Dear Global Ageing Network colleagues and friends

Our challenging times have become even more challenging. In countries around the world, we are faced with a pandemic that has taken far too many lives. The response from governments in many countries has been wholly inadequate in supporting older adults and providers. Given events in the U.S. in the last week, what is crystal clear is that “we are also living in a racism pandemic,” as the American Psychological Association declared. That fact is as disconcerting as it is a challenge to each of us, individually and collectively. Only by confronting the systemic racism in our countries can we ever achieve understanding and justice. I believe this with every beat of my heart.

The terrible events in Minneapolis, Minnesota – and so many others that have occurred around the U.S. – are more than heartbreaking. What we are witnessing reflects blithe indifference to racism and casual acceptance of the violence directed at people of color. For many at LeadingAge and in the Global Ageing Network, the string of killings is deeply personal and painful beyond belief. Some of us don’t know what fear in our daily lives is really like. But we do know that the victims of violence could be one of us, one of our friends, or one of our colleagues. While we can’t walk in anyone else’s shoes, we can try to empathize with what it feels like to be black or brown or Asian, and we must stand with them.  

COVID-19, the coronavirus that we are all fighting, robs people of their health, instills fear, and, in many cases, ends lives. Racism, bigotry and hatred do the same — robbing lives while instilling fear and anger. What is taking place across the U.S. right now, shines a spotlight on people who have to live their lives being afraid, angry, and hurting. It shines an intense light on what many of you face daily.

The Global Ageing Network is our community. Our values – of acceptance, respect, justice, and inclusion – are what set us apart. We have worked hard to build a community that nurtures belonging and compassion for one another. I am heartened by the outpouring of peaceful protests in countries around the world, visible expressions of solidarity with these values. It gives me great hope. So, in this time of grievous social injustice, let us reach out, comfort each other, and respond as friends and colleagues who care deeply about each other. Let us also use this incredible moment in history to ask the hard questions, to challenge the easy answers, to engage in the fierce conversations that will lead towards a full-throated acceptance of our diversity, our unique strengths, and our power to change the course of history. In our community. At this moment.  

Global Ageing Network will continue to be a community that continually strives to be free from discrimination and striving for inclusion. A community that practices the value of respect and encourages each of us to accept and embrace each other, knowing that while we may differ, we are all bound to each other in our humanity. A community that values every person’s voice, no matter how different the opinion, striving for greater understanding overall.

My heart goes out to all. I hope that we can come together, in our communities, to do our best to beat this disease, to defeat the hatred, racism, bigotry and divisiveness we see around us and to raise awareness of the social injustices in our societies.  

With gratitude, appreciation and in solidarity,

Katie Smith Sloan, 

Executive Director, Global Ageing Network 

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Countries across the globe are changing economic policy to respond to the COVID-19 crisis. Today’s emergency response will specifically impact the world’s aged, and how people will age in the future. For example, the International Monetary Fund reports that in Jordan, as of March 23, the country is allocating 50 percent of its maternity insurance revenues (JD 16 million) to material assistance for the elderly and the sick. As of April 2, Mexico is advancing pension plans to the elderly. Hong Kong offered 1.3 billion dollars for vulnerable populations, including programs targeting the elderly.

These responses are coming at great cost in all countries. As of March 26, the Organization for Economic Co-operation and Development (OECD) predicted a decrease in GDP of at least 15% for the majority of the world’s largest developed countries. Higher- income countries like the United States are feeling institutional impacts of the coronavirus, without clear future standards yet in place. Some hospitals in the United States opted out of offering elective surgeries, and are now feeling the monetary impact of that decision. At a time when staff is needed, hospital funding sources are questionable. 

 LeadingAge recently educated its provider network on the U.S. “Paycheck Protection Program” to maintain and restore payroll for health care workers throughout the pandemic. Without care workers, there is no care. But in the fog of crisis, immediate responses from localities are being made sooner without considering than long-term policy issues.

Regardless of any country’s wealth, every city has its rich and poor. Many wealthier parts of cities can rely on digital solutions for social distancing in a way that those without access to basic needs cannot. COVID-19 knows no class system, so countries are developing policies to find relief for the majority of citizens, like suspending rent payments. Bratislava, Slovakia, developed a free phone line for seniors to access their basic needs like food and medication. Lima, Peru, has a voluntary register for elders and a program for bonus income. Yokohama, Japan, distributed 500,000 free face masks to elder care institutions.

With cities in higher income countries strapped, how can we put in perspective what that looks like for countries who entered the crisis without the same capital?

Oxfam highlights that while developed countries’ health systems are overwhelmed, low-income countries’ systems are devastated. Italy has one doctor for every 243 people. Compare that to Zambia’s one doctor for every 10,000 people. In refugee camps globally, there is one doctor for an estimated 25,000 people. Mali has 3 ventilators for every million people. Oxfam released a report suggesting solutions for how the globe should react to build a long-term worldwide response. Oxfam recommends doubling funding to 85 of the world’s poorest countries. That funding could hire 10 million workers, affecting the health of 3.7 billion people. We know how quickly the COVID-19 virus spreads, so preventing coronavirus in 3.7 billion people can change world history.

Asking high-income countries for aid in a time of severe economic downturn may seem impossible. However, recontamination after travel bans are lifted seems worse. One country’s inequitable health care system is another country’s second wave contamination. The World Economic Forum suggests forgiving country debt in combination with Oxfam’s aid proposal. It also suggests that nations must follow Spain’s lead and requisite items from private health care centers. Free testing and treatment must be made immediately to all. The World Economic Forum says that these solutions are doable: “One hundred and sixty billion dollars sounds like a lot. It’s entirely possible. It’s less than 10% of the U.S. fiscal stimulus to tackle coronavirus.”

While nations around the globe seek a clear way forward, there are solid policy recommendations that should be implemented on both local action and international scales. If you have suggestions, please email your innovative global policy recommendations to us at info@globalageing.org. 

By Beth Brodsky

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The Coronavirus shines a bright light on what those of us committed to the well-being of our world’s elders have known for a  long time: We have long undervalued, underfunded, and largely ignored the plight of older adults. As the virus rages through communities and countries, older adults are disproportionately impacted. We knew, at the outset, that older adults, those with underlying health conditions, and members of specific ethnic and racial groups were most at risk. We had a chance to target resources to prevent unnecessary deaths. We are losing our elders not just because they are most susceptible to this vicious virus but because we have failed to protect them.

Ageism is at the root of this. As nations, we invest in what we value most. The impact of this virus is a stark reminder that we have—as societies—failed our older adults. We have failed those who have built our communities, fought in our wars, contributed to our economies, and brought creative talent, scientific mastery, grit, and compassion to our daily lives. Older adults are integral to the strength and humanity of our societies. And yet, we have failed them.

Ageism is evident in the lack of prioritization of PPE, testing and support. It is evident in prioritizing hospitals over aged care homes. It is evident in how quick we are to blame dedicated care providers for some failing on their part. In truth, the pandemic is the enemy. We are dealing with an uncharted pandemic. It takes no prisoners. It is invisible. The response needs to target those most at risk, focus on the hot spots, and take advice from the scientists and public health experts around testing and physical distancing. Not just for some people, but for ALL people, regardless of age.

The Global Ageing Network is witnessing the impact of the pandemic through the eyes of providers and others in more than 60 countries.  We are seeing deep commitment, fortitude, and compassion that is nothing short of inspiring. Our elders deserve this. And, we are seeing institutional and attitudinal barriers that stand in the way of progress.

This is a time for the global community committed to the well-being of older adults to come together. To raise our voices and call for an end to ageist policies and practices. It is a time to repair the economic, political and social fault lines in our societies. It is a time to reimagine how services and supports for older adults fit into our broader health systems – not as stepchildren, but as equal partners playing an essential role. It is a time to rebuild communities that have become fractured by social and physical distancing.

But most immediately, it is a time to express our deep sympathy for the thousands of lives lost. Every community has lost a part of its soul. And, to express our gratitude to the dedicated direct care workers, the nurses, the social workers, and so many others who have put their lives at risk to show up every day to support those in their care. We are grateful.

By Katie Smith Sloan

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Common feelings around aging services providers include fatigue for working 24/7 work; sadness, feeling losses in their communities, and in the face of all that: gratitude for those who continue their work. Care providers are still trying to obtain masks, personal protective equipment (PPE), and testing while doing their jobs– on top of the fear of biological threat. That is what is what many countries are calling “Phase 1.”  What are some lessons from Phase 1?

• In the United States, the first nursing home in Seattle was a major sign of coronavirus in the country. The Center for Disease Control completed its debrief on how COVID-19 spread there.
• Belgium’s death rate appeared higher than other countries. They’ve been counting care home deaths from the beginning, compared to many other countries that excluded care home data.
• To procure masks for aging services providers, Australia, France, and the Netherlands have government-wide national coordination. Countries like the United States, Lebanon, and South Africa have had little or no national coordinated roll out. Aging services providers in these countries turn to private markets and homemade masks.
• The South Africa Department of Social Development published guidelines on caring for older persons to align with their Disaster Management Act.
• Australian and American providers have eliminated visitation or created screening checkpoints before anyone can enter care homes.
• The United States started experiencing staffing shortages at nursing homes, so some facilities are partnering with restaurants to hire and streamline training for previously displaced staff. LeadingAge aggregated COVID-19 specific classes for aging services providers to share with staff. Separately, states are acting. The state of Maryland called upon the National Guard for “strike teams” to aid overburdened nursing homes. The New York governor added to his press briefings statistics on nursing home cases after journalists asked for statistics on the homes for days.
• Global Ageing Network countries around the world are finding there were not enough tests available in Phase 1.

For their Phase 1, Taiwan, Iceland, Germany, and South Korea have been the Big 4 countries who have maintained the most control over COVID-19. The crux of many of their strategies was coordination on testing and contact tracing:

• Taiwan and South Korea were the best prepared, but that didn’t happen in a vacuum. Both countries had learned from previous outbreaks. Both countries already had a culture of wearing masks.
• Taiwan used public-private collaboration, open communication early and often, and a fact check center to ensure their citizens were receiving appropriate information.
• Iceland tested early and aggressively, with the goal to test everybody in the population.
• As Germany enters Phase 2, Germany will gradually scale back their lockdown while also testing for antibodies.

So, as we enter Phase 2, which countries will use these strategies? What’s next?

• Italy’s Phase 1 sounds familiar to us now. In March, they had the second highest number of cases. They went on lockdown. Many their elderly population were heavily affected. Now what?  Italy will not move to Phase 2 until May, at the earliest. The country still has concern that reopening will overwhelm the healthcare system once again.
• The Africa Global HelpAge International Network Statement shared upcoming plans to tailor coronavirus communications for older adults in rural areas. They emphasize protecting farmers, because many are older persons and simultaneously, protecting farmers will protect food security.
• Ghana is experimenting with drones to deliver testing to rural areas.
• The UK National Care Forum developed a #ringofsteel exit plan to protect against coronavirus: Including preparing an army of nursing workforce, billions of pounds in council funding, and plans for routine testing.
• Ireland prepares for herd immunity before a second wave of the pandemic begins. As of April 20, Ireland is concerned that society’s fatigue and complacency may not lead to much needed tests.
• Now that South Africa flattened their curve, their Phase 2 is starting to unlock places like transport hubs. However, the government continues to ask the elderly to continue lockdown and stay at home until there are vaccines or treatment. The Department of Health, as of the week of April 20, are training staff to test eldercare facilities.
• Developing nations weigh the economic factors of reopening. Requests for freezing or writing off debts are under consideration, but none of yet to be granted.
• Some care homes are continuing hazard pay, and plan to do so moving forward.

For aging services, phase 1 may feel longer within countries that are already moving to phase 2. Ideally, countries can apply lessons from the Big 4 countries with low case rates. If you have tips for what aging services providers could do to move into their phase 2, email info@globalageing.org.

By Beth Brodsky

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