In February 2020, my grandmother was 95 years old. She lived in a nursing home. As Covid flared up, policymakers around the world struggled to align on responsible countermeasures. But as much as there was controversy over mask mandates, everyone agreed on one thing – let’s protect the most at-risk people in our society. Nursing homes around the world closed their doors, sealing themselves into hermetic isolation.
Today – two years later – many nursing homes are still closed off to outside visitors and operate under the strictest of health guidelines. The policy remains in effect.
This policy, reasonable on its face, has effectively killed my grandmother, and I suspect it has done the same for millions of the voiceless elderly. Before Covid, she was mentally lucid and conversational. Today, she is still alive, but a shell of her former self – she doesn’t recognize her children anymore, she can hardly speak in sentences. She was fortunate to never have Alzheimer’s or any neurodegenerative disease – but her mind is gone all the same.
And why is her mind gone? Dare I hazard a guess: she’s spent two years in solitary confinement. With great, socially responsible caution, her nursing home cancelled all social activities, restricted visitors, and so every resident was locked into their 300-square-foot single with an ensuite bath. Meals were delivered with minimal social contact, as good Covid protocol dictates. This is solitary confinement. It’s very nice, as far as solitary confinement goes – her room is tastefully decorated and there’s a balcony – but it’s solitary confinement all the same. We know that solitary confinement is a profoundly destructive punishment even for healthy young adults, creating permanent trauma in mere days. And it didn’t cross our minds that the elderly, who are obviously much more frail and already struggle with loneliness, might not hold up under these circumstances? Did anyone think for how long nursing home lockdowns could possibly be useful before they cause vast destruction? Did anyone ask when should this policy end?
The policy has not ended, of course. No nursing home wants to be responsible for a Covid-induced death, so it continues. And adding insult to injury, the mathematics of the entire situation are a farce. While my grandmother was not vaccinated in 2020, had she caught Covid, her chance of death might have been around 28%. But because she’s elderly, she was vaccinated in December of 2020 – dropping her probability of death perhaps to 5%.1 Of course the true risk rates are much lower yet, because it can take a very long time to actually catch Covid. Today, perhaps 40% of Americans have had it. Therefore, her real risk of death was at most around 11% had she stayed unvaccinated the entire time, or 2% since being vaccinated.
Who the fuck thought it was a good idea for my grandmother to spend the entire of 2021 in solitary confinement over a 1-in-50 risk of death? She’s in her late 90s, for crying out loud. She has a greater chance of death literally in any month just due to old age.
The average 95-year-old woman has a remaining life expectancy of 3.4 years.2 On that short of a horizon, there is virtually no lockdown policy that makes sense, especially for statistically minor risks. Even a big risk can be calculably taken if you believe you only have a small amount of time left. And though a lot of the hardcore take-every-precaution folks in the public discourse argued emphatically against taking any downside risk, there is simply no way that spending the last few months of your life in solitary confinement and losing your mind is a better alternative than just taking on a marginal additional risk.
Perhaps the worst part is that this is not just the story of my grandmother. It’s the story of millions of elderly, forgotten in their nursing homes. They don’t know how to use computers, they are shut off from discourse. There is a vast voiceless population that is enduring a terrible fate for no reason. The math around life expectancy and actual health risk makes it trivially obvious that there’s virtually no lockdown policy that makes sense for people in their 90s. The alternative of condemning the elderly to lose their minds in solitary confinement is staggeringly careless, a great cruelty steeped in irony, championed by people thoughtlessly believing they are doing social good.
Next time, the we-have-to-do-something crowd should try thinking about it first. There’s nuance to easy decisions. It is ironic that everyone agreed on lockdowns for the elderly while debating general lockdowns for the broader society – and while general lockdowns may or may not have been useful, I believe that lockdowns for the elderly quickly veered into being damaging overall. But with no-one to advocate for the elderly, the damage was done silently, and it continues today. Policymaking is hard, and the hardest part – perhaps more in managing the policymaker’s own ego rather than in predicting the future – is to acknowledge that policies must eventually expire. This one shouldn’t have lasted longer than two weeks.
Rigorous statistics on this are surprisingly hard to obtain. ↩
And due to the rapid physical decay that people suffer at that age, the health-adjusted life expectancy is even shorter yet. Even if you have a few years left, you may have much less than that left in terms of being active in the ways that are important to you. ↩