COVID-19: Decisions to Offer Interventions With Limited Availability Should Be Decided Based on Chance of Recovery

Abstract

Services wishing to use remote delivery must therefore ensure the necessary technology is provided to overcome access barriers, and that its use is supported. Studies have indicated that it is possible to provide equipment such as tablets, laptops, or devices connected to the TV 4,5,10 ; however, studies also frequently report technical failures even in pilot studies, which can be associated with dropouts. 6 Technical support was frequently used in feasibility studies, indicating that providing this is an important part of remote intervention delivery.In conclusion, although these interventions are potentially effective and received positively by some frail older people, those evaluating or providing services should ensure that digitally underserved older people are not left behind by facilitating contact with health care professionals and providing both the technology and technical support needed for interventions to be successful. References 1. Vestergaard S, Kronborg C, Puggaard L. Home-based video exercise intervention for community-dwelling frail older women: A randomized controlled trial.

Age discrimination in delivery of health services to old people during COVID-19 pandemic: a scoping review study

“…Thus, improvement of the resilience of the health system to deal with such a crisis is a priority for all public health systems 46 . One can mention the following as examples of discrimination against old people in the treatment process of this disease: age limitations in receiving care and treatment services, exclusion of patients with underlying diseases from the list of the service receiver, allocation of resources to people with a higher chance of survival 4,25 , preferring medical staff infected in allocating care resources 13 , giving a lower priority for old people in allocating care services and equipment 4 , elimination of old people from protocols to maintain the longest life years 4,37 , random selection of patients with similar prognosis for the delivery of medical services.…”

“…The old people, who depended on other people to meet the normal needs of their lives, were forgotten in this method, and their loneliness and isolation were intensified. Quarantine reduced old people's access to health services and care 6,37 . Ageism, at the societal level, includes stereotypes, prejudgments, and practical discrimination against old people, which in turn results in neglecting old people, their social separation, and loneliness 52,53 .…”

“…Several articles have referred to the allocation of medical facilities to old people and discriminatory measures. For example, one can mention the priority of medical staff to receive medical services as a discriminatory measure 13,37 . The following are the examples of guidelines for the delivery of health services to COVID-19 patients during the disease outbreak: exclusion of patients with underlying diseases from the list of services 9 ; decision on who should receive services, old people or young, with or without underlying diseases, medical staffs or other people 38 ; allocation of resources to those with a higher chance of survival, determination of a given age 4 to use the facilities and then reduction of it from 80 to 75 years, liberation of patients with a low chance of survival from the ventilator 25 , and decision on who survives and who dies 24,25,39,40 .…”

“…The priority of maintaining a maximum life and the random selection of patients with similar prognosis were among the problems of existing protocols 37 . In Spain, protocols were adjusted based on patients' age and disability, so that medical facilities and equipment such as ventilators, use of intensive care units, and home care services, were not provided to old people or disabled people, and the order of non-admission of people over 80 years of age to intensive care units was issued 32 .…”

“…An emphasis was put on social distancing to prevent the spread of this disease in the development of protocols. Although the social distancing law is an essential measure to prevent the spread of COVID-19 disease, in the case of old people, this law reduces care for them and limits their access to health services 4,37 . Moreover, in social distancing laws, examples of vulnerability have not been specified; hence, governments have been accused of discriminatory behavior 31 .…”