The CDC and Seniors, a disconnect

Because of Covid-19 the CDC is recommending that those over 60 (and anyone with chronic medical conditions) stock up and prepare to stay at home for the foreseeable future. Some articles have gone so far as to equate foreseeable future with being through 2021. While I am sure that is sound conservative medical advice about Covid-19 given current data, it also ignores the reality of being over 60.

By your mid-60s you are looking at a life expectancy of around 20 years. Moreover, at some point in your 70s your physical (and perhaps cognitive abilities) will likely decline significantly. So the CDC guidance is to flush 10% of your remaining life expectancy, and perhaps 20% (or more!) of your remaining fully active life, down the toilet to reduce the chance that you will die from Covid-19. Using some current data (and all data about Covid-19 is, at this point, suspect) that means giving up 20% of your active life trying to avoid a 4.6% chance of dying if you contract the SARS-CoV-2 virus.

To put a slightly different spin on it, if you are in your 60s and contract the SARS-CoV-2 virus you have a 95.4% chance of survival. But while you are busy trying to improve on that 95.4% survival rate by following the CDC’s advice to be a hermit, the ills of aging are racing at you like a train in a tunnel. Let me give one example, the rate of new cancers rises dramatically as you age. It roughly doubles from your late 50s to late 60s. The all cancer 5 year survival rate is 69.3%. Now imagine trying to improve on that Covid-19 95.4% survival rate by following the CDC’s advice to be a hermit only to find, when you are finally free to start living your life again, that you’ve developed cancer and only have a 69.3% chance of survival. And that’s the all cancer rate, what about stomach (30.9%) or esophageal (18.7%) cancer survival rates? And even if you survive, you will have given up another year or more of your life to fight the cancer. Now do you want to start talking about Alzheimer’s and Dementia? Starting at age 65 the risk of contracting Alzheimer’s increases at 23% per year of age. I’m going to stop looking at data now, because I’ll make myself horribly depressed.

The truth for those of us in our 60s is that our mortality has become real even if, for the moment, we are healthy and active. Becoming hermits for a year or two means, quite literally, giving up the few remaining good years of our lives. I’m pretty sure this is not the right trade-off. Certainly it isn’t for me.

Although not specifically part of my point I do want to add one thing that has been pointed out to me by others. The health risks, particularly mental health risks, of long-term isolation are significant. So while I’m making the point that you could be giving up the few remaining good years of your life, they were making the point that extended social distancing could actually accelerate your decline.

Please don’t think I’m advocating against most measures to avoid and stop the spread of SARS-CoV-2. Wash your hands frequently. Avoid crowds. Try not to touch your face. Stay home if you are sick. Etc. But if the CDC thinks that people in their 60s should hide in their homes for many months or even years then they aren’t looking at the big picture.

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