My mother turned 70 this weekend. As is typical of birthdays in the time of COVID-19, we feted her virtually with birthday hugs and kisses. To be sure, she’s extraordinarily fortunate. With my father, family and friends nearby, and her digital literacy, she is well-equipped to handle our new way of life in the pandemic age. What saddens me is that America is not well-equipped to handle her should she get COVID-19.
According to the Kaiser Family Foundation, over 50 million adults older than age 65, (almost the entire population of Americans of that age), have a higher chance of developing a serious illness due to COVID-19 because of their propensity for pre-existing chronic conditions such as diabetes and heart disease. The Journal of the American Medical Association recently shared that the death rate of those older than age 65 hospitalized with COVID-19 in New York City was almost 27 percent. It’s not difficult to see how COVID-19 could kill nearly a third of the U.S. population over age 65.
Yet faced with the disproportionate impact on older adults of COVID-19 seen in China, Iran and Italy, this country’s leaders failed to prepare. Not only was there no plan executed for all Americans, such as a focused effort to build and deploy pandemic-levels of Personal Protective Equipment, ventilators or reagents for testing, but also basic early protections for older adults were ignored.
States like Florida, South Carolina and Maine, which have large populations of older adults, delayed imposing social distancing and shelter-in-place orders, despite evidence showing that for elders with chronic conditions, public contact raises their risk of contracting COVID-19. And with these orders now in place, many isolated older adults are going hungry, often relying on important programs like Meals on Wheels.
Then there are those older adults who live in nursing homes, which have become a hotbed for COVID-19. These older adults are often isolated in their rooms, with no chance of visitors, and are dying alone. Until recently, there were no requirements that nursing homes report residents with COVID-19. Now we know our country has had more than 16,000 COVID-19 related deaths in nursing homes alone — more than the entire number of reported COVID-19 deaths in Germany, Iran or China.
As if this lack of national preparedness wasn’t enough of a burden on our healthcare workers, they are also forced to deal with the specter of rationing healthcare. There is no national framework for apportioning ICU beds and ventilators while in the midst of a pandemic. So we’re left with associations, healthcare systems and states coming up with their own methods for determining who lives and who doesn’t — known as “exclusion criteria.”
Some criteria include rationing care based on severe congestive heart failure or chronic lung disease — both of which occur in elders frequently — others disallow people with severe dementia, and still others designate certain ages and older as lowest priority. These are categories of individuals who would have no access to a ventilator if they had complications from COVID-19.
We cannot reach a situation where such criteria becomes necessary. Joe Biden agrees, as he weighed in on April 28 when he tweeted: “We shouldn’t allow rationing of health care that discriminates based on age or disability.”
If Americans valued the years in our age as we do the dollars in our bank accounts, would we have been better prepared?
Just look at Greece. Despite global ridicule for decades of poor economic management, it has so far prevented catastrophe, while having one of the highest populations of older adults in Europe.
In Greek society, elders and good health are equally valued. Happy Birthday wishes include “may you live to be 100,” and every meal begins with “to your health.” It’s easy to assume that these values have resulted, as of April 28, in only 2,534 confirmed cases and 136 deaths, one of the lowest counts in the European Union.
America could learn a lot from our Greek friends. Perhaps if we prioritized older adults and welcomed their knowledge, experience and wise counsel in times of crisis (after all, many of them survived wars, economic and social disruptions), we would value them instead of sacrificing them to our need to get on with life. Now is the time to safely reach out to older adults with offers to shop and help in other ways. Instead of embracing exclusion criteria that discount elders first, how about we practice social distancing for another month and keep older adults out of the hospital in the first place?
I’m optimistic that our ingenuity will lead to innovations and investments in public health and better preparedness. For example, important recent federal investments in food access for older adults should be incorporated into future budgets so that our already stretched infrastructure doesn’t buckle under the weight of a growing demographic shift. Also we should use this moment to pivot from ageist reflexes and take action to show how all of us have value and are worth saving, regardless of age.
No matter how much she socially distances and wears her new stylish face masks, my mother is at a greater risk of contracting COVID-19. She did tear up while watching her 9-year-old granddaughter sing Happy Birthday on FaceTime — but she’s human and misses the warm, loving embraces of her granddaughters. My mother’s name is Zoi, which means life in Greek — a fitting name because she values life. Our country needs to do more to value hers.
Peter Kaldes is President and CEO of the American Society on Aging.