Interviewer: Dr. David Strain, thank you very much for
taking the time to do this interview with us today to
discuss the impact of COVID specifically in the elderly and in care homes.
Let me start by asking you about the core of the problem.
Why does the same SARS-2 virus lead to
such disparate disease outcomes in the
elderly, compared to the younger general population
(basically anyone under the age of 60, 65)?
Dr. Strain: Hi Scott, thanks for giving me the opportunity to talk about this.
You've asked a really important question there.
We've heard lots about COVID in younger adults,
those under the age of 65,
and how it causes this cytokine storm,
which is the inflammatory response that
ultimately puts people on ITU and sadly kills people.
Most recently we've heard that steroids can ameliorate this.
But in our older population,
it's a very different disease.
It's a highly transmissible viral illness that spreads
more like a vascular event than it does a typical respiratory disease.
As a result, the symptoms are very different.
Our patients are presenting with an acute delirium that's often unrecognised.
They can present with vascular events that might be strokes,
small vessel disease events,
progression of their dementia.
Very commonly, we just see very vague non-specific diarrhoea, nausea, vomiting.
Of course, the symptoms that we heard about in younger adults don't
necessarily present in the older adults because they
just don't notice things like the anosmia,
or the generalised fatigue that they go on.
The symptoms are poorly recognised and therefore