Why it's so difficult to protect older people from Covid-19

Data analysis shows that segmenting the population does not stop cases from rising across the population as a whole.

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In early October, three epidemiologists from the universities of Oxford, Harvard and Stanford signed a statement on the global response to Covid-19. The “Great Barrington Declaration” argued that the most vulnerable people should be isolated while the rest of the population returns to life as normal, spreading Covid-19 and building up herd immunity. The declaration has been co-signed by other academics and won support from commentators, particularly on the more lockdown-sceptical side of the political right.

However, it was swiftly criticised by the broader scientific community, including 80 scientists who signed a letter to the Lancet. A SAGE report on population segmentation, written in July but only published last week, agreed that “policies to segment the population by age, relaxing restrictions for younger groups while restricting them for older groups, are likely to fail [...] Increased transmission in the younger age groups is highly likely to result in an increase in incidence in older age groups.”

A New Statesman analysis of the most recent data in England and Wales supports this analysis. While younger people are still the most likely to become infected with Covid-19, following the return of schools and universities, the rate of infection among those of university age is starting to level off, but it is rising among all other age groups. Older people are still much more likely to become hospitalised or die from the virus.

Despite shielding policies for the elderly and vulnerable, the virus spread rapidly through care homes and the elderly population in the spring. Shielding for the clinically vulnerable was paused during the summer and only implemented again on 15 October, when the government updated its advice. Currently, people are only advised to shield in the very worst affected local areas, and for a limited period of time.

[See also: When will we have a Covid-19 vaccine?]

As can be seen below, during the first wave of the pandemic, the highest rate of Covid-19 was recorded among those aged 80 and over. This is because testing was not widely available to the general public, so many positive cases were people tested in hospital – who tended to be the more vulnerable.

The latest figures from PHE show a spike in rates among those ages 10-19 (silver line) and 20-29 (yellow) from the end of September –  after schools and universities reopened.

 

 

 

What is particularly concerning is that while the sudden “second-wave” increase was clearly initially driven by younger age groups, it rapidly spread across the generations. Every age group is now seeing a rise.

These case figures are mostly mirrored in the ONS survey estimates, with nearly every generation seeing their likelihood of catching the disease rising. This is true even as rates at universities are beginning to level off, suggesting the isolation of students may be starting to have an effect.

[See also: How England is heading for the worst of both worlds on Covid-19]

The infection rate for people aged 70+ also tapered off and fell slightly in the first week of October – although it is too early to say why.

 

 

 

Once patients are in hospital, the rate of admission to ICU is more even across all age groups over 45. With the start of the second wave, figures from NHS England show that although younger populations have the highest rate of infection, it is the same groups as before that are becoming seriously ill.

 

 

 

In terms of deaths from Covid-19, figures from the ONS show the recent rise in England and Wales has been almost completely among those over the age of 70.

Figures from earlier in the year also show that a slow rise in deaths can rapidly accelerate – although treatment of the disease has improved.

 

 

 

But the main takeaway from current data is that a rise in any age group leads to rises elsewhere, and it only takes a small increase in cases among the elderly to lead to a rise in deaths. 

[See also: The Welsh “firebreak” is a lockdown made in Westminster]

New research shows that six in ten single people without children aged 20 to 34 now live with their parents, while a separate report shows a third of homes are now multi-generational – the young are now less able to keep the economy moving because, for many young people, the economy had already slowed. The idea that it would be possible to contain the disease entirely among the young does not account for real life.

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