Older persons have suffered a terrible toll from the coronavirus—now countries must invest in long-term care.
Covid-19 is devastating for older persons. The numbers are staggering: more than 80 per cent of the fatalities due to coronavirus in the United States and east Asia have occurred among adults aged 65 and over. In Europe and Australia, the figures are even higher: 94 and 97 per cent of the deaths respectively have been among persons aged 60 and above.
Yet as the contagion spread, older persons were denied access to beds and ventilators, despite being the most vulnerable group. Human-rights experts were alarmed by decisions made around the use of scarce medical resources in hospitals and intensive-care units—discrimination based solely on age. Despite being helpless and most at risk, older persons were not prioritised: they were in effect sacrificed, denied treatment and emergency support.
‘Older people have the same rights to life and health as everyone else. Difficult decisions around life-saving medical care must respect the human rights and dignity of all,’ said the United Nations secretary-general, António Guterres, deeply concerned about events during the pandemic.
About half of the coronavirus casualties in high-income countries have been in care homes, though this is an underestimation because originally official death tolls did not include those who had died outside hospitals without a Covid-19 test.
Most countries reported insufficient protective equipment and testing in care homes for both residents and care workers. Thousands were infected by the coronavirus in nursing homes and, while some staff heroically worked in dangerous conditions, others did not. Staff absenteeism added to real horror stories.
For example, in a nursing home in France, 24 persons passed away in just five days; they died alone in their rooms of hypovolemic shock, without food or water, because 40 per cent of the staff were absent. In Canada, a criminal investigation was launched after 31 residents were found dead, unfed and unchanged at an older persons’ residence. Following other such disturbing cases, the Canadian military had to be deployed to assist and the government is considering taking over all private, long-term care institutions.
In Sweden, protocols discouraged care workers from sending older persons to hospitals, letting them die in the care homes. In Spain, when the military were deployed to disinfect nursing homes, they were shocked to find people ‘completely abandoned or even dead in their beds’. Spain has launched criminal investigations into dozens of care homes, after grieving relatives of thousands of elderly coronavirus victims claimed ‘our parents were left to die’.
In Italy’s Lombardy region, a resolution offering €150 euro to care homes for accepting Covid-19 patients, to ease the burden on hospital beds, accelerated the spread of the virus among health workers and residents. Coffins piled up in nursing homes. Families are filing lawsuits claiming mishandling of the epidemic.
In the US, more than 38,000 older persons have died in residences because of Covid-19 and many families have filed lawsuits against nursing homes for wrongful death and gross negligence. In the UK, families of care-home residents who died from Covid-19 are suing the health and social care secretary, Matt Hancock. The claims accuse the government of breaching the European Convention on Human Rights, the National Health Service Act 2006 and the Equalities Act.
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Long-term care is a lucrative and powerful industry. Europe’s care sector is concentrated in the hands of a few large private groups, often run by pension and investment funds. In the US, 70 per cent of the 15,000 nursing homes are run by for-profit companies; many have been bought and sold in recent years by private-equity firms.
There, nursing homes and long-term care operators have been lobbying state and federal legislators across the US to pass laws giving them broad immunity, denying responsibility for conditions inside care homes during Covid-19. Nineteen states have recently enacted laws or gubernatorial executive orders granting nursing homes protection from civil liability in this connection. Nobody is responsible for the suffering of thousands of older persons who have died alone in care homes.
Due to the rapidly ageing population, all countries should invest more in health and long-term care services for older persons. Health-system capacity is however strained because of austerity cuts in earlier years.
It was the shortage of beds, staff and equipment that made doctors discriminate against older persons and prioritise the younger, with more chance of survival from Covid-19. Governments and international financial institutions must stop mean budget cuts which have condemned many to die, and instead invest in universal public-health and social-protection systems.
Countries must also invest in quality long-term care services for older persons. Half the world’s elderly lack access to long-term care. At the moment, governments spend very little on it; instead, they have allowed private care services to develop, with minimal regulation. As a result, most older persons have to pay up to 100 per cent of the costs of long-term care out of their own pocket and most cannot afford quality services—a highly unequal system.
Societies have failed older persons during the Covid-19 pandemic. Countries must redress this neglect and support survivors by properly regulating, inspecting and investing in quality care services for all older persons.
This article was originally published in Inter Press Service news
Isabel Ortiz is director of the Global Social Justice Program at the Initiative for Policy Dialogue at Columbia University. She was previously director of the Social Protection Department of the International Labor Organization.