Those arguing for a more rapid lifting of coronavirus restrictions have a refrain that goes something along the lines of: “Isolate the elderly and more vulnerable populations, and let everybody else go on with their lives.”
The argument does not come out of thin air. It is driven by data showing that, overwhelmingly, those who become severely ill and die as a result of the coronavirus tend to be either older or have an underlying health condition. Children, younger adults, and healthier individuals face very little risk from COVID-19, and yet, they are being asked to endure lockdowns, lose work, and see their businesses crumble.
So, conceptually, the idea of isolating the most vulnerable and targeting resources their way while allowing for life to go back to normal for everybody else has a clear appeal.
The problem is that those advocating such a strategy have not done a very effective job of explaining what that would look like in practice.
The most obvious way to “isolate” older and more vulnerable people would seem to be to put them in specialized living quarters along the lines of nursing homes. Yet, these homes have been proven to be absolute death traps.
Nursing homes have been the hardest-hit places, with tens of thousands dying as the virus has spread like wildfire among the vulnerable populations there. Nearly 5,000 have died in New York nursing homes alone. These numbers understate the problem, as they do not account for residents who die in hospitals or who are taken home to die with relatives.
Removing the elderly from these facilities would run counter to the strategy of isolation. If they came home to live with grown children, for instance, they’d be exposed to individuals who would be, under the reopening strategies, participating in society. Also, those who end up in nursing homes are there because they require assistance with daily activities, and they don’t have any family members who can take on the burden of around-the-clock care. Right now, the sandwich generation is grappling with the unprecedented challenge of trying to maintain full-time jobs with schools and childcare closed and all activities canceled. Adding the burden of caring for vulnerable parents will be backbreaking for many families.
The United States has 51 million people over 65. There are 103 million people with high blood pressure, over 100 million with obesity, and 34 million have diabetes. Now, you can’t simply add up all of these numbers, as some people will fit into multiple categories. But were you to add up everybody who fit into at least one of these categories (or who had different underlying health conditions) and then take into account those who are in regular contact with somebody who fits into these categories, the pool of people who could simply go back to normal under this “isolate the vulnerable” strategy dwindles considerably.
Don’t get me wrong: The fact that we can say with a high degree of confidence that the risk to younger populations is low gives us some information we can use to craft a more sustainable social distancing strategy. In conjunction with other measures, some sort of targeted approach can be part of the overall way we return to some semblance of normal.
But people presenting “isolate the elderly and vulnerable” as some sort of easy solution really need to flesh out what they think that would look like in practice.
