Coronavirus: we should have learnt from Sars, not swine flu

 If H1N1 had been worse, the elderly might not be in such danger today

The word “genocide” — meaning the murder of a tribe or people — was coined in 1944 by Raphael Lemkin, a Polish-Jewish refugee from Nazism, whose family was all but obliterated in the Holocaust. The word “senicide” — meaning the deliberate murder of the elderly — is less well known, though of older provenance. According to the Oxford English Dictionary, it was first used by the Victorian explorer Sir Henry Hamilton Johnston. “The ancient Sardi of Sardinia,” he wrote in 1889, “regarded it as a sacred . . . duty for the young to kill their old relations.”

Lemkin’s word caught on. Not only did the United Nations general assembly unanimously pass a resolution in 1946 condemning genocide; by 1948 it had also approved — again, nem con — a convention on the prevention and punishment of the crime of genocide.

Although America did not ratify that convention until 1985, use of the word grew exponentially from its first publication. (I hesitate to say that it went viral.) Enter “genocide” into Amazon’s search field and you will have more than 10,000 results to trawl through.

Not so “senicide”. There are just two books on that subject on Amazon’s site: The Customary Practice of Senicide. With Special Reference to India by Pyali Chatterjee, and Death Clock Ticking: Senicide, Ageism and Dementia Discrimination in Geriatric Medicine by Itu Taito. The latter has not yet been published. Oh, and there’s a perfectly ghastly song called Senicide by a Californian heavy metal band called Huntress.

There are a few older books that use the word, nearly all in connection with the alleged practices of ancient or obscure tribes (the Padaeans of India, the Votyaks of Russia, the early American Hopi, the Netsilik Inuit of Canada, South Africa’s San people and the Amazonian Bororos). But senicide is so rare a word that Microsoft Word’s spellcheck underlines it in red, itching to auto-correct it to “suicide”.

All that is about to change. If, as seems increasingly likely, a significant number of western countries are going to continue mismanaging the pandemic caused by the virus Sars-CoV-2 — the novel coronavirus that originated in Wuhan, China, in December — then a very large number of old people are going to die before their time.

The statistics are unequivocal. In China, where the epidemic seems for the moment to be under control, the case fatality rate for those under 50 was 0.2%. For those over 60 it was 3.6%, for the over-70s 8% and for the over-80s 14.8%. In Italy — now the country worst affected by Covid-19, the disease the virus carries — the fatality rate for the over-70s thus far has been 11.8%, for the over-80s 18.8% and for the over-90s 21.6%.

It is, in one respect, a blessing Covid-19 seems to be “ageist”. Most pandemics are not so merciful towards children. In America, for example, the 1957-8 influenza pandemic killed the under-5s at an even higher rate than it killed the over-64s.

It is also true that there have never, in all of history, been so many old folk. Today more than a quarter of Japan’s population are aged 65 or older. In 1960, the share was just 5.6%. In the European Union, the share has doubled from 10% to 20%. The world as a whole has gone from 5% elderly to 9%.

And it is true, too, that doctors in an overwhelmed hospital with insufficient intensive care units are correct, from a utilitarian perspective, to give priority to the young over those nearing the end of their natural lives. I do not blame the Italian doctors who have been practising this form of triage.

Yet when this pandemic has run its course — when we have achieved “herd immunity” as a species and when vaccines and therapies have been devised — there will have been a lot more funerals for elderly Italians and, very probably, Americans and Britons than for Taiwanese or South Koreans.

And the reason for this discrepancy will not be bad luck. The reason will be that east Asian countries drew the right conclusions from the searing experiences of Sars in 2003, while most western countries drew the wrong conclusions from their relatively mild encounter with H1N1, commonly known as swine flu, in 2009.

That Covid-19 was both highly contagious (because it is easy to carry and transmit by asymptomatic individuals) and much more deadly than seasonal flu was already obvious as early as January 26, when I first wrote about the coming pandemic in this column. And yet numerous governments — including the American and the British ones — dithered for the better part of two months.

It was not only Donald Trump’s irresponsible nonchalance that did the damage. There were also failures by the very organisations that were supposed to prepare our countries for a threat such as this. In America there has been a scandalous insufficiency of testing kits, so that, as recently as last week, the country was still lagging behind Belarus and Russia in terms of tests per capita.

In the UK, policy was initially based on the notion that the country would be better off aiming for early herd immunity than trying to suppress the spread of the new disease — until epidemiologists such as my near namesake Neil Ferguson (whom we must all wish a swift recovery, as he developed Covid-19-like symptoms last week) pointed out the likely disastrous consequences.

Because of these blunders, America and the UK have moved far too slowly to adopt the combination of mass testing, enforced social distancing and contact tracing that has successfully contained the virus’s spread in east Asian countries. There is a reason the death toll in South Korea is just over 100, while in Italy it is almost 5,000

How many people will die in the end? We do not know. In America, if Italian conditions are replicated in New York and California, we could see between half a million and million deaths by the end of this year. I have seen estimates as high as 1.7 million, even 2.2 million. The other Ferguson’s worst-case scenario for Britain was 510,000 deaths. But the key point is that most of the victims will be old. And most of the deaths could have been avoided with better preparation and earlier action.

The 19th-century Russian historian Nikolai Karamzin defined senicide as “the right of children to murder parents overburdened by senium [old age] and illnesses, onerous to the family and useless to fellow citizens”. The explorers Knud Rasmussen and Gontran de Poncins reported that senicide was still practised by the Netsilik of King William Island as recently as the 1930s.

But senicide will never be tolerated in the 2020s, least of all in modern, developed democracies. Those whose sins of omission and commission lead to nationwide senicides will, like the perpetrators of genocides in the 20th century, be judged harshly, not only by history, but also by voters — and quite possibly by judges too.

Niall Ferguson is the Milbank Family senior fellow at the Hoover Institution, Stanford

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