COVID is taking a much lower toll in the United States than it did during the 2021 delta wave, at 300 deaths per day now versus 2,000 then, but the majority of the deaths are skewing older, according to a new report based on federal data.
Deaths due to COVID among older adults are more than two to three times the rate of flu deaths, begging the question of what “acceptable loss” means, wrote Ariana Eunjung Cha and Dan Keating of the Washington Post.
The proportion of deaths among older adults has varied during the course of the pandemic, they reported. In the first few months, those aged 65 or older accounted for eight in 10 deaths. This number dropped to a low of six in 10 during the summer of 2021 but is now back up to nine in 10.
Overall, seniors accounted for approximately 90% of US COVID-19 deaths in October, although older adults account for 16% of the population. When grouped by age, a Post analysis found that:
- People aged 85 years and older represented 41% of the deaths;
- People aged 75 to 84 accounted for 30% of the deaths; and
- Those aged 65 to 74 represented 17.5% of the deaths.
Ageism in play
Some infectious disease experts contended that US leaders are not doing enough to encourage COVID mitigation measures that would protect these vulnerable Americans, such as booster vaccinations or masking in healthcare settings. The economy could remain open while doing so, one bioethicist told the reporters.
“There’s a bit of ageism, so to speak, attached to it,” said S. Matthew Liao, PhD, of New York University. “People, even if they are older, they still have as much claim to live as me.”
The weakened messaging regarding masking is that the US has given up, Andrew Noymer, MSc, PhD, a public health professor at the University of California at Irvine, told the Post. He expects the number of COVID-19 deaths to spike this winter.
“The message is, ‘don’t bother masking,’ ” he said. “We have given up, and the fact we’ve given up means we don’t care about a certain amount of deaths.”
Protecting the vulnerable
In recent weeks, the Centers for Medicare & Medicaid Services released new guidance urging nursing facilities and other congregate care providers that they are required to actively offer updated COVID-19 vaccinations and provide timely treatment to prevent severe outcomes.
Vaccination rates with the updated COVID-19 booster are much higher in nursing homes than in the general population, yet less than half (44%) have received an updated vaccine, according to data from the Centers for Disease Control and Prevention.
Federal officials repeatedly have emphasized protection of the vulnerable, including the elderly, by keeping them up to date with vaccinations and quickly diagnosing and treating infections. But when relaxing mitigation efforts earlier this year, federal officials said that Americans have more tools to fight the coronavirus than they did a year or two ago, including vaccines and antiviral pills.
Rochelle Walensky, MD, MPH, director of the Centers for Disease Control and Prevention, has acknowledged that protecting the most vulnerable elderly is “a real challenge,” the Post reported. A COVID-19 infection may turn a stabilized chronic disease into something they no longer can live with, she said in a November briefing.
Maintaining a balance in LTC
Eldercare facility operators and staff members likely understand the complexities of this problem better than most. With high initial rates of COVID-related deaths among both residents and nursing home workers, they have juggled infection control while grappling with the mental and physical health problems linked to COVID-19 measures, such as isolation and distancing.
At the same time, long-term care industry advocates have continued to push for a balanced approach that keeps the focus on protecting residents. Safety and quality of life in LTC settings are not mutually exclusive, according to Mark Parkinson, president and CEO of the American Health Care Association/National Center for Assisted Living. AHCA/NCAL has pushed for continued extensions of the public health emergency to keep facilities supplied with the resources, flexibilities and policies needed to appropriately respond to the virus.