Older people are more vulnerable to COVID-19

From the firstly reported cases of pneumonia in late 2019, over the onset of a global pandemic in March 2020, to diverse national response models our knowledge about the virus has been changing. Treatment protocols get adjusted, policies updated, and behaviours followed. There was an observation, however, that remained the same throughout the year: older people are at higher risk of adverse outcomes of COVID-19 infection. That is why long-term care facilities in Serbia, like nursing homes and rehabilitative centres, diligently applied preventive measures. Restricting or prohibiting visits, minimizing social activities or increasing administrative demands for contact tracing have been some of them. Among other factors, they contributed to the relatively low share of infected residents (2,64%) and health/social workers (2,68%) as of May 2020[1]. Yet, at the same time, new challenges were taking shape - prolonged working hours, necessity to acquire new skills under time pressure or information sharing between multiple bodies. In order to review effects of its actions, but also to learn from their impacts, Ministry of Labour, Employment, Veterans and Social Affairs (MLEVSA) initiated a review of its response to the pandemic, in line with the WHO methodology.

Integrated approach - health and social care

Trusted with a coordinator role, WHO provided a know-how to a working group consisting of interdisciplinary members, broadly categorized in three groups: (1) social/health workers from long-term care facilities; (2) social workers from social institutions of other kind (for example centres for social work); (3) health workers from public health institutes and hospitals. From May to June 2020, the group met in plenary sessions, workshops, and ad hoc meetings to exchange experiences and identify recommendations. Equally important was a perspective from residents and employees in long-term care facilities other than social/health workers: psychologists, cleaning personnel, financial managers or cooking staff. Their opinions came through focus groups and interviews in nine long-term care facilities. The review identified good practices and outlined more than 20 actions able to strengthen MLEVSA’s emergency preparedness.  

Looking ahead to leave no one behind

Good practices and recommended actions covered a multitude of topics and actors. To facilitate their implementation, they were prioritized based on the shared estimate of urgency. Firstly, the correct usage of personal protective equipment (PPE) and related preventive measures were dominant challenges in the short term. WHO developed 24 000 posters that were distributed to more than 300 social care facilities across the country. Illustrating ways to use and dispose PPE, maintain hand and respiratory hygiene, and protect others the posters gave continuous support to health/social workers and visitors alike. This was especially important in early stages of the pandemic, as it took some time for protective routines to translate to peoples’ behaviour. Secondly, expanding the knowledge on infection prevention and control was one of recommended actions in the medium term. Towards the end of 2020, WHO organized a training on these topics for nearly 100 social/health workers from more than 40 social care facilities. Ensuring a diversity of participants and facilities, the trainings straightened both individual skills and institutional knowledge in infection prevention. Finally, looking ahead in the long term, recommendations focused on maintaining good practices and ensuring resiliency of the system. WHO support to this end looks into ways of improving pieces of legislation issued during the pandemic - updating them with new knowledge. Moreover, the learning part goes beyond the legislation to include self-care advice for all people, who had COVID-19 related illness. This is the topic of the WHO developed brochure that reaches people in 2021, thus providing advice for faster recovery from disease, with a view to promoting well-being for all at all ages.