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Letter to the Editor
DOI: 10.1016/j.gaceta.2020.09.004
Open Access
Disponible online el 1 de Noviembre de 2020
Sociodemographic aspects of the older population in front of COVID-19 pandemic in a developing country: the case of Peru
Aspectos sociodemográficos de la población adulta mayor frente a la pandemia de la COVID-19 en un país en vías de desarrollo: el caso de Perú
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Juan-Diego Mendoza-Saldaña
Autor para correspondencia
juan.mendoza.s@upch.pe

Corresponding author.
, J. Enrique Viton-Rubio
School of Medicine Alberto Hurtado, Peruvian University Cayetano Heredia, Lima, Peru
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Table 1. Cases, deaths by COVID-19 and case fatality rates (data updated September 9, 2020).
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To the editor:

On August 2020, National Institute of Statistics and Information updated population data (32,625,948 citizens)1 in which Peru became the second country with the highest mortality rate from coronavirus disease 2019 (COVID-19) around the world with 91.5 deaths per 100,000 people and a case fatality rate (CFR) of 4.32%.2 It is known public health system deficiencies could contribute to high mortality rates but sociodemographic features of individuals over 60 years old (older adult) are also matter factors which may explain the impact of the disease.

First of all, older adults are a risk group for severe COVID-19 and represent 12.7% of the national population1. In fact, almost 70% of COVID-19 deaths have been of this group age in Peru. We did not have access to the quantity data of stratified age groups but present CFRs by age and sex in Table 1. Our findings determined that males between 90-99 years was the most affected age group (CFR=39.35%). In accordance with the current evidence,3,4 we corroborated older adults and men were the most affected groups.

Table 1.

Cases, deaths by COVID-19 and case fatality rates (data updated September 9, 2020).

Items    0-9 years  10-19 years  20-29 years  30-39 years  40-49 years  50-59 years  60-69 years  70-79 years  80-89 years  90-99 years  Over 100 years 
Cases  Total  17731  31731  117138  154091  137889  113166  70551  36254  15264  2666  117 
  Women  8492  16514  56590  72760  62502  50358  31662  15754  6794  1365  74 
  Men  9239  14662  60548  81331  75387  62808  38889  20500  8470  1301  43 
                         
Deaths  Total  78  62  241  834  2444  5495  8432  7399  4269  849  20 
  Women  35  26  87  245  613  1344  2495  2314  1446  337 
  Men  43  36  154  589  1831  4151  5937  5085  2823  512  12 
                         
Case fatality rates  Total  0.44  0.20  0.21  0.54  1.77  4.86  11.95  20.41  27.97  31.85  17.09 
  Women  0.41  0.16  0.15  0.34  0.98  2.67  7.88  14.69  21.28  24.69  10.81 
  Men  0.47  0.25  0.25  0.72  2.43  6.61  15.27  24.80  33.33  39.35  27.91 

On the other hand, 42% and 29.5% of nuclear and extended families had at least one older adult respectively; and 19.6% were one-older adult households1, so they might be exposed to potential cases. In order to contain COVID-19, Peruvian government has implemented several strategies and diffuse mainly precautionary measures through the media. Nevertheless, 66.3% and 61.1% of households with at least one older adult do not have internet service and cable television, respectively and almost 17 out of every 100 older adults are illiterate at the national level1. These conditions may make it difficult the access to preventive information.

Staying at home has also been recommended but this is unlikely because 14.9% of older adults are in poverty, more than half who work (53.5%) are independent and 63% does not have any retirement system3. Furthermore, 63% of the national population, with at least one older adult, do not have a refrigerator.1 These characteristics influence this group in order to go out street or to work in informal jobs, exposing themselves to contagion risk and possible adverse outcomes.

Finally, another recommendation to avoid COVID-19 is frequent hand washing. Indeed, it has been recognized as the most efficient form of prevention among Peruvian general population (98.2%).5 Although, 10% of households, with at least one older adult, still do not have a public water supply network.1

COVID-19 pandemic affected Peru in a vulnerability context for the older population. This letter suggests sociodemographic components, including age, sex, type of household, the situation of internet service and cable television, illiteracy, economic situation, job category, the state of retirement system, the possession of refrigerator and the condition of water service, are potential key factors in shaping the pattern of COVID-19 deaths across the country. It is necessary to find a suitable way to support and reach this risk population.

Availability of data

The data of COVID-19 cases and deaths used in this letter are freely available online in Spanish at National Open Data Platform: https://www.datosabiertos.gob.pe/search/field_topic/covid-19-917?sort_by=changed.

Authorship contributions

J.D. Mendoza-Saldaña and J.E. Viton-Rubio contributed to conceptualization, data curation, formal analysis, writing-original draft, writing-review and editing. Authors guarantee the precision, transparency and honesty of the data and information contained in the letter; no relevant information has been omitted; and that all discrepancies between authors have been adequately resolved.

Funding

None.

Conflicts of interest

None.

References
[1]
Instituto Nacional de Estadística e Informática. Estado de la población peruana 2020. Lima; 2020. Available at: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1743/Libro.pdf.
[2]
Worldometer. COVID-19 coronavirus pandemic. 2020. Available at: https://www.worldometers.info/coronavirus/?.
[3]
N. Sudharsanan, O. Didzun, T. Bärnighausen, et al.
The contribution of the age distribution of cases to COVID-19 case fatality across countries.
Ann Intern Med., (2020), pp. M20-M2973
[4]
M. Alkhouli, A. Nanjundappa, F. Annie, et al.
Sex differences in case fatality rate of COVID-19: insights from a multinational registry.
Mayo Clin Proc., 95 (2020), pp. 1613-1620
[5]
J. Zegarra-Valdivia, B.N.C. Vilca, R.J.A. Guerrero.
Knowledge, perception and attitudes in regard to COVID-19 pandemic in Peruvian population.
Psyarxiv., (2020),
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