WHO must issue clearer guidelines on the needs of older people

Published

An appeal has been issued to the World Health Organisation (WHO) to increase the priority placed on the needs of older people in response to the coronavirus COVID-19 pandemic by leading academic experts on ageing and supported by HelpAge International.

In an open letter to the WHO and its member states, published in the British Medical Journal, they identified an “alarming oversight” by the WHO in failing to address the specific needs of the 98% of older people who do not live in long-term care facilities.

The majority of severe cases and deaths caused by COVID-19 are amongst the over 60s, but no guidance has been issued by the WHO for health care workers on how to work with older people. Nor has anything been produced advising older people and their families on how to manage infection risks, deal with symptoms and mitigate wider issues such as depression.

The group acknowledged the work done by the WHO, the most influential global organisation in guiding responses to the COVID-19 pandemic, in working round the clock to issue helpful guidance for technical experts and the general public. But they wanted more to be done for the specific needs of those who are most at risk from the virus.

“We cannot ignore the fact that the majority of those falling severely ill or dying as a result of COVID-19 are over 60 and the WHO must acknowledge and address the risks they face and what should be done to protect them,” said Justin Derbyshire, Chief Executive at HelpAge International.

“Member states must also ensure they prioritise the needs of older people in their own national responses and in their support for low- and middle-income countries.

“We very much respect the lead taken by the WHO in responding to this pandemic but it is now time to provide information aimed at older people and their specific care needs.”

The full text of the letter is below or can be found on the BMJ here:
bmj.com/content/368/bmj.m1141/rr-5


Rapid Response:

Re: Covid-19: control measures must be equitable and inclusive – Open letter to World Health Organisation (and to Member States).

Dear Editor

Open letter to World Health Organisation (and to Member States).

WHO must prioritize the needs of older people in its response to the Covid-19 pandemic.

WHO is the most influential global organisation in guiding responses to the Covid-19 pandemic. It is working around the clock to issue helpful guidance for technical experts and the general public. WHO has just issued guidance for long term care facilities. [1] However, this new guidance is not placed on the main page of technical guidance reports. Instead, it is hidden behind a link to “Guidance for schools, workplaces & institutions.” People responsible for long term care facilities are unlikely to identify with this link. Even more importantly, WHO has not issued any guidance of specific relevance to the more than 98% of older people who do not live in such facilities.

This is an alarming oversight, given that this age group accounts for the large majority of severe cases and of deaths. This oversight must be addressed immediately. WHO must issue different sets of expert guidance on issues such as:

  • Guidance for health workers, especially in primary care, about how to work with older people, including those who are frail and cognitively impaired.
  • Guidance for older health workers (including those coming out of retirement)
  • Guidance for older people and their families to manage infection risks, deal with symptoms and mitigate wider issues such as depression.

Unless WHO acts immediately to address its neglect of older people and Covid-19, we believe it will lose credibility as an organization with a special mandate to provide guidance to Member States.

Member States must urge WHO to act on this now and must ring-fence part of Covid-19 funding provided by WHO for this purpose. They must also ensure they prioritise the needs of older people in their own national responses and in their support for low and middle-income countries.

Peter G Lloyd-Sherlock

Professor of Social Policy and International Development

University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK

Alexandre Kalache

Former Director, WHO Department of Ageing and Life Course

Centro Internacional de Longevidade – ILC BRASIL , Ladeira da Glória, 26 – Bloco 3 – Centro, Rio de Janeiro – RJ, 22211-120, Brazil

Martin McKee

Professor of European Public Health

London School of Hygiene and Tropical Medicine, London, UK

Justin Derbyshire

CEO

HelpAge International, 6 Tavistock Pl, London WC1H 9NA

Leon Geffen

Executive Director

Samson Institute For Ageing Research, 234 Upper Buitenkant St, Cape Town, South Africa

F.Gomez-Olive Casas

Associated Professor

MRC/Wits Agincourt Research Unit, New School Of Public Health Building, Education Campus, University of the Witwatersrand, Parktown, South Africa

Reference

1 World Health Organization. Coronavirus disease (COVID-19) technical guidance: Guidance for schools, workplaces, and institutions. 

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/guidance-for-schools-workplaces-institutions