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The Hidden Harms of CPR - The New Yorker   

Shortly after his sixty-seventh birthday, Ernesto Chavez retired from his job at a Los Angeles food warehouse. Sara, his wife of forty-five years, told me that he meticulously took his medications for high blood pressure and cholesterol, hoping to enjoy his time with his grandchildren. But one morning in January, 2021, Ernesto burned with fever, his chest heaving as though he were once again lifting heavy boxes. At the hospital, he tested positive for COVID-19. His oxygen levels plummeted, and he was quickly intubated. Ten days later, his lungs were failing, his face was bloated from litres of intravenous fluid, and his hands and feet had begun to cool. As his chances of survival waned, I arranged to speak with his family about a subject inseparable from death itself: cardiopulmonary resuscitation, or CPR.

For decades, physicians have debated whether CPR should be offered to people who suffer from the final blows of incurable illness, be it heart failure, advanced cancer, or dementia. Although CPR has become synonymous with medical heroism, nearly eighty-five per cent of those who receive it in a hospital die, their last moments marked by pain and chaos. The pandemic only deepened the risks: every chest compression spewed contagious particles into the air, and intubation, which often follows compressions, exposed doctors to virus-laden saliva. Hospitals in Michigan and Georgia reported that no COVID patient survived the procedure. An old question acquired new urgency: Why was CPR a default treatment, even for people as sick as Ernesto?

As a palliative-care physician, I help people with serious, often terminal, illness consider a path forward. During the pandemic, this involved weekly Zoom meetings with each family whose loved one was in the I.C.U. with COVID. We discussed how the virus could damage the lungs irreversibly, how we gauged a patient’s condition, and what we would do if, despite being on life support, that patient died.

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Morocco earthquake: 296 killed as buildings damaged - BBC News   

A strong earthquake of magnitude 6.8 has struck central Morocco, killing at least 296 people, the country's interior ministry says.

The epicentre was in the High Atlas Mountains, 71km (44 miles) south-west of Marrakesh, at a depth of 18.5km, the US Geological Survey said.

"According to a provisional report, the earthquake killed 296 people in the provinces and municipalities of al-Haouz, Marrakesh, Ouarzazate, Azilal, Chichaoua and Taroudant," the statement said, adding that 153 people were injured and hospitalised.

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The old have come to dominate American politics - The Economist   

YOUTH, OR EVEN middle age, seems sure to be absent from the presidential ballot when Americans vote in November 2024. Joe Biden, the oldest president yet, is 80; his likely rival, Donald Trump, is 77. Both are well past the median age for the world’s heads of government, which is just 62. Only eight of the 187 leaders in an analysis by the Pew Research Centre are older than Mr Biden (see chart 1). Both Americans are also much older than most of their predecessors: the median age of presidential nominees and presidents since 1900 is 55.5.

They would be less out of place in Congress. For many years, America’s lawmakers have been getting less youthful (see chart 2). In 1900 people in their 40s made up 38% of the House and Senate. Now they account for just 20%. This could in part be explained by changes in life expectancy in America (it was 47 in 1900 and is 76 now), but structural factors, such as incumbency advantage and party leaders’ bias towards recruiting established politicians as candidates, favour older people.

In midterm elections in 2022 the Senate continued to get older. But the median age in the House of Representatives edged down from 58.9 to 57.9. Now four senators and 11 House members are in their 80s, down from seven and 14 before the midterms. The proportion of Congress’s members older than 70 fell from almost a quarter to less than a fifth. That is partly because 64% of newly elected members were under 40. They include 26-year-old Maxwell Alejandro Frost, a Democrat from Florida, who is the first Gen-Z member of the House. Still, octogenarians soldier on: the 83-year-old former House speaker, Nancy Pelosi, announced she will run again in 2024.

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