For the past couple of months, I’ve been juggling my day job with helping my wife, sister-in-law and brother-in-law to provide care in our homes for two elderly relatives with serious health conditions, cancer and diabetes among them. We removed them from their assisted-living facility when the first covid-19 case hit there. “GET THEM OUT!” their doctor demanded, and he was probably right. Cases there quickly grew to more than a dozen. Though our lives became a blur of doctors, quarantines and prescriptions, we figured that if we could keep them safe for a while, federal and state governments would fix the group-living problem with the necessary testing, equipment and infection control.
That didn’t happen. Now we’re sending them back to the facility, aware that it could be a fateful choice. But they would be no safer with us as the economy reopens: Kids return to their orthodontists, camps and schools, and we return to postponed appointments and eventually offices and mass transit.
Our struggle between two bad choices is nothing compared with what many Americans have had to confront. Some 40 million have lost their jobs (not to mention the nearly 100,000 who have lost their lives). More than 8 million are in the care of long-term facilities, home health-care agencies and the like. One in 5 U.S. households handles caregiving for family members, most of them old — and few of them have the luxury of juggling hours or taking time off to do it.
For frail seniors in the United States, there simply is no haven. The unspoken, if inherent, trade-off in reopening the economy without safeguards is the lives of our elders. Two months ago, Dan Patrick, the Republican lieutenant governor of Texas who was about to turn 70, argued that those his age and older are “willing to take a chance on [their own] survival” to reopen the economy. Now they have no choice.
Geriatric psychiatrist Nicholas Schor, president of the Washington, D.C.-area chapter of the American Geriatrics Society, pleaded with local officials nearly two months ago, in a letter signed by 30 local practitioners, for a better pandemic response at long-term care facilities, saying “testing and proper PPE are widely unavailable.”
And now? Schor says that of the nearly 40 facilities he works with, only 30 percent are doing sufficient testing (testing all residents and staff every two weeks). With flawed tests yielding false negatives of 12 percent to 40 percent, even facilities trying hardest can’t reliably fight the virus.
The lack of protective equipment is also glaring. Virtually all facilities are reusing single-use equipment, he said, and one facility uses gloves made for cattle birthing. Staff attrition has been high — the low-paid workers know their own lives are at risk — and residents live in “fear and isolation.”
“I don’t want to express complete futility,” Schor told me. But “Pandora’s box has been opened,” and not just in senior facilities. The virus “is going to run its course. Everybody’s going to get exposed eventually.”
Republican Gov. Larry Hogan of Maryland, where Schor has concentrated his effort, has led one of the country’s most aggressive responses to the pandemic. Yet even there, 1 in 5 cases, and 3 in 5 deaths, have been in congregate living facilities. Nationwide, more than one-third of deaths have been in care facilities, and about 80 percent of deaths have been people 65 and over.
Seniors are well aware that the current administration has essentially offered them up as sacrifices on the altar of economic recovery.
Back in March, three-fifths of those 65 and over approved of the federal government’s response to the pandemic. Now a majority of that age group disapprove. Poll after poll has shown Trump in the past two months losing his lead among 65-and-over voters, a crucial demographic for Republicans, both nationally and in battleground states. The political handicapping site FiveThirtyEight observes that Trump won voters 65 and older by 13.3 percentage points in 2016. At the moment, Trump trails Biden by 1.0 points among such voters in an average of national polls — an enormous swing.
Near the end of his life, Vice President Hubert H. Humphrey, the 1968 Democratic presidential nominee, said that “the ultimate moral test of any government” is how it treats the most vulnerable, including “those in the twilight of life, our elderly.”
By opening up commerce without a haven for our seniors, the Trump administration and its gubernatorial mimics have failed that moral test utterly.