Colin Powell's Death Is a Reminder of the Risk to Older Americans
The death of Colin Powell, an 84-year-old former four-star general who served as Chairman of the Joint Chiefs of Staff under U.S. President George H.W. Bush and Secretary of State under President George W. Bush and is perhaps best known for his role in bringing the U.S. to its second war in Iraq, is a high-profile reminder of a grim reality: COVID-19 is not just a pandemic of the unvaccinated, as current president Joe Biden likes to say, but a pandemic of the elderly, too.
From early on in the pandemic, we've known the virus disproportionately kills older people, and the overall data make that pretty clear: About 543,200 people 65 or older have died with COVID-19 in the U.S. so far, per the U.S. Centers for Disease Control and Prevention (CDC), or about 76.2% of the country's total death toll, despite making up just 16.5% of the pre-pandemic population.
When vaccinations began to roll out in the beginning of this year, it became evident almost immediately that people who received a full course of a vaccine—including the elderly—were less likely to become gravely ill from COVID-19. Before the Delta variant took hold in the summer, those 65 and over who had been fully vaccinated were hospitalized at a rate of less than 5 people per 100,000 on average, compared to about 40 per 100,000 among their unvaccinated peers.
As the Delta variant became widespread, that disparity widened. In late August (the most recent month for which CDC data is available), when Delta cases were surging across the country and the FDA hadn’t yet authorized booster shots, the oldest vaccinated Americans were being hospitalized for COVID-19 at a rate of only 15 people per 100,000. For their unvaccinated peers, on the other hand, the rate had surged to more than 200.
Nevertheless, it remains a reality that the elderly—even those who are vaccinated—are at risk for serious COVID-19. Indeed, vaccinated people 80 and above have died at significantly higher rates than even some unvaccinated younger people, per the CDC (though, of course, they still fare remarkably better than their unvaccinated peers). In part, this is likely because older people are more likely to have conditions that make them more susceptible to infection, or that blunt vaccinations' impact. Powell, for instance, was fully vaccinated, but also had multiple myeloma, a form of blood cancer that weakens the immune system.
It's these factors that led a U.S. Food and Drug Administration panel to authorize Pfizer-BioNTech and Moderna boosters specifically for Americans 65 and up (plus younger folks at higher risk for health or occupational reasons) in recent weeks. Another dose, the thinking goes, should help better protect our most vulnerable neighbors. A promising Israeli study published last month showed that people over 60 who got a Pfizer booster were nearly 20 times less likely to develop severe disease, data that in part informed the FDA panel's decision. Even if cases keep falling, the relative risk facing older people will remain fairly high, in part because falling cases will lead more people to engage in riskier behaviors, potentially leading them to spread the virus to elderly loved ones—Thanksgiving and the winter holidays are just around the corner, and were major drivers of spread last year.
The key now is convincing vaccinated older Americans to get their booster shot, and getting those who remain unvaccinated to get their first doses. The former should be far easier—older Americans are vaccinated at much higher rates compared to younger groups, perhaps in part because they generally have more to fear from the virus, and those who got their shots once or twice will likely be willing to get another. Convincing the latter will be a steep climb; what's left to say to those who remain unprotected despite facing the greatest risk? That Powell died of a breakthrough infection is already fueling the anti-vaccine fire, as people incorrectly cite his death as evidence of the vaccines' imperfection, even though it's really just more evidence that a more fully vaccinated population and boosters are both urgently needed.
TODAY'S CORONAVIRUS OUTLOOK
About 494.7 million doses of the COVID-19 vaccine have been shipped to various U.S. states as of this morning, of which nearly 408.8 million doses have been administered thus far, according to TIME's vaccine tracker . About 57% of Americans have been completely vaccinated.
More than 240.6 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and nearly 4.9 million people have died. On Oct. 17, there were 263,863 new cases and 3,642 new deaths confirmed globally.
Here's how the world as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
And here's every country that has reported over 4.5 million cases:
The U.S. had recorded more than 44.9 million coronavirus cases as of 1 a.m. E.T. today. More than 724,300 people have died. On Oct. 17, there were 16,913 new cases and 164 new deaths confirmed in the U.S.
Here's how the country as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of Oct. 18, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
The lockdown in Auckland, New Zealand will continue for another two weeks, Prime Minister Jacinda Ardern said today, making it an outlier in a region that has generally abandoned strict containment measures and other "COVID Zero" strategies. Ardern framed the decision as an effort to halt viral spread while vaccination continues. The country reported 60 new cases today, with all but three in the Auckland area. The city—New Zealand's largest—has been under lockdown since mid-August.
It's the opposite story in Japan, where viral spread has inexplicably plummeted, the Associated Press reports, leaving experts scratching their heads as to why. Daily new cases in the Tokyo capital region have fallen to around 100 from a high of nearly 6,000 this past August, despite the lack of strong lockdown measures. A breakneck vaccination campaign and widespread masking may have contributed to the phenomenon, but experts fear that if they can't be sure what worked, another surge is possible.
Police officers across the U.S. should get vaccinated as part of their duty to serve and protect, Dr. Anthony Fauci said on Fox News Sunday yesterday. He added that COVID-19 is now the leading cause of death among officers, "so it doesn't make any sense to not try to protect yourself, as well as the colleagues you work with."
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com. If you have specific questions you'd like us to answer, please send them to covidquestions@time.com.
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Today's newsletter was written by Alex Fitzpatrick and edited by Elijah Wolfson. Emily Barone contributed reporting.
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