The official response to COVID-19 lumps all people over 70 together, regardless of health status, as a vulnerable and at risk group. In normal times, that would be regarded as ageist, ie as stereotyping all people over an arbitrary age as vulnerable and needing protection and care.
Fortunately, the Government has rowed back from the unfortunate media interviews given by Matt Hancock in which he announced a plan to require all people over 70 to stay at home. But even the less sweeping injunctions to take particular care, differentiating us from the under 70s, and the warnings as schools close not to ask grandparents to look after children because all over 70s are vulnerable, are, by normal standards, ageist: a demeaning way of reducing many healthy contributors to society to a homogenous vulnerable group.
If has proved uncomfortably easy for politicians, public health officials and commentators to regress into that way of thinking about older people. To be fair, the Prime Minister and the Chief Medical Officer have said during press conferences that they know there are plenty of very healthy people over 70, but that has done little to counter the main flow of treating them nevertheless as a single vulnerable group. Ethnic minority people, many women, and disabled people will be familiar with how dehumanising it feels to be lumped together and subjected to sweeping assumptions that undermine dignity. Now a lot of us healthy people in our early 70s are experiencing it.
“Diddums”, I hear you say. “It’s a public health emergency. The currency of crisis and a war footing needs to be oversimplified. Get over it.” Yes. But if we are riding roughshod, for pragmatic reasons, over the advances in thinking about older people in the last 40 years, we need to be conscious of doing so and know that it is one damaging cost of the crisis. Is it necessary?
Take the statistics of risk. The Imperial College study that influenced the Government’s intensification of suppression measures a few days’ ago uses categories of 60-69, 70-79 and 80+. Yes, the percentage of the 70-79 age group that are estimated to require hospitalisation if infected with the virus is 24%, of whom 43% (5 per cent of the total) may require critical care. Multiply that up by millions and it’s a massive burden on the NHS. But what those figures don’t tell us is: how far is that due to age, or how far is it due to underlying health conditions that do not affect a huge chunk of the age range? We know that many such underlying health conditions accumulate as we get older, so of course you find much higher numbers of those with such conditions as you move up the age range. But if you eliminate the effect of underlying health problems, what is the higher risk of hospitalisation from being a healthy 70, or 75? We don’t know from the Imperial study, and I have asked various bodies but have as yet no answer. Yet we do need to know if we are to make sensible judgements – as individuals and as Government – about how far the contribution to society of healthy people in their 70s must be curtailed or eliminated for the next 12 to 18 months, until a vaccine comes on stream – regardless of health status.
What is that contribution? We are massive contributors to volunteering. At the same time as Ministers are telling us we are vulnerable, at risk and must pull in our horns, we receive urgent pleas to volunteer time and effort to fetch prescriptions, buy food for the isolated, walk their dogs and so on. We are massive contributors to childcare, especially of our grandchildren. This may be particularly important for the children of those struggling with alcoholism, drugs, mental health problems, family breakdown, and imprisonment. When I was a member of the Parole Board it was striking how many prisoners whose rehabilitation had been progressing well went off the rails when they heard of the death of their Nan, the one person who had ever been a reliable source of love and support in their lives. In many less extreme cases, grandparents’ love, free of the stress of the parents, is nevertheless a precious emotional and practical mainstay in the development of childen, as well as being a profound joy to the grandparents. So those pronouncing a general edict that you shouldn’t let children visit the grandparents are detached from the reality of many families where grandparents’ care is core to their functioning and quality. And for many others where the contribution is not strictly essential, the cost and damage of sudden separation has properly to be measured against the risk to grandparents who are in many cases, even if they are over 70 at all, are in excellent health, with time, attention and stimulation to offer that are impossible for many parents.
Remember: suppression of the virus is not a matter of weeks. According to the Imperial College study, we may have to continue suppressive measures until a vaccine is ready in 12 to 18 months, otherwise the suppressed virus will surge up again.
I know there is another side to this. Many of us of all ages are slow to realise just how serious the situation is and how we personally must play our part in reducing infection and the burden on the NHS. Many elderly people may underestimate how vulnerable they are, and be extremely reluctant to give up an active life participating in and contributing to society. Nobody wants to be isolated and treated as vulnerable and dependent when they desperately want to preserve their independence. So grown up children are rightly having to read the riot act to older parents who don’t want to abide strictly by the Government’s guidance.
Nevertheless, we need to understand better what the risk of age, rather than health status, is. We need to remember that people over 70 are hugely varied, and millions are in great health and have a lot to contribute to getting us through this. Ageism is not only offensive to rather a lot of us – and a dehumanising way of thinking – but also might be counterproductive. So let’s be vigilant lest the rampant ageism of the response to COVID-19 goes beyond what is actually necessary.