Q&A Transcript: Layton Long, Dennis Streets share advice, ways to help seniors in Chatham through COVID-19

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In the latest installment of our chats with experts and people making a difference in Chatham through the COVID-19 pandemic, we spoke to Layton Long, director of the Chatham County Public Health Department, and Dennis Streets, executive director of the Chatham County Council on Aging, about why seniors are a group at-risk for contracting COVID-19, advice for seniors and their caregivers and what different groups are doing to help this vulnerable population during this time.

The interview took place Thursday around 11:30 a.m. and was posted to the News + Record Facebook soon afterward. You can view that video by clicking here.

For the latest from the Chatham County Government on COVID-19, visit chathamnc.org/coronavirus, and you can also follow the health department on Facebook at facebook.com/chathamhealth. For the latest from the Council on Aging, visit chathamcouncilonaging.com or their Facebook page at facebook.com/ChathamCOA.

The interview has been edited for clarity.

Why are seniors considered a group that’s particularly at risk for contracting COVID-19?

Long: I think generally we all understand that seniors are more at-risk for other types of infections, and they have limitations on what they can do in a lot of ways. What we're seeing — and I think this is the biggest issue, and what the data shows from the CDC and worldwide — is that about 80 percent of those that end up either in severe care, and 80 percent of the fatalities related to COVID-19 have been persons at 65 years and older.

So it is a particularly susceptible population to very bad outcomes if they do became affected. The other part of the issue is that a lot of seniors live in congregate sites — whether it be in retirement communities, assisted livings and nursing homes — where they are in close proximity to each other. So it becomes more problematic if you do get an infection that it can spread through the facility.

Streets: With those living in assisted living, in nursing homes, it only represents about a little less than 3 percent of that population. But I would add, though, you've got those living in the continuing care retirement communities, again, often in close quarters in terms of where they eat and so on. And I would say that's closer to maybe around a total of 4,000-5,000 of that number. That suggests, though, that the vast majority of our older adults are living out amongst us in the various parts of the county.

So in addition to what Layton was talking about, in terms of their medical vulnerabilities, the physical isolation, the shelter in place, plus the social distancing that we're have to do in this situation, I think just compounds the problem. A lot of them do have conditions, chronic conditions, often more than one that might be respiratory in nature, which is one of the big factors with this disease as well as other factors like heart disease.

What are some good steps seniors should take if they haven’t already to protect themselves during this time?

Long: Well, I think it's the same things that all of us should be doing. One of the things I want to emphasize is anybody, regardless of age, should be following the governor's directive to do this today, if at all possible. If you're in a senior situation, a lot of seniors in our community needs support systems to help them maintain in the home and there's a lot about that side of the equation.

Speaking from my own personal experience with my very elderly parents, I have worked with my sister who's their primary caregiver: that she's the only one going into the house and she takes all precautions before she goes to the house. We just limit access to them. In terms of physical presence now, they still talk to people on the phone and those kind of things, the socialization aspect of it, but I think it's critical to realize that, the other way the virus is going to get there is somebody brings it to them.

And so try to put those procedures in place now, to limit those opportunities, make sure that anybody coming in the house is not sick themselves, washes their hands thoroughly. I've even talked to my sister before she goes over there, even taking a shower before she goes, just to make sure she wipes down everything in her own personal car before she goes in. She wipes down the doorknobs. There's just a lot of things you can do that take those necessary precautions just to prevent that virus the opportunity from being transmitted in the home.

Streets: All of what Layton said is just so critical, and that's something that we were certainly talking about before all this happened, but it became something that we started preaching about that first week of March with our participants that are both of our Centers, up to the point that we then had to close both centers to the public.

I think the tricky thing in this is about a quarter of our seniors in the community live alone. And so all of what Layton said in terms of the physical distancing, restricting visitation is so vital. At the same time, we don't want to leave these folks socially isolated. And so it's that balancing act. We're trying to do a lot, but a lot with the friendly calls. But it is vital that we stay in contact, not just for the social side, but also to help determine what people may still need, whether it is food or medication or pet supplies or mental health counseling or whatever it might be.

What are some things that seniors can do on their own at this time and still protect themselves?

Streets: Recently, in one of our days when we were doing friendly calls, one of our staff persons here at the Council shared with me some of the quotes from folks, the seniors who were at home, I'll just read you a couple of these because I think it gives you a sense. Now this was about a week ago, and I assume that a few things have changed, but not probably much.

This person said, “Doing well. Eating, sleeping, exercise and as best I can. My house has never been so clean.” Someone else said, “I've changed my bedsheets, done all my laundry.” I'm sure they may be doing that more frequently than maybe they have in the past. Someone else said, “I'm growing flowers.” So to the extent they can get outside, whether it's sitting on a porch or just walking out into a little garden area. This person is “enjoying the spring flowers and birds, are loving seeing the deer and rabbits. That's what keeps me going.” This person said, “Doing fine. I'm picking out a seam,” meaning I guess they were doing something in hopes that they could submit it to Silver Arts. Somebody else was working on a quilt. Somebody else was watching a church service on TV and somebody else said they “have a lot of friends calling to check on me.”

But then you also get the concerning calls or comments. This person's again worried about everybody else. This person, “Doing okay but all the churches are closed, about to go stir crazy, but hanging in there.” Somebody else said “Faith should work, always darkest before the dawn before the dawn.” Then the last one was, “You really never miss the well until the water goes dry.”

Long: I think some of the things Dennis pointed out, they’re incredibly important — getting out and physically exercising is critical, benefit to physical as well as mental health and just feeling good about yourself generally. One of the things that I did recently — my parents have never done is a video chat. If you've got somebody that is going in the home to assist with the elderly folks, then maybe they can set up (one). It was very useful because I haven't been able to see personally see my parents in a long time. So it was very useful to have that opportunity.

Streets: One thing that we hope to start on a pilot basis next week will be some, in a sense, peer support groups being facilitated either by a staff member or we have volunteer community ambassadors, others who have volunteered. It would be a group of about four or five seniors.

A lot of us seniors don't have the ability right now, they haven't used computers, they don't have access to the internet. They can't afford It. So a lot of it is the phone calling. So we're doing the friendly calls, at least once, often daily to individuals. Occasionally we have somebody tells us, “Quit calling me.” I'd rather go on err and making sure people are okay. And we've got the reassurance of the emergency management, of Layton, of the health department of the sheriff's office, that if we need somebody to go get checked on for a wellness or well-being check that we can do that as well.

But we’re going to try these peer support groups so they how they do every Friday morning with our participants, but it's open to anybody. I've been doing a telephone conference call just to update people about what we're doing, what we know from Layton and from others that we can share. Certainly the scams and the fraud are something that we're very concerned about as people live alone and they're hearing from different people, “I can do this for you, I can test I can buy your groceries,” and they're taking their money. Not so much yet in Chatham, but we know it's happening and could happen. So it's really just staying in touch through whatever means we can at this point.

Dennis, you mentioned the amount of people to live alone — there have been a lot of conversations around mental health during a time like this, so having a group like that has to be a good development.

Streets: I’ve really been pleased with people calling to want to contribute or volunteer in different ways. And people have given us for example, word search puzzles and different things. So when we're delivering meals to those who are sheltering in place, we're making copies of these. People have donated colored pencils. We're giving these to folks as, again, one other way for them to stay not only active and engaged but mentally active and engaged. And I think that's very critical.

Long: One of the suggestions I noticed from the CDC is for people to turn off the TV and the news and take a break from all of the bad information that we're continually hearing. You need to stay updated, you need to stay current on what the best advice is, but after a while, you do need a break. And particularly if you're shut at home and you're watching a TV, maybe watch something that's not so bad, you know, something humorous or funny, that might lift your spirits a little bit and, again, just turn it off and walk outside and look at the flowers if you're able to do that.

I think something that’s been really encouraging to see is the way people in Chatham have been reaching out and supporting the community as a whole, especially with seniors. What are some practical ways Chatham residents can help right now?

Streets: I don't have a real good handle at this point, we're gonna start trying to get a better handle on it. But I did mention earlier about pet supplies and so on. I do worry a lot of our seniors that live alone, and even those that don't obviously, enjoy, whether it's a cat or a dog or something else. And yet if they're not able to get out shopping, what's going on with that? And we've had a couple instances recently where people have called and said, “Can you help us out with that?” Just yesterday, as soon as we put it out on our Facebook, somebody brought some pet food.

And we don't want to be overwhelmed with pet food, but on a case-by-case basis, if we're able to publicize things, whether it's through you, your paper or whether it's through our Facebook or our website or other social media, having people respond as they have is just so uplifting and so empowering.

We’ve also seen, with others — I don’t mean to just call out a few — AngeLynn Fox at Siler City Pharmacy, who reached out to me this weekend and starting, I think Monday is when they actually started delivering free delivery of medications and other toiletries around the county, not just in Siler City. 501 Pharmacy [in Briar Chapel] I think's doing the same thing. We were working with CORA for people who they serve, and we also have served those who can no longer get their their box of food from CORA. When we deliver our meals, we're getting those (people) box of food from CORA to also go with it. This afternoon, it's a local caterer, actually a caterer from Durham, who's going to be delivering some hot food to us here that we're going to convert into frozen meals — Sweeties Southern & Vegan Catering.

These are just remarkable, I think, outreach stories that community is coming together. This morning I got an email from our emergency management that had taken a call from someone who they could just tell — who was calling just for general information about what's going on, but they could tell from the person's voice that they might have some issues going on. So immediately they referred to us and a staff member right now is following up with that individual.

It really does take people coming together. I felt a little guilty that we've had so many wonderful efforts on the part of people wanting to volunteer, volunteer with friendly calls and so on. At least at this point in time, we've tried to limit the friendly calls to our participants to those who are participants know, because again, there's so much uncertainty already. We didn’t want to introduce something new. So we're calling for them, as much as we can, and it’s a voice they know, it's somebody they trust.

I just want to thank, in whatever way, people volunteered, as well as donated because toward the cost of our shelf stable meals and and other expenses that we're incurring. So I just really want to thank Layton and all the county officials, everybody coming together.

You’ve shared a couple of these things, but what’s a quick rundown of some of the programs and practical things you guys are doing? You’ve mentioned the calls, mentioned the meals — what else is going on?

Long: Specific to seniors, we're just pushing out the information again, for the caregivers and for the general public, imploring them to — I believe the message is beginning to resonate, people are really beginning to pay attention to the seriousness of this — pay particular attention to what you're doing around seniors, because they are very susceptible to the bad outcomes with this disease, and employ those things that will protect their health, sanitizing everything they come in contact with. As far as the health department, that's what we're trying to do, get the message out. We had some discussions this morning about how we can help support Dennis or any other agency with addressing senior needs through our local nurses or other staff. We’re working looking at some of those issues. So we want to we want to react as a community here as agencies and partners to respond to the needs of all of our citizens, but particularly the seniors which may have special difficulties during this time.

Streets: Layton, thank you so much for all you are doing for the entire community, including the seniors and their families.

We first started talking, as I said, to our seniors about the seriousness of this first week of March and then realize we really did have to close our doors to the public and we did that. I think it was March 10. That first Friday before, we made sure that people were going home with again, some of these puzzles but not just puzzles and exercise. We actually gave a lot of a lot of our stretch bands and lightweights, but we also made sure that we had the emergency contact information up-to-date, that we asked them questions: “Do you want a frozen or a shelf-stable meal? Or do you need one? Are you going to be helped by family? Do you want a friendly call, and if so, how often? do you need incontinence supplies?” These kinds of questions and based on that is how we responded.

Then on the 17th of March, was really our first day getting out the meals again, either frozen or shelf-stable. And initially, we used our Meals on Wheels volunteers, most of them seniors themselves, to deliver the meals to those who are traditional homebound Meals on Wheels clients.

We also then were able to connect with Chatham Transit. It's sort of interesting, it’s more than that sort of interesting. Of course, Chatham Transit would run routes to bring seniors to our two senior centers, and now a sort of senior centers without walls. They're taking our supplies, our meals, our incontinence supplies and otherwise, each week out to the seniors on those same routes. How wonderful it is, they’ve told us, the seniors have told us and and the drivers from Chatham Transit, that they're seeing that friendly face, they still have that exchange, using all the precautions that that Layton has emphasized. So this past Tuesday, that route of by Chatham Transit continued and will continue. But we also had those same volunteers, sending the meals out to the Meals on Wheels. We've decided to further protect our senior volunteers, so that the next time we're going to be sending it out, we're going to be getting help from Layton’s staff and emergency management, law enforcement to just help us with that to make it even safer for all of us seniors.

So meals have been critical. We actually have given out close to 2,400 meals shelf-stable and frozen since we started this to over 140 different seniors. That's a fraction, obviously, of the whole population. But these are some of the seniors who are most vulnerable.

This morning, I actually ran to Durham for another supply from the NC Diaper Bank that’s an amazing organization, another nonprofit. But the incontinence supplies have been so important because they people hoarded those and they bought them off the shelves and so there wasn't a lot available. So this is really important.

What we've done is people aren't being transported to our center now, but we are still arranging for essential medical appointments through Chatham Transit. But we're emphasizing, as I know Layton has, call your doctor first and make sure that you truly do need to go to this medical appointment. I know I've canceled some for myself that I don't think were essential. If they are essential, though, we're still arranging for the transportation. I think the mental health counseling, the calls, all of that is so critical as well.

So our staff, we're close to the public, but we're keeping physical distance even in the office, but we're still here at both centers. Our kitchen is very busy. I want to give them credit for continuing to produce the frozen meals. That's been essential. We're trying to get more shelf-stable meals, so keep your fingers crossed, we initially ordered another 3,000 which we got the most recently. We're ordering it another 6,000 because there's really no telling how long we're going to need to ask folks to stay sheltering in place.

The latest numbers for COVID-19 in North Carolina is 1,857 cases with nearly 50 percent of those 50 and older, and 75 percent of the deaths 65 and older. So it’s definitely a population that I think a lot of people are concerned about. The last question for both of you guys: There’s a lot of things closed and changes — why should people living in Chatham County be attentive to the needs of the seniors in Chatham County?

Long: There's a lot of reasons. All of us hope to, at some point in time, be seniors ourselves. And we would hope that we would be given those considerations at that age. And these are folks that have dedicated their lives to the community in so many ways in whatever job they did. And so we feel a need to to help them at this at this time. This is a very different, very trying time that we're in.

The other part of the equation is that as part of a larger plan of trying to mitigate some of this is that the safer and the healthier we can keep the seniors, the less it strains the capacity of the hospitals and the medical providers to support their health needs.

So it’s critical because if a senior person becomes effective, they stand a very good possibility of needing hospitalization, a very good possibility of needing a ventilator. And even very significant possibility of dying. So I think it's incredibly important for the community as a whole that we support our seniors during this time.

Streets: And I would just add, at age 67, which is what I am, I take it personally too. We are in family, we're neighbors, we're friends, we're fellow parishioners. And I just think it's important that all of us, regardless of our age in the community, think about those that we know and those we don't know, those that are strangers to us, but might need some help.

Following though all the precautions that Layton has laid out for us and emphasize about the physical distancing — it still doesn't mean that I can't call my neighbor who I might be worried about same way I would have in a hurricane and or a snowstorm and said, “Layton, are you okay? Do you need me to do anything for you?” Whether it's taking the trash out to the road or getting the mail or picking up something at the grocery store since I might also be going, and then keeping my distance when I bring it to Layton’s house. Or I might know that Layton is not sounding exactly right, and I say, “Are you alright, is if alright if I call somebody on your behalf?” So I think it's all those things that we personally have responsibility to do.

Long: As bad as this entire situation is and continues to be, you have to always try to find a bright side. And I think the bright side is an opportunity to connect to people that you haven’t connected to before at a different level.

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