Colin Powell’s death at 84 underscores the continuing risk that Covid-19 presents to older people — even if they are fully vaccinated, as Powell was.
For vaccinated Americans in their 70s and 80s, Covid remains more dangerous on average than many other everyday risks, including falls, choking, gunshot wounds or vehicle accidents:
The numbers in this chart are averages, of course, covering a wide range of situations. They encompass both healthy older people and those with compromised immune systems (as was the case with Powell, who had multiple myeloma and Parkinson’s disease). At every age, Covid presents considerably more danger to people with serious underlying medical conditions.
“Vaccines turn Covid into a mild disease,” Dr. Ashish Jha, dean of the Brown University School of Public Health, wrote yesterday. But mild infections can “kill vulnerable people,” he explained.
For older people with a medical condition, the vaccines both sharply reduce the dangers of Covid and still leave Covid as a meaningful threat, one that arguably justifies a different approach to day-to-day life. Spending time indoors with an unmasked, untested grandchild or eating a meal inside a restaurant may not be worth the risk, at least until case counts have fallen to low levels.
For older people who are healthy, the risks may be more tolerable. Covid is probably not vastly more dangerous than other activities that people do without thinking — like driving a vehicle or climbing a flight of stairs — but it is not zero risk, either.
“Getting vaccinated doesn’t deliver you into an entirely new category of pandemic safety — safer and more protected than anyone who hasn’t gotten vaccinated — but simply pushes you down the slope of mortality risk by the equivalent of a few decades,” David Wallace-Wells has written in New York Magazine.
As a country, what can we do to protect older people from Covid? The data points to at least three good answers.
1. Reduce caseloads
The main reason that Covid deaths surged in the U.S. recently is that cases surged. If cases return to their low levels of the spring and early summer, deaths among older adults will probably plummet as well. In June, only about one-tenth as many Americans over 65 were dying from Covid as in August, according to the C.D.C.
The most effective way to reduce caseloads is to continue raising the country’s vaccination rate, through workplace mandates and other measures. Vaccinating children under 12 can also save the lives of older people.
Cases in the U.S. have already fallen 50 percent since Sept 1. If the declines continue — and can be maintained — the risks for older Americans will be much more manageable than they were in the late summer.
2. Give booster shots
Scientists are still trying to figure out how quickly vaccine immunity wanes. But the bulk of the evidence suggests that it does wane at least somewhat in the first year after vaccination, which creates additional risks for older people. Among that evidence: Covid case counts are higher in Britain, where vaccinations tended to happen earlier, than in other parts of Europe, as John Burn-Murdoch of The Financial Times has noted.
Waning immunity, in turn, suggests that booster shots can protect vulnerable people.
In the U.S., the federal government has not yet authorized booster shots for any recipients of the Moderna or Johnson & Johnson vaccines, although a scientific advisory panel has recommended them for people who are 65 and older, among others. Pfizer vaccine recipients 65 and older are already eligible for a booster once they are at least six months removed from their second shot.
Powell was set to receive a booster shot last week but had to postpone it when he became sick, a spokeswoman said.
3. Expand rapid testing
If rapid Covid tests were widely available, as they have been in much of Western Europe, they could help protect the elderly.
In a previous newsletter, I mentioned a woman in Germany who greeted visitors with a stash of rapid tests — allowing her husband, who has Parkinson’s disease, to stay safe and still have a social life. Imagine if American families could do the same. Grandma and grandpa are coming over for Sunday dinner? Everybody else takes a rapid test before they arrive.
The Biden administration has promised to make rapid tests widely available this fall. For now, they are still difficult to find, largely because the F.D.A. has been slow to approve them.
For most Americans, vaccination makes the risk of a serious form of Covid extremely rare. And for children, Covid tends to be mild even without vaccination. But until caseloads decline more, the situation remains frightening for many older people.
More on Powell’s life
Powell was a child of New York City (as he discussed in a PBS interview). He was born in Harlem, raised in the Bronx and graduated from City College.
After serving in the Vietnam War, he rose through the military and became the first Black national security adviser, chairman of the Joint Chiefs of Staff and secretary of state.
Heading into the 1996 presidential campaign, Powell was among the country’s most popular figures, but he chose not run (as Bob Woodward detailed at the time; Woodward also conducted Powell’s final interview).
In the prelude to war in 2003, Powell accused Iraq — falsely, it later became clear — of having weapons of mass destruction. He would describe it as a blot on his record. (Our colleague Robert Draper has told the back story.)
Powell, once a Republican, lamented the party’s move to the right, endorsing Barack Obama, Hillary Clinton and Joe Biden.
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