New Delhi: The recovery of an elderly couple, aged 93 and 88, in Kerala from coronavirus in the face of high mortality rate in the older population globally due to the infection has brought a ray of hope to other patients, with some experts describing it as “rarest of the rare” case. Thomas and his wife Mariyamma, hailing from Ranni locality in Pathanamthitta municipality in Central Travancore region, tested positive and remained critical for days, before recovering completely from the infection.
While some experts are calling it “one of the rarest of the rare case”, others attributed their recovery to good patient care system in the southern state. Globally, the death rate due to coronavirus was overwhelmingly weighted against the elderly and those suffering from various ailments. Dr Neeraj Gupta, professor in the Department of Pulmonary, Critical Care and Sleep Medicine at the Safdarjung Hospital in Delhi said,
It is one of the rarest of rare cases in the light of reported high mortality in the higher age groups, especially in the age bracket of above 70 years. It is nothing short of a miracle. It is giving a ray of hope to the healthcare workers and the elderly fighting against this dreaded disease that recovery is always possible.
Dr. Gupta, also part of the team which is treating COVID-19 patients admitted at Safdarjung Hospital, said probably this couple’s immune system was able to sustain the fight to such an extent that they were able to recover and “this gives us hope”.
A large number of older people above aged 60 have died in China, Italy, the US and the Spain, the countries which have been hit hardest by the virus. India has recorded over 1,250 positive cases of coronavirus and at least 32 deaths so far.
Globally, coronavirus has infected more than 8.5 lakh people and caused over 42,000 deaths, as on March 31. The tale of survival from India is expected to lift the spirits of both patients and doctors fighting against the monumental global crisis, said an official.
The couple’s son had travelled to Italy along with his wife and son and tested positive for the disease earlier this month. The elderly had contracted the disease after coming in contact with them and had been admitted to the Kottayam Medical College and Hospital, according to health officials in Kerala.
They were already suffering from various age-related diseases and their condition was very critical in one phase of the treatment, they said adding both Thomas and Mariyamma completely recovered from the infection. In an advisory, the Union Health Minister on Sunday said the virus infection tends to be more severe in the case of the elderly population, resulting in higher mortality. It listed some “dos and don’ts” for reducing the transmission of the virus among the aged section. The advisory said,
Elderly people are at a higher risk of COVID-19 infection due to their decreased immunity and body reserves, as well as multiple associated comorbidities like diabetes, hypertension, chronic kidney disease and chronic obstructive pulmonary disease.
Dr Arvind Kumar, lung surgeon at the Sir Ganga Ram Hospital here, said elderly people are in high mortality risk bracket as far as coronavirus infection is concerned and added,
I wouldn’t call it a rare case. Rather, it should be attributed to the excellent healthcare they received in Kerala. Survival rate increases if the health care system is not good and not burdened. In Italy too, the morality rate of people above 80 is about 14 per cent. So, healthcare system makes all the difference and how burdened they are.
In New York, the healthcare system has got overwhelmed by rising number of cases, and medical camps have been set up in the Central Park and a US Navy hospital ship ‘Confort’ has arrived in that city to provide help, he said.
Associate Professor of Geriatrics at AIIMS, and consultant of WHO, SEARO, Dr Prasun Chatterjee said that not all aged people are immuno-compromised and the severity of COVID-19 depends on one’s immune system, biological reserve and the severity of manifestation.
Considering this example what can be understood is this that these two elderly persons had a good amount of immunity to fight against the viral load, he added. The elderly are at the risk of mortality due to the fading immune system and multi-morbidity and geriatric syndrome (fall frailty and dementia and impaired mobility). And, this couple’s survival story gives a positive message that the elderly can survive this dreaded disease, Dr. Chatterjee said.
Coronavirus has claimed 11,591 lives in Italy; over 3,300 in China; 2,898 in Iran and and more than 3,100 in the US. Dr Nevin Kishore, head of bronchology & senior consultant, respiratory medicine, Max Healthcare, also said that the Kerala couple surviving COVID-19 is “not rare” but it is less likely than in younger people. He said.
Survival rate is 95 per cent in 20 and above; 70 per cent in 40-60 age group and 20-25 per cent in 90 and above.
It is also true that 80 per cent of patients who are infected with coronavirus will have mild or almost no symptoms. This section would also include some elderly people, specially those who are otherwise fit and have none of the medical conditions mentioned, he added.
Dr Udgeath Dhir, Director and Head, Cardiothoracic and Vascular Surgery, Fortis Memorial Research Institute, Gurgaon, said high mortality of the elderly to COVID-19 does not mean that older patients won’t recover. He said.
Some of them will. That is what has happened in this (Kerala couple) case. It is not a miracle. It is just a simple case of some surviving the virus. If adequate care is given, if properly treated, detected before it becomes too severe, there is a good chance anyone can recover from this virus.
Dr Neeraj Gupta of Safdarjung Hospital, who calls this a rare case, noted that in Italy a 102-year-old woman surviving the onsalught of COVID-19 proves the point and there can be several more such cases across the world, which come as a “glimmer of hope in this dark hour”.