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Older adults didn’t think COVID-19 would affect them

They didn’t change daily routine, delayed social distancing

Many individuals in the highest risk category for COVID-19 because of multiple chronic health conditions didn’t think the disease would affect them and reported not changing their behavior at the beginning of Chicago’s outbreak, reports a new Northwestern Medicine study.  

“They didn’t think they would get the virus and weren’t changing their daily routine or plans,” said lead investigator Michael Wolf, a professor of medicine at Northwestern University Feinberg School of Medicine. “If you don’t take action early on, it can be too late. Their delayed action to social distance could have put them at risk."  

The study was published April 9 in the Annals of Internal Medicine.  

Two-thirds of these patients had three or more chronic conditions, increasing the likelihood they could have serious complications or death from the disease. Many of them had lung disease, kidney transplants, cardiovascular disease and type 2 diabetes, among other conditions. 

During the first week of Illinois’ COVID-19 outbreak, before the shelter-in-place order, Wolf‘s research team at the Center for Applied Health Research on Aging at Northwestern called 673 participants in five National Institutes of Health studies the center was already conducting. The majority of participants are 60 years and older, which also puts them at higher risk for contracting the coronavirus.  

“We wanted to track their awareness of COVID-19 throughout the period of the pandemic and after to see what they’re doing differently and how it is affecting their ability to manage their chronic diseases,” Wolf said. “We were very concerned, given the conflicting public health messaging from the very beginning, that these high-risk individuals may not be getting the information they need.”

Disparities by race and social status also emerged in the survey. Black adults reported being less worried and perceived themselves less likely to get COVID-19, yet also felt less prepared for an outbreak compared to whites.

Those living below the poverty level were also less worried and perceived themselves less likely to get infected compared to those with higher incomes.  And individuals with low health literacy also felt they were not likely to get COVID-19 and were more likely to report not feeling prepared for an outbreak. 

“There were no racial or socioeconomic differences in how people perceived the seriousness of the COVID-19 threat, nor in knowledge of the virus or in changing routines and plans accordingly,” Wolf said. “These differences around level of worry, likelihood of becoming infected and feeling unprepared might reflect more longstanding social and economic disparities.”   

Wolf’s team will survey this group several more times, now checking to see if these patients can access their medication because of the shelter-in-place order or prescription shortages, how they may be now handling telehealth visits, and the overall impact of the pandemic on their personal physical and mental health. Especially now that many are not able to be seen in person or to get routine bloodwork or other tests done. 

The research was supported by the National Institutes of Health.