June 28, 2020

The CDC COVID-19 guidelines were updated this week. Age is no longer considered a risk factor. It’s still true that the effects of the coronavirus are more severe in older adults, but the actual risk of severe outcomes depends on the current health of the individual rather than an arbitrary age cut-off point.

Am I the only one who saw a disconnect when the state requirement that everyone over 65 should stay at home until we have a vaccine, while almost all the epidemiologists and politicians seen on television referring to us as the “most vulnerable” were themselves well over 65? The venerable Dr. Fauci himself will turn 80 this very Christmas Eve.

Los Angeles Times. March 16, 2020.

What we heard almost daily here in California was the governor saying that adults over 65 were the “most vulnerable” and should stay indoors. As he announced the phases of reopening he made an exception for the “most vulnerable,” who should probably stay home for a year or until a vaccine was ready.

The California website still echos this outdated message: “Some people are at higher risk to get very sick from COVID-19, including: people over 65 years old, people with compromised immune systems, individuals who have serious chronic medical conditions . . .” and adds, “If you are at higher risk, you should . . . stay home. It’s the most important thing you can do.”

See: https://covid19.ca.gov/symptoms-and-risks/#top

I know, I know . . .

Now I learned early on that this virus spreads like wildfire and I do not want to get it, so I don’t go out much and when I do I use the tried-and-true precautions of social distancing, masks, and hand washing. I’ve tried to be gracious when friends and family remind me that, “you are in that vulnerable group, you know.”

Yes, I know how old I am, but I also know that viruses can’t read birth certificates. We can all get COVID. It’s a question of probable outcomes. Early reports showed that about 90% of the deaths from COVID-19 were in people with pre-existing medical conditions or comorbidities. About 60 % of adults over 65 have one or more of these medical conditions. I expect that one day I will too. But I don’t now.

However, the significance of removing age from the risk factors for COVID-19 isn’t about me. It’s a matter of public health. Here’s why:

  1. The repetition that over age 65 equals “vulnerable” implies that people under 65 are safe, whereas actually anyone with a chronic health issue is at risk of a serious outcome, regardless of age.
  2. Putting the emphasis on age 65 focuses our attention on an arbitrary cut-off point that we can’t do anything about. Just stay inside.
  3. Whereas knowing that poor outcomes are associated with existing health risks gives all of us a strong incentive to take care of ourselves regardless of age. If we have health issues this is a time to do whatever we can to manage them. If we don’t have health issues (that we know of) yet, this is a time to develop good habits that will keep us there.

The new information on the CDC website doesn’t ignore age. It says: “Risk for Severe Illness Increases with Age” and “There are also other factors that can increase your risk for severe illness, such as having underlying medical conditions. By understanding the factors that put you at an increased risk, you can make decisions about what kind of precautions to take in your daily life.” Indeed.

To see the entire statement, updated June 25, 2020, go to: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html

Bottom line: Age matters. Health matters more.

Today’s Notable Headlines

“California Calls for Residents 65 and Older to Stay at Home,” New York Times, March 15, 2020. https://www.nytimes.com/2020/03/15/us/coronavirus-newsom-california-seniors-restaurants-bars.html

“U.S. officials change virus risk groups, add pregnant women,” AP, June 25, 2020. https://apnews.com/d4ca187cdf84a4f96c1f24ab213ce4bf?utm_source=piano&utm_medium=email&utm_campaign=morningwire&pnespid=kLAxp_NGWxKNofJfjj7LuiR1QcPc_jdgBUOaGMUD

“Update on the risk factors of COVID-19,” The Daily Star, June 27, 2020. https://www.thedailystar.net/health/news/update-the-risk-factors-covid-19-1921461

Additional Sources:

“Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020,” CDC, April 17, 2020. https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm

“Who is considered high risk for coronavirus? Nine in ten deaths involving the virus were in people suffering from a pre-existing disease,” The Telegraph, April 17, 2020. https://www.telegraph.co.uk/news/2020/04/17/high-risk-coronavirus/

“Comorbidities in older people,” GP, August 2, 2017. https://www.gponline.com/comorbidities-older-people/elderly-care/article/1440520

CDC: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html

State of California: https://covid19.ca.gov/symptoms-and-risks/#top

Why am I doing this?

The coronavirus pandemic will be indelibly written on our memories just as the Great Depression or the Battle of Britain left their mark on past generations. It is my intention to journal the events of these days from three perspectives: as a retired medical technologist, a historian (Ph.D., 2014), and an ordinary person living through an extraordinary crisis.

You are on History’s Edge.

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