MAID IN AMERICA:

At least, this late in the pandemic, families can be with their loved ones at the end of life. When the family agreed to remove Aldo Caretti from the ventilator and provide comfort care, "he was alert, very aware of what was happening," his son said. "He was holding everyone's hand." He died a few hours later, on Dec. 14.

For older Americans, the pandemic still poses significant dangers. About three-quarters of COVID deaths have occurred in people older than 65, with the greatest losses concentrated among those older than 75.

In January, the number of COVID-related deaths fell after a holiday spike but nevertheless numbered about 2,100 among those ages 65 to 74, more than 3,500 among 75- to 84-year-olds and nearly 5,000 among those older than 85. Those three groups accounted for about 90% of the nation's COVID deaths last month.

Hospital admissions, which have also been dropping, remain more than five times as high for people older than 70 than for those in their 50s. Hospitals can endanger older patients even when the conditions that brought them in are successfully treated; the harmful effects of drugs, inactivity, sleep deprivation, delirium and other stresses can take months to recover from -- or can land them back in the hospital.

"There continue to be very high costs of COVID," said Julia Raifman, a public health policy specialist at the Boston University School of Public Health and a co-author of a recent editorial in the New England Journal of Medicine.

The demographic divide reflects a debate that continues as the pandemic wears on: What responsibility do those at lower risk from the virus have to those at higher risk -- not only older people, but those who are immunosuppressed or who have chronic conditions?

Should individuals, institutions, businesses and governments maintain strategies, like masking, that help protect everyone but particularly benefit the more vulnerable?

"Do we distribute them among the whole population?" Raifman asked of those measures. "Or do we forgo that, and let the chips fall where they may?"

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