It appears that we — all of us globally — will be living with some form of the Covid-19 pandemic for the next couple of years. And it’s increasingly likely that Covid-19 will drive profound structural shifts in our societies and economies; much like the Black Plague of Europe that wiped out half of the population and transformed how we think about labor, or the more recent 1919 Spanish Flu that led to border closings and all-around isolation. These implications include not just a pandemic’s direct health impacts, but what it reveals about our societies and the long-term challenges we face.
Though the lessons of Covid-19 have yet to be fully understood, they are already emerging — and they are closely linked to population aging. The effects of the pandemic are concentrated among older adults, who account for approximately 80–90% of all Covid-19 deaths. This has a number of wide-reaching implications. Here are three worth focusing on in the short term to help frame how society adjusts to life during — and after — a global pandemic:
1. The AMR Health Crisis Hiding in Plain Sight. Even as we cope with the current and urgent Covid-19 outbreak, it is equally critical that we not lose sight of the looming crisis in antimicrobial resistance (AMR), which the WHO reports could potentially kill as many as 10 million people every year by 2050. AMR is especially dangerous for older adults, which led Japanese and global leaders to hold a special AMR and Healthy Aging Roundtable earlier this month, given that Japan is home to oldest population on the planet. As John Beard and I wrote back in February, Covid-19’s impact on older people, especially those who are immune-compromised, could soon be repeated by AMR, due to the rise of infections resistant to today’s antibiotics, exacerbated by the shrinking pipeline of new, innovative drugs capable of fighting them.
In Japan and globally, AMR is well-understood not only as a health matter, but as a profound economic weight. Routine medical procedures that have improved the lives of millions will become risky events. In fact, this has already begun — doctors are advising against hip and knee replacements for fear patients will contract untreatable infections. Conditions once easily addressed by antibiotics — such as urinary tract infections that cause over 8 million doctor visits every year — could turn deadly. Even a simple visit to the dentist might result in an infection that can kill.
The problem becomes even more urgent given a rapidly aging global population. By 2050, the number of people age 60+ will double, while those 80+ will triple. As we age, we face far greater risk of infection because we are more likely to be exposed in hospitals, clinics, or even doctors’ offices; undergo routine surgeries; and, critically, our bodies are simply subject to more vulnerable immune systems. In this worst-case scenario for super-aging Japan, the AMR crisis could begin to unravel the miracle of longevity, triggering a cascade of dire economic, health, and social consequences. It’s no surprise, therefore, that one of the conclusions of our recent Roundtable was that for super-aging Japan, the multi-stakeholder interest must be broad and deep — including anyone interested in healthy aging, which should be everyone in Japan. This urgency demands action from policymakers and health systems to focus on AMR solutions for sustainable healthy and active aging.
2. Urgency of an Active Aging for a Healthier Aging. If Covid-19 teaches us anything, it’s the importance of maintaining healthier and more vital bodies, especially as we age, to build up protections against viruses and other health threats. And if we should remain more active, isn’t it time to do away with forced retirement? It’s clear that active and therefore healthier aging can be powerfully linked to work — keeping our minds active and our bodies healthy. Moreover, there is growing evidence of the value, productivity, and innovation of the multi-generational workforce, not unlike the recognized value of diverse workforces. Diverse ages matter also!
The health impact is equally powerful. Consider research from Cornell University that finds a 2% increase in mortality in men after age 62 due to the lifestyle changes of retirement. A study from Boston College finds a Dutch policy that incentivized working longer also reduced the five-year mortality risk for men in their early 60s by 32%. Further, retirement may even accelerate cognitive decline, as suggested by a French study of retirees. And, of course, there are also financial benefits of extending careers, as an additional year of work increases future annual retirement income by an average of nearly 10%.
3. The Value of Innovation for Healthy Aging. As Japan’s super-aging model shows, we should understand spending on health as an investment, rather than a cost. Historically, healthcare innovations evolve slowly. Drug treatments and vaccines can take years to travel from the laboratory through clinical trials to regulatory approval and widespread patient use. Just consider the slow pace of incorporating digital technology and AI into patient care at hospitals and physician practices, which has lagged far behind tech in other sectors of the economy.
The global pandemic has catalyzed action on these and other fronts. If we learn the appropriate lessons, the benefits will accumulate long after the worst of the pandemic passes — promising faster innovation, better patient care, improved health outcomes, lower health care costs, and greater access to care for those most in need. While Covid-19 has accelerated innovation, the foundation for such rapid progress was built on decades of extensive, difficult scientific investigation supported by trillions of dollars invested in core R&D efforts, often with little or no immediate returns. Innovations that are saving lives and speeding recoveries in today’s pandemic simply would not have been possible without that foundation.
So, what are the policies and programs to ensure this global innovative base is solid, robust, and sustainable? How can we ensure that we are driving progress on each of these critical fronts? While Covid-19 will — slowly, but eventually — recede, these questions of healthy aging will remain, and they will require real, sustainable solutions beyond the pandemic.