Beethoven its for. Beethoven. And beethoven is for. Beethoven is for. Beethoven 2020 to 50000 or verse 3 here on t w. No signal arms are off bounds this is the only way for these belgian woman to visit. The coronavirus is isolating the elderly. To see my sister even a few minutes like thats just its such a great idea i feel. First of all and i couldnt greats woman. So many others werent allowed to say goodbye in person leaving relatives to die alone. In countries like germany every 2nd person infected with the virus lives or works in a Cancer Center the local towns are raising but not always for the elderly is that fear. I got the message i really hadnt expected on the weekend after 50 days in intensive care flirting with death my friends father had recovered from the corona virus and was being released is lucky oh people are at highest risk and in the hospitals no care homes are the safest of places right now a report takes you to portugal. In this nursing home near lisbon a carer brings 90 year old adriano borders to the visitors room youll be able to see through the window when his daughter and grandson enter the visitors box and then have to speak over the loud speaker. Let me take this mask off so you recognize 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 the up to now it was very painful you can know he was constantly keeping up with the news it was very painful and i have 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 ventilation and can be disinfected after each visit. There are 2 and a half 1000 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 or 4 would give the word some people didnt understand it some still dont think their families have abandoned them or. What others think they behaved badly and thats why they were deprived of visits you 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 for letting elderly elderly people have an increased risk was severe or cope with 19. 00 illnesses and higher risk for 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 it causes some harm to these elderly people so the protection must be balanced against the restriction of freedom and the 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 of being left to die alone gary 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 the the 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 resolve. The issue of how do you protect the older person and if you cant protect them their autonomy is at risk because of the infection it turns out that older adults not in congregate living situations Nursing Homes other Long Term Care facilities but those who are. In place in their own residences. They may be actually doing better psychologically than younger people do so much more custom to being out and about 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 flights awaiting risk of corrin cheney and thats you know thats one way to try to protect their autonomy but at the same time. Protect their health as well gayle 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 will add to this surely that is not effective surely thats not effective just locking out one High Risk Group when there are many well that thats true so we have to address several High Risk Group another High Risk Group who are would be younger adults with chronic diseases on 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 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 and 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 a somewhere in the middle but but europe is all. Oh no this isnt this is a genuine pandemic and as you were as you were alluding to earlier others with multi morbidity compromised of unity. 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 the kind infected and theyre out and about in there checking out the people there is this difficult balance and i agree it has to be open and it is frustrating for people theres no question theres no denying that this is a very difficult situation to. Bear up under there just no denying that. Kennedy that thank you very much to assist. Now its your chance to ask any questions you may have on the coronavirus is our 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 wore suits 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 it 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. Will really be a kind of a one shot fix is all kind of the 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. Williams that if youve got any questions get in touch on our digital im in physical and ill see you again soon about. The virus has become talk of the system. Is the world on the brink of a major transition some believe globalization is coming to an end while others think we should keep going full speed ahead of future for as long as we can. Or is it time for a clean deal future scenarios for the economy and Society Total 3000. 00. Toughed talk to. Come to want to. Discover the baja was effective you almost cant overestimate the central influence of our house was on the artists training. How the radical ideas developed by an art school travelled around the world 100 years our house. Our house world part to the effect. T. W. When the water rises cities will sink into the sea. Entire stretches of land will be abandoned. And the water rise. Cannot be stopped its happening faster than anticipated. Massive sprinklers are supposed to prevent flooding but they only delay the inevitable. Oh will when live in the future. 66 may. See levels starts to slip on g. W. Welcome to global 3000. 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