According to the Centers for Disease Control and Prevention (CDC), older people and people with underlying health conditions are about twice as likely to “develop serious outcomes” from the COVID19 coronavirus—get really sick and possibly die—as younger and otherwise healthier people.
One reason is that older immune systems are less able to fight off infections. Lungs also deteriorate, becoming less elastic and resilient over time, and like the seasonal flu, COVID19 is a respiratory virus. And olders are more likely to have underlying conditions—such as heart disease, lung disease and diabetes—that make us more vulnerable to other illnesses and slower to recover.
This doesn’t mean that the day someone turns 65, they’re at higher risk. It also says very little about what any given individual is up against when it comes to getting sick or getting better. Underlying health plays a much bigger role than age does. And while older people do have more health issues, plenty are in excellent health and plenty of young people are immune-suppressed and/or live with chronic disease.
Being old doesn’t make you more likely to spread the virus either, any more than being ethnically Asian does. Yet some people have been avoiding contact with people who “look a bit Chinese.” Hello, racism! Where does ageism enter in? In suggestions, mostly on social media, that since “only old people” have been dying from this coronavirus in significant numbers, the rest of the world needn’t be too worried about it. Even worse, in suggestions of setting an age limit for medical treatment, so it won’t be “wasted” on people less likely to survive. A public health emergency can indeed make it necessary to allocate resources by health status. That’s triage. Allocating resources by age, under any circumstances, is not triage. It is ageism at its most lethal.
In some quarters the AIDS epidemic was considered divine retribution for sinful behavior. Shamefully, many of those most at risk, already marginalized by homophobia and racism, were overlooked and even left to die. Doing the same to those marginalized by ageism—the corrosive belief, at its ugly heart, that to age is to lose value as a human being—is just as reprehensible. It is not ethical, or legal, to allocate resources by race, gender, or sexual orientation. Doing so by age is equally unacceptable. Period.
No one deserves to be sick. Everyone deserves respect and care. Viruses infect everyone. Humans shouldn’t discriminate either. The way we respond to a challenge, especially a fearsome one, shows who we truly are, as individuals and societies. There’s nothing like a global pandemic to prove that we’re all in this together. Let’s act like it, in solidarity across age, race, and borders.
March 17th postscript: Since writing this post, I’ve come to understand that when hospitals get completely overwhelmed, as has happened in Italy and is likely in the US very soon, people on the front lines have to make hideous decisions, very fast, about which of the many people in dire condition are likely to benefit most from getting, say, the only available ventilator. Their job is to save as many lives as possible. Age is way quicker to assess than health status, and advanced age is a clear disadvantage under these circumstances. Boom. Such decisions are tragic, horrible, wrong, and—under these conditions—necessary. I sure don’t envy the people making them. If we didn’t have a government controlled by corporate interests like Big Pharma and insurance companies, and it had invested in decent healthcare for all, supported public hospitals, not fired the scientists trained to deal with outbreaks, gave a damn about the most vulnerable (not just olders but people with disabilities and/or substance abuse problems and/or who are homeless and/or incarcerated) and not ignored the coronavirus threat for months, far fewer people would now be at risk. Capitalism kills.
March 22 postscript: A fascinating and nuanced New York Times article about the ethics of medical rationing, and a terrific GeriPal podcast in which two doctors break this down in the light of the current crisis.
[i] https://www.aarp.org/health/conditions-treatments/info-2020/coronavirus-severe-seniors.html
Brilliant essay, as always. I have chronic breathing and allergy issues since I’m 21, and worsened by working downtown for the past 23 years in the 9/11 Ground Zero zone. Yet, I remember having to be on shot therapy twice per week when I was 24 through about 28 years old, and haven’t had to take allergy shots for 30 years. Age has nothing to do with it, as you wrote. Yet, I was recently diagnosed by the WTC Health Program as having only about 50% lung capacity. Does it scare me? Sure. Have I stopped eating Chinese food. No.
Very well said. I am sick and tired of people popping-up everywhere implying that it’s somehow ‘acceptable’ if it’s an older person who dies from the virus. Also, there is a significantly growing number of older people who are making self-damning statements that support this tainted view. Stuff like:’Well I’m older and you have to go sometime….’ almost as if this response is expected of them and they are trying somehow to placate the masses; as if it would be rude to want to go on living….
There’s a sickening attitude out there at the moment that reveals a deepening arrogance and callousness towards older people – as if they have no right to any treatment, quality of life or even of continuing to live at all. Better make way for the next generation etc….
What a world! I intend to fight my corner and stay alive as long as possible, even if it means self-isolating for as long as it takes!
As an HIV LONG TERM SURVIVOR of 36 years, and founder of the largest group of HIV LONG TERM SURVIVORS group around the world, and feeling every day what my community goes through, this new threat scares me more about the lack of empathy, the self-preservation based on fear, the ageism, racism and yes, that people are not thinking about the dangers of our mental health because we already knew that isolation and loneliness have been our biggest problems. Now, this is almost an obligatory “self-distancing”….HORRIBLE, it hurts. I come from a pandemic where we were not wanted, society saw as like happening to the worse of the worse according to them: gays and drug users, where people didn’t want to use the same bathrooms, to touch us, to even breathe the same air….IT HURTS! this new era is bringing once again the worst and the best on people……you decide.
I have been incensed by the tone of ageism attached to reporting especially at the beginning here in Ireland. Casually and callously disregarding people of a certain age as dispensable and less valued members of the population in the context of the virus crisis. Eugenics sprang to mind quiet frighteningly especially in reference to selecting who would be treated if things got worse, as the article says this is not triage. There was outrage in response by many senior medical professionals and ordinary people on some social media platforms and the tone has changed here for the better but one wonders how that will play out in practice if things really escalate. Ageism like other forms of prejudice is deeply embedded in modern western culture. We have ancient traditions world wide of revering the elderly foe their knowledge and wisdom and being of key importance. We need bring to foreground and re-embed this as the norm and afford all our people the same respect and dignity, especially when they are vulnerable irrespective of age.
I neither revere old age nor do I want to continue to revile it. Having grown up in this ageist culture, I have implicit bias against my own now 67 year old self.
I do not want to consign myself, as I’m told I should, to constant decline and diminution but neither do I want to pretend that my body is the same as when I was 40 or 30 or 20. What I want is to have the same respect and value paid to me as I did, all other things being equal, when I was younger, a younger human being. That’s all. This crisis is surfacing our beliefs about aging, our beliefs about what we value and our beliefs about our ability to fight back. My belief is that
I have the right to continue to want to look like my younger self and buy the products that help that be so. I will continue to want to stay as fit and strong as I can. I will not allow myself to be referred to as “elderly”. I will not apologize for having been on the planet 67 years. I will not identify with any homogenous stereotype of what that length of time is supposed to be or look like and I will not expect that because I’m getting older that I should claim I automatically have some special age related wisdom.
Capitalism is a serious problem and that is so because we are collectively and institutionally valued as consumers, not humans, and producers for the benefit of another, not for ourselves. In capitalism, those who consume less and produce less are valued less. What’s happening sucks but when things suck this bad, we all know that is the time for great opportunity. I intend to make the most of this time and hope others do as well.