Covid and Older People the risks: breaking down the statistics

During the crisis, the issue of over 70s being riskier and needing lockdown was hotly debated and the government backed down under pressure. But what are the statistics behind the risks of catching COVID as you get older? We’ve reviewed the evidence which confirms that although age does affect your risk of becoming ill from coronavirus it’s too crude to say that at 70 you automatically become riskier and that younger age groups are just fine. It depends on several factors – your health, what conditions you may have, and your economic and social circumstances. 

The high death toll for older people from COVID has been chilling. But it’s too easy to view COVID as just being an “older people’s” disease.  When the pandemic started age 70 was when you fell into the vulnerable category for COVID.  The prospects of a further lockdown of the over 70s was overturned only when this was widely challenged.

Government’s formal advice has recently changed slightly – if you’re 70 or older and usually need a flu jab for underlying medical conditions, you might be in the clinically vulnerable category.  However, the NHS website still says if you are 70 and over then you are still at moderate risk from coronavirus.  Yet there is no explanation of why exactly 70 is chosen and clearly a crude age rule like this can stigmatize older people.

So, what are the facts behind age and coronavirus? When examining the data there’s a crucial difference between the risks of dying from COVID among people who get the disease and the risk of dying across the total population among people who do not currently have COVID.

The evidence shows the strong relationship between COVID deaths and older people and this risk rises with age, as happens with all illnesses. Office for National Statistics data shows that roughly up to age 69, fewer than 1 in a 1000 died,  but once in your 70s it rises to 2 in every 1000, then increasing  to 7 in every 1000 people in your eighties and once over the age of 90 it’s 18 in every 1000 people.   The other important data to know is what has happened to those with COVID in hospital receiving critical care and here the risks of dying again increases with age. Across all age groups two in five patients died, but for older people a half of over 60s died and sixty per cent of those aged above 70. And one significant but unexplained fact is that more men have died from COVID deaths than women

across all age groups not just the over 70s.

But the risk of dying also depends on the state of your health.  91 per cent of those who died from COVID also had an underlying health condition, with only 8.9 per cent having none. Getting health conditions is a fact of getting older – so around a half of people in their early 60s have one of a range of health conditions (hypertension, heart disease, diabetes, lung disease, asthma, or cancer) and almost one in five people in their 60s have two or more of these conditions. But it’s important to note that 30 per cent of over 70s have no health condition and are in good health. One of the largest study of deaths so far from COVID confirms age as increasing the risk of dying or becoming extremely ill, but together with obesity, major health conditions, but also economic and social deprivation. Another study of patients admitted to hospital showed that outcomes were better predicted by frailty than either age or having other health conditions.

So, it’s more complicated than saying at 70 you automatically become riskier- it depends not only on your health, but also your economic and social circumstances. ONS data shows that Coronavirus has had a proportionally higher impact on the most deprived areas in England and this is reflected in patterns in London. Ethnicity is also an important factor – people from ethnic minorities have higher rates of mortality from coronavirus than white people.

The other big question is are you more at risk from catching COVID as you get older? Here the evidence suggests that older people living in the community are not more likely than younger people to catch coronavirus. Your risk is really down to what activities you pursue which may mean you are more likely to pick up the virus and particularly the type of job you may do. We know that front line jobs were more susceptible to picking up the virus during the crisis. The recent outbreak in Leicester showed that the excess in infections from COVID tended to occur in younger and middle-aged people. But the figures for catching COVID though are obviously still greater in care homes or hospitals than if you are in the community – and a fifth of older people who died from COVID were in care homes.

These statistics point to some key lessons in understanding COVID and older people:

  1. Clearly age is a key factor in getting extremely ill or dying from COVID and important in how we judge our own risks.
  2. But chronological age should not be a factor on its own in for lockdown or other policies affecting older people. There are big problems in depicting all over 70s as vulnerable and a burden because they are more at risk of dying having got coronavirus.  There are a lot of factors which affect health and you can’t generalise about the health of older people. Older people are a truly diverse group with different states of health and circumstances and different level of activities.
  3. We need a better and more informed debate about the statistics relating to older people and COVID. Most people are inevitably concerned about the death ratio and older people but it’s equally important to know much more about the effects of having suffered from COVID and the health implications over time.

Tim Whitaker

Covid and Older People the risks: breaking down the statistics

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