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A terrible triage: How COVID-19 speaks to our future

Human RightsCOVID-19

The COVID-19 crisis has exposed Canada’s shameful treatment of its elderly. Illustration by Damon Jah/Flickr.

From causes to cures, masks to missteps, instructions to regulations, economic impacts to lost livelihoods, the coverage of the COVID-19 pandemic has expropriated all social media platforms and has become the dominant preoccupation in the lives of Canadians. And with good reason: lives are being lost and we are disconnecting from all that we have taken for granted in a manner unprecedented in most of our lifetimes.

What is equally tragic and may well serve as a harbinger of an even darker future is the havoc wrought upon the elderly by this vicious visitor. As might be expected the elderly are least able to fight the ravages of this virus—particularly if their immune systems offer any concession. One of our parents, a sprite and lovely but immune-compromised 90 year-old is in an assisted care facility and the worry is constant; a worry which is more than justified.

According to Canada’s chief public health officer, over 90 percent of COVID-19 related deaths are of those over the age of 60, and fully half of them lived in long-term care facilities. We have all heard of the horrifying conditions, infection rates and deaths of the elderly in facilities across Canada, with Residence Herron in Quebec being of the worst examples. There and without debate, a mask would have been required. The stench of forgotten food and human excrement and the pain and suffering caused by gross negligence at this privately run nursing home for the most vulnerable must have been overwhelming.

The Washington Post recently painted an equally grim picture suggesting that since 2016, 40 percent of the over 650 nursing homes across the United States reporting cases of the coronavirus were cited for hundreds of deficiencies influencing the spread of diseases from urinary tract infections to the flu virus.

The more cynical among us might conclude that this viral emergency has forced over-burdened health care professionals and underpaid personal support workers to affect a “terrible triage”. Given the availability of insufficient resources, to whom are you going to provide the needed ventilator: the 22-year-old millennial mother of two with her future ahead of her, or the 80 year-old senior with her past behind her?

Beyond this emergency however, what does this “response” portend for the future of health care for the elderly? The answers are not encouraging. According to Statistics Canada, Canadians over 65 now represent the largest age demographic in the country. By the middle of the next decade seniors could represent up to 25 percent of the projected population of 40 million plus Canadians. That is almost 11 million elderly, over twice the number of a decade ago.

So how prepared are we for the less visible, more measured but equally insidious “graduation” of the boomer cohort into a future of assisted and acute care facilities? Currently almost all such facilities have waiting lists for available rooms or “beds” as they are more accurately called. Assuming that the vision of most of our elected politicians rarely extends beyond their term of office, can we expect our governments to provide a sufficient number of “beds” to accommodate the substantial increase in the number of elderly requiring admission?

Past practice does not augur well for future planning. Are we looking at converting abandoned warehouses into ‘Seniors Storage Facilities’ with sheets for walls and refrigerated trucks at the end of the journey? Will younger Canadians of the next generation consider the convolutions of current medically assisted death conversations as quaint and antiquated in the same way we seniors look upon bell-bottom pants and hula-hoops—a fad that enjoyed its time but has now become passé? Will “checking out” become commonplace and expected if our mental and physical functions become “compromised” as they so often do in our later years?

These are uncomfortable questions made no less so by difficult answers. Unless we begin planning for the “onslaught of the elderly” now, our sheer numbers may dictate this form of terrible triage—as much out of kindness as out of necessity.

Without question, these exceptional circumstances found all Canadians and the governments they elected woefully unprepared for its management and control. Hopefully, we will learn lessons from the many tragedies visited upon the elderly by this pandemic which will permit us to prepare for a very uncertain future. We do not want that perennial philosopher of our generation, Pogo the Possum, to prove prophetic: “We have met the enemy and he is us”.

Retired from academia and public service, Beverly Sabourin and Peter Globensky are seniors living in Winnipeg. Currently, they are apprehensive about getting older.

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