Medical decline means all over-70s must be protected

The readers in the 70+ age group who wrote to me complaining about staying in lockdown till there’s a vaccine must be feeling mightily relieved.  As of today, they can go outdoors, even meet up with members of their family and see their grandchildren, as long as they socially distance. So far so good.

There is, however, still a need to protect medically vulnerable people. And by the way, vulnerable people aren’t all old.

A 30 year old who has had a liver transplant comes in for the same shielding as someone aged over 70, as does a child with cystic fibrosis.

What all vulnerable people lack is ‘medical fitness’. So far we have no ready measurement, other than age, with which to gauge medical fitness. But, as I’ve said, the criterion for shielding isn’t wholly about age.

Well, you may argue, I’m a very fit 70/80 year old, I’ve lived long enough to know what’s sensible and I’ll be sensible about relaxing my self-­isolation or shielding. Yes, I accept that you’re wise, sensible and ­experienced about life, but you’re not necessarily wise and experienced in your medical judgement.

Your doctor may have declared you fit and healthy. You may have never suffered any serious illness, nor been admitted to hospital, but I’m sorry to tell you that at 70+ you’re in ‘medical decline’. Even in fit old people all systems are in decline. So as we age we have less capability to deal with a fierce infection such as Covid-19 no matter how fit and healthy we are.

You may also say that it’s just plain unfair for old folk to be treated differently from any other age group, that the rules have to be for all or none.

Well, no. That would be fine if we were all similarly fit and healthy but we’re not. The plain fact is in some way or other we’re medically unequal. So we must be treated differently.

Our risk profile for serious ­conditions such as heart attack, stroke, high blood pressure, diabetes and cancer changes radically as we age.

It worsens, rapidly in some, less so in others, but regardless, it happens to all of us.

But what about biological age versus chronological age you ask? Yes, we all know people who seem to be less than their chronological age. But in making rules for large numbers of people it’s difficult to take account of that when considering the good of the whole.