Intended for healthcare professionals

Rapid response to:


Covid-19: control measures must be equitable and inclusive

BMJ 2020; 368 doi: (Published 20 March 2020) Cite this as: BMJ 2020;368:m1141

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Rapid Response:

Re: Covid-19: control measures must be equitable and inclusive - Open letter to World Health Organisation (and to Member States).

Dear Editor

Open letter to World Health Organisation (and to Member States).

WHO must prioritize the needs of older people in its response to the Covid-19 pandemic.

WHO is the most influential global organisation in guiding responses to the Covid-19 pandemic. It is working around the clock to issue helpful guidance for technical experts and the general public. WHO has just issued guidance for long term care facilities. [1] However, this new guidance is not placed on the main page of technical guidance reports. Instead, it is hidden behind a link to “Guidance for schools, workplaces & institutions.” People responsible for long term care facilities are unlikely to identify with this link. Even more importantly, WHO has not issued any guidance of specific relevance to the more than 98% of older people who do not live in such facilities.

This is an alarming oversight, given that this age group accounts for the large majority of severe cases and of deaths. This oversight must be addressed immediately. WHO must issue different sets of expert guidance on issues such as:

• Guidance for health workers, especially in primary care, about how to work with older people, including those who are frail and cognitively impaired.
• Guidance for older health workers (including those coming out of retirement)
• Guidance for older people and their families to manage infection risks, deal with symptoms and mitigate wider issues such as depression.

Unless WHO acts immediately to address its neglect of older people and Covid-19, we believe it will lose credibility as an organization with a special mandate to provide guidance to Member States.

Member States must urge WHO to act on this now and must ring-fence part of Covid-19 funding provided by WHO for this purpose. They must also ensure they prioritise the needs of older people in their own national responses and in their support for low and middle-income countries.

Peter G Lloyd-Sherlock
Professor of Social Policy and International Development
University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK

Alexandre Kalache
Former Director, WHO Department of Ageing and Life Course
Centro Internacional de Longevidade - ILC BRASIL , Ladeira da Glória, 26 - Bloco 3 - Centro, Rio de Janeiro - RJ, 22211-120, Brazil

Martin McKee
Professor of European Public Health
London School of Hygiene and Tropical Medicine, London, UK

Justin Derbyshire
HelpAge International, 6 Tavistock Pl, London WC1H 9NA

Leon Geffen
Executive Director
Samson Institute For Ageing Research, 234 Upper Buitenkant St, Cape Town, South Africa

F.Gomez-Olive Casas
Associated Professor
MRC/Wits Agincourt Research Unit, New School Of Public Health Building, Education Campus, University of the Witwatersrand, Parktown, South Africa

1 World Health Organization. Coronavirus disease (COVID-19) technical guidance: Guidance for schools, workplaces, and institutions.

Competing interests: No competing interests

23 March 2020
Peter G Lloyd-Sherlock
Alexandre Kalache, Martin McKee, Justin Derbyshire, Leon Geffen, F.Gomez-Olive
University of East Anglia
University of East Anglia, Norwich, UK