This article was first published by the PBS site NextAvenue, which named me their Influencer of the Year in Aging in 2016–and which deleted the last paragraph.
Why is coronavirus spreading across the US? Not because a virulent virus jumped from an animal into a human. Not because of China, or selfish youngers and clueless olders. COVID is spreading because the virus is new and contagious and because we live under a system that picks profit over people at every turn. The pandemic has exposed our shredded social safety net as never before, and a hospital system hollowed out by decades of cost-cutting, underfunding, and chronic understaffing by underpaid workers to benefit profiteering corporations.
This is playing out nakedly on Twitter at the moment. The hashtag #NotDying4WallStreet is trending as people recognize the implications of President Trump’s calls to end the lockdown soon, which infectious disease experts strongly recommend against. #GrandparentsShould is trending too, in response to the suggestion that grandparents should sacrifice themselves for the good of the economy. (Sample tweet: #GrandparentsShould stop voting for Nazis who want to kill them off to give the stock market a boost.)
Never have ageism and ableism been so glaringly exposed—as well as the systemic racism that underlies far higher death rates among Black and Latinx people.
We olders are more at risk from COVID19. That’s biology, not bias. Our immune systems are weaker, our lungs less elastic, and we’re 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.
The most dangerous manifestation of ageism during the pandemic is the suggestion of an age limit for medical treatment, so it won’t be “wasted.” A public health emergency can indeed make it necessary to allocate resources by health status. That’s triage. I wrote earlier, “Allocating resources by age, under any circumstances, is not triage. It is ageism at its most lethal.” I’ve since 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. These decisions involve a complex ethical calculus, delineated in this Ars Technica article and this GeriPal podcast. Age is way quicker to assess than health status, and advanced age is a clear disadvantage under these circumstances. So is having a visible disability. Boom. Such decisions are tragic, horrible, wrong, and—under these conditions—sometimes necessary. I sure don’t envy the heroic people making them in hospitals today.
In every other context, it’s up to the rest of us to push back against every form of social bias. Are testing and outreach prioritizing men over women, white people over people of color, youngers over older, cis people over trans? Are we including the most exposed—not just olders but black and brown people, people with disabilities and those who are homeless or incarcerated—in our efforts? We are engaged in a massive collective experiment to protect the vulnerable, whoever they turn out to be. It’s high-stakes, and it’s as intersectional as it can get. We are truly all in this together.
Let’s also ditch the generational finger-pointing and place the blame where it belongs. 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, and not ignored the coronavirus threat for months, there might be enough ventilators to go around.