Aging and the COVID-19 pandemic: The inter-related roles of biology, physical wellbeing, social norms and global health systems.

The coronavirus disease 2019 (COVID-19) pandemic has had a devastating and disproportionate impact on the elderly population. As the virus has swept through the world, already vulnerable elderly populations worldwide have faced a far greater burden of deaths and severe disease, crippling isolation, widespread societal stigma, and wide-ranging practical difficulties in maintaining access to basic health care and social services - all of which have had significant detrimental effects on their mental and physical wellbeing. In this paper, we present an overview of aging and COVID-19 from the interrelated perspectives of underlying biological mechanisms, physical manifestations, societal aspects, and health services related to the excess risk observed among the elderly population. We conclude that to tackle future pandemics in an efficient manner, it is essential to reform national health systems and response strategies from an age perspective. As the global population continues to age, elderly-focused health services should be integrated into the global health systems and global strategies, especially in low- and middle-income countries with historically underfunded public health infrastructure and insufficient gerontological care.

A novel index-based decision support toolkit for safe reopening following a generalized lockdown in low and middle-income countries.

While the effectiveness of lockdowns to reduce Coronavirus Disease-2019 (COVID-19) transmission is well established, uncertainties remain on the lifting principles of these restrictive interventions. World Health Organization recommends case positive rate of 5% or lower as a threshold for safe reopening. However, inadequate testing capacity limits the applicability of this recommendation, especially in the low-income and middle-income countries (LMICs). To develop a practical reopening strategy for LMICs, in this study, we first identify the optimal timing of safe reopening by exploring accessible epidemiological data of 24 countries during the initial COVID-19 surge. We find that a safe opening can occur two weeks after the crossover of daily infection and recovery rates while maintaining a negative trend in daily new cases. Epidemiologic SIRM model-based example simulation supports our findings. Finally, we develop an easily interpretable large-scale reopening (LSR) index, which is an evidence-based toolkit-to guide/inform reopening decision for LMICs.

The Devastating Cost of Racial and Ethnic Health Inequity in the COVID-19 Pandemic.

The COVID-19 pandemic has laid bare the devastating truth about pervasive health inequity in the United States. As the virus swept through the country, underserved racial and ethnic minority populations disproportionately bore the brunt of the hospitalizations, severe illness, and fatalities. The devastation among these groups far outstripped their privileged counterparts due to convergence of disadvantages that created a perfect storm of exposures. We used empirical evidence incorporated into a theoretical framework analyzing vulnerabilities that have long plagued these communities. These exposures were further exacerbated by the rapid transmission of this virus and impaired the capability of these communities to escape illness and death due to a lack of adequate public health and medical responses. Will the aftermath of this coronavirus prove to be a reckoning for how American society addresses the conditions of most vulnerable populations or another ignored data-point? We suggest some policy steps to address the problem.