“If we only knew” — Four Deadly Words Amidst the Covid-19 Pandemic

By Drs. Prabhjot Singh, James Firman, and Alexis Travis

The Covid-19 pandemic has taken the lives of over 400,000 people, and the sheer magnitude of this national tragedy has left many people feeling helpless. By nature, we all have a default behavior in the midst of a threat — minimizers or maximizers. But what counts is personal — what is the real impact on me or someone I care about? In our work to help multiple state governments understand their citizens’ behaviors amid the pandemic, we’ve learned that most people don’t know that older adults are hundreds of times more likely to die than younger adults. Insights like this can help us change how we act and behave to end the pandemic.

Over the winter holidays, multiple surveys indicated that after a long period of isolation, many families chose to get together despite the risk. However, “risk” is a big, vague term, and the terms “high” or “low” risk don’t really help us as much as we may think because they are judgements. Based upon the best scientific evidence, we know that compared to younger adults, people over 65 are 90 times more likely to die if they get Covid-19, people over 75 are 220 times more likely to die, and people over 85 are 630 times more likely to die. In math terms, this is a risk that rises exponentially, a concept that is difficult to put in plain language.

But ask yourself the following question: if you knew that your upcoming visit with grandma and grandpa was, compared to the danger for a younger person, 100 times more likely to cause harm, would you still take the risk with that planned visit? Probably not. But that is precisely the situation and risks that family gatherings over the holiday represented. If people fully understood their risks, and then chose to gather, then they are informed and do so with their eyes open. However, based upon work our group has done with multiple states, we know that people of all ages do not think in terms of the harsh math of exponential risks. We have a three-part plan to change that.

THE PLAN

First, all older adults should understand their specific Covid-19 risk based upon their underlying health and their usual behavior patterns. Data collected with the Michigan Department of Health and Human Services Aging & Adult Services Agency indicates that even people who wear masks publicly let their guard down with friends and relatives. Today approximately 89% of coronavirus-related deaths in Michigan are in the older adult population. The “living room” is actually quite deadly — and a significant source of spreading Covid-19. The CV19 CheckUp platform, utilized by state governments including Michigan, Florida and New York, is designed to give individuals specific and actionable insights on ways to understand what they can specifically do to lower their risk.

Second, people who care for older adults or people with underlying medical conditions should carefully evaluate the risk they pose to them. In work with participating states, New York States’ Department of Aging, we found that young, healthy New Yorkers did accurately understand that they were at lower risk of hospitalization or death, but they did not take the risks of other people around them into account. This is critical because one out of every two people over 75 dangerously underestimated their own risk and many of them felt lonely and isolated. The spread of Covid-19 is always about more than one person, and each of us needs to do our part for others.

Third, we have been encouraged by the pioneering efforts by multiple states and public health leaders to make sure citizens and consumers in their state know their risk and know the action they can take. Now that we have federal leadership that is advancing a national strategy to end this tragic pandemic, there must be a united effort to educate our citizens about Covid-19 related risks, the importance of testing and vaccination, and how we can look out for one another. This effort will reduce hospitalizations, save lives, and put citizens back in a state of proactively caring for one another.

Covid-19 deaths should be a tragic, exceptional event in America, rather than a daily reminder of our helplessness. An educated and informed citizenry is the best partner to a successful vaccination program, and each of us is part of the solution. We hope that no family in the country will look back and say, “if we only knew” as they remember someone they lost.

Prabhjot Singh, M.D., Ph.D. is Chief Scientific and Medical Advisor at CV19 CheckUp, a vital tool that helps people assess their COVID-19 risk. He is a physician focused on health system design, and an associate clinical professor of medicine, health system design and global health at the Icahn School of Medicine at Mount Sinai.

James Firman Ed.D. was the President and CEO of the National Council on Aging (NCOA) for 25 years. Today, he is the Co-Founder and Chief Innovation Officer at BellAge — developer of CV19 CheckUp — a company that is using artificial intelligence to improve public health.

Alexis Travis, Ph.D. is the Senior Deputy Director of Aging and Adult Services in the Michigan Department of Health and Human Services and board member of Advancing States, the association of state and territorial agencies on aging, disabilities, and long-term services and support directors.