Bonnie-Jeanne MacDonald is the director of financial security research at the National Institute on Ageing at Ryerson University, fellow of the Canadian Institute of Actuaries and resident scholar at Eckler Ltd.
Samir Sinha is the director of health policy research at the NIA, and the director of geriatrics at Sinai Health System and the University Health Network in Toronto.
Older Canadians have more to fear as COVID-19 moves broadly through Canada and the United States. While the spread of the disease is concerning, it can – and should – motivate us to come together and help older Canadians better prepare for worst-case scenarios.
A new study in the Journal of the American Medical Association reported that COVID-19 has a case fatality rate as high as 15 per cent in older adults in China, compared with 1 per cent to 2 per cent over all. That 15 per cent is significantly lower than the 50-per-cent fatality rate of the 2003 SARS outbreak among older adults. But scale matters: The number of people reportedly infected with COVID-19 is already more than 10 times larger than the total population affected by SARS.
The elderly are undoubtedly more vulnerable from a medical perspective, since our immune systems weaken as we age. At even greater risk are those who are frail, living with chronic diseases or both.
The risk is further amplified for the 500,000 older Canadians living collectively in senior residences, nursing homes and even hospitals. The age factor, plus higher risk of exposure through close living conditions, largely explains why the first major clusters of infections and victims occurred in nursing homes – first in the U.S. and now in Canada.
Another concern is how to best care for and support Canadian seniors who need to be quarantined. Canadian fertility rates declined significantly after the mid-1960s, so baby boomers will have fewer adult children to call on for help, and even fewer living close to home. There are already widespread concerns that we won’t have enough facilities and resources to deal with a pandemic. Rationing of scarce resources could leave older Canadians with the least amount of help.
So far, the threat of illness, disability and even death has been the primary focus of the media coverage of the coronavirus and the resulting COVID-19 disease. But the economic threat of the virus is emerging as a key challenge as well – and that’s another area where seniors are highly vulnerable.
During the last week of February, the S&P 500, Dow Jones Industrial Average and Nasdaq Composite indexes had their biggest declines since October, 2008, as each fell by more than 10 per cent. Another market downturn occurred on Monday, with all three indexes falling by more than 7 per cent.
On this side of the border, Canada’s largest stock index, the S&P/TSX Composite, fell by more than 11 per cent in the last week of February – also its worst week since the 2008 global financial crisis – and Monday marked its worst single-day drop since October, 1987, at 10 per cent.
The implications of financial downturns such as these on individuals can be long-lasting and even permanent.
In the U.S., for example, the proportion of seniors filing for bankruptcy has doubled since 2008. With the decline of traditional defined-benefit workplace pension plans, older Canadians are increasingly relying on their investments to support them through retirement.
Facing health issues or their potential lack of employment options, the vast majority aren’t able to return to work to make up any losses from market declines. Without the necessary time or resources to recover from an economic downturn, the only option left is to curb their spending and scale back their living standards.
But all this anxiety has an upside, too, since it motivates us to plan and take actions now that will protect us later.
Public Health Agency of Canada provides important recommendations, such as not shaking hands and staying home, or minimizing contact with others if you are sick.
Canada has an aging population, and helping the elderly better prepare themselves will protect us all. This is an opportunity for communities to come together and support the vulnerable people who live among us.
PHAC also suggests neighbors create “a buddy system in which you agree to check in on each other and run essential errands if you become sick” – community support that is essential for older adults living alone.
In the neutral zone between panic and complacency is an opportunity to think about what we can do – and maybe should already have done – to protect ourselves and our loved ones in the future.