The Longevity-Frailty Hypothesis: Evidence from COVID-19 Death Rates in Europe

Sammy Zahran; Levi Altringer; Ashok Prasad

From a mortality selection standpoint, in advanced economies the long survival of the elderly is accompanied by the accumulation of elderly frailty. This renders a sizeable segment of the population at-risk to an adverse health event like a lethal respiratory assault. Our index of elderly frailty, emphasizing the proneness of elderly to dependency is positively correlated with life expectancy at 65. In France, Spain and Italy, the three hardest hit countries of Europe, about half to two-thirds of elderly require assistance for basic personal and household care activities. This fact educates that a sizeable percentage of European elderly cannot easily socially distance. They require the intimacy of care, and intimate care or interpersonal proximity is a transmission risk. More proximate, our results imply that the order-of-magnitude higher COVID-19 mortality risk in Italy and Spain may result from patterns of interpersonal contact required to support an increasingly frail elderly population. Moreover, viral spread through the social intimacy that characterizes elderly care is plausibly associated with a higher viral load of initial infection as compared with random contact, a factor implicated in disease severity (Liu et al, 2020) .