Covid-19 Is Hitting the Middle Aged Harder Than We Think
As we open up and go back to work, it’s possible we’ve missed something important — the danger to many 50–64 year olds
I can’t tell you how many times I’ve read that Covid-19 is completely overstated and just hits the elderly. Usually from Wall Street types, not scientists. There’s a narrative that the disease is only dangerous to old people, so everyone else can safely go to work. To the contrary, compared to the flu, it’s much more dangerous for middle aged people than for older people. In fact, Covid-19 is a special threat to many of the people heading back to work — and to bars and restaurants.
It is primarily in these middle years that you are far more likely to die from Covid-19 than the flu. Whereas flu effects the old and the young immune systems, the people in the middle fend it off better. Covid-19 hits those beginning to age much harder.
Death rates look like they will end up ~5x or more than the flu for 45–64 year olds. Because flu is under-reported and under-diagnosed, it may be greater than that.
A study compared H1N1 fatality rates to coronavirus as well:
The British group said the fatality rate among all of those infected with new coronavirus — including those who don’t have symptoms — is 0.66%. By comparison, that is more than 30 times greater than the death rate for the H1N1 influenza, the cause of a 2009 pandemic, which was 0.02%.
Hospitalization rates are also high among the middle aged group.
One issue, of course, is that we don’t all age the same way. Our bodies and our immune systems devolve based on other factors. And those factors start to hit us pretty hard at age 50.
“It is not chronological age alone that determines how one does in the face of a life-threatening infection such as Covid-19,” cautioned geriatrician and gerontologist George Kuchel of the University of Connecticut. “Having multiple chronic diseases and frailty is in many ways as or more important than chronological age. An 80-year-old who is otherwise healthy and not frail might be more resilient in fighting off infection than a 60-year-old with many chronic conditions.” Reason: She may have a younger immune system.
And people who have underlying conditions — high blood pressure, diabetes, or a BMI over 30 — are very prone, possibly as much as some extra years.
We should resist the impulse to blame someone for conditions we think of as controllable by calling them lifestyle choices. It’s hardly ever half the story. And many communities lack access to fresh and nutritious foods, as my friend Chef José Andrés tells me a lot. Besides, by the time you get to my age, chances are about even that you have something which puts you at higher risk.
For folks over 50, the risks steadily grow, both due to their age and because they are more likely to have a preexisting medical condition that exacerbates their risk. Almost half of Americans ages 55 to 64 have at least one preexisting condition, according to the Kaiser Family Foundation.
There is also more prevalence of Covid-19 among younger people. In New York, and in other concentrated areas, most of the patients are under 65. The truth is people who are getting back to work are exposing themselves more and more to illness, whereas younger people are less prone and older people will be more sheltered. This includes teachers who will spend a lot of time with asymptomatic spreaders.
Even when people survive it, 5% of 50 year olds that get COVID are hospitalized. Way more than the flu. And the effects of being on a ventilator are often a long, slow recovery. Essential workers are good evidence of this. Dr. Cleavon Gilman has been bearing witness to essential workers who have lost their lives. So many of them are young.
What happens when more 55 year olds begin showing up in call centers again? They’re not all going to get sick, but those with prolonged exposure or undiagnosed high blood pressure are at greater risk. We should not be living in fear. We can #OpenSafely. We can open certain businesses. There are low risk activities. Masks make us safer. Screenings make us safer. Distancing makes us safer.
Covid-19 may not be ravaging middle-aged people like it is other groups. They may not die by the dozens, as sadly others do. But in unsafe settings — and certainly with pre-ex conditions — this group is as much a danger of hospitalization as anyone.
The more important point is that every “narrative” getting shaped right now is imaginary and often self-serving. Trump says masks are PC. Fox commentators say this is no worse than the flu. Matt Goetz wears a gas mask. Fake interest in mental health and addiction. These narratives are sometimes what we all do to make sense of a complicated situation. They are also a part of how our politics works. But we shouldn’t fool ourselves into confusing narratives with reality.
Our rush job laissez faire approach to opening our economy isn’t a price our politicians expect to pay. It’s upside for them if it works; downside to us for everything that doesn’t. There is a propaganda machine being built to target mask wearers and anything that stands in the way of economic growth. It serves nobody. There are smarter ways.
