October 19, 2021

By David Leonhardt

Good morning. Colin Powell's death highlights the continuing Covid risks to older Americans with medical conditions.

Colin Powell in 2002, when he was secretary of state.Brooks Kraft/Corbis, via Getty Images

The threat, in perspective

Colin Powell's death at 84 underscores the continuing risk that Covid-19 presents to older people — even if they are fully vaccinated, as Powell was.

For vaccinated Americans in their 70s and 80s, Covid remains more dangerous on average than many other everyday risks, including falls, choking, gunshot wounds or vehicle accidents:

Covid data is an annualized rate from the week of Aug. 29 to Sept. 4, and is a sample from 16 U.S. jurisdictions. Data for other causes is from 2019.Source: Centers for Disease Control and Prevention

The numbers in this chart are averages, of course, covering a wide range of situations. They encompass both healthy older people and those with compromised immune systems (as was the case with Powell, who had multiple myeloma and Parkinson's disease). At every age, Covid presents considerably more danger to people with serious underlying medical conditions.

"Vaccines turn Covid into a mild disease," Dr. Ashish Jha, dean of the Brown University School of Public Health, wrote yesterday. But mild infections can "kill vulnerable people," he explained.

For older people with a medical condition, the vaccines both sharply reduce the dangers of Covid and still leave Covid as a meaningful threat, one that arguably justifies a different approach to day-to-day life. Spending time indoors with an unmasked, untested grandchild or eating a meal inside a restaurant may not be worth the risk, at least until case counts have fallen to low levels.

For older people who are healthy, the risks may be more tolerable. Covid is probably not vastly more dangerous than other activities that people do without thinking — like driving a vehicle or climbing a flight of stairs — but it is not zero risk, either.

"Getting vaccinated doesn't deliver you into an entirely new category of pandemic safety — safer and more protected than anyone who hasn't gotten vaccinated — but simply pushes you down the slope of mortality risk by the equivalent of a few decades," David Wallace-Wells has written in New York Magazine.

As a country, what can we do to protect older people from Covid? The data points to at least three good answers.

1. Reduce caseloads

The main reason that Covid deaths surged in the U.S. recently is that cases surged. If cases return to their low levels of the spring and early summer, deaths among older adults will probably plummet as well. In June, only about one-tenth as many Americans over 65 were dying from Covid as in August, according to the C.D.C.

Chart shows data from a sample of 16 U.S. jurisdictions.Source: Centers for Disease Control and Prevention

The most effective way to reduce caseloads is to continue raising the country's vaccination rate, through workplace mandates and other measures. Vaccinating children under 12 can also save the lives of older people.

Cases in the U.S. have already fallen 50 percent since Sept 1. If the declines continue — and can be maintained — the risks for older Americans will be much more manageable than they were in the late summer.

2. Give booster shots

Scientists are still trying to figure out how quickly vaccine immunity wanes. But the bulk of the evidence suggests that it does wane at least somewhat in the first year after vaccination, which creates additional risks for older people. Among that evidence: Covid case counts are higher in Britain, where vaccinations tended to happen earlier, than in other parts of Europe, as John Burn-Murdoch of The Financial Times has noted.

Waning immunity, in turn, suggests that booster shots can protect vulnerable people.

In the U.S., the federal government has not yet authorized booster shots for any recipients of the Moderna or Johnson & Johnson vaccines, although a scientific advisory panel has recommended them for people who are 65 and older, among others. Pfizer vaccine recipients 65 and older are already eligible for a booster once they are at least six months removed from their second shot.

Powell was set to receive a booster shot last week but had to postpone it when he became sick, a spokeswoman said.

3. Expand rapid testing

If rapid Covid tests were widely available, as they have been in much of Western Europe, they could help protect the elderly.

In a previous newsletter, I mentioned a woman in Germany who greeted visitors with a stash of rapid tests — allowing her husband, who has Parkinson's disease, to stay safe and still have a social life. Imagine if American families could do the same. Grandma and grandpa are coming over for Sunday dinner? Everybody else takes a rapid test before they arrive.

The Biden administration has promised to make rapid tests widely available this fall. For now, they are still difficult to find, largely because the F.D.A. has been slow to approve them.

For most Americans, vaccination makes the risk of a serious form of Covid extremely rare. And for children, Covid tends to be mild even without vaccination. But until caseloads decline more, the situation remains frightening for many older people.

Colin Powell with Ronald Reagan in 1988.Barry Thumma/Associated Press

More on Powell's life

Powell was a child of New York City (as he discussed in a PBS interview). He was born in Harlem, raised in the Bronx and graduated from City College.
After serving in the Vietnam War, he rose through the military and became the first Black national security adviser, chairman of the Joint Chiefs of Staff and secretary of state.
Heading into the 1996 presidential campaign, Powell was among the country's most popular figures, but he chose not run (as Bob Woodward detailed at the time; Woodward also conducted Powell's final interview).
In the prelude to war in 2003, Powell accused Iraq — falsely, it later became clear — of having weapons of mass destruction. He would describe it as a blot on his record. (Our colleague Robert Draper has told the back story.)
Powell, once a Republican, lamented the party's move to the right, endorsing Barack Obama, Hillary Clinton and Joe Biden.
Powell first appeared in The Times on Aug. 30, 1979, in a story about the Department of Energy, where he worked. And here's The Times's obituary.

THE LATEST NEWS

The Virus

The F.D.A. plans to allow people to receive a different Covid vaccine as a booster.
Washington State University fired its football coach for not getting vaccinated.
Covid deaths are rising in Russia, where many people are unvaccinated.
Infection rates remain low in New York City's schools, these maps show.

Politics

The Justice Department asked the Supreme Court to block a Texas law that bans most abortions.
Donald Trump sued Congress to prohibit the disclosure of White House documents related to the Jan. 6 Capitol attack.
The Biden administration will regulate chemicals used in household items that can contaminate drinking water.

International

Four years after Hurricane Maria, many Puerto Ricans still do not have reliable electricity.
North Korea conducted its first submarine-launched ballistic missile test in two years.
The German media giant Axel Springer removed a top tabloid editor after The Times reported that he had mistreated women.

MORNING READS

Ricky Jay in 1996.Ken Hively/Los Angeles Times, via Getty Images

Magic: An automaton and a magic lantern projector are part of the astounding collection left behind by the magician Ricky Jay.

Found: A 900-year-old sword dating to the Crusades.

The Calm Line: Feeling jealous or angry? This antimachismo hotline will take your call.

A Times classic: How to raise a feminist son.

Lives Lived: From the 1963 March on Washington to Barack Obama's rise, Timuel Black wielded the solidarity of Black Chicagoans as a tool for political power. He died at 102.

ARTS AND IDEAS

LordeJustin J. Wee for The New York Times

A musical mission to help a language

In August, Lorde put out her third record, "Solar Power." Three weeks later, she released "Te Ao Marama," an EP with five of the album's songs translated into Maori, the Indigenous language of New Zealand. It's part of an effort in her native country to boost a language that, not long ago, experts feared could die out, Brian Ng reports.

Beginning in the 1850s, the country's European settler government punished children who spoke the language at school and isolated Maori families by embedding them in white neighborhoods. New Zealand declared Maori an official language in 1987, but by then most of its speakers were older.

One of the artists behind the musical Maori resurgence is Dame Hinewehi Mohi, who in 2019 compiled "Waiata/Anthems," an album of contemporary English tracks performed in Maori that debuted at No. 1 on the New Zealand charts. (Waiata means "song.")

Language revitalization is "a never-ending battle," Sir Timoti Karetu, an expert on Maori language, said. "All of us who have been colonized by somebody else are struggling for our languages to survive." He added: "Waiata will never die. I think waiata will go on forever and ever." — Sanam Yar, a Morning writer

PLAY, WATCH, EAT

What to Cook

David Malosh for The New York Times

Enjoy golden, crispy sheet-pan pork schnitzel.

One to Watch

Get to know Paulina Alexis, an Indigenous Canadian actress who is a revelation on the FX dark comedy "Reservation Dogs" and who will star in the next "Ghostbusters" movie.

What to Read

John Grisham — whose new book, "The Judge's List," is about a murderous member of the bench — spoke about the Supreme Court and wrongful convictions.

Late Night

The hosts talked about boosters.

Now Time to Play

The pangram from yesterday's Spelling Bee was unboxing. Here is today's puzzle — or you can play online.

Here's today's Mini Crossword, and a clue: Spanish for "rice" (five letters).

If you're in the mood to play more, find all our games here.

Thanks for spending part of your morning with The Times. See you tomorrow. — David

P.S. Join Nikole Hannah-Jones and others at 7 p.m. Eastern tomorrow for a virtual event about homecoming at historically Black colleges.

Here's today's print front page.

"The Daily" is about Colin Powell.

Claire Moses, Ian Prasad Philbrick, Tom Wright-Piersanti, Ashley Wu and Sanam Yar contributed to The Morning. You can reach the team at themorning@nytimes.com.