COVID-19 shined a spotlight on the issue of our aging planet.
As the famous saying goes, there are only two certainties in life: death and taxes. Ray Kurzweil didn’t agree. In his 2004 book, Fantastic Voyage: Live Long Enough to Live Forever, he argued that if we can just make it to the ripe old age of 120, biotechnology will have advanced so much that humanity will have been cured of death.
Unsurprisingly, lots of people loved this idea, and though it seemed fantastical in the early 21st century, the spirit behind it motivated many people to regard longevity as a moral good.
In reality, though, we all know we’re going to die – we just don’t know when (and we’re still all paying the tax bills to allay the damage of the virus).
In addition to the metaphysical panic it unleashed, COVID-19 forced a reckoning of how we treat aging and dying in a post-pandemic world.
We watched as health services around the globe (both privately and publicly funded) buckled under the strain of coping with sudden huge numbers of infected people, in large part due to institutions’ routine deployment of resources and budgets to extend the lives of the very elderly and already very sick.
We flinched in horror as doctors on the front lines decided who to save based on their age and likelihood of survival. Many people criticized Britain's ex-chief scientist Sir David King for telling citizens in their 90s who had contracted the virus to stay home, lest they overburden the NHS. But many people privately, thought he might have a point.
COVID-19 shined a spotlight on the issue of our aging planet. We could no longer ignore that between 2020 and 2030, 10,000 baby boomers a day would turn 65, and seven in 10 would need long-term care. Or that while 80% of Americans said they would like to die in their homes vs. a hospital, close to 55% of older adults met their end in a hospital or nursing home. We realized there were more people over the age of 65 globally than under the age of 5. Who, some asked, would pay for Kurzweil’s dream?
Shifting healthcare budgets from sick care to prevention became the existential challenge. In Japan, which had the oldest population in the world (28% over 65) and longest life expectancy (84), the cost to care for the elderly was more than $138 billion a year. With public debt at 250% of GDP, and debt service consuming 24% of spending, the government there desperately sought ways to cut costs – keeping people at home became one of the main options.
To improve the lives of the aging, a new field of study called gerontechnology emerged; helping older people age at home on their terms, including palliative care for the terminally ill, became a leading-edge discipline. Advancements included using AI, sensors, virtual reality and usability design to improve vision and hearing and support memory loss, with the goal of keeping people out of the hospital – and off government payrolls.
Many people also began to understand the need to prepare ourselves for our inevitable passing. People started having open conversations about how they wanted to die and when. The oncologist and director of bioethics at the U.S. National Institutes of Health, Ezekiel Emanuel, whose controversial 2018 article for The Atlantic angered many on its publication, found a new audience. His argument for a “defined death date,” which would remove the fuzziness of trying to live as long as possible (and facilitate better planning at a macro and micro level), began to move into the Overton Window. According to Emanuel, “Its specificity forces us to think about the end of our lives and engage with the deepest existential questions and ponder what we want to leave our children and grandchildren, our community, our fellow Americans, the world. The deadline also forces each of us to ask whether our consumption is worth our contribution.”
We’re still not close to resolving the questions around life and death for our aging populations, but at least we’re in synch now with one of the most oft-repeated quotes of our time – and finally embracing the folly of thinking we can override it.
