PurposeThe purpose of this study is to highlight the experiences and issues of an overlooked demographic: older LGBTQ + adults in the US, in the context of the COVID-19 pandemic. This allows the authors to explore possible changes in policy and practice regarding the management of the pandemic with attention to elderly LGBTQ.Design/methodology/approachBuilding on the authors’ experience in disaster research and a study of older LGBTQ + adults in the San Francisco Bay Area, the authors analyze key trends in COVID-19 pandemic management while drawing lessons from the AIDS epidemic.FindingsThe authors have found that LGBTQ + people, especially older and transgender individuals, have unique experiences with hazards and public safety and healthcare professionals and organizations (e.g. heteronormative care, traumatic insensitivity, deprioritizing essential treatments as elective). Second, older LGBTQ + adults' perceptions of state responses to pandemics were heavily influenced by experiences with the HIV/AIDS pandemic. And third, experiences with the COVID-19 pandemic have important implications for preventing, responding to and recovering from future epidemics/pandemics.Originality/valueThe authors point to two parallel implications of this work. The first entails novel approaches to queering disaster prevention, response and recovery. And the second is to connect the management of the COVID-19 pandemic to the principles of harm reduction developed by grassroots organizations to suggest new ways to think about contagion and organize physical distancing, while still socializing to take care of people’s physical and mental health, especially the more marginalized like elderly LGBTQ + people.