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For every COVID death, many more older people develop serious illness. Risk increases with age, and people older than 70 “have a substantially higher rate of hospitalizations” than those ages 60 to 69,

Persistent coughs, aches, and joint pain can linger long after serious illness, together with indirect impacts such as loss of muscle strength and flexibility, which can affect older people’s ability to be independent, Rivers said. Older COVID survivors may also have a higher risk of cognitive decline. In some cases, these ailments could be part of long COVID, which may be more prevalent in older people.

The antiviral Paxlovid was supposed to help blunt the wave of old people falling sick and ending up in the hospital—and it can reduce severe disease by 50 to 90 percent. But unfortunately, it is not widely used; as of July, just a third of Americans 80 or older took Paxlovid.

The reality is that as long as the virus continues to be prevalent, older Americans will face these potential outcomes every time they leave their home. That doesn’t mean they will barricade themselves indoors, or that they even should. Still, “every decision that we make now is weighing that balance between risk and socialization,”

Where America has landed is hardly a new way of life but rather one that is simply more onerous. “One way to think about it is that this is a new risk that’s out there” alongside other natural causes of death, such as diabetes and heart failure,

Before the pandemic, the association between loneliness and higher mortality rates, increased cardiovascular risks, and dementia among older adults was already well established. Increased isolation during COVID amplified this association.

Even older adults who have weathered the direct and indirect effects of the pandemic still face other challenges that COVID has exacerbated. Many have long relied on personal caregivers or the staff at nursing facilities. These workers, already scarce before the pandemic, are even more so now because many quit or were affected by COVID themselves

“Long-term care has been in a crisis situation for a long time, but it’s even worse now,” Muramatsu said, noting that many home care workers are older adults themselves

Older people won’t have one single approach to contending with this sad reality. “Everybody is trying to figure out what is the best way to function, to try to have some level of everyday life and activity, but also keep your risk of getting sick as low as possible,”

Again, many of these people did not have it great before the pandemic, even if the rest of the country wasn’t paying attention. “We often don’t provide the basic social support that older people need,” Kenneth Covinsky, a clinician-researcher at the UCSF Division of Geriatrics, said. Rather, ageism, the willful ignorance or indifference to the needs of older people, is baked into American life.

It is perhaps the main reason older adults were so badly affected by the pandemic in the first place, as illustrated by the delayed introduction of safety precautions in nursing homes and the blithe acceptance of COVID deaths among older adults. If Americans couldn’t bring themselves to care at any point over the past three years, will they ever?

But while those are huge numbers by any measure (world GDP is around $100 trillion), they aren’t big enough to motivate most leaders to justify mitigation, which will also cost a whole lot of money.

To put it in terms the authors use, the recently enacted Inflation Reduction Act will cost Americans roughly $80 per ton of carbon emissions avoided, and while each ton not pumped into the atmosphere would save the world $200 as a whole, it would only save Americans about $40 of that $200, making it feel to some altruistic but not self-evident in purely economic terms.

In their new paper, economists Adrien Bilal of Harvard and Diego Känzig of Northwestern take a fresh look at the data

They show that the social cost of carbon is likely far bigger — six times bigger — than previously estimated: losses of more than $1,000 per ton, or around 12 percent of world GDP per degree of warming.

— roughly equivalent to the economic drag on big economies if they were permanently at war.

Suddenly, that $80 Americans are spending on reducing one ton of carbon emissions is netting them $200 or so in U.S. economic activity.

Bilal and Känzig argue that it’s very much worth it for countries of means to spend the money now to avoid much greater costs down the line

the potential losses are so vast it makes sense for these countries to go ahead and act on their own to avoid climate change losses, even if other nations do nothing.

What’s different about your methodology and how did it lead you to the numbers you've come up with?

Adrien Bilal: So virtually all of the previous work that's been done on the subject has relied on comparisons of different countries that heat up or cool down at different points in time. The U.K. gets a little hotter in one year, and then Germany stays cool. And then you look at how GDP in the U.K. evolves following that change in temperature.

that generally gives you numbers in the vicinity of $150 per ton of carbon emitted and a 2 percent decline in GDP per degree Celsius in warming

we think that is quite different from what climate change is actually doing to the world. It's not only that the U.K. is going to heat up a little more than Germany, but the whole world is heating up because of climate change. And, in particular, oceans are also heating up. And when the whole planet warms, that has potentially really different implications for the climate system, increased frequency of extreme weather events that then have big local impacts. 

that's actually what geoscientists have been telling us for a long time, but it simply hadn't percolated into economics. And so we took that perspective very seriously and thought, "Well, what happens when we basically compare years where the world is very hot to years where the world is cooler?" And that gives you a much larger effect of climate change on the economy.