Covid-19 coronavirus: Simon Wilson: Being old in a Covid world

We find it hard to think about being old. You're not old, and you live your life. Eventually, at some point, you are old, and apparently that means you're waiting to die. Although who's surprised to learn most people who are old don't see it that way?

When exactly do you become old? That's no easier to answer than deciding when you've become an adult.

Both are complicated by the truism, itself very old, that the age you behave is not the same as what it says on the calendar. Winston Peters has been old for 50 years. Captain Tom Moore seems not to be old at all and he's just turned 100.

Actually, he's Colonel Tom now, which is nice but if they had really understood his inner youth, wouldn't they have made him Major Tom?

Maybe your age is what you want it to be, divided by how much pain and tiredness and incapacity your body makes you accept. I'm at least 20 years away even from being old-adjacent, but I know my knees, back, arthritic fingers and who knows what else see it differently.

Covid-19 kills people of any age and any prior health condition. But we know it's most deadly among the old and we think we know that's especially true for those with "underlying conditions". This has led some people to mount the brave argument that perhaps they would have died anyway.

I'm being kind in calling them brave.

The thing about "underlying conditions" is that most old people have them. Your "underlying conditions" are the stuff of your daily life. They're what you manage. They aren't killing you, at least not today or tomorrow, and if you do manage them well, you're going to keep on living, and enjoying it, for quite a while.

The Economist has reported on research from Scotland relevant to this. The researchers looked at Italian, Scottish and Welsh data to compare the health status of people who had died of Covid-19 and the health of their general age cohorts.

They found that Covid-19 victims had only slightly higher rates of underlying illness than everyone else their age.

That meant, they said, that those who died of Covid-19 in their 50s would have had an average life expectancy of another 30 years. For those in their 60s it was 21 years, for those in their 70s it was 12. Even those who died in their 80s were robbed of 5 more years of life.

The thing about being in your 80s, even when you have "underlying conditions", is that your life expectancy is probably higher than most people think. That's because you've survived the ravages of youth and many of your less-healthy contemporaries have already died. Whole-of-life averages no longer apply to you.

The Scottish researchers did warn that their data excluded people from rest homes, which raises the next big question. In New Zealand, most deaths have occurred among residents of retirement facilities.

The industry is quick to point out that there have been very few outbreaks and therefore there's no reason to doubt the safety of most rest homes.

But the issue runs deeper than that. Schools, weddings and St Patrick's Day parties haven't been incubators either, except when they have. The cluster evidence tells us clearly that when the virus takes hold in a close community, it can spread widely within that group.

How keen are we still on the idea that old people should be set apart from everyone else, as happens in rest homes? It's a white-people cultural thing, and many people like it. But why is it supposed to be the norm?

Will we start a more serious conversation at some stage about the benefits for everyone of more integrated communities? That option should be far more common.

• Covid19.govt.nz: The Government's official Covid-19 advisory website

The Ministry of Health is going to conduct a review of rest homes affected by Covid-19. That's good. But it will be an internal review, involving only the ministry and the companies. Residents and their families won't be represented and nor will staff and their unions. That's ridiculous.

Meanwhile, in the name of one-law-for-all and safety-first regulations, we've had a string of cases of elderly and sometimes confused people dying alone. It's awful.

And it's not easy to know the best policy. But there are two things we do know. One is this: we expect our health officials and politicians to put a very high priority on compassion. Therefore, we want them to evolve their systems to be flexible.

It isn't possible to ensure the safety of all concerned for special, compassion-based visits to the dying? I'm not sure I believe that.

The other thing we know is that every time crowds gather, it gets harder. Those crowds, and those who cheer them on with their barrage of "Why can't we do what we like yet?", are the reason the rules don't yet have the flexibility and compassion we all want.