The COVID-19 pandemic poses extraordinary risks to the health of older adults and, upon contraction, has immediate consequences for individual well-being and connectivity and, potentially, for mortality outcomes. However, aside from the detrimental health impacts of the disease itself, older people can experience other damaging outcomes as a result of strategies and discourses related to controlling and treating the virus. This is both in terms of material and symbolic disadvantages. In response to these concerning circumstances, we offer four critical messages for policy and response formulation during the COVID-19 crisis.
State and community responses to COVID-19 must be cognizant of direct exclusions that impact older people as a result of policies and strategies implemented to combat the virus, and where possible account for these negative circumstances through supports and action. These exclusions include a lack of credible and up-to-date information due to difficulties in accessing on-line communication channels used by public health and other key agencies. They also include the increased risk of social isolation, and heightened levels of loneliness, due to the disruption of social and support networks because of the need for restricted interpersonal contact and ‘cocooning’.
We must continue to ensure that treatment for COVID-19, and other forms of resource allocation associated with the crisis, are based on need, and not a simple age threshold. Worryingly, in some countries, a shortage of intensive care unit beds, respirators and other supports has led to what are fundamentally ‘ageist’ calls for the prioritisation of younger, healthier patients with a higher chance of recovery. Anecdotal evidence suggests health professionals in some of these nations are under considerable moral strain to engage in decision making practices that prioritise those who are likely to have more positive outcomes from treatment, or, more generally, those who have longer life expectancies and a greater potential for ‘life years saved’.
In implementing polices and strategies to protect older people during COVID-19, we must not ignore the heterogeneity of the older population and frame older individuals as highly vulnerable, passive agents, ignoring their contribution during the pandemic. While policies such as cocooning are needed and are clear in their sentiment of concern and protection, they may inadvertently contribute to a homogenisation of the over 70s population. This can as such undermine the considerable practices engaged in by older people that are emerging in support of family and neighbours, and more formal community and national efforts to address the outbreak.
Policy and strategies combating COVID-19 must not be based on a problematisation of ageing and older people in the context of the crisis, or function to destabilise the considerable solidarity currently being witnessed across the generations. There is evidence that older people have been framed in some sections of our public and political spheres as mass consumers of valuable and limited resources, blocking the access of younger, healthier individuals, who are deemed to be more ’productive’, to treatment services. Such discourses function to devalue not only the status of older people as equal citizens, but the value that we place on their contributions, and their lives, in our society.
Prof. Kieran Walsh,
Professor of Ageing and Public Policy (Economics) / Chair – ROSEnet COST Action CA15122
Director – Irish Centre for Social Gerontology, Institute for Lifecourse and Society,