Jo DeCarlo, 86, used to be an active senior — the kind who meets friends for lunch and frequents the Waikiki Community Center, where she started taking line-dancing classes 25 years ago.

But DeCarlo’s life changed dramatically in mid-March after her doctor ordered her to stay home because of the heightened threat the COVID-19 pandemic poses for seniors. Her social life was curtailed, and picking up supplies and food became more difficult, especially when many of the neighborhood shops around her started closing.

”I’ve gotten to the point that even if it’s a robocall, I’ll take it,” DeCarlo joked recently.

But what’s happening to her and other seniors, who are at higher risk of COVID-19 due to age, is serious.

As of Sunday, 163 Hawaii seniors over 60 had tested positive for COVID-19, and 20% of those cases required hospitalization. In comparison, hospitalization was required for just 6% of the cases for those 40 to 59 years old and just over 3% for those 20 to 39 years old. These statistics show why it’s more critical for Hawaii’s seniors to stay in their homes and maintain social distancing.

“If I caught the virus, I would probably be history — that’s the reason why I’m trying to stay in and not expose myself to the germs,” DeCarlo said.

DeCarlo counts her blessings because she’s gotten services that have allowed her to follow self-isolation guidelines. If she needs anybody, she can turn to a Waikiki Community Center caseworker. Meals on Wheels delivers hot meals to her home. And, she has friends and family in Hawaii.

But sticking to social distancing recommendations can be lonely and isolating for some seniors and can lead to depression. For those who don’t have support and must go out to get food and medicine, the process can provoke fear, anxiety or frustration.

Even some seniors who have always relied on family support are now more vulnerable. Hawaii’s soaring unemployment rate, which at 37% is the highest in the nation, has put more people at risk of becoming homeless, and some of them were taking care of kupuna. Some seniors also are vulnerable to losing food, medical and other necessities as their families are stretched thin.

Connie Mitchell, Institute of Human Services executive director, said there’s been an uptick in calls from people who provide support for their kupuna and fear that job loss will lead to homelessness.

“There are people that are facing perhaps eviction after the initial moratorium,” Mitchell said. “My hope is that some of the federal stimulus money and protections will mitigate some of the damage, but we’ll have a considerable amount of fallout from this crisis.”

Mitchell said IHS has stepped up efforts to get kupuna and other vulner- able people off the street. IHS has created a new isolated space in its men’s and women’s shelters for kupuna and other vulner- able clients to safely stay.

“We’ve prioritized seniors in our coordinated entry systems. All things equal, we’ll try to help those folks first. But, homeless shelters are the last place that anyone would want kupuna and special groups to be right now,” she said.

Mitchell suggests the state launch a homeless prevention program.

Even if seniors aren’t facing housing vulnerabilities due to the new coronavirus, COVID-19 challenges could affect other aspects of their well-being.

Lori Lau, Lanakila Meals on Wheels director, said some caregivers are having a harder time supporting their seniors.

“Maybe they are afraid of passing anything to them, so they are limiting contact. Some caregivers also might have experienced job loss or wage reduction, so they are less financially stable themselves,” Lau said.

Independent seniors, who typically don’t rely on others for their care, might suddenly be struggling because they fear going out. When they do go out, it may be difficult to find what they need, she said. Some might not be technically savvy enough to order online, Lau said.

“We’ve had more people than ever contacting us wanting the meal service,” she said. “We are easily getting 75 to 100 inquires per day from people that are interested in the service since the stay-at-home recommendations. Before then we would have gotten maybe 10 people a day looking to start. Because of COVID-19 we are experiencing so much more need from folks that would normally be out and about.”

Caroline Hayashi, Waikiki Community Center president, said the center has also seen an uptick in seniors needing case management assistance, especially in Waikiki where every 1 in 3 residents is an older adult.

“So many are having a hard time getting access to their food and medicine. They are so scared of going out, and they aren’t able to pay for delivery. They don’t have cars, and they view getting on the bus as a risky activity. They can’t afford a taxi. We’ve seen so many of our clients running low on basic supplies,” she said.

Hayashi said the Waikiki Community Center is partnering with Waikiki businesses to mitigate some of the impacts that COVID-19 has had on the neighborhood’s seniors and on the center’s ability to help them.

With help from Elite Parking, TS Restaurants, the Hyatt and many others, the center has been delivering boxed meals to seniors.

It is seeking donations of cleaning products and canned goods and other staples.

Hayashi said even if seniors are OK financially and have had their physical needs met, they might have psychological issues that need to be addressed. Some clients are struggling with loneliness since Waikiki Community Center and other social outlets closed, she said.

“Negative psychological experiences affect your physical well-being and lower your immunity. Studies have shown that loneliness can be just as unhealthy as smoking a pack of cigarettes a day,” Hayashi said. “Just knowing that someone cares can make all the difference.”

Jane Belding, nearly 87, said Waikiki Community Center senior assistance coordinator Crystal Antonio has brought her great peace of mind, as have the hot-meal deliveries.

“At my age they say you have to be more careful with COVID-19, but so far, every night before I go to bed, I put my hands together and say thank you,” Belding said.