Of the hundreds of thousands of Americans who have died of COVID-19, 32% of them were 85 or older, and 59% of them were 75 or older. And 98% of all those that died had at least one comorbidity. I highlight this information not to suggest that the lives of those that died were unimportant because they “weren’t going to live much longer anyway.” Quite the opposite, actually - because many of these people aren’t going to live for much longer, what remains of their life is extremely important. But when I say their life is important, I do not simply mean that we should do everything we can to keep them alive as long as possible. I mean that we should also do everything we can to make sure their last years on Earth are happy.
And thus creates what I call “The Coronavirus Lockdown Paradox” - The people who stand to gain the most from coronavirus prevention measures due to being at the highest risk simultaneously stand to lose the most from coronavirus prevention measures, because the time under the restrictions will be a much larger percentage of their remaining time on earth than it will be for most other people. It’s one thing to tell a 25 year old not to see their family this Christmas - in all likelihood, they’ll have many more Christmases with family in their future. But for a 90 year old? There’s a very strong possibility that this may be their last Christmas. About 7,500 people die every day in the United States (or about 2.7 million every year). This year, most of them are missing out on the opportunity at one last holiday meal with their loved ones. One last trip to the bar with their old friends. One last game at the stadium. Sure, these activities do increase one’s chances of catching and spreading COVID-19, and anyone who does not feel comfortable doing them should of course not be pressured into doing so. But is it right for us to command the world’s elderly to wait until next Christmas to hug their grandchildren, or to wait until June to see their friends again, when we know hundreds of thousands of them will not live to see June (regardless of COVID-19)? If a 84 year old with Stage III cancer has decided that the marginal increase in their risk of contracting COVID-19 is a small price to pay for spending what will in all likelihood be their last Christmas on Earth with people they love, shouldn’t they have the right to make that decision for themselves?
PBS’ Liz Seegert wrote an article, which I highly recommend (link below), covering the mental toll that isolation has had on those in nursing homes, which is often ground zero for COVID deaths. A few heartbreaking quotes from nursing home residents were shared in the article, perhaps most succinctly. “If the virus doesn’t kill me the loneliness will.” Seegert noted that many residents “felt they should be afforded the option to assume a higher risk from visiting with family”. Also noted in the article was the fact that isolation itself is a major risk factor for premature death, which is on par with “smoking, obesity, and physical inactivity”. So even if our goal was purely to keep people alive as long as possible, extreme social isolation for our elders might still be a bad idea.
Nobody ever asked the most vulnerable people if they even wanted protection. In our well-meaning but myopic push to save as many lives as possible, we forgot to consider if the trade-offs were worth it for the people we were trying hardest to protect. It’s true that many do want to be as safe from the virus as possible - after all, just being old doesn’t necessarily mean you have only a few years left. Many of today’s 80 year olds will live to be 100, or even 105. And it’s also true that while one vulnerable person may accept the risk as “worth it”, they could still spread the disease to someone who feels otherwise. But the fact of the matter is, just because some event has an increased chance of spreading the coronavirus (or any other communicable disease, for that matter) does not mean that it shouldn’t happen. If we made all our decisions solely with the intent of stopping the spread of disease, all of us would be self-isolating in our rooms forever. But we don’t do that, because everything is a trade-off. The marginal increase in risk when one goes to the grocery store is worth it because we need food. The marginal increase in risk when firefighters go into work is worth it because we need someone to put out fires. In other words, we accept risk when it comes to essential services. In my opinion, allowing those who are going to die soon experience as happy a final year as they can possibly have should be considered an essential service. Poet Kingsley Aims once wrote: “No pleasure is worth giving up for the sake of two more years in a geriatric home.” Not everyone has to feel the same way as Aims, but for those that do, should we have the right to deny them countless pleasures so that they might live longer? Do we have the right to tell someone that they can’t see their grandchildren for another six months, even when there’s a very strong possibility that person won’t live another six months? A saying often attributed to Abraham Lincoln goes “In the end, it’s not the years in your life that count. It’s the life in your years.” When we focus only on preventing death, we focus on the number of years in people’s lives, and ignore the life in their years.
Cited Sources
Liz Seegert’s brilliant article: https://www.pbs.org/newshour/health/covid-19-is-taking-a-huge-emotional-toll-on-nursing-home-residents#:~:text=The%20devastating%20emotional%20impact%20on,homes%20and%20assisted%20living%20facilities.
CDC’s death counts for coronavirus: https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm