Taiwan needs to prepare its aging population for next pandemic

台灣需要為即將到來的大流行做好準備

Healthier elders guarantee Taiwan sufficient resources to fight future deadly outbreak


TAIPEI (Taiwan News) — After more than two months of upheaval, the world has now understood how transmissible and deadly the coronavirus (COVID-19) is, especially for the elderly, who appear to be the most vulnerable amid this pandemic.

In the past weeks, the outbreak of COVID-19 has affected many developed countries. Italy, among the most hard hit, has demonstrated how disastrous things can be for an aged country unprepared for the lethal virus: 23 percent of its population are aged 65 or older, while 38 percent of its coronavirus cases are people more than 70 years old.

Although Taiwan's swift actions were able to effectively stem the spread of coronavirus, a similar virus scenario decades later would result in a completely different outcome. By 2065, 41.2 percent of Taiwan's population would be above 65 years old.

A future virus outbreak would result in medical staff overwhelmed by a wave of elderly infections.

Since the increase of elderly people is an inevitable trend, Taiwan ought to have robust seniors who are resilient to diseases and able to continue contributing to the country despite their age.

"Nations around the world are redefining the meaning of old people," said Chen Liang-gong (陳亮恭), Geriatrician at Taipei Veterans General Hospital. He believes as people live longer and healthier, using the age of 65 to define the retirement age and categorize people into a group that needs to be taken care of, loses its footing.

Chen believes the key to alleviating the burden the aging population puts on the health care system is to shift the goal of health care. Taiwan's geriatrics should work to prevent the elderly from developing disabilities, such as malfunctioned organs or mobility issues, rather than merely curing their illnesses.

A disease's influence tends to be underestimated: diabetes might shorten a patient's life for two years but will cause him eight years of kidney dialysis before he passes away. In total, the disease places eight years of disability and strain on the health care system.

"According to clinical experience, we know that many chronic diseases will just occur as people age, but we can decide when it will happen and minimize the time of disability and dementia that seniors might suffer," Chen argued. This approach means people can actually systematically free up capacity of the health care system.

Chronic diseases also cast a vast demand for personal care. In 2019, more than 260,000 foreign personal care workers supported Taiwanese households by taking care of the elderly and disabled. If another devastating pandemic were to reach Taiwan, these care takers would be unable to tend to the tens of thousands of elderly across the country.

Chen pointed out that rethinking how medical services function would be the first step to more efficient hospitals: many medical facilities have implemented integrated outpatient services to provide one-stop clinics for patients with multiple chronic diseases. These services allow doctors to provide holistic, informed medical advice to patients to make sure their ailments would not deprive them from remaining self-reliant.

In addition, this new measure could preserve more medical resources as the Taiwanese elderly can visit clinics up to 30 times per year on average, according to Chen.

A virus can be an equalizer for all age groups in a pandemic. However, a country replete with healthy elders means it has spare resources when an unprecedented disease catches people off guard; it is especially crucial for a populated island nation in which an aging population and shrinking workforce are becoming an inevitable reality.