When Leonidas Romero returned home to Chelsea on April 15, the first thing the 92-year-old asked for was a shower. The second thing he wanted was a bowl of his daughter’s homemade chicken soup.
After weeks in the hospital fighting COVID-19, Romero and his daughter, Carolina — who also had been sick with the virus — were eager to celebrate.
As the pandemic’s death toll climbs, driven largely by victims in their 80s and above, Romero’s story might seem like an outlier: a lone survivor who beat back a death sentence. But just how rare Romero’s recovery is remains unknown. And absent any meaningful data about how many older people survive and recover, fear has spread far more quickly than the virus.
“Elders are looking at the death numbers in our state, and they’re getting increasingly concerned by the day,” said Al Norman, a longtime advocate for seniors.
According to census data, people 80 and older make up just 4 percent of the Massachusetts population. But the same group accounts for 15 percent of confirmed COVID-19 cases and more than 60 percent of reported coronavirus-related deaths — 1,905 people, according to state statistics released Monday. The average age of a COVID-19 patient who died in Massachusetts is 82.
This group faces much steeper odds than do younger seniors. The death rate for people over 80 is nearly five times higher than the rate for people in their 70s, and more than 18 times higher than the rate for those in their 60s.
For many in this high-risk age group, the data translate into a desperate fear of contracting the virus. “A lot of elders I’m running into are very aware of just how their demographic is particularly at risk,” Norman said.
Their families are concerned, too. West Roxbury resident Deanne Sullivan calls to check on her mother, Nellie, every day. “I’m hoping she doesn’t have [COVID-19] because I don’t know how anyone who’s 98 would survive it,” Sullivan said. Her mother is a resident at the Elizabeth Seton nursing home in Wellesley, where she has been unable to receive visitors for several weeks.
“I just don’t want her to die alone,” Sullivan said.
There is some evidence to suggest that COVID-19 is not a death sentence for the elderly, even for those who would seem to be most at risk.
A 97-year-old woman in Brazil overcame the virus. An Oregon man survived it at 104 years old. A 106-year-old woman in the United Kingdom recovered after three weeks of hospitalization. And closer to home, despite several preexisting conditions, Leonidas Romero pulled through after a harrowing eight days at Massachusetts General Hospital and 12 days at Spaulding Hospital Cambridge, a rehabilitative center treating COVID-19 patients.
Preliminary data suggests these cases, though remarkable, might not be as rare as they seem. A UK study of cases in China found an estimated fatality rate of 13.4 percent for people 80 and older. In Italy, 20 percent of patients 80 and older have died. In other words, beating COVID-19 is especially tough for the elderly, but it is not impossible.
At Spaulding in Cambridge, Romero was the second patient to recover and return home. Several more have been discharged since, said Joanne Fucile, vice president of operations and head of nursing.
“This week has been an amazing, emotional week at Cambridge,” Fucile said this month. “It’s just an amazing experience of hope. . . . People do survive and are able to go home.”
But how common that is remains unclear.
Through Tuesday, over 20 percent of Massachusetts coronavirus patients aged 80 and older have died from the infection, according to statistics released by the Department of Public Health. While that tally appears to be rising, it still leaves the vast majority of infected elders recovered or in various stages of fighting the disease — a battle an unknown number will win. Several factors make it difficult to anticipate what that number will be.
For one thing, age is not a perfect predictor of risk. “Eighty-plus doesn’t mean the same thing” for everyone, said Elizabeth Dugan, an associate professor of gerontology at the University of Massachusetts Boston. “It’s more about the underlying health status of the person and the amount of the virus they got.” A healthy person in their 90s, for example, might be better equipped than someone in their 60s with a number of chronic health issues.
Dr. Mark Messenger, an internal medicine physician who treats patients in their homes — now while wearing protective gear — agreed. “In geriatrics, it’s not your age. It’s what your comorbidities are.” Many of his patients are homebound with a range of chronic health challenges, and few who have contracted the virus show signs of improving.
Beyond individual patients’ risk factors, it is still too early in the pandemic to determine accurate fatality rates, experts said.
At this point, comparing the current number of cases and deaths does not offer much clarity, said Dr. David Hamer, an infectious disease expert at Boston Medical Center and a professor at Boston University. “Because of the nature of this disease, it can have an extended course. I think that over the next week or two, we’re going to see more deaths of people who are currently considered [unresolved] cases.”
One measure might provide more clarity, or at least hope, for the elderly: a tally of people their age who have recovered from the virus. But according to Department of Public Health spokeswoman Ann Scales, the state is not formally tracking that statistic.
The result is that the bad news — hospitalizations, new cases, deaths — piles up, without any good news as an antidote. “People are bombarded by this day and night,” said Messenger. “They’re living in constant fear.”
Catherine Hurst, a 76-year-old Providence resident, has managed to escape fear of the virus by limiting her news intake to the essentials. “I don’t want to spend a lot of time on it every day because you can almost work yourself into a state of anxiety,” she said. Instead, Hurst focuses on sensible measures for staying safe. She rises early to go shopping during her grocery store’s senior hours. She wears a mask and gloves when going for walks. And of course, she keeps her distance from others. Luckily, Hurst said, “I’m an introvert. I’m really good at being alone.”
But for others, the isolation the pandemic has imposed is itself a type of loss. Sullivan described the difficulty her mother has had adjusting to being confined to her room with no visitors. “She is used to having family all around her.”
“It’s a whole complex of losses that people are feeling,” said Norman, who was the director of Mass Home Care, a network of nonprofits serving seniors, for 31 years and continues to care for elder community members.
“Even in families where everyone seems to be doing fine,” Norman said, “there is still that sense of, ‘I’ve been robbed of something. I can’t give my grandson a hug and feed him.’ Those things are important to grandparents.”
For Romero and his daughter, recovery brought a reunion for which both are grateful. “He’s just so thankful, above all things, to God,” Carolina Romero said on behalf of her father. “And he is very thankful for all the care he received at Mass. General and at Spaulding Cambridge.” When he came home, she continued, “my father and I celebrated. We said, ‘We are champions because we survived this virus together.' ”