Covid becomes plague of elderly, reviving debate over ‘acceptable loss’

Authors: Ariana Eunjung Cha, Dan Keating November 27, 2022

President Biden may have declared the coronavirus pandemic “over,” but from John Felton’s view as the Yellowstone County health officer in Billings, Mont., it’s not over, just different.

In October, Felton’s team logged six deaths due to the virus, many of them among vaccinated people. Their ages: 80s, 60s, 70s, 80s, 90s, 90s. They included Betty Witzel, 88, described by her family as a tomboy who carried snakes in her pocket as a child and grew up to be a teacher, mother of four, grandmother of nine and great-grandmother of five. And there was Nadine Alice Stark, 85, a ranch owner who planted sugar beets and corn.

Yellowstone County made the decision early in the crisis to recognize each death individually, and Felton said that is as important as ever to acknowledge the unrelenting toll on a still-vulnerable older generation, while most everyone else has moved on.

“I think about someone’s grandfather — the plays they wouldn’t watch, the games on the football field they wouldn’t see,” he said.

More than 300 people are still dying each day on average from covid-19, most of them 65 or older, according to data from the Centers for Disease Control and Prevention. While that’s much lower than the 2,000 daily toll at the peak of the delta wave, it is still roughly two to three times the rate at which people die of the flu — renewing debate about what is an “acceptable loss.”

And while older Americans have consistently been the worst hit during the crisis, as evident in the scores of early nursing home deaths, that trend has become more pronounced. Today, nearly 9 in 10 covid deaths are in people 65 or older — the highest rate ever, according to a Washington Post analysis of CDC data.

Some epidemiologists and demographers predict the trend of older, sicker and poorer people dying at disproportionate rates will continue, raising hard questions about the trade-offs Americans are making in pursuit of normalcy — and at whose expense. The situation mirrors the way some other infectious diseases, such as malaria and polio, rage in the developing world while they are largely ignored elsewhere.

S. Matthew Liao, a professor of bioethics, philosophy and public health at New York University, argued that it is possible to keep the economy open while still aggressively pursuing a national booster campaign and requiring masks in health-care settings and nursing homes, for example. But U.S. leaders have chosen not to do so, he said. That worries him.

“There’s a bit of ageism, so to speak, attached to it,” he said, adding, “People, even if they are older, they still have as much claim to live as me.”

In an open letter published Oct. 7 in the BMJ, formerly the British Medicine Journal, Gregg Gonsalves, an associate professor at the Yale School of Public Health, and about a dozen other experts emphasized that “pandemics do not end with a flip of the switch.”

“Despite the widespread belief that the pandemic is over, death and disruption continue,” they wrote.

CDC Director Rochelle Walensky and other officials have justified their pandemic reset by emphasizing that Americans have more tools to fight the coronavirus than they did a year or two ago. This includes not only vaccines, booster shots and rapid tests, but antiviral pills that can be taken at home and have been shown to greatly reduce severe illness and death if taken early.

“We can now prevent almost all of the deaths that are happening,” she said at a news briefing this month.

However, Walensky acknowledged that deaths among the elderly, especially those with multiple chronic conditions, is “a real challenge.”

“An additional infection,” she said, referring to covid-19, “is something that may turn something they are able to stably live with to something they are not.”

Leave a Reply

Your email address will not be published. Required fields are marked *