70 years of age and 87% of mortality is concentrated in this age range.

There are compelling reasons to care for those who are being especially hit by the coronavirus. It is necessary that in order to offer them a good treatment, minimum requirements must be met and the possibility of guaranteeing the rights of the elderly. "Prevention measures in residences, where there is a high percentage of vulnerable people, are very important. It should have begun to act sooner in these centers," says Alonso Bouzón.

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