Why are the elderly dicing with death? For people with few quality years left, it's perfectly rational to prefer pandemic to imprisonment

Precisely why older people are more susceptible to the virus is not clear. The factor most often cited is that the immune system tends to decline with age, but it could also be that older people who catch Covid-19 are more likely to already have other medical problems. The message, though — as leaked to the media and subsequently confirmed by the Prime Minister and other ministers — is that, as the virus spreads, the over-70s will have to stay at home.

It has not yet been spelled out how complete this confinement is intended to be. Transport secretary Grant Shapps suggested that people would be able to take their dog for a walk, and that solitary promenades could be permitted. Shopping, however, and anything that might mean encountering other people, will be discouraged or ruled out. This includes entertaining the grandchildren at Sunday lunch, as they could carry the virus, with dire consequences for someone older.

While the whole intention, they were told, was to keep them safe, this was not appreciated by all seniors. Letters pages, social media and phone-ins were at once flooded with protests from those of a certain age, most calling to insist that theirs was a defiant generation and they intended to carry on going out as they pleased. If that meant the prisons were full of bolshie geriatrics, so be it.

Broadcaster and campaigner, Esther Rantzen (79), was one of few who said that she had been self-isolating from early on and regarded it as the responsible course. There were also those who pointed to something not made explicit in official pronouncements; put crudely, that while the Government might indeed have the safety of the UK’s elderly population at heart, there was another priority, too, which was to minimise, so far as possible, the number of elderly people taking up precious hospital beds — beds that could, dare one say, be more productively used by those needing shorter stays and more likely to get better.

So advising the over-70s to stay within their four walls for months was not entirely or even primarily for their own protection; it was also, even mainly, to stop them clogging up the NHS. Given that older people have been around long enough to sense an ulterior motive, it might have been preferable for officials to set out the calculation straight. How about: if you don’t withdraw from circulation, if you insist on selfishly swanning around in society, you could find yourself taking up a bed and depriving your son, daughter or grandchild of treatment they might need.

That is a fair case to make — but it cannot be the last word. By singling out over-70s, the burden has been placed on them to self-isolate rather than on others to keep what is now described as their social distance. But it has also risked the perception that older people are the main problem. My hair is barely greying, but I have been told several times in the past week by complete strangers that I should not be out on the streets — as though I was a danger to them, rather than they to me.

Given that older people are no more of a risk to others than anyone else, why should over-70s not be left to decide for themselves whether to stay at home, isolated, for the prescribed 12 weeks or not? For some, perhaps many, there will be a calculation to be made.

For those at the older or frailer end of the spectrum,  this could be the last spring they expect to see. If you were in your 80s or 90s, reasonably alert and mobile, would you choose to gamble on the prospect of another few years at the cost of what could be a long period of incarceration, or would you prefer to keep a measure of your freedom now? It hardly needs to be said that not everyone has a garden or private open space, or even much space at all.

In leaving the choice open, would that not risk a disproportionate number of elderly Covid-19 sufferers clogging intensive care in the NHS? One solution might be for over-70 “refuseniks” to place their decision on the record, along with a signed statement akin to a “living will”, to the effect that they will require only palliative care if they become seriously ill.

UK medical professionals have been agitating for official guidance on the sort of life and death choices that their Italian colleagues have faced, when confronted with many acutely ill patients and limited resources. These are indeed agonising choices, but they are hardly unknown in the NHS.

A declaration from an elderly patient, stating that he or she agrees not to take precedence for an intensive care bed or a ventilator or whatever, preferring to accept that their time has come, could nonetheless be helpful. Might it come perilously close to assisted suicide — a course that both the courts and Parliament have declined to legalise? I don’t think so.

As of now, there are young people blithely discounting all the health warnings in the belief that they have little to fear from Covid-19 — as would indeed appear to be the case. If they carry the virus, however, they are far more of a danger to their elders than their elders are to them.

Those over 70 should be informed of the risks they are taking, and encouraged to do the right thing as individuals. If they were then to decide that three or more months in a personal prison was too high a price to pay for however many more months or years of life they might judge they had left, they should be allowed that choice. It should be theirs and theirs alone.

---

Mary Dejevsky was Moscow correspondent for The Times between 1988 and 1992. She has also been a correspondent from Paris, Washington and China.

marydejevsky