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OPINION

Western mismanagement of coronavirus means the elderly are targets

Many will die, but most of the deaths could have been avoided with better preparation and earlier action.

Seniors shop during special morning hours at Market Basket in West Bridgewater on Thursday.
Seniors shop during special morning hours at Market Basket in West Bridgewater on Thursday.David L. Ryan/Globe Staff

The word “genocide” — meaning the murder of a tribe or people — was coined in 1944 by Raphael Lemkin, a Polish-Jewish refugee whose family was all but obliterated in the Holocaust.

The word “senicide” — meaning the deliberate murder of the elderly — is less well known, though of older provenance. According to the Oxford English Dictionary, it was first used by the Victorian explorer Sir Henry Hamilton Johnston. “The ancient Sardi of Sardinia,” he wrote in 1889, “regarded it as a sacred . . . duty for the young to kill their old relations.”

Lemkin’s word caught on. Not so “senicide,” which is so rare a word that Microsoft Word’s spellcheck underlines it in red, itching to autocorrect it to “suicide.”

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All that is about to change. If, as seems increasingly likely, a significant number of Western countries are going to continue mismanaging the pandemic caused by the virus SARS-CoV-2 — the novel coronavirus that originated in Wuhan, China, in December — then a very large number of old people are going to die before their time.

The statistics are unequivocal. In China, where the epidemic seems for the moment to be under control, the case fatality rate for those under 50 was 0.2 percent. For those over 60 it was 3.6 percent, for those over 70, 8 percent, and for those over 80, 14.8 percent. In Italy — now the country worst affected by COVID-19, the disease the virus carries — the fatality rate for those over 70 thus far has been 11.8 percent, for those over 80, 18.8 percent, and for the over 90s 21.6 percent.

It is, in one respect, a blessing that COVID-19 seems to be “ageist.” Most pandemics are not so merciful toward children. In the United States, for example, the 1957-58 influenza pandemic killed those under age 5 at a higher rate than it killed those over 64.

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It is also true that there have never been so many old folk. Today, more than a quarter of Japan’s population are 65 or older. In 1960 the share was just 5.6 percent. In the European Union, the share has doubled from 10 percent to 20 percent. The world as a whole has gone from 5 percent elderly to 9 percent.

And it is true, too, that doctors in an overwhelmed hospital with insufficient intensive care units are correct, from a utilitarian perspective, to give priority to the young over those nearing the end of their natural lives.

Yet when this pandemic has run its course — when we have achieved “herd immunity” as a species and when vaccines and therapies have been devised — there will have been a lot more funerals for elderly Italians and, very probably, Americans and Britons, than for Taiwanese or South Koreans.

And the reason for this discrepancy will not be bad luck. The reason will be that East Asian countries drew the right conclusions from the searing experiences of SARS in 2003, while most Western countries drew the wrong conclusions from their relatively mild encounter with H1N1 in 2009.

That COVID-19 was both highly contagious (because easy to carry and transmit by asymptomatic individuals) and much more deadly than seasonal flu was already obvious as early as Jan. 27, when I first wrote about the coming pandemic in this column. And yet our governments dithered for the better part of two months.

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It was not only President Trump’s irresponsible nonchalance that did the damage. There were also failures by the very organizations that were supposed to prepare our countries for a threat such as this. In the United States there has been a scandalous insufficiency of testing kits thanks to missteps by the US Centers for Disease Control and Prevention.

In Britain, policy was initially based on the notion advanced by the government’s chief scientific adviser that the country would be better off aiming for early herd immunity — until epidemiologists, such as my near-namesake Neil Ferguson and his colleagues at the Imperial College London, pointed out the likely disastrous consequences.

Because of these blunders, the United States and Britain have moved far too slowly to adopt the combination of mass testing, enforced social distancing, and contact tracing that has successfully contained the virus’s spread in East Asian countries. There is a reason that the death toll in South Korea is just 94, while in Italy it is 3,405.

How many people will die in the end? We do not know. In the United States, I predict if Italian conditions are replicated in New York, California, and other states, we could see between a half-million and 1 million deaths by the end of this year. I have seen estimates as high as 1.7 million, even 2.2 million. The other Ferguson’s worst-case scenario for the UK was 510,000 deaths. But the key point is that most of the victims will be old. And most of the deaths could have been avoided with better preparation and earlier action.

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The explorers Knud Rasmussen and Gontran de Poncins reported that senicide was still practiced by the Netsilik of King William’s Land as recently as the 1930s.

But senicide will never be tolerated in the 2020s, least of all in modern developed democracies. Those whose sins of omission and commission lead to nationwide senicides will, like the perpetrators of genocides in the 20th century, be judged harshly not only by history but also by voters — and possibly by judges, too.

Niall Ferguson is the Milbank Family Senior Fellow at the Hoover Institution at Stanford University.

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