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| EDITORIAL |
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| Year : 2021 | Volume
: 17
| Issue : 2 | Page : 49-50 |
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Ageism in time of COVID-19
Venugopalan Gunasekaran
Department of Geriatric Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| Date of Web Publication | 22-Oct-2021 |
Correspondence Address:
Venugopalan Gunasekaran
Department of Geriatric Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jiag.jiag_22_21
How to cite this article:
Gunasekaran V. Ageism in time of COVID-19. J Indian Acad Geriatr 2021;17:49-50 |
Ageism is stereotyping, prejudice, and discrimination of older adults based on their age, which carries a serious risk of affecting the physical and mental health of the individual and public health system. We are in the Decade of Healthy Ageing (2021-2030), and combating ageism was one of the four action areas proposed by the United Nations.[1] Ever since the COVID-19 pandemic began, older adults are the major sufferers. The rate of hospitalization, intensive care unit (ICU) admission, and mortality were high in older adults and increased with age. Among those tested positive in England, older adults 80 years and above were 70 times more likely to die than those under 40 years of age.[2] In the same study, most excess deaths (75%) occurred in adults 75 years and above. A study that looked at data from 16 countries showed that the mortality rate of COVID-19 was 8.1 times and 62 times higher in older adults in 55–64 years and 65 years or older age group, respectively, as compared to those below 54 years.[3] The pandemic had caused stress on the healthcare system around the globe. There were reports where younger people were prioritized over older adults for admission in ICU, due to a sudden increase in the need for ICU beds, even in high-income countries,[4],[5] restriction of movement of people in various countries had affected the care of older adults residing in long-term care homes and leading to crisis and death. These vulnerable groups in long-term care homes became the hotspot of COVID-19 cases, and their share was estimated to be 41% of the total COVID-19 deaths,[6],[7] The overburdened healthcare system and movement restriction led to lack of care for other non-COVID illnesses and noncommunicable diseases, which are the leading cause of death in older adults. The early pandemic findings showed that the mental health issues in older adults were lesser than in younger people, but the effect of long COVID needs to be studied.[8]
One of the top courts in India said that “If we have to choose, the young will have to be chosen. They are the future. 80 year olds are not going to carry this country forward. They have lived their lives” in a case related to the distribution of medication for COVID-associated mucormycosis. Court is a pillar of democracy and has to ensure the right to equity, but the above statement does not reflect that. This statement is just an example of the subtle ageism in most people's minds, which the court has spilled out. When the beds need to be rationed in many ICUs, young people are preferred over older adults leaving the latter lurching for bed and die outside ICU. The court and policymakers need to formulate a strategy where triaging brings in equity too. Triaging merely based on age is just absurd. These irresponsible statements and attitudes will further affect the overall health of older adults and impact public health measures as well.
There are some silver linings as well in the tragic situation of older adults. Vaccination against COVID-19 started in India on January 16, 2021. The health care workers were prioritized first and then frontline workers. The vaccination for older adults 60 years and above started on March 1, 2021, a month ahead of those between 45 and 59 years. The Government program rightly prioritized older adults who are at high risk of COVID-19-related mortality. As of September 23, 2021, 98 million older adults, 60 years and above of age, have received the first dose of the COVID vaccine, roughly 72% of the total older adult population. More than one-third are yet to receive the first dose of vaccine. Even a single dose of the ChAdOx1 vaccine effectively reduced symptomatic infection and viral load in older adults residing in long-term care facilities in England.[9]
As of now, vaccination remains the primary tool to prevent severe disease and mortality related to COVID. Going forward, we should all join hands in combating the ageist attitude from each section of society. Inclusion of older adults in clinical trials, triaging based on disease severity and not based on chronological age, health education are some of the measures that health care professionals can take. The government should improve an age-friendly environment to create an inclusive society, allow older adults to be heard, and address their concerns.
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| 3. | Yanez ND, Weiss NS, Romand JA, Treggiari MM. COVID-19 mortality risk for older men and women. BMC Public Health 2020;20:1742.  |
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| 5. | Moosa MR, Luyckx VA. The realities of rationing in health care. Nat Rev Nephrol 2021;17:435-6. |
| 6. | Thompson DC, Barbu MG, Beiu C, Popa LG, Mihai MM, Berteanu M, et al. The impact of COVID-19 pandemic on long-term care facilities worldwide: An overview on international issues. Biomed Res Int 2020;2020:8870249. |
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| 8. | Vahia IV, Jeste DV, Reynolds CF 3 rd. Older adults and the mental health effects of COVID-19. JAMA 2020;324:2253-4. |
| 9. | Krutikov M, Palmer T, Tut G, Fuller C, Shrotri M, Williams H, et al. Incidence of SARS-CoV-2 infection according to baseline antibody status in staff and residents of 100 long-term care facilities (VIVALDI): A prospective cohort study. Lancet Healthy Longev 2021;2:e362-70. |
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