Pandemic highlights widespread societal ageism

Ever since whispers of a virus began trickling into the mainstream, Dr. Michelle Porter had a sense that her area of expertise — aging — would soon become increasingly relevant.

She heard reports and commentary from hotspots in Asia and Europe early in 2020 that the novel coronavirus was "just" or "only" killing elderly people. Somehow, despite hundreds of people of all ages in hospital or facing death at home, the severity of the situation was being downplayed as a niche threat facing older individuals.

There were morbid suggestions, including by the lieutenant-governor of Texas, that seniors should sacrifice their lives in order for the economy to continue functioning.

"Ageism hasn’t been made worse by the pandemic," says Porter, the director of the University of Manitoba’s Centre on Aging. "It’s just highlighting that it exists."

First coined in the 1960s, ageism refers to a form of prejudicial discrimination, akin to racism or sexism, that devalues lives while harming people based on implicit and explicit biases surrounding age. Typified by stereotypes and differential — often patronizing, demeaning and dangerous — treatment, ageism can occur at individual, collective and institutional levels.

"It’s a form of discrimination that has largely remained acceptable," said Porter.

Dr. Alison Chasteen, a professor of psychology at the University of Toronto, focuses on ageism, and says since the start of the pandemic, "old" people have been portrayed as a vulnerable monolith, but that there’s great diversity within that subsection of the population: Porter points out that "old" could include people as much as 50 years apart, with varying abilities, interests and life experiences.

Still, seniors living in care or nursing homes have been more segregated from society than any other age group, even as restrictions were lifted throughout the summer. That only emphasizes the degree of separation many seniors already faced prior to the pandemic.

Chasteen says age is far from the only determining factor in how the virus affects people, even though it is one of the few pieces of information shared by the provincial government when it reports deaths confirmed to have been caused by the virus. In those scenarios, a person is described by where they lived, whether they were male or female, and how old they were. Here, ageism also shows through, Chasteen says.

In Manitoba, although most active infections are concentrated in the 20-49 age bracket, the bulk of people who have died from the virus are considered "elderly." To date, the youngest people confirmed to die from COVID-19 in Manitoba have been in their 40s, and Chasteen says society’s reaction to death or tragedy is heavily influenced by the age of the people affected.

A study Chasteen published several years ago examined participants’ responses to different scenarios where an individual died in a car crash, and the findings showed that when the victims were younger, their deaths were regarded as more tragic than those who were older.

"This suggested that there is a differential weighting of life when using age as criteria," she says. "And I think that’s really unfortunate, because we know that any individual can make an impact or contribution in any given year of their life."

Porter agreed. "Every death from COVID-19 is premature," she says. "It doesn’t and shouldn’t matter if the person was 70 or 17: if they died of COVID, they died prematurely, and neither should ‘underlying conditions’ make it OK.

"We are all going to die eventually, but it shouldn’t be seen as less troublesome that someone died because they were 95 and living in a long-term care facility," she adds.

Long-term care facilities, notably the Revera-run Parkview Place home, have been the site of some of the deadliest outbreaks of the virus in the province thus far.

Located in downtown Winnipeg, Parkview has seen nearly 100 of its 220 residents test positive for the virus, with 18 dying.

In an interview with CBC Radio, provincial health minister Cameron Friesen called care-home deaths "tragic... regrettable" and "unavoidable." NDP health critic Uzoma Asagwara called it a "false, callous and ageist statement."

Friesen’s comment also angered Toronto-based, Winnipeg-born physician and geriatrician Dr. Nathan Stall, who is currently studying toward a PhD in clinical epidemiology.

"To label it as ‘unavoidable’ really is an attitude we refer to as therapeutic nihilism," he said. "If you start with the premise that nothing you do matters, it becomes easier to justify doing nothing."

Stall’s study of care-home outbreaks in Ontario and Quebec during the pandemic’s first wave showed pre-pandemic conditions played a major role in how the virus spread: non-profit homes had smaller and less deadly outbreaks than for-profit ones, and matters such as sanitation and design standards — ventilation, efforts to reduce crowding — contributed significantly to resident safety.

Stall says conditions at Parkview — including a cockroach problem and unsanitary conditions — are "very avoidable" in his opinion, and that the clear issue is oversight.

"I found it appalling that any health minister, in Canada or elsewhere, would call what has happened ‘unavoidable,’" he says. (On Monday, the WRHA revealed that "the majority" of Parkview’s 12 floors had confirmed COVID-19 cases, despite Revera’s assurance the cases had been confined to two.)

Porter, along with U of M staff, is in the midst of a qualitative study on ageism and how internalized ageism in the pandemic is affecting older people.

May Wady, 65, is on the study’s oversight committee. She says the pandemic has highlighted some dark realities about societal preconceptions about aging, and ultimately, a lack of respect and value given to seniors.

"(Some people) think it’s OK when an old person dies because they were going to die anyway," Wady says. "It’s all based on how we think about age and the assumptions we make."

Every person, whether 17, 56 or 102, is much more than just their age, Porter says. The pandemic hasn’t changed that.

ben.waldman@freepress.mb.ca