Outbreaks of COVID-19 first emerged in Asia and Europe in December 2019 and January 2020. What was already evolving in those areas clearly pointed to particularly challenging and concerning situations, underscoring a need to protect older adults in long-term care (LTC) homes during a major pandemic. Health providers in countries such as Italy expressed major concerns regarding the safety and security of residents, pleading for more staff and protective equipment. Now, in Canada, many LTCs have been unable to manage devastation from of the virus. We were slow, and possibly even negligent in preparing a response to COVID-19 that could have reduced the number of victims in LTCs. Did a pre-pandemic lack of resources for residents of LTC homes exacerbate this looming crisis and slow our response?
Canadian data now suggest that younger adults represent the largest proportion of COVID-19 carriers, and people under 60 years of age account for a significant portion of hospitalizations (including >35% in intensive care) [10]. Younger adults are not immune to this virus, and they share responsibility for its spread. A lackadaisical attitude towards public health directives increases risk for everyone. Ultimately, COVID-19 is not a disease of older adults, and it effects will be felt by everyone. We all must do our part to curtail its spread.
Ageism reached a new level with the hashtag #BoomerRemover. This vulgar concept highlights two prevalent ageist attitudes in the COVID-19 pandemic response [11]:
- Older adults are ‘sitting ducks’, vulnerable and helpless against COVID-19. High mortality rates amongst older adults are considered an ‘inevitable’ and ‘normal’ outcome of this pandemic.
- Healthy younger adults may perceive themselves as invulnerable to COVID-19 and, as a result, may not realise the importance of following public health advice and policies on infection prevention. Videos of university-age students engaging in mass gatherings for Spring Break in Miami, FL [12] or St Patrick’s Day in Kingston, ON [13], despite calls from public health officials to engage in social distancing, highlight this misperception.
Public messaging is important. How older and younger adults perceive their susceptibility to COVID-19 influences their health behaviours and has consequences.
The value of a life as age-dependent
Even though COVID-19 mortality rates are higher in older adults compared to other age groups, our concern is that age is being conflated with frailty and co-morbidity, which are likely to be the more important factors associated with mortality. Social media highlights older adults who sacrifice their own lives so that ventilators can be used for someone younger. When medical equipment, and hospital capacity becomes scarce, care providers may be faced with the ethical decisions about whose life takes priority and age may become a deciding factor. The USA has formally adopted the Ventilator Allocation Guidelines whereby ‘age may be considered as a tie-breaking criterion in limited circumstances’ [14]. This may lead people to believe that an older person’s life may be less valuable than that of someone younger. What will be the cost to society of the sacrificed lives of older adults?
BUT also intergenerational solidarity
Despite clear indications of ageism, there are also encouraging signs of intergenerational solidarity during this pandemic. There are myriad examples of younger people supporting older adults during their isolation: dropping off groceries, looking after their garden and working to keep them socially connected. Some health care professionals who are working tirelessly to help others have taken the time to show compassion and connect older adults in hospitals or residences with their loved ones via smartphones [15]. Although the ‘vulnerable person registry’ has an unfortunate, ageist name, the goal of the programme is to communicate regularly with older adults (once per week) and ensure that they are aware of the resources available to them and that their needs are being met.
Conclusion
As concerned advocates and researchers interested in ageing, it is our opinion that we should be aware of and try to reduce the ageist views being propagated during COVID-19. Higher mortality rates for any group, including older adults, have devastating consequences. It’s not just the preventable loss of human lives or strain being placed on our healthcare and social systems or older adults are invaluable members of society. They are a source of generational knowledge and wisdom, they contribute to the workforce in increasing numbers, they volunteer and they are key to the strength of our economies and our families. We cannot afford to be careless about these lost lives because of ageist attitudes. We need to consider what we stand to lose if we let ageism influence how we discuss and treat older adults during and after the COVID-19 pandemic.
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