I was talking to a friend recently who is over 70. She explained that because she's unable to hold her lovely infant granddaughter the pain was intense, almost physical in nature. She and her family FaceTime most days but, but even so, it wasn’t the same. I thought of my friend when I saw the speculation about a possible lengthy lockdown for older people being on the cards, while other sections of the population are allowed to begin to make a gradual return to normal life.
Truth or speculation
It may be, of course, that this is just a wild media invention, but a Health and Social Care Minister, Lord Bethell, declined to rubbish the idea a few days ago. All in all it does look like the Government may at least be considering some kind of prolonged lockdown for older people as part of its ‘exit plan’. If so it will no doubt be because older people are more likely to become seriously ill and die if they contract the virus, compared to younger age groups.
The Government doesn’t have many tools in its box to help us safely get out of the hole we are in: a vaccine is some way off, there are no proven medications and the testing and tracing regime is only just getting going. Meanwhile, the financial cost of mothballing much of the economy is huge and continuing to mount. Whether we should be in this position is debatable but it is where we are and as a result there are no good or easy choices for Ministers.
Ageist and deeply objectionable
And yet proposing that everyone beyond a certain age puts their life on hold and hunkers down for many months or longer is, by definition, ageist and deeply objectionable. A big question that arises though is whether it’s those advocating an elongated lock down for older people who are being ageist – or the virus itself.
What I mean is that at the moment it is unclear whether advancing age in and of itself makes it more likely that a person will become seriously ill with the virus, or whether it is that as we age we are more likely to have other health problems (‘comorbidities’) and lower resilience (‘frailty’) that reduce our capacity to fight off the disease. If it’s the second then age is being used merely as a convenient, rather lazy proxy for these other factors – a blunt instrument that overlooks the enormous differences in fitness and health across the older population and even between people of the same chronological age.
Too many ‘blanket policies’
At Age UK we have heard suggestions for some time now that there is emerging clinical evidence showing age to be an independent factor when it comes to serious illness and death from the virus – distinct from how fit and well a person may be. However, even if this evidence exists it doesn’t follow that an elongated lockdown for everyone over – say – age 70 would be appropriate or acceptable, firstly because ‘blanket policies’ of all kinds are objectionable.
We’ve already seen too many being proposed for older people during this pandemic – concerning DNRs, hospital admissions and access to treatment. These leaked or draft policies have generally been withdrawn or disowned following protests from Age UK and many others, but they have generated a feeling of unease and mistrust. They have made many older people and their families worry that they may be discriminated during this terrible health crisis when being treated fairly and individually may well be a matter of life and death.
The practical implications
The second problem with any proposal to lockdown older people for a long time is that the practical implications would be huge. For example, Age UK’s Advice Line is now receiving many calls from older workers who cannot carry out their jobs from home, who have been furloughed or told to take unpaid leave, and who fear they may never work again – and most badly need the money. Or consider the enormous contribution many ageing grandparents make by providing regular childcare and the importance of the ‘grey pound’ to sectors of the economy, including travel and leisure – all jeopardised if older people are locked down for a long time.
Then there are the likely consequences for mental health. Keeping older people apart from families, friends and the wider community for a prolonged period would be a recipe for deep unhappiness, depression and loneliness, most of all for those not online – the majority past 75. The adverse physical impact of being stuck largely at home would be considerable too.
Taking all this into account many might say the proposed cure, if it was a long lock down for older people, really was as bad as or worse than the disease.
The choices that lie ahead
Government needs to level with all of us about the choices that lie ahead when it comes to relaxing the lockdown and publish the clinical and other evidence on which its decisions will be made. If the science is clear that age in and of itself is a key risk factor for becoming seriously ill with the virus then we need to know about it. This knowledge would change the policy debate to a degree, but not I believe to the extent that blanket, compulsory approaches based on age (or indeed disability) would ever be acceptable or appropriate. There really is no place for these in a modern and progressive society.
Older people should be treated as the experienced, individual human beings they are and provided with the best information available. They should be expected to take responsibility for making their own decisions about how to live their lives, in the fullest possible understanding of the likely impact on them, their families and others around them – just like everyone else.
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