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As Japan prepares for at least another month under a state of emergency, the large elderly population faces a double fight — avoiding the coronavirus and making sure the very measures taken to protect them don’t cause their health to deteriorate.

Increased calls to stay home to slow the virus have seen older people reduce both physical activity and social interaction with friends, family and neighbors, raising the risk of physical and mental decline.

Medical experts are advising seniors to exercise, eat well and stay connected with people — not necessarily face to face but by telephone, mail or social media — to stay healthy.

“Elderly people need to be active even when they stay at home, and there are a variety of ways to do physical activity,” Haruo Ozaki, who heads the Tokyo Medical Association, said last week. “When they are confined at home, they risk losing physical strength and becoming frail.”

Frailty is defined as the stage between being healthy and needing care, but proper steps can help people prevent and overcome it.

Japan has a rapidly graying society in which 28 percent of the population, or about one in four, is 65 or older — an all-time high.

Elderly people and those with underlying health conditions are known to be at higher risk of developing severe symptoms or dying if they develop COVID-19, the disease caused by the virus.

Japan’s COVID-19 total has officially eclipsed 15,000 cases, with about 550 deaths. This is far fewer than in places like the United States, where cases have topped 1 million, and Italy and Spain.

But for Japan’s elderly, that good news is tempered by data showing that mortality climbs sharply for patients over 60.

The rate for those in their 30s, 40s and 50s is below 1 percent. But that climbs to 2.1 percent for those in their 60s, 6.0 percent for those in their 70s and 12.9 percent for those in their 80s, according to health ministry data as of Saturday.

The state of emergency, which was expanded nationwide on April 16, does not contain compulsory lockdown measures, and people can only be asked to refrain from unnecessary and nonurgent outings.

As countries scramble to contain COVID-19, the World Health Organization is giving adults tips on how to stay active. They include climbing the stairs as much as possible and doing household chores.

For older people with poor mobility, the WHO recommends doing some kind of physical activity three or more days a week to improve balance and prevent falls.

A recent survey in Japan has revealed that less than 10 minutes of moderate-to-vigorous physical activity — walking the dog, playing with children or vacuuming, for instance — can lower the risk of elderly people requiring care in the future.

The research, conducted by Fukuoka Institute of Technology in cooperation with the town of Sasaguri, tracked for six years some 1,600 people age 65 and above in 2011 who did not have functional disabilities.

With no immediate end in sight to the pandemic, a panel of medical experts has recommended the government take steps to help seniors, especially those living alone, maintain their health during the stay-at-home period.

Some municipalities have already turned to rajio taiso (radio calisthenics), a program already familiar to the elderly. The short exercise routine, accompanied by piano music, has also been used in areas damaged by natural disasters to help evacuees in shelters or temporary housing stay fit.

While Iwate is the only prefecture with no reported coronavirus cases, the town of Otsuchi there has been broadcasting the time-honored NHK program twice a day via disaster prevention radio since mid-April.

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