Beethoven is for. Beethoven is for. Beethoven is for. Beethoven is for crayon. Beethoven 2020. 50th anniversary here on new. Nursing homes are off bounds this is the only way for this belgian woman to visit. The coronavirus is isolating the elderly. To see my sister even a few minutes late thats just it such a great idea. First of all and cook a great school and so many others werent allowed to say goodbye in person leaving bella. He used to die alone. In countries like germany every 2nd person infected with a virus lives or works in a Cancer Center to loke downs are raising but not always for the elderly is that fair. I got the message i really hadnt expected on the weekend after 15 days in intensive care flirting with death my friends father had recovered from the corona virus and was being released is lucky all people are at highest risk and in the hospitals. The safest of places right at our reports takes you to portugal in this nursing home near lisbon a carer brings 90 year old adriano board goes to the visitors room hell be able to see through the window when his daughter and grandson enter the visitors box and theyll have to speak over the loudspeaker. Let me take this mask off so you recognise me his daughter says. He its an emotional encounter but a brief 115 minutes of intimacy through the protective glass pane the voices are slightly distorted by the loud speaker but its better than nothing when we get up to now it was very painful even though he was constantly keeping up with the news it was very painful now this method even though its not what we want is a consolation a way to see each other in a safe way. Through. The visitor boxes being constructed adjacent to the nursing home its a small room with mental ation and can be disinfected after each visit. There are 2 and a half paos in Nursing Homes in portugal and corona virus infections have occurred in one 6th of those thats why no visits have been allowed for 2 months its a painful period for everyone especially perhaps for residents who are suffering from dementia but with 3 for what some people didnt understand it some still dont think their families have abandoned them what. Others think they behaved badly and thats why they were deprived of visits we have several different situations through this time of confinement we try to explain with more calm and patients whats been going on. Portugal is gradually easing the lockdown care homes are starting to open their doors but restrictions like social distancing will be strictly enforced for the safety of the residents. Gary kennedy joins us on the phone now hes director of geriatric psychiatry at new yorks Albert Einstein college of medicine much money is an ethicist at munichs. University gail starting with you is it fair 1st of all to segregate old people. Well at least there is a justification an ethical relevant justification price alleging elderly elderly people have an increased risk was severe or 19. 00 illnesses and higher risk or fatal cause of the disease due to age related trail t. And comorbidities they often have chronic diseases so at 1st hand there isnt good ethical justification to really isolate and protect people from cope with 92nd hand i can hear but coming. Yes because their autonomy is restricted and restricting ones autonomy is a problem ethically and from a legal perspective in itself but it also has negative impacts on these other people especially if they live in care homes this isolation has negative psychological and physical impact due to the social isolation and it will be latika so they have a negative impact they it causes some harm to these elderly people so the protection must be balanced against the restriction of freedom and. Possible harm that is caused by the isolation of the elderly people but i think thats one of the biggest tragedies in this crisis is the fact that so many of the elderly have been left to die alone gerri can can you chime in here i mean is it fair is it even working has it been necessary. Well i agree with the previous speaker the key issue is when as a conflicts arise where there are competing imperatives the approaches have out as one mitigate how do you manage moderate not going to resolve. The issue of how do you protect the older person and if you cant protect them then their autonomy is at risk because of the infection it turns out that older adults are not in congregate living situations Nursing Homes other Long Term Care facilities but those who are aging in place in their own residences. They may be actually doing better psychologically than younger people do so much more custom to being on the bow and older adults have a bit of a psychological advantage as well as that they live through so much that they tend to have interestingly a little bit more of an optimistic outlook i also agree with the multi morbidity and the frailty that puts the older person at risk and for my older patients i find out frequently that theyre having friends and relatives or someone else who are dropping off food and supplies at their front door so they dont have to get out so there are still flies awaiting corin cheney and thats you know thats one way to try to protect their autonomy but at the same time. Protect their health as well gail back to you but what about all the other High Risk Groups because the elderly the only High Risk Group but they seem to be one of the only groups that are being segregated. Yeah because age is a very easy marker and especially in germany we have many elderly and Long Term Care homes and then it was very easy to just lock the homes down and there were no visitors allowed and the residents were not allowed to go out i when i had to strongly that are not effective surely thats not effective just locking out one High Risk Group when there are many. Well thats true so we have to address several High Risk Group and other High Risk Group who are would be younger adults with chronic diseases are multiple chronic conditions but its not so easy to protect them and there you have to just give provide the individuals the the adults with information and say if you have a certain disease then you have to be especially cautious and stay at home but i would like to stress one point that has been mentioned by my colleague from from new york perhaps we should grant a little more autonomy to those risk groups and let them decide themselves how much risk they want to carry especially in the out early and many out early said well i have lived my life i will die sometime anyway i dont want to restrict my freedom i am ready to carry on this risk so i think it would be good to have some more individualized solutions instead of isolating whole population groups gary i just want to ask you one more question is this from your perspective just a european problem because africas population is extremely young asia and the americas are somewhere in the middle but but europe is all. Oh no this is it this is a genuine pandemic and as you were as you were alluding to earlier others with multi morbidity compromised. You know theyre at risk as well and the issue is not locking people up i think the issue is how do you moderate it with us because we cant you know you cant eliminate risk so the goal is to kind minimize it and at the same time honoring the persons autonomy but it also making sure that you know they may not be so concerned about becoming infected themselves but if they do become infected and theyre out and about in their checking on the people so there is this difficult balance and i agree it has to be open and its frustrating for people theres no question theres no denying that this is a very difficult situation to could bear up under there just no no no denying that. Kennedy that thank you very much to assist you. Now is your chance to ask any questions you may have on the coronavirus is science correspondent. Do asymptomatic people produce the perfect antibodies against code 19 to answer this we have to look a little more closely at how the immune system works its its actually made up of 2 lines of defense what are called the innate response and the adaptive response now you can think of the innate response as a as a general defense thats on constant patrol in the body or relies on certain proteins and molecules and cells that are always present to quickly clear invaders of every stripe antibodies on the other hand come from the 2nd line of defense the adaptive immune system which involves whats called immunological memory the adaptive response recognizes very specific pathogens and makes antibodies that flag them for destruction but it takes time for your adaptive system to learn about those new pathogens most experts are guessing the answer to why some people never develop symptoms probably doesnt lie in the quality of antibodies theyre making but rather assume we are in their 1st line of defense the innate immune system. Will we need seasonal shelves if and when a vaccine is rolled out. This is yet another question will only be able to answer a couple of years down the road but we can speculate based on what we know about related corona viruses and our adaptive response to them unfortunately with this group of viruses generally our adaptive response seems to to wane over time which is why you can catch less harmful corona viruses that cause cold like symptoms more than once in the course of your life so it seems unlikely at this point that any vaccine for sars co 2. You will really be a kind of a one shot fixes all kind of a deal the good news is that with other coronaviruses immune memory at least doesnt appear to get a raised completely which means subsequent infections with them are are usually milder than the 1st one. Eric williams there if youve got any questions get in touch on our future joe im also you against a. Target for preservation german businessman bill fleet pabst owns a large concert wildlife park in zimbabwe the organizes the sustainable hunting tourism there are other Animal Protection activists in zimbabwe say hunting should not be allowed the danger of abuse is too great how trophy hunting can save species close on. Next on d w. Ringback one the water rises cities will sink into the sea. The entire stretches of land will be abandoned. When the water is strongest. It can be stopped its happening faster than anticipated. Massive records are supposed to prevent flooding but they only delayed the inevitable. And how will we live in the future. 66 major rising sea levels starts june 5th on g. W. By helicopter chases elephants there are too many here in song goes im bob. They destroy the vegetation. 100 elephants have to go. Ive been a committed conservationist for many many years and what weve created here in sango is finances to a large extent from the income from sustainable hunting. That means trophy hunting doesnt have to be this way either north or up