By Sampada A. Khatiwada

Kathmandu, Sep 1: With the increasing cases of COVID-19, the death toll in Nepal has been surging of late. As of Monday, 228 people across the nation have succumbed to the novel coronavirus infection. The death rate in the nation witnessed a sudden increase as 102 cases of COVID-19 related deaths were recorded within a span of 11 days, from August 20 to August 31.  
According to the data released by the Ministry of Health and Population (MoHP) on a daily basis, the death rate is higher in the COVID-19 patients belonging to middle adulthood and in elderly patients.
As of Monday, as many as 1,653 people, 1,070 males and 583 females, above 60 years of age have been infected with SARS-CoV-2 of which, 96 people have succumbed to the infection. Until now, 49 people, 31 males and 18 females belonging to 61-70 years of age, 32 people, 25 males and seven females belonging to 71-80 years of age, and 15 people, 12 males and three females above 80 years, infected with the virus have died.
With the old-aged people being exposed to the greater risk of COVID-19, the old-age homes have been in fear of the senior citizens being infected with the novel coronavirus.
In the United Kingdom, according to the Office for National Statistics (ONS), 8,312 COVID-19 related deaths were recorded in care homes in England and Wales up to May 1. Not only in the UK, of the COVID-19 related deaths in the USA, Italy, Spain and France, among others, majority were senior citizens.
Krishna Murari Gautam, also known as Chatyang Master, president of Aging Nepal, an NGO working for senior citizens, said, "If we look into the world's experience with COVID-19, the old-age people with underlying medical conditions are at higher risk of succumbing to the virus infection. The COVID-19 fatality rate is higher in people suffering from chronic diseases and it is no brainer that the majority of the old-age groups have the medical condition of one or the other disease."
"It is universally proven that the people above 60 years of age have low immunity power to fight the virus. So, the senior citizens residing at the old-age homes, be it private or government-owned, are at greater risk of losing their lives, if infected with the virus," said Gautam.
He added that the government should give first priority to old-age homes while conducting COVID-19 tests or while implementing the protective measures against virus spread. "Until now, no cases of virus infection have been recorded in old-age homes. But if a single case of infection is seen, then the care homes will face a dire situation," he added.
"The people in care homes are in close contact with each other as they live together, eat together and participate in the recreational activities together. If one gets infected, then the entire care home will be gripped by the virus, which may escalate the death rate in Nepal," said Gautam. "Thus, the government must consider conducting PCR tests in old-age homes and provide them with all the essentials required to prevent and combat the virus."
Dr. Jageshwor Gautam, spokesperson of the MoHP, said that the elderly, whether at home or at care homes, should be kept in isolation in order to prevent them from facing the fatal consequences. "The active members of the family, who could possibly be the carrier of the virus to their homes, must make sure that they follow all the health safety protocols while coming in contact with the senior citizens," said the spokesperson.
Likewise, Dr. Rabindra Pandey, a public health specialist, said, "We should act as if we have been infected with the virus while coming in contact with the senior citizens."
"After 60 years of age, the immune system of an individual starts weakening. Also, people above 60 years are most likely to be suffering from chronic diseases," said Dr. Pandey. "People above 60 years, particularly those suffering from chronic diseases, are naturally at greater risk of COVID-19 fatality."
The senior citizens suffering from chronic diseases must be kept in isolation to prevent them from contracting the virus. People belonging to active age should not come in direct contact with the elderly. All the safety protocols like maintaining

social distancing, wearing masks and washing hands must be followed while at home also, added Dr. Pandey.
He added that if the virus entered the old-age homes, the COVID-19 death toll of the country would surge. "We should learn from the western countries and make sure that all the public health standards are being followed in the old-age homes," he added.
Dr. Pandey said that health assistants should be mobilised in every care home and the PCR tests should be conducted frequently to avoid coronavirus infection in senior citizens.