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Age: How it interacts with COVID-19

Life expectancy. Copyright: paulprescott72 / 123RF Stock Photo. Age concept.
Image credit: paulprescott72 / 123RF Stock Photo

India’s seniors continue to account for the largest proportion of deaths due to COVID-19 – but those in younger age demographics are far from immune to the effects of the disease according to recent figures.

As reported by Sushmi Dey for The Times News Network (TNN), those above the age of sixty account for fifty percent of fatalities due to COVID-19, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or, simply, the coronavirus. However, this is tempered by the statistic that those in the 45-60 age demographic account for 37 percent of fatalities – indicating what TNN states is their emergence as an “increasingly vulnerable” group given that they accounted for 32 percent of deaths a month ago.

Age has been extensively commented upon in the context of COVID-19. As noted by the World Health Organization (WHO), “although all age groups are at risk of contracting COVID-19, older people face significant risk of developing severe illness if they contract the disease due to physiological changes that come with ageing and potential underlying health conditions.” A study published in the journal Nature outlines that the correlation between advanced age and heightened risk of severe complications is “a feature shared with the 2003 SARS epidemics.

“This age gradient in reported cases, which has been observed from the earliest stages of the pandemic, could result from children having decreased susceptibility to infection, a lower probability of showing disease on infection or a combination of both, compared with adults. Understanding the role of age in transmission and disease severity is critical for determining the likely impact of social-distancing interventions on SARS-CoV-2 transmission, especially those aimed at schools, and for estimating the expected global disease burden.” 

India’s elderly population is growing. In 2018, then-Minister of State for Health and Family Welfare Anupriya Patel informed parliamentarians in the Lok Sabha that India’s elderly population is projected to number at more than 340 million by 2050. As I noted at the time, “ageing increases one’s risk of a plethora of conditions…noncommunicable diseases (NCDs) such as heart disease, cancer, osteoporosis, strokes and Alzheimer’s disease. Ageing also weakens the immune system, leaving older persons more susceptible to infectious diseases such as pneumonia.” Such vulnerabilities in terms of immunocompromisation arguably become even starker in the context of a global pandemic triggered by the outbreak of a viral disease, one of which our understanding is continuing to evolve.

However, as much as it is important to recognise the accentuated risk of those at an advanced age from COVID-19, this should not detract from the reality that we are all vulnerable. As the WHO stresses, “all age groups are at risk.” As my colleague Nicholas Parry wrote for this publication in April, “the stereotype of the disease being restricted to the elderly is largely derived from the mortality rate. While younger individuals have indeed died from coronavirus, the death toll has been dominated by the elderly. 

“The cause of this is the increased likeliness of comorbidity. With diseases such as cancer, heart disease, hypertension and a range of lung conditions being prevalent among the elderly population, it is this group that has borne the brunt of the deaths. However, the view that the disease is limited to this group has done little to help global efforts to stem the tide of the coronavirus outbreak.” 

Citing examples from a number of countries, such as young people gathering for spring break parties in the United States, Parry observed “the willingness to break quarantine measures amongst the young stems in part from the view that those below a certain age are all but immune to the health impacts of the coronavirus. While the majority of young people may catch the disease and only be affected by very mild symptoms — for some amounting to a mild cough — the danger of this logic is the ability to pass the disease on to others. It is in this capacity that mortality rates can climb to staggering levels. 

“Young people not taking precautionary measures to stop the disease can allow the coronavirus to spread unchecked, often showing little to no symptoms. Upon interaction between these young people and, for example, their grandparents, the virus can pass to a population deemed to be at-risk and cause greater levels of fatality.” 

In India, where stringent lockdown restrictions have been or were eased across great swathes of the country, imparting the message that advanced age is a factor – but not the only factor – is important. As we reopen, we must continue to discuss the importance of physical distancing measures; of adhering to proper hygiene practices; and of following government guidance on how best to protect ourselves and others. Nobody is immune. We are all at risk. 

More than one in five people worldwide are at risk of contracting a serious or critical condition of COVID-19 as a consequence of underlying conditions. This pandemic makes it incumbent upon us all to take the steps we can to safeguard the wellbeing of those around us.

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