The collegiality, goodwill, camaraderie and expertise among healthcare professionals and providers in Ireland has been mobilised into a powerful force. We are collaborating like never before as we strive to combat Covid-19.
Each of us has a role to play in slowing the rise of the coronavirus. We have been given the playbook by leading public health figures and the HSE. We are trying to “flatten the curve” to protect those who are most vulnerable. We are also trying to buy time and capacity for the healthcare sector. A community army is being mobilised to assist us.
In the midst of this unifying spirit, society must be careful not to stigmatise, marginalise or disadvantage any group – particularly older people. We must be mindful that, like every age group in society, older people are a heterogeneous group. There are many older people who are very well. Labelling all older individuals as highly vulnerable, frail and passive agents is obviously incorrect and inappropriate. This ignores the positive contribution that older people make.
We are all aware of the many benefits of intergenerational and cross-generational connectivity and interactions. We have all benefited through the years from these relationships. The Irish Longitundinal Study in Ageing (Tilda) has highlighted many of them.
As our familiarity with “cocooning” of older people increases, we need to have a better understanding of the risks and adverse effects that come with social isolation. This includes heightened levels of loneliness.
This is where local community and local authority efforts are so important. We must find new ways in these socially isolating times, through letter, phone, technology and other innovative ways, to bridge these gaps.
Treatment for Covid-19, and other forms of resource allocation associated with this crisis, must be based on need. It is concerning that we are hearing reports from other countries that when it comes to decisions on available treatments – be it home care support, medicines or ventilation – age was the only factor considered.
Morbidity, cumulative chronic illnesses and pre-existing physical conditions should sufficiently indicate or predict likelihood of surviving an illness. An arbitrary age cut-off takes none of these in to account. Prioritising younger, healthier patients with a higher chance of recovery, as has been suggested in other countries, is ageist in the extreme. This is not something we should countenance.
We must not let this crisis undo all the work many before us have done to establish the strong bond that we have witnessed across the generations.
Modern Ireland has evolved into a forward-thinking society, leading the world in certain areas. We need to continue to foster a culture that upholds dignity, respect and compassion over the course of our lives. There is no doubt that our thinking and actions are being tested, but we are up to this challenge, and should not compromise our principles. WB Yeats said: “We thread the needle’s eye, and all we do / All must do together.” While we each have a personal duty, there is also a shared societal and governmental policy responsibility.
I will leave the last words to President Michael D Higgins. In his speech at the start of his second term, he spoke of “a life lived together, one where there is a commitment to equality, to strong sustainable communities, to the sharing of history and to shaping of the future together; recognising our vulnerabilities, drawing on and enhancing our individual and collective capacities”. Never has this been truer, more challenged and more needed.
Dr Diarmuid O’Shea is a consultant geriatrician at St Vincent’s University Hospital in Dublin. He is the registrar of the Royal College of Physicians in Ireland and president of the Irish Gerontological Society of Ireland.