Among the more than 800,000 Americans now dead of Covid-19, three-fourths have been 65 or older, with the virus having killed one-in-100 older Americans over the past two years. The pandemic may have deprived people of experiences at every stage of life—including students who’ve fallen behind during crucial stages of their education—but for older people, it’s taken years that time can no longer really compensate for. Many Americans are mourning older family members this holiday season, and many elderly people who’ve survived the pandemic are now living with the lingering effects of disruption, isolation, and loss. What do these tolls mean for American society?

Brian McGarry is an assistant professor in the Department of Medicine at the University of Rochester. According to McGarry, the pandemic has amplified some of the worst effects of getting older—the experiences of losing people your own age, feeling vulnerable, worrying about your own mortality, and even dealing with the effects of ageism in American life, both directly from people and indirectly in public policies. It’s also accelerated these effects at a time when life expectancy for most groups of Americans has been increasing and many have begun looking to retire later, effectively prolonging middle age. For those in need of long-term care and for their loved ones, McGarry says, the last two years have raised new questions about how they want to address vulnerability and need later in life—and the American healthcare system’s capability of addressing them.

Graham Vyse: Has there ever been a situation like this in America before, when so many elderly people have died so quickly from a single cause?

Brian McGarry: Not in my lifetime or my parents’ lifetime. Early in the pandemic, we looked to the Spanish flu of 1918 as a model of what to expect. This is a pivotal moment in history.

Vyse: How has the pandemic affected different segments of older Americans?

McGarry: A lot of the fatalities have been among the “oldest old,” people 85 and older. People 65 to 74 have had substantial fatalities, too. We can’t talk about the devastation the virus brought without talking about nursing homes, which in many ways have been the epicenter of the pandemic. They’re the perfect environment to spread infectious respiratory disease. You have an old, vulnerable population, often physically disabled with multiple chronic conditions. Typically people in nursing homes are there because they can’t live at home independently anymore.

Meanwhile, most nursing homes in the U.S. are old buildings, somewhat institutional, often with shared rooms and shared bathrooms and communal dining spaces. These buildings probably don’t have the best ventilation either. Nursing-home residents were very much at a disadvantage from the outset of the pandemic and there were substantial deaths among them.

It’s difficult to get entirely accurate statistics, because the population of nursing homes isn’t static, but one estimate we’ve looked at suggests that roughly one in 10 nursing-home residents has died. That’s the real devastation of a particular group of people—and of a group that’s historically been marginalized in U.S. policy discussions about where to put public resources.

Vyse: How do race or other demographic factors figure into thes ways Covid has affected older Americans?

McGarry: Mirroring what we’ve seen in the general population, Blacks and Hispanics have experienced a disproportionate share of the death. The United States has a long history of racial and ethnic biases, and we’ve certainly seen some of the effects of these biases play out in this pandemic. But I also think we’re witnessing an ageism in the way we’ve chosen to handle Covid in the U.S.

Vyse: How so?

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