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COVID Update May 27: COVID-19 is the disease of the middle aged in some ways more than even of the elderly.

As we open up & go back to work, it’s possible we’ve missed something important— the danger to many of the returning 50-64 year olds. 1/
I can’t tell you how many times I’ve read that COVID-19 is completely overstated and just hits the elderly. Therefore we have overdone it. (Usually by Wall St types, not scientists). 2/
There’s a narrative that this is only dangerous to old people so everyone else can safely go to work. To the contrary, compared to the flu, it’s much more dangerous for middle aged people than older people. 3/
In fact COVID-19 is a special threat directly to many of the people heading back to work & bars & restaurants who may buy this narrative. 4/
It is primarily in these middle years that you are far more likely to die from CV than the flu.

Whereas flu effects the old and the young immune systems, people in the middle fend it off better. CV hits those beginning to age much harder. 5/
Death rates look like they will end up ~5x or more than the flu for 45-64 year olds. Because flu is under-reported & under-diagnosed, it may be greater than that. 6/
A study compared H1N1 fatality rates to Cornoavirus as well. 7/
Hospitalization rates are also high among the middle aged group. 8/
One issue of course is that we don’t all age the same way. Our bodies and our immune systems devolve based on other factors. And those factor start to hit us pretty hard at age 50. 9/
And people who have underlying conditions— high blood pressure, diabetes, or a BMI over 30– are very prone, possibly as much as some extra years. 10/
We should resist the impulse to blame someone for conditions we think of as controllable by calling them lifestyle choices. Its hardly ever half the story. And many communities lack access to fresh & nutritious foods as my friend @chefjoseandres tells me a lot. 11/
Besides, by the time you get to my age, chances are about even that you have something which puts you at higher risk. 12/
Thera is also more prevelance of COVID among younger people. In New York and and in other concentrated areas, most of the patients are under 65. 13/…
The truth is people who are getting back to work are exposing themselves more & more to illness whereas younger people are less prone and older people will be more sheltered. 14/
This includes teachers who will spend a lot of time with asymptomatic spreaders. 15/…
Even when people survive it, 5% of 50 year olds that get COVID are hospitalized. (Way more than the flu.) And the effects of being on a ventilator are often a long, slow recovery. 16/…
Essential workers are good evidence of this. @cleavon_md has been bearing witness to essential workers who have lost their lives. So many of them are young. 17/
It’s exposure and indoor settings and poorly circulating air and not older people. Grocery workers. 18/
More meat packing workers than some health commissioners are willing to admit to. 19/
What happens when more 55 year olds begin showing up in call centers again? They’re not all going to get sick. But those with prolonged exposure. Or undiagnosed high blood pressure. 20/
We should not be living in fear. We can #OpenSafely. We can open certain businesses. There are low risk activities.

Masks make us safer. Screenings make us safer. Distancing makes us safer. 21/
The more important point is that every “narrative” getting shaped right now is imaginary & often self-serving.

Trump says masks are PC.
Fox commentators say this is no worse than the flu.
Matt Goetz wears a gas mask.
Fake interest in mental health & addiction. 22/
These narratives are sometimes what we all do to make sense of a complicated situation.

They are also a part of how our politics works.

But we shouldn’t fool ourselves into confusing narratives with reality. 23/
Our rush job laissez faire approach to opening our economy isn’t a price our politicians expect to pay. It’s upside for them if it works; downside to us for everything that doesn’t. 24/
This thread has credits. The following people sent me useful info. They texted me on a group text (952-234-6315 if you’re interested).
You can listen as I talked to @amyklobuchar about her husband John, in his mid-50s, talk about his time in the hospital alone with COVID-19. I know John. He’s very healthy otherwise but he was part of the 5%. 26/…
COVID-19 may not ravage middle-aged people like it is other groups. They may not die by the dozens as sadly others do.

But in unsafe settings— and certainly with pre-ex condition— this is as much a danger of hospitalization as anything. 27/
There is a propaganda machine being built to target mask wearers & anything that stands in the way of economic growth. It serves nobody. There are smarter ways. end/
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