According to data of the Centre for Disease Control in the US, nearly 25 per cent of all those who have died of COVID-19 are more than 55 years old. However, it is not just the direct effects of the virus that increases mortality and morbidity among the elderly. Measures like social distancing, self-isolation and travel restrictions have a disproportionate effect on their lives, especially in matters relating to healthcare access.
Asking the elderly to self-isolate is one of the most effective COVID-19 prevention strategies. But strong intergenerational ties and issues related to living arrangements can make physical distancing difficult for older persons. About 88 per cent of elderly people in India live with their children. So their risk of contracting the infection from family members remains high. Living with the extended family may allow the elderly to access healthcare services, but a growing body of scholarship shows that it leaves them vulnerable to abuse and mistreatment. On the other hand, for the 17 million who don’t live with their extended family, or have made arrangements to live separately due to COVID-19, life is lonely. They have difficulty in accessing food, water and basic services.
Technology and internet connectivity play an important role in navigating social distancing restrictions and maintaining access to essential care, services, and important information. In India, only 7 per cent of older people have smartphones. The literacy rate among this segment is also low, further limiting access to technology and important information.
Reports have indicated that the lack of access to healthcare services could aggravate physical disabilities, hinder the effective management of communicable diseases and lead to mental ill-health problems amongst the elderly. Outpatient treatment of nearly all major non-communicable diseases has been severely affected due to COVID-related restrictions. Older people seem to be missing out on treatment for illnesses. Medical check-ups have become infrequent. All this is likely to show up in the mortality and morbidity rates among the elderly.
The precarious nature of economic work of older persons and inadequate salaries means that more than 80 per cent of such people in the workforce are either partially or fully dependent on others, who are anyway facing difficult circumstances. In its first relief package, the government announced a one-off payment of Rs 1,000 and an increase in the pension for 30 million widows and senior citizens. But this will reach only to about 20 per cent of the older people. There was no support for senior citizens in the second relief package.
Healthcare schemes like the Ayushman Bharat Yojana should have special provisions for the elderly. Tele-health and mobile home-based health care check-ups should be conducted for them. Direct subsidies to pensioners, especially in healthcare matters, can also help them tide over these difficult times. Such measures are essential to the right of a dignified life.
Shankardass is Associate Professor, Maitreyi College, Delhi University and Mallick is with the Eastern Institute for Integrated Learning in Management. Views are personal