Medical staff in a protective suit treats a patient suffering from coronavirus disease (COVID-19) in an intensive care unit at the Oglio Po hospital in Cremona, Italy on March 19, 2020.FLAVIO LO SCALZO/Reuters
Niall Ferguson is the Milbank Family senior fellow at the Hoover Institution, Stanford
The word genocide, the murder of a tribe or people, was coined in 1944 by Raphael Lemkin, a Polish-Jewish refugee escaping Nazism. The word senicide, the deliberate murder of the elderly, though of older provenance is less well known.
That is about to change.
If, as seems increasingly likely, a significant number of western countries are going to continue mismanaging the pandemic caused by the virus SARS-CoV-2 – the novel coronavirus that originated in Wuhan, China, in December – then a very large number of old people are going to die before their time.
The statistics are unequivocal. In China, where the epidemic seems for the moment to be under control, the case fatality rate for those under 50 was 0.2 per cent. For those over 60 it was 3.6 per cent, for the over-70s 8 per cent and for the over-80s 14.8 per cent. In Italy – now the country worst affected by COVID-19 – the fatality rate for the over-70s thus far has been 11.8 per cent, for the over-80s 18.8 per cent and for the over-90s 21.6 per cent.
It is, in one respect, a blessing that COVID-19 seems to be ageist. Most pandemics are not so merciful toward children. In the United States, for example, the 1957-8 influenza pandemic killed the under-5s at an even higher rate than it killed the over-64s. It is also true that there have never been so many old folk. (The global elderly population is 9 per cent.)
And it is true, too, that doctors in an overwhelmed hospital with insufficient intensive care units are correct, from a utilitarian perspective, to give priority to the young over those nearing the end of their natural lives.
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Yet when this pandemic has run its course – when we have achieved "herd immunity” as a species and when vaccines and therapies have been devised – there will have been a lot more funerals for elderly Italians and, very probably, Americans and Britons. There will be fewer for senior Taiwanese or South Korean citizens.
And the reason for this discrepancy will not be bad luck. The reason will be that east Asian countries drew the right conclusions from the searing experiences of SARS in 2003, while most western countries drew the wrong conclusions from their relatively mild encounter with H1N1, commonly known as swine flu, in 2009.
That COVID-19 was both highly contagious (because it is easy to carry and transmit by asymptomatic individuals) and much more deadly than seasonal flu was already obvious as early as January 26, when I first wrote about the coming pandemic in this column. And yet our governments dithered for the better part of two months.
It was not only Donald Trump’s irresponsible nonchalance that did the damage. There were also failures by the very organizations that were supposed to prepare our countries for a threat such as this. In the United States, there has been a scandalous insufficiency of testing kits.
In the United Kingdom, policy was initially based on the notion that the country would be better off aiming for early herd immunity – until epidemiologists such as my near namesake Neil Ferguson pointed out the likely disastrous consequences.
Because of these blunders, the U.S. and the U.K. have moved far too slowly to adopt the combination of mass testing, enforced social distancing and contact tracing that has successfully contained the virus’s spread in east Asian countries. There is a reason that the death toll, (as of Sunday) in South Korea is just more than100, while in Italy it is more than 5,000.
How many people will die in the end? We do not know. In the U.S., if Italian conditions are replicated in New York and California, we could see between half a million and million deaths by the end of this year. I have seen estimates as high as 1.7 million, even 2.2 million. The other Ferguson’s worst-case scenario for Britain was 510,000 deaths. But the key point is that most of the victims will be old. And most of the deaths could have been avoided with better preparation and earlier action.
The explorers Knud Rasmussen and Gontran de Poncins reported that senicide was still practiced by the Netsilik Inuits of King William Island in Canada as recently as the 1930s. But senicide will never be tolerated in the 2020s, least of all in modern, developed democracies. Those whose sins of omission and commission lead to nationwide senicides will, like the perpetrators of genocides in the 20th century, be judged harshly, not only by history, but also by voters – and quite possibly by judges, too.
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