Intended for healthcare professionals

Letters Covid-19: open letter to WHO and member states

WHO must prioritise the needs of older people in its response to the covid-19 pandemic

BMJ 2020; 368 doi: (Published 23 March 2020) Cite this as: BMJ 2020;368:m1164
  1. Peter G Lloyd-Sherlock, professor of social policy and international development1,
  2. Alexandre Kalache, former director of the WHO Department of Ageing and Life Course2,
  3. Martin McKee, professor of European public health3,
  4. Justin Derbyshire, chief executive officer4,
  5. Leon Geffen, executive director5,
  6. F Gomez-Olive Casas, associate professor6
  1. 1University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
  2. 2Centro Internacional de Longevidade—ILC BRASIL, Rio de Janeiro, Brazil
  3. 3London School of Hygiene and Tropical Medicine, London, UK
  4. 4HelpAge International, London, UK
  5. 5Samson Institute for Ageing Research, Cape Town, South Africa
  6. 6MRC/Wits Agincourt Research Unit, University of the Witwatersrand, Parktown, South Africa
  1. p.lloyd-sherlock{at}

The World Health Organization is the most influential global body 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 but it is not placed on the main page of technical guidance reports. Instead, it is hidden behind a link to guidance for schools, workplaces, and 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 how to work with older people, including those who are frail and cognitively impaired; for older health workers, including those coming out of retirement; and for older people and their families on managing infection risks, dealing with symptoms, and mitigating wider issues such as depression.

Unless WHO acts immediately to redress its neglect of older people and covid-19, it will lose credibility as an organisation with a special mandate to provide guidance to its member states.

Member states must urge WHO to act on this now and must ring fence part of the covid-19 funding provided by WHO for this purpose. They must also ensure that they prioritise the needs of older people in their own national responses2 and in their support for low and middle income countries.


  • Competing interests: None declared.