'Err on the side of safety': When can seniors get back out amid coronavirus reopening?

My husband and I sit at home day after day, looking out at the street and wondering: When can we get out and do things?

With both of us in the 65+ category (him more than me), we have been diligently heeding Nashville's "stay at home" order for those 65 and older. 

Our months of coronavirus quarantines have been spent with me working at our dining room table, the two of us sitting on our porch or taking a drive to pick up curbside food or to see our grandchildren from a distance.

We are more than ready to get back to our normal routines.

We are both aching to play with our grandchildren. I am eager to get back to the office and church and to play tennis again. My husband just wants to go to a store or join his pals for a late afternoon nip and conversation.

Even though Metro Nashville's phased in re-opening order now allows for salons, bowling alleys, fitness centers, tattoo parlors and several other enterprises to be open, the continuing order is to "stay at home" for people 65 and older. 

So how much longer before we can expect to be able to safely go out? And if we do make a bold move to venture out, what is the best — or least risky — way to do it?

When can the 65+ crowd go out?

"You have hit the most frustrating topic there is on so many levels," said Dr. Victor Legner, a geriatric specialist at Vanderbilt University Medical Center. "There are no guidelines nationally or locally."

Dr. Jim Powers, a Vanderbilt doctor who has specialized in geriatrics for more than 40 years, said just what I didn't want to hear: "When will it be over? Nobody knows, but I'd say many more months to come. Until people are immunized, (the virus) is with us."

Powers said he would "err on the side of safety" and urged seniors, especially ones with existing health issues, to take advantage of services like telehealth, grocery and restaurant deliveries and curbside pickup when possible.

He said that 85% of coronavirus deaths in Tennessee have been of people 61 or older.

"The odds are bad," he said. "At age 68, I take social distancing seriously and have personally restricted travel and exposure to groups."

Dr. William Schaffner, Professor of Preventive Medicine and Infectious Diseases at Vanderbilt University, explained that just because you are 65 and older does not mean you are more likely to get the coronavirus, but if a person in that age range gets it, they are more likely to have complications.

He also emphasized that people suffering from diabetes, heart disease, lung disease and high blood pressure are more at risk to have adverse effects from the virus. So "take another look at who you are," as you weigh the decision of whether to go out, he said.

"There is a difference in healthy old and frail old," Schaffner said. "The older you are the more cautious you should be. You should not be the first to bolt out the front door."

If you do go out, be cautious

"My advice to older adults would be to assume everyone you encounter when you go out can potentially transmit the virus, and act accordingly," said Dr. James Hildreth, president of Meharry Medical College.

He emphasized that older adults need to be proactive in protecting themselves from exposure because they are at a higher risk for severe disease.

Schaffner agreed, saying, "No matter where you are on the spectrum, if you go out, you need to be cautious."

He said its a matter determining your "risk tolerance" and doing things to minimize that risk, like adhering to staying six feet apart and having hand sanitizer with you.

"If you are going to the store, go in the  morning, stick to your list, limit the time in the store, wear a mask. Masks are the new normal," Schaffner said.

If families want to get together, they need to talk about how to be careful ahead of time,  Schaffner said. Discuss if you can be outside, no hugging and if everyone can wear a mask.

"If you want to be completely safe, lock your front door and wrap yourself in Saran Wrap," he said. "And know that when you open the door, you are opening yourself up to some risk."

"The bottom line is for people to understand the risk," Legner said. "Yes, you can do it, but do it with caution. It may take a leap of faith at some point with people weighing the risks.

"At some point we have to get back to being social beings. We should not belittle that need for companionship. Many would argue that it is essential to mental health and emotional health."

Other risks and dangers 

"I think in some cases we are pushing the limit on how long you can socially isolate and not have other adverse effects," Legner said. "A good thing is that there has been more and more of a push to consider the emotional health of older adults. It is so important."

Powers agreed, saying that in normal times, he encourages his patients to be active and to get out and interact with other people, but now he is urging them to stay home.

"There are consequences of isolation. But none of us have any immunity to (COVID-19), so it is best to not put yourself at risk," Powers said.

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"Studies have shown isolation, not just pandemic isolation, but isolation of seniors can precipitate other chronic illnesses," including diabetes and dementia, said Dr. Bryan Ward, Hospitalist System Medical Director for Ascension Saint Thomas. "It is definitely a concern."

Ward also said that even though people are being advised to stay in, they need to take care of urgent or emergency needs, said Ward.

The emergency department at St. Thomas has seen a number of cases where patients were reluctant to break their quarantine to go to the hospital for treatment, and their conditions dangerously deteriorated because of the delay in treatment. Ward emphasized that people who need urgent or emergency care should go to a hospital.

How to keep your face mask safe

• Wash your hands before putting on your face covering.
• Put it over your nose and mouth, and secure it. 
• Keep the covering on your face the entire time you’re in public.
• Don’t put the covering around your neck or up on your forehead.
• Don’t touch the face covering, and, if you do, wash your hands.
• Take off your cloth face covering carefully, handling only by the ear loops or ties.
• Place covering in the washing machine or wash in a bleach solution to disinfect.
• Be careful not to touch your eyes, nose and mouth when removing, and wash your hands immediately after removing.

Heath department guidelines

The Metro COVID-19 site cautions that "the threat of COVID-19 will be with us for the foreseeable future." Spokesman Brian Todd said the department's recommendation is to stay at home if possible, and if you go out to use the following precautions:

• Avoid large crowds.
• Wear a mask or cloth face covering.
• Use social distancing (stay at least six feet away from others).
• Use hand sanitizer after leaving stores or restaurants.
• Don’t touch your eyes, nose or mouth.
• Wash your hands with soap and water for at least 20 seconds when you get home.
• In restaurants, make sure your server is wearing a facial covering and the tables are situated where you can practice social distancing from other diners.

Reach Ms. Cheap at 615-259-8282 or mscheap@tennessean.com. Follow her on Facebook at facebook.com/mscheap, and at Tennessean.com/mscheap, and on Twitter @Ms_Cheap, and catch her every Thursday at 11 a.m. on WTVF-Channel 5’s “Talk of the Town.”