Previous studies have found negative ageing narratives in the media during the COVID-19 pandemic. However, few have focused on compassionate ageism and how the news responded to the progression of the COVID-19 pandemic. We investigated (a) media themes of negative and compassionate ageism and (b) their relationships with COVID-19 parameters and the public health response. The sample included 1,197 articles relevant to COVID-19 and older people in Hong Kong published between January and December 2020. We used thematic analysis to identify themes from the news articles and structural equation modelling to explore these themes' relationship with the number of older people infected, effective reproduction number, number of COVID-19 deaths and public health response parallel in time. Pandemic-related variables were lagged for a day – the time needed to be reflected in the news. Two negative ageism themes portrayed older people as vulnerable to COVID-19 but counterproductive in combating the pandemic. Two compassionate ageism themes depicted older people as a homogenous group of passive assistance recipients. The theme blaming older people was associated with the number of confirmed infections (β = 0.418, p = 0.002) but vulnerability of older people was not associated with pandemic-related variables. The theme helping older people was negatively associated with the percentage of older people in confirmed infections (β = −0.155, p = 0.019). The theme resources available was negatively associated with confirmed infections (β = −0.342, p < 0.001) but positively associated with the Containment and Health Index (β = 0.217, p = 0.005). Findings suggested that negative and compassionate ageism were translated into narratives about older people in the media as the pandemic evolved but did not address the actual risk they faced. Media professionals should be aware of the potential negative and compassionate ageism prompted by the news agenda and promote adequate health behaviours and responses.