It’s now a pandemic of the old
By David Wallace-Wells
(originally published in the New York Times — 12/7/2022
Americans received their first Covid-19 vaccine doses in December 2020, which means we are now approaching the beginning of the third year of the pandemic’s vaccine phase. And yet hundreds of Americans are still dying each day. Who are they? The data offers a straightforward answer: older adults.
Though it’s sometimes uncomfortable to say it, mortality risk has been dramatically skewed by age throughout the pandemic. The earliest reports of Covid deaths from China sketched a pattern quickly confirmed everywhere in the world: In an immunologically naïve population, the oldest were several thousand times more at risk of dying from infection than the youngest.
But the skew is actually more dramatic now — even amid mass vaccinations and reinfections — than it was at any previous point over the last three years. Since the beginning of the pandemic, people 65 and older accounted for 75 percent of all American Covid deaths. That dropped below 60 percent as recently as September 2021. But today Americans 65 and over account for 90 percent of new Covid deaths, an especially large share given that 94 percent of American seniors are vaccinated.
Yet these facts seem to contradict stories we’ve told about what drives vulnerability to Covid-19. In January, Joe Biden warned that the illness and death threatened by the Omicron variant represented “a pandemic of the unvaccinated.” But that month, in which nearly 85,000 Americans died, the unvaccinated accounted for 59 percent of those deaths, down from 77 percent the previous September, according to analysis by the Kaiser Family Foundation. The share of deaths among older adults that January was nearly 74 percent.
Over the months that followed, the unvaccinated share of mortality fell even further, to 38 percent in May 2022. The share of deaths among people vaccinated and boosted grew significantly as well, from 12 percent in January 2022 to 36 percent in April. Those levels held roughly steady throughout the duration of the summer, during which time just about as many boosted Americans were dying as the unvaccinated. The share of deaths among older adults kept growing: In April, 79 percent of American deaths were among those 65 and older. In November, 90 percent.
As many Twitter discussions about the “base rate fallacy” have emphasized, this is not because the vaccines are ineffective — we know, also from the Centers for Disease Control and Prevention data, that they work very well. Estimates of the effectiveness of updated bivalent boosters suggest they reduce the risk of mortality in Americans over the age of 12 by a factor of 15 compared to the population of unvaccinated. That is a very large factor.
But it isn’t the whole story, or vaccinated older adults wouldn’t now make up a larger share of Covid deaths than the unvaccinated do. That phenomenon arises from several other factors that are often underplayed. First is the simple fact that more Americans are vaccinated than not, and those older Americans most vulnerable to severe disease are far more likely to be vaccinated than others.
It is also partly a reflection of how many fewer Americans, including older ones, have gotten boosters than got the initial vaccines: 34 percent, compared to 69 percent. The number of those who have gotten updated bivalent boosters is lower still — just 12.7 percent of Americans over the age of 5.
Finally, vaccines are not as effective among older adults because the immune system weakens with age. It’s much harder to train older immune systems, and that training diminishes more quickly. In Americans between the ages of 65 and 79, for instance, vaccination reduced mortality risk about eightfold, compared to the unvaccinated. This is a very significant reduction, to be sure, but less than the 15-fold decline observed among those both vaccinated and bivalent-boosted in the overall population. For those 80 and above, the reduction from vaccination alone is less than fourfold.
That is a very good deal, of course. But it also means that, given the underlying age skew, a twice-boosted 87-year-old shares a similar risk of Covid death as a never-vaccinated 70-year-old. Which is to say, some real risk. If it was ever comfortable to say that the unconscionable levels of American deaths were a “pandemic of the unvaccinated,” it is surely now accurate to describe the ongoing toll as a “pandemic of the old.”
So why aren’t we?
One answer is that as a country, we prefer just to not see those deaths at all, regarding a baseline of several hundred deaths a day as a sort of background noise or morbid but faded wallpaper. We don’t need to understand who is dying or why in part because we don’t want to reckon with the fact that around 300 Americans are now dying from Covid-19 every day, at a rough pace of about 100,000 per year, making it the country’s third leading cause of death. This is normalization at work, but it is also a familiar pattern: We don’t exactly track the ups and downs of cancer or heart disease either.
Another answer is that — partly to promote good behavior, partly to more easily blame others for our general predicament — the country spent a lot of time emphasizing what you could do to protect yourself, which left us without much of a vocabulary to describe what underlying vulnerability inevitably remained. Vaccine refusal was a cancer on the American experience of the Covid years — that is undeniable. But we got so comfortable equating personal choices and individual risk that even identifying vulnerabilities came to feel like an accusation of irresponsibility. And where does that leave older adults? In a pandemic of the unvaccinated, what do you say to or about the 45 percent of seniors who died in January who’d gotten their shots? Or the 60 percent of them who died this summer?
Many of us were also turned off by dismissive rhetoric from the beginning of the pandemic, when those minimizing the threat pointed to the disproportionate risks to the very old as a reason to not worry all that much about limiting spread. The country as a whole may be ageist, without all that much empathy for the well-being of octogenarians and nonagenarians. But hearing the conservative commentator Ben Shapiro or the Texas lieutenant governor Dan Patrick so blithely dismissing the deaths of older adults in 2020 probably made the whole subject seem considerably more taboo to the rest of us than it might’ve been otherwise.
Throughout the last few years, the country has also struggled to consider individual risk and social risk separately. In the first year of the pandemic, we seemed to build our sense of individual risk backward from the social need to limit spread — underemphasizing some of the differential threat and focusing instead on universal measures like social distancing and mask wearing. With the arrival of vaccines, we began to build a collective picture of social risk in the opposite way, up from an individual basis instead.
The picture that resulted was hugely relieving to most of us without being, at the highest levels, misleading: Vaccination and natural immunity had indeed dramatically reduced the country’s overall mortality risk. But while it’s comforting to believe that protection is a choice, for some populations it isn’t. And in moving pretty swiftly from treating everyone as high-risk to treating everyone as low-risk, we neglected to pay much attention to the differential of risk: that even if the average American had reduced his or her chances of dying by a factor of five or 10, 300 or more Americans might still be dying each day for many months, and there were probably some targeted things to do about that.
What are they? There is no simple or silver-bullet solution, which may be another reason we’ve spent more energy on the need for vaccination than on the vulnerabilities of age (that is, the fix is far more straightforward). But clearer communication — from public health officials to politicians and the media — about differential risk could nevertheless help, emphasizing not just that more shots are good but that different groups probably need different approaches, and that even with up-to-date vaccination and bivalent boosting, infection represents a considerable threat to older adults.
More targeted guidance might also underline the way that boosters still deliver what would have seemed like mind-blowing reductions in risk two years ago, even if they don’t eliminate it entirely, and point to certain settings where rapid testing should continue or be reinstituted (nursing homes, say). And there is surely much more to be done to aggressively promote treatments like Paxlovid, which are being criminally underutilized given their efficacy in vulnerable populations. (Their efficacy for younger and healthier people remains a kind of open question.) And while infrastructure investments and other mitigation strategies do not come as cheaply as communication, there is a bundle of things we know could help reduce transmission almost invisibly, without really burdening individuals: higher indoor air quality standards, for instance. You might even choose to target those investments and improvements less in schools than in care facilities, too.
Would all that be sufficient? Probably not to eliminate some ongoing death toll, unfortunately, given how promiscuously the disease is spreading. But it would presumably reduce by some fraction those hundreds of deaths we’re seeing each day. At the moment, the country is treating those deaths as the cost of normalcy.
Immediate release allowed
December 5, 2022
We Support This Country’s Rail Workers Right to Strike For Safer Working Conditions and Paid Sick Leave!
An Official Statement from Radical Elders
On December 1st the U.S. Senate voted to deny rail workers their democratic right to strike and to side again with some of the most powerful robber barons in US history, the seven Class 1 freight railroads.
For elders, the protection of railway work and its workers is essential. For Radical Elders, that social importance is enhanced by the political importance of these workers’ fighting for the right to strike over safety and paid sick days.
Radical Elders understands that, for seniors, the agreement represents the continuing abuse of a vital part of this country’s frontline workforce. Biden and Congress are carrying out the will of rail companies at the expense of those who put their lives at risk each day to get us food, water, medicine, clothing, fuel and vital equipment. The rail-based supply line is crippled after lay-offs of over 20 percent of the workforce between 2019 and 2021. These supply-line disruptions have sent prices soaring, forcing many elders to choose between some of these basics and paying their rent or mortgage and face a potentially life-threatening winter.
We should all be rallying to honor the work of rail workers and protect their security. It’s clear that President Biden and the Congress aren’t going to do that.
Eighty Democratic and Republican Senators approved President Biden’s rail contract agreement that does not contain any paid sick days for overworked rail workers, fails to address the companies’ unfair points-based attendance policy, and does nothing to improve the federal government’s oversight of the dangerous Precision Scheduled Railroading (PSR). The Senate failed to pass an amendment to guarantee the seven sick days the House passed in a separate bill Wednesday or the 15 paid sick days rail workers demanded.
“Because of PSR, our members are forced to work more hours, have less stability, suffer more stress, and receive less rest. The ask for sick leave was not out of preference, but rather out of necessity. No American worker should ever have to face the decision of going to work sick, fatigued or mentally unwell versus getting disciplined or being fired by their employer, yet that is exactly what is happening every single day on this nation’s largest freight railroads” Brotherhood of Maintenance of Way Employees of International Teamsters (BMWED)
“This agreement,” President Biden said, “is a big win for America, a great deal for both sides. What was negotiated was so much better than anything they ever had.” The “big win” agreement calls for a 24% pay raise over 4 years (below the inflation index) and one personal day per year.
Four unions, representing the majority of the 110,000 U.S. rail workers, who handle a third of all freight, voted against the contract and oppose this week’s Senate vote: BMWED; The Brotherhood of Railroad Signalmen; The Sheet Metal, Air & Transportation Workers (SMART); and the International Brotherhood of Boilermakers, Iron Ship Builders, Blacksmiths, Forgers & Helpers: “Congress should not have to intervene. The railroads should provide paid sick leave to its employees. They have the money to do it, and it literally would cost them a penny of every dollar of record profits to provide it. It’s only 2% of what CSX, NS and UP spent so far this year in stock buybacks. It’s literally nothing to them, yet they refuse to provide it.”
Rail workers have a strict points-based attendance policy forced upon them with no relief from either the U.S. Department of Labor or OSHA: “Workers say that they have been pushed to their physical and mental limits on the job, where they are expected to be on call 24/7 — sometimes working for weeks at a time with only one day off per month — and face a strict points-based attendance policy that quickly leads to penalties.”
Instead of the federal government using the power of the President, the Secretaries of Labor, Transportation and Commerce and the Congress they have given in to every move the rail robber barons have made to increase profits by cutting the workforce, failing to modernize and maintain equipment and rails and violating safety rules. Trying to force one worker crew on trains up to 4 miles long and PSR, have resulted in more deadly accidents across the country.
We should all unite in solidarity with rail workers and their unions to force Biden to extend President Obama’s 2015 Executive Order 13706, requiring federal contractors to provide employees with seven paid sick days annually, to cover up to now excluded rail workers. The struggle over PSR, points-based attendance continue as does the need to abolish the 1926 Railway Labor Act, which substitutes bargaining, arbitration and mediation for strikes to resolve labor disputes and for the revolutionary reform of public/worker control of rail and all transportation.
Radical Elders is a U.S.-based national organization of elder activists committed to fundamental social change. It practices democracy and intentionality.
Pretty shocking stuff published in Naked Capitalism and of importance to every elder in this country.
Radical Elders joins so many others in mourning the death and celebrating the remarkable life of Dr. Jeffrey Perry: life-long revolutionary, scholar, analyst and leader of RE.
Jeff joined our ancestors yesterday, September 24, 8:45 am Eastern/U.S. time.
Many of us in RE met Jeff in the Puerto Rican Socialist Party. He later was a postal worker and union organizer/activist in the Post Office while he obtained his degrees including the Doctorate from Columbia University.
During his prolific life, he wrote on a wide variety of subjects but his major theme, the one he constantly returned to, was racism: the folly on which it was based and the importance of centralizing it in all our struggles in this country. He wrote and lectured on that theme extensively and he spoke frequently about it within RE, helping make it one of the principles on which we organize.
We continue that organizing, thinking of him and being inspired by his life of commitment. He will always be “presente” for us!
From January of 2020 to last month, June 2022, 1,005,236 people have died from COVID in the United States.
Of that number, 936,323 were over the age of 55.
That’s 93 percent!
COVID is an elders’ disease. Now what???
A Statement by Radical Elders
Radical Elders denounces the criminally negligent response to the ongoing threat to the lives and survival of all vulnerable people posed by the continuing COVID-19 pandemic as the latest Omicron variants infect more than 100,000 new people in this country every day (a number that because only counts reported positive tests could be actually ten time as high when unreported positives, and untested infected people are added in).
We demand a fundamental policy change now!
There’s a reason why the US, the world’s richest country, has had the highest death rate from the pandemic of modern industrialized nations.
The U.S. government’s response to the COVID-19 pandemic has always been driven primarily by capitalist concern for the economy and a focus on how favored companies could make money off of it while ignoring the threat posed to the 100 million or so Americans particularly vulnerable because of age, poverty, reliance on mass transit, inadequate or non-existent medical insurance, and the many medical and physical issues related to those conditions.
Rules regarding mask-wearing, which public health experts know should still be worn in all enclosed spaces, have been dropped to exploit the ignorance of some potential voters and benefit capitalist employers more interested in profit than public health. Free PCR tests — the only tests that can assure that a person is not infectious before associating with others— have ended — replaced with quick antigen tests that are often falsely negative when infected people have no symptoms, giving millions daily the deadly, false illusion people are free of the virus, not contagious and are safe to go to work, school or get on public transit.
People, including many in the service industries, are being forced to return to in-person work situations without adequate protections and measures designed to prevent virus spread. Such actions are almost certain to produce Omicron infection.
Eldercare facilities, housing the most vulnerable people, are still plagued by absent or inadequate protection measures and have long been among the leading situations for virus spread.
The country’s prisons cram two million people into cages, denying them tests and vaccines, in a situation perfect for disseminating disease, which then gets spread to guards and visiting relatives who in turn deliver the virus to their families and the world outside the prison walls.
“This threat to elders, among whom African Americans, Latinos & Native Americans have the highest infection and death rates, must end immediately.”
* That beginning immediately, this threat to the elderly and other vulnerable populations end and public health policy going forward be founded on concern for society’s vulnerable, not on professed concerns about the economy, profits or the political demands of people who selfishly only care about their own convenience and don’t care about those who are at risk in society.
* That PCR testing, rapid tests, Covid vaccinations and N-95 masks all be made available free in all public spaces — train stations, schools, churches, workplaces, libraries, town halls, health care centers, etc.
* That the Medicare program be immediately expanded by a national emergency health crisis executive order to cover the health care of people of all ages, and that this expansion then be extended not just while Covid continues to spread, but permanently.
Put simply, we will not accept being ignored or neglected at this time of health crisis.
We demand the means to protect ourselves from this killer epidemic.
Radical Elders is a U.S.-based national organization of elder activists committed to fundamental social change. It practices democracy and intentionality.
This is the video of our June 28 gathering. Two hours in length. This is a Youtube video.
On July 3, journalist/activist and Radical Elders member Mumia Abu-Jamal will have been caged by the state for more than 40 years with thirty years spent on Death Row, after a thoroughly corrupt trial and after a demonstrably racist judge misinformed his mainly white jury they could not individually find him not guilty. The majority of these four decades he has been held in solitary confinement, with no hope of parole. Since his unconstitutional death sentence was overturned he has been a victim of multiple government efforts to execute him in prison through neglect and denial of medical care. Through it all, Mumia has maintained a posture of principled outspoken opposition to all oppression and a refusal to buckle under the unspeakable pressure brought against him.
We Radical Elders, an organization whose founding conference was addressed by Mumia, demand that he be immediately freed given the corrupt prosecution and appeal process that sent him to prison and has kept him there. We want Mumia to be present at our next gathering.
We call on all movements for justice and change to join the world, July 3 and demand Mumia’s immediate release.