COVID-19 inquiry must get to the heart of pandemic ageism

Baroness Heather Hallett has an unenviable task of seismic proportions. The chair of the Covid-19 inquiry has stated her intentions to listen to evidence on almost every aspect of a pandemic that resulted in more than 220,000 deaths in Britain and overturned many aspects of our daily lives.

To deliver findings that will bring satisfaction to the majority on such a divisive and emotionally charged subject feels like an almost impossible task. I wish her and her team the very best of luck.

While the challenge feels enormous, it is vitally important and necessary the inquiry delivers an effective and timely response to the defining issue of this era.

Looking back, I hope it will bring some sort of closure and answer those unanswered questions for the millions impacted by the loss of a loved one in the pandemic.

Looking forward, we need the inquiry to deliver the answers that will ensure our response as a nation is better the next time we face such an all-encompassing health risk.

At the Centre for Ageing Better, we will be paying closest attention to the inquiry’s evidence and findings around the treatment of older people. Did our approach to the pandemic save the lives of older people or did it put older people closer into harm’s way?

Older people bore the brunt of COVID. In the first year of the pandemic, older adults accounted for most excess deaths. Among the groups 75–85 and 85 and older, there were 17.2% and 13.7% more deaths than expected. By contrast, the 15–44-year-old age group saw 652 excess deaths (6.2%) above the expected level.

We also know that COVID proved more deadly for some social groups than others. The raised risk of death for black people was two times greater for men and 1.4 times greater for women compared with white people. Another study found working age adults in England’s poorest areas were almost four times more likely to die from COVID-19 than those in the wealthiest areas.

A successful inquiry will help steer national policies towards tackling these health inequalities. Not just in preparation for any potential future pandemic but also to ensure a more balanced prospect of a healthy later life for everyone, regardless of wealth or ethnicity.

The pandemic also stripped back and showed us how we as a nation feel about and treat ageing older people.

One decision likely to be heavily scrutinised by the inquiry is the discharge of untested hospital patients into care homes during the early stages of the pandemic, a policy already judged unlawful by the High Court. To many, the reasoning behind the decision, freeing up health service capacity for younger, fitter patients, is a prime example of how older lives are given less value in society.

In the early weeks of the epidemic, it was common to see reassurances publicly expressed that COVID was not a major concern because it was fatal “only” to older people or those with underlying health conditions. This thinking reached its nadir with a newspaper column arguing for the economic benefits of the virus “culling” the elderly population. While this callous thinking was roundly condemned, the fact that a national newspaper felt there was merit in publicising such ageist thinking just shows how far we still must travel as a country to end age-based prejudice.

While a shocking lack of concern for older people was seen during the pandemic, the way that concern for older people was expressed was driven by stereotypical and patronising thinking.

While it was right to try and protect the most vulnerable and there was a need to speak in very general terms in public health messaging, it will be interesting if the inquiry tells us whether lumping everyone over a certain age into a category labelled “vulnerable” did more harm than good? Many over-70s will not have recognised how their government was describing them and may have chosen to ignore advice they perceived as patronising, irrelevant or even ageist.

How many older people’s personal wellbeing and mental health were negatively impacted by the provisions to keep them safe which exceeded what their general health required? How much did this diminish the role that older people could have played in our communities in supporting those who really did need that greater protection?

The pandemic has changed so much about our country. It has left huge scars on a personal and societal level. Picking through all that will be an enormously challenging but supremely vital task. Not just to provide clarity on our nation’s recent past but to provide us with the roadmap for where we go in the future