The coronavirus epidemic is a warning for Hong Kong, and others, to prepare for the reality of an ageing world
- Because the coronavirus disproportionately affects people over 65, health care systems in countries with large elderly populations are struggling to cope
- The epidemic should prompt governments to think through how policies such as social distancing affect the elderly and to bolster health care systems well in advance
Covid-19 is an alarm bell, reminding us of the need to be better prepared to protect our most vulnerable citizens – both now and in preparation for future epidemics. Some of the countries most affected by the virus are also among the world’s oldest.
Japan and Italy are the global leaders in ageing. The percentage of residents over 65 is at a global high of 28 per cent in Japan and 23 per cent in Italy, according to the World Bank. Nearly all countries with significant recorded outbreaks have senior populations above the world average of 9 per cent.
The study found an 8 per cent death rate for people in their 70s and a 3.6 per cent death rate for those in their 60s. By comparison, estimates of the death rate in the overall population are around 1 per cent or lower.
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Covid-19 has already strained medical systems to breaking point. In Italy, there are not enough respirators and intensive care units to meet demand, and doctors may face the task of deciding who should receive life-saving treatment. Italy’s unusually old population offers a worrying vision of our collective future.

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Some medical specialists have questioned whether countrywide school closures were warranted. Would it have been more effective to allow those children who live with older adults or adults with pre-existing health issues to stay home from school? Policymakers need to put plans in place ahead of time – in consultation with medical experts and with an eye towards each country’s situation and demographics – to avoid such ad hoc responses in the next crisis.
Hong Kong’s success in containing the virus, thanks to a quick government and public response alike, is laudable. But more thought could be given to how practices like social distancing, which is almost universally recommended, are affecting older adults, some of whom are already lonely and socially isolated.
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Cities like Hong Kong could put in place crisis response teams specifically for the older population – checking up on them, ensuring that this “less digital” portion of the population has access to accurate and updated information, and perhaps even providing reassurance and a social outlet.
These sort of elderly-focused intervention teams could go some way towards mitigating not just epidemics but other crises that disproportionately affect older adults. The elderly will be heavily affected by climate change, too, as they are vulnerable to heatwave-induced medical issues and are at risk from extreme weather events like hurricanes.
Such disasters have seen older adults trapped in flats without functioning lifts or unable to refrigerate their medication. A heatwave in France in the summer of 2003 killed as many as 19,000 people, many of them senior citizens.
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It’s crucial that we pay attention to who is most vulnerable and take corresponding measures to halt the crisis without bringing the global economy to a standstill.
Higher investment in medical systems to cope with ageing populations will necessarily come at the cost of other social services. Public health issues will increasingly become economic issues as the working-age population is hollowed out.
Hong Kong and China need to double down on creative thinking and action to get ready for an ever-older future. The Covid-19 crisis will pass. But the challenges of an older society will remain.
Colleen K. Howe is a programme associate at the Asia Business Council
