Blog Harvey A. Friedman Center for Aging COVID-19 Infectious Disease

Ageism in the time of coronavirus

Written by Jeff Brandt, MSW, Brown School; Natalie Galucia, MSW; Nancy Morrow-Howell, PhD, MSW; and Emma Swinford, MPH, MSW

There is no denying it: the threat of COVID-19 looms large for older adults.

According to a CDC study, 80% of Coronavirus deaths in the U.S. between February 12 and March 16 occurred in adults age 65 and older. More than half of ICU admissions were for older adults. International data indicate similar trends, where the majority of severe cases are seen in older populations. In Mainland China, 81% of deaths were in people older than 60. Data collected in Italy indicate that while the fatality rate for people under the age of 59 was less than 1%, the rate increases to almost 20% for those between ages 80-89.

Most readers will be familiar with this genre of statistics, where older adults face higher mortality rates and where the rate of death increases with each age cohort. Yes, the threat posed to older adults by COVID-19 is alarming. But the threat is made worse by the ageism that this pandemic has engendered.

Older adults are at a greater risk of experiencing severe outcomes associated with COVID-19 because they are more likely to have chronic health conditions, compromised immune systems, or to live in residential settings like nursing homes and independent living complexes where the virus can spread easily. By the same token, younger people with chronic health conditions such as diabetes cardiovascular disease also face a higher risk of mortality.

Thus, chronological age by itself does not necessarily present risk. While there are a growing number of protocols in hospitals and intensive care units focused on children and adults, there are very few that are specific to the care of older adults. The entire adult population, including older adults, is not a homogenous group. When these protocols are not in place and hospitals become overwhelmed with severe cases, older adults’ perceived frailty puts them at risk for receiving lesser care.

The rationale is that older people are less likely to survive and have fewer years to live anyway. As Desmond O’Neill of Trinity College-Dublin points out, this line of thinking is problematic, as it suggests that subpopulations in our society that have lower life expectancies, like low-income people and homeless people, could also be viewed as meriting less attention.

Ageism is a prejudice so ubiquitous and unrecognized that few stop to question the assumption that older people ought to suffer the brunt of COVID-19 fatalities—perhaps even in the name of restarting the economy. Many social media commenters have suggested that Coronavirus is not a serious concern. Others have argued that temporarily shuttering businesses has been more damaging than the virus because “only old people” are dying.

However, we know that this claim is untrue. Younger people are also dying—some without underlying medical conditions.  Second, even if it were true, how is this line of thinking acceptable? As Kathy Sheridan from The Irish Times writes, “What other demographic would be represented so crudely without some serious blowback?”

We call upon health care ethics committees to ensure age-neutral triaging, and we support the Office for Civil Right’s effort to ensure that lifesaving medical care is not administered based on age. We call upon governments to take public health seriously and implement prevention and response measures that protect the health and safety of all citizens. And we call upon the public at large to stop downplaying the harm of COVID-19 simply because most of those dying from the virus are older people.

For those who believe older people have nothing to contribute: What about the health care workers coming out of retirement to do their part for the cause? What about Dr. Anthony Fauci, who himself is 79 years old? What about your own parents or grandparents?

Older adults are not expendable. Period.

For more information on Ageism in the Time of Coronavirus, view Dr. Nancy Morrow-Howell’s webinar – The Coronavirus: What Age Has to Do with it. For additional resources, the Powerpoint presentation and the Center for Aging’s COVID-19 Resource Page may be downloaded.