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Teleasamblea sobre el coronavirus

Respuestas de los expertos sobre la prevención y el cuidado de la COVID-19.

Bill Walsh: Hello. I am AARP vice president, Bill Walsh. And I want to welcome you to this important discussion about the Corona virus. Before we begin, if you'd like to hear this telephone town hall in Spanish, press star zero on your telephone keypad. Now

AARP a nonprofit nonpartisan membership organization has been working to promote the health and wellbeing of older Americans for more than 60 years. And the face of the global Corona virus pandemic AARP is providing information and resources to help older adults and those caring for. The past week has brought a wave of good news on COVID-19 vaccine booster, shots and treatments, but it has also prompted a lot of questions about who is eligible and when across the country, the number of new cases of COVID continues to trend steadily downward, which is welcome news.

However, it's a different story in the nation's nursing homes, we would, we've seen an uptick in new cases. And COVID related deaths today. We'll hear from an impressive panel of experts on these issues and more if you've participated in one of our tele town halls before, you know, this is similar to a radio talk show, and you have the opportunity to ask your questions live.

For those of you joining us on the phone. If you'd like to ask a question about the pandemic, press star three on your telephone to be connected with an ARP staff member who will note your name and question and place you in acute ass. That question live. If you're joining on Facebook or YouTube, you can post your question and the comments.

Hello, if you're just joining I'm Bill Walsh with AARP, and I want to welcome you to this important discussion about the global coronavirus pandemic. We're talking with leading experts in taking your questions live. To ask your question, please press star three. And if you're joining on Facebook or YouTube, you can post your question in the comments.

We have some outstanding guests joining us today, including an infectious disease expert and another on family caregiving. We'll also be joined by my AARP colleague, Mike Watson, who will help facilitate your calls today. This event is being recorded and you can access the recording at AARP dot org slash coronavirus 24 hours.

After we wrap up again, to ask your question, please press star three. At any time on your telephone keypad. To be connected with an ARP staff member, or if you're joining on Facebook or YouTube, drop your question in the comments section. Now I'd like to welcome our guests. Katie Pesa, Reddy MD is the chief epidemiologist at atrium health in the Southeast.

Welcome to the program Dr. Passaretti?

Katie Passaretti: Thank you.

Bill Walsh: All right. And our guest is Lori Smetanka. Laurie is the executive director of the national consumer voice for longterm care. We'll come back to the program, Laurie.

Lori Smetanka: Thanks bill. Glad to be here.

Bill Walsh: All right, let's go ahead and get started with the discussion and just a reminder to ask your question, please press star three on your telephone keypad, or you can drop it in the comments section on faith.

Or YouTube Dr. Press already. Let's let's go ahead and begin with you. Um, I know our listeners have a lot of questions on booster shots. Would you mind reviewing the basics for us and the developments this week? Who is eligible? Can you, can you mix brands? And of course, uh, uh, there's a booster for the Pfizer vaccine.

Is there a booster for J and J and Moderna, uh, nearing approval.

Katie Passaretti: Yeah, great questions. It's been a couple of weeks of kind of evolving information. Um, just to level set first. I want to draw the distinction between. Third doses for people that are moderately or severely immunocompromised, which are intended to get those individuals whose immune system protection is lower to the same level of protection as someone with a quote-unquote normal immune system.

And that has been approved for both Pfizer. And Moderna when we're talking about boosters, we're talking about broader use of an additional dose of vaccine because over time, the protection from the vaccine has decreased somewhat. Um, so what is currently approved is if you were initially. Fully vaccinated with Pfizer, both doses, at least six months out, um, and considered high risk.

So the recommended to get the booster are individuals, all individuals over the age of 65 and then anyone between 18 and 65 or 50 and 65 that have other medical problems it's recommended. And people that can consider a booster within the current recommendations are those 18 to 50, again, with other medical conditions, which, you know, maybe diabetes, obesity, the usual kind of things that we've heard throughout the pandemic, um, or individuals that are at high risk for exposure due to occupation or institutional settings.

So like healthcare workers like myself, um, are, can go ahead and get a booster. Um, the, the. Current discussion. And I will say the CDC and ACI P, which is the group of scientists that weigh in, in the U S on immunization recommendations are meeting as we speak about Moderna Johnson and Johnson, and whether we can mix and match different types of vaccines.

So the FDA vaccine advisory group. Over the past week and their recommendation that will be considered by the ACRP and CD heat for Moderna is essentially exactly what I said for Pfizer. So more than six months out. So it's high risk group, reasonable to consider, to get a booster, to boost up that level of protection, Johnson and Johnson.

It appears that the recommendations are going to be different. And that's reflecting that Johnson and Johnson at baseline has a little bit lower, um, effectiveness in preventing illness from COVID. So for that particular vaccine, what the FDA has approved is for anyone, not just high risk that, that Johnson and Johnson, if you're more than two months out from getting Johnson and Johnson, consider getting a booster to boost up that level of protect. The other kind of burning question on everyone's mind is can we mix and match different vaccines? So all of the vaccines, um, have primarily been studied in isolation, right? So Pfizer, Pfizer Moderna with Moderna. We are starting to get a hint of data, both from Europe and from a recently released NIH study, suggesting that one there isn't harm associated with mixing and matching vaccines.

And two, in some cases specifically, if you got, um, you know, the Johnson and Johnson type of vaccine, there may be actually. Extra protection offered by getting at MRNs so that Pfizer or Moderna. So that data is very early. It'll be interesting to see what the CDC recommends. The FDA has opened the door to more mixing and matching.

So, you know, that's the piece that will be interested, interesting to see where the CDC comes out. At the end of today, I suspect the, they will also say, you know, it's reasonable to consider mixing and matching vaccines, but we have to stay tuned to see what the official recommendations are.

Bill Walsh: right a lot more to come on that front. Thanks very much for that Dr. Passaretti. And let me follow up quickly. So if you're fully vaccinate, Booster, can you still carry and spread the virus? Uh, I asked because I'm wondering in what circumstances it's necessary to mask or social distance, if you've been vaccinated and gotten a booster and, you know, we've all seen large crowds at public, uh, an entertainment events.

Is this a cause for concern, given that a core of the country still isn't vaccinated.

Katie Passaretti: Yeah, so that scenes are amazing. They have saved millions and millions of lives, but they are not perfect. So yes, someone that is fully vaccinated, even with a booster could potentially carry and spread the virus. Having said that your risk of getting infected. The length of time that you are able to spread the virus is much lower.

If you are vaccinated. And Pfizer actually just came out today with data that showed a 95% protection against any infection, if you get a booster. So that booster bumps up your level of protection, the vaccines are great at baseline at kind of decreasing that risk in general, decreasing the risk of you getting infected and spreading to other people.

Um, and that booster helps get that higher. Um, you know, I do think we are, fortunately, as you mentioned, um, decreasing in cases, the level of community burden is coming down and after this very kind of, um, hard, hard surge from Delta over the past couple of months, but as the. Boosters and higher levels of just baseline vaccination in our communities.

And that amount of community cases come down. Things like larger events, particularly outdoors become less risky. So I think we're headed toward a better area. Um, you know, I think for many people boosters can help prevent that spread and, and are a good thing. Moving forward.

Bill Walsh: very good. Thank you very much. And as a reminder to our listeners, if you'd like to ask your question, please press star three on your telephone keypad. Now,Lori, let's turn to you. We just heard Dr.

Pesa already talk about a steadily downward trend in new cases, but that's not the same story in, in the nations nursing homes. Is it, um, we've seen the number of nursing home deaths from COVID almost double in September what's causing that spike.

Lori Smetanka: Sure. Yeah. The numbers, um, between July and September have increased significantly almost 400% in terms of cases, um, and higher numbers with respect to deaths too. And we know that the increase is primarily due as a result of the Delta variant, um, but contributing to that as the low vaccination rates among staff and others that are bringing it into facilities, where then it spreads quickly among the staff and the residents.

This population continues to be very vulnerable to COVID and the spread in the setting is so alarming because how vulnerable. They can be fortunately, nearly 90% of residents have been vaccinated, but many are susceptible to the breakthrough infections. And so that's obviously been a really big problem.

And other piece of it is that as the numbers increase, it's important to point out that, um, the. Um, increases. It's not just the COVID cases, but it also affects the ability of residents to receive visits from family and friends, their ability to participate in group activities, meals in the dining room and more.

And so it really leads to isolation of residents and the impact of that, that we've seen over the last year and a half has been significant on residents, physical and mental health. So we really want to ensure that we get those numbers down again. Um, the biggest factor that's helped protect residents has been the vaccine.

So we are strongly encouraging all staff, residents, families, anyone entering a nursing home to be vaccinated and ensure that proper infection prevention protocols are being followed.

Bill Walsh: okay. Well, let me dig into that a little bit. Uh, you were talking about the vaccination rates among nursing home staff.

And right now it's at about 65% nationwide. Now some states have mandated vaccines for nursing home staff, but others have passed legislation that bans employers from requiring vaccines, you know, for families, this can be really confusing. What, what questions should families ask if they have a loved one in a nursing home and what information should they expect to get?

And, and what about assisted living? I mean, we don't have the same visibility into assisted living facilities as we do into nursing homes. Do we?

Lori Smetanka: Right. Absolutely. It's definitely confusing for families with all of the different rules, the different mandates and timelines that's happening out there. So it is important to pay attention to what's happening in your state and know what the rules are, but also to know what's happening in your, in your nursing home or your loved ones in nursing homes.

So for any long-term care facility, um, this includes nursing homes or assisted living facilities. We would encourage residents and families to ask questions about the vaccination rates of residents and staff while they won't give you personal information about who is and who is not vaccinated, they should tell you with no problem what the percentage is of the residents and staff that are vaccinated.

Um, and as I mentioned, close to 90% of residents, and you've noted that, um, more than 65% of staff have been vaccinated so far. They should also be asking facilities what they're doing to encourage and supporting their staff, to get vaccinated, ensuring that all new residents coming into the facility are vaccinated or have access to vaccines and how they're working to protect residents from the spread of COVID.

Um, do they have in place their policies and procedures that have to be followed by everyone that comes into the facility to prevent the spread of COVID? Are they ensuring that they're being followed? Um, our staff being trained appropriately and are they providing information to residents and families about that?

There's no excuse at this point for the staff and others, not to have the information they need or to be trained properly in infection prevention protocols. The other thing to remember is that, um, while a number of, well, the federal government. It's also posting vaccination rates on its care compare website, which is where you can get information about nursing homes.

And that website And you can click on their care, compare site and get information, and you can get the actual vaccination rates for staff and residents in nursing homes on that site for assisted living. It's more dependent on what information the state provides. Um, and so you can certainly ask your nursing home or contact your state's department of health for more information about that.

But we're seeing mandates come down in some states, um, for workers to be vaccinated. Um, we're seeing many employers as you know, both healthcare providers, as well as other employers that are requiring workers to be vaccinated. And the federal government has issued a mandate and we're waiting for more information about that and its implementation to come soon.

Bill Walsh: all right, very good. Thank you, Lori. Some terrific advice there. Um, and as a reminder to our listeners to ask your question, please press star three on your telephone keypad. Or if you're on Facebook, YouTube, just go ahead and drop it in the comments section.

We're going to get to those live questions shortly, but before we do, I want to bring in Megan O'Reilly. Megan is the vice president of health and family and government affairs at AARP. Welcome Megan.

Megan O'Reilly: Delighted to be here, Bill.

Bill Walsh: Alright. In addition to sharing the most current coronavirus information, we'd like to take a few minutes to update our listeners on important issues facing Congress. Megan, thanks for joining us today. And what can you tell us about what ARP is fighting for right now? That will help older Americans.

Megan O'Reilly: Thanks Bill. You know, our fight to lower prescription drug prices continues to be one of our biggest priorities. We are urging Congress allow Medicare to negotiate drug prices with pharmaceutical companies, despite nationwide ads that the drug companies are running that say, uh, it would limit choice for consumers. Medicare negotiation would actually maintain choice and dramatically lower the price of life-saving medications, which would benefit all Americans. We're also fighting to have dental hearing and vision benefits added to Medicare's covered.

Bill Walsh: Well, that would be great. And in addition to Medicare ARP fights to protect social security, there's been some news on social security this week.


Megan O'Reilly: Yes. Uh, Congress recently announced that highest social security cost of living increase in 40 years, those receiving social security benefits will receive a 5.9% boost to checks. Next year, an average of about $92 a month, this will greatly help older and disabled Americans keep up with rising prices.

Bill Walsh: That's fantastic news.

Megan O'Reilly: It is, you know, many retirees tell us that what they pay at the grocery store or for utilities or prescription drugs is going up much faster than their social security checks can cover. These cost of living increases are crucial to help keep up with these rising costs. That being said, we also need to strengthen and protect social security for the longterm.

So that those who paid into the program over their working lives can count on getting the benefits they have earned.

Bill Walsh: okay. Now, today we've been learning more about the crisis. That's still facing nursing homes in the face of COVID-19, you know, tragically. There've been more than 2000 nursing home residents deaths, uh, just in the past month alone. What's what's happening there

Megan O'Reilly: No COVID continues to ravage nursing homes across the country. We are, we are seeing far too many infections and deaths in these facilities. A RP is leading the way in analyzing and reporting how COVID impact nursing homes and we're advocating for greater protection. It's our hope that by shining a light on what's happening, the families will have the information they need to make decisions.

And policy makers will prioritize the safety of highly vulnerable nursing homes.

Bill Walsh: Okay. Well, how can people find out more about what's happening inside nursing homes?

Megan O'Reilly: AARP has a very informative website called the nursing home dashboard, which is devoted to tracking and analyzing COVID data in nursing homes. We've been hosting this online dashboard for a full year. Now this information can help families advocate on behalf of their loved ones. Anyone is welcome to visit us online and learn backslash nursing home dashboard.

Bill Walsh: Okay. That's AARP dot org slash nursing home dashboard. All one word. Thanks so much for being here, Megan and giving us those updates.

Megan O'Reilly: Great. Thank you.

Bill Walsh: right, it's now time to address your questions about the Corona virus with Dr. Passaretti and Lori Smetanka. As a reminder, press star three. At any time on your telephone keypad, to be connected with an ARP staff member to share your question live. If you'd like to listen in Spanish, press star zero on your telephone keypad now.

Now I'd like to bring in my AARP colleague, Mike Watson, to help facilitate your calls today. Welcome Mike.

Mike Watson: Thanks Bill to be

Bill Walsh: All right, who is? Uh, let's take our first question.

Mike Watson: Our first question is going to be BJ from Louisiana.

Bill Walsh: Hey, BJ. Welcome to the program. Go ahead with your.

BJ: Thank you very much. And we truly are enjoying all the information that you're giving us. My question is we saw our


famous governor, John Bel Edwards receive his booster for a COVID as well as his, uh, flu shot on maybe a couple of weeks ago. One on right on one of the left arm. My question is, as a nurse, we are holding that if you have never had, uh, any type of reaction, negative for your flu shot, you still need to wait.

Get the, if you get your flu vaccine and then wait two, three weeks or even a month before getting your COVID booster, because if you take them simultaneously, if you do have a reaction, you would not know which you're having to reaction from all from the COVID booster or.


The flu shot. So that was my question, but that's what I have done.

That's not, that's my rationale for me holding out from my mom and I she's 95 and I'm 76. So, uh, just want some feedback on that and, and, how, um, relevant you think that is for that particular rationale.

Bill Walsh: I think it's a great question. Um,

Katie Passaretti: Yeah, it really is a great question. And an important question. Um, you know, early on with the, when the COVID vaccines were released, there was a recommendation to separate out the COVID vaccine from other types of vaccines by 14 days. What we have seen since then is that there's really no. Either increased risks from getting two different types of vaccines at the same time, nor is there an impact on effectiveness of either vaccine.

So that recommendation to face out the vaccines went away and you know, myself, I did the same thing as your governor. I got my flu shot and my COVID shot as an infectious disease specialist, kind of looking at this data, um, on the same day, at the same time. And I think it's important to recognize, you know, we are heading into flu season and, you know, just coming down off a large surge of COVID cases.

So, um, unfortunately the anticipation is that flu season will be worse this year than it was last year because large chunks of the country aren't masking. And some of those distancing measures have kind of gone away. Um, so making sure that we are protecting individuals as much as we can from both infection with COVID and influenza is super important right now and that, you know, it really is okay to go ahead and get those vaccines at the same time, whether it's flu in COVID COVID and tetanus, any of those now, um, really would encourage people to go ahead and, and do what makes sense for them personally.

But I did find to get the vaccines, um, at the same time.

Bill Walsh: great.

Okay. Thanks for that, Dr. um, Mike, who's our next.

Mike Watson: So our next question is going to be from Lisa online. And Lisa asks, what happens if someone tests positive in a nursing home? Are they isolated? Are they taken to a hospice? What types of infection controls are there in place?

Bill Walsh: Lori? I wonder if you can address this, I assume it, it kind of matters what state you're in, but can you make any general statements and let our literal listeners know how to find out more?

Lori Smetanka: Sure. So, um, if a person does test positive at a nursing home, they're quarantined. Um, so if it's a resident still be quarantined on site, and if it's a staff person, they would have to leave and be in quarantine at home. Um, they are isolated for a period of time. Uh, there would be continued testing during the time that they're being quarantined until they receive negative tests or, or complete their quarantine period, whether or not they're taken to the hospital would depend on their symptoms.

Um, and so, um, if they need additional medical attention, they would most likely be transferred, but otherwise they may just be treated onsite at the facility. While someone is quarantined. One of the things to remember is that while generally they can't receive just general visitors, they are still eligible to receive compassionate care visits.

So if they need some special assistance or special supports, um, because of concern about, um, decline, um, or the impact of being isolated, they are still eligible for compassionate care visits. Or if they're at the end of life, they could still receive visits from their family members at the end of life.

Bill Walsh: Um, let me follow up on that.

Now, if, if somebody, it does test positive within a skilled nursing facility is a requirement that the families are notified, even families of other residence.

Lori Smetanka: Well, that's a really good question. Um, they should certainly notify the family of the resident who tests positive. Um, they would, they may or may not notify, um, the families of other residents. Um, certainly, um, it makes good sense to let family members know that, um, someone in the facility has tested positive, um, so that they also potentially could get tested themselves if there's a need for that contact tracing or if they had been in the facility and had spent any time around them.

So it's good practice. Um, I think to let people know, um, but certainly whether there's no requirement that the facility let other families know at this time, um, but certainly the family of the resident, if a resident test positive, they should certainly be notified.

Bill Walsh: Okay. Thank you very much, Laurie, Mike, who's our next.

Mike Watson: Our next caller is going to be Jane from California.

Bill Walsh: Hey Jane, welcome to the program. Go ahead with your question.

Jane: Oh, hi. Um, I've heard Dr. Fauci and other doctors on media say that we should enjoy the holidays. And I'm wondering how about seniors over 75 with relatives flying in that will be staying with them for a few weeks. Everybody will be boosted up by then. Um, and they're from places that have worse statistics than what, where I live or where the person lives.

So how do we do that? Enjoy the holidays and, and bring new people into our fold. So to speak in home, to be there, uh, for awhile. I'm not sure how to do

Bill Walsh: Yeah, well, let's, let's find out, uh, Jane, that's a very timely question. Dr. Pesa. Ready? Can you offer any advice?

Katie Passaretti: Yeah, it is a great question. And so, so important, you know, not only have COVID had a huge impact on everyone, the isolation and emotional and psychological impact of COVID, it is, you know, seemingly never ending. And a big chunk of that is being able to reconnect with people, reconnect with loved ones. Um, so it is important to figure out how to be able to see the people that we love as safely as possible.

I do think there's a bit of, um, individual risk assessment that has to go on. So the most important things we can do, you know, make sure everyone that's coming is vaccinated. And if they're eligible for boosters, go ahead and get a booster that decreases your risk. No matter what your vaccination statuses, making sure if anyone has any symptoms of being sick and that could be COVID could be flu, could be something else.

You know, we shouldn't in any kind of situation, be mixing and matching if there's anyone with any symptoms. And then if you are going out and about in higher risk settings, um, you know, indoors in particular, it may still make sense to mask if you're kind of mixing groups and whatnot. But I do think, you know, looking at prevalence of cases in your community, number of cases in your community, taking those extra steps to make sure, you know, no one sick everyone's vaccinated wearing masks, where it makes sense in higher risk settings, um, does make sense for the vast majority of people.

I will say, you know, for people that have. Increased risk. You know, so age is one of those, but like if you have a weak immune system on top of being elderly and those cases, I might advise someone, even with those loved ones, visiting, trying to wear masks, um, you know, that extra layer of protection, um, to make sure that you're, you're really doing everything you can to stay healthy, but still interact.

And how the, on your level.

Bill Walsh: ones.

Okay. Very good. Thank you for that doctor Mike, let's take note of.

Mike Watson: Our next question is going to be from YouTube. And this is crouching photographer asks, uh, ask the question about vaccine immunity versus, uh, COVID virus immunity, especially concerning the boosters. There's some disagreement as to whether those who have had the virus have the same immunity as those who are vaccinated and should both get the booster.

Bill Walsh: Hmm. That's an interesting question, Dr. Pesa already, can you handle that one?

Katie Passaretti: Yeah, sure. So, you know, we are still very much learning about, um, protection after quote unquote, natural


So the problem with natural infection is that not everyone has the same level of illness. Some people have no symptoms. Some people have very mild symptoms. Some people are really, really sick.

Some people have kind of a normal immune system, some don't. So with all those variables, It is much less consistent, how an individual is protected after natural infection against future infection. Um, you know, being, if you have fewer symptoms might be protected for a short period of time, but not for six months, you know?

So there's a lot of variables. So that is part of the reason why, um, COVID vaccine Kevin recommended, even if you have had prior infection to try to get a consistent level of protection and, you know, honestly, studies that have been done looking at vaccines after natural infection. So some of the highest levels of antibodies, levels of protection.

So, you know, do I think people that had natural infections to be at the front of the line. For getting a booster. No, they probably have a little bit more protection, but the further you get out from infection, the less consistent that level of protection is in a booster may make sense. And in particular, if you're a high risk individual, you know, that extra level of protection makes sense.

And you know, the good news is we have not seen any evidence of increased side effects or harm from getting the vaccine after natural infections. So no downsides, potential benefit consider doing it, especially as you get further and further out from your natural infection.

Bill Walsh: and have we seen side effects with the.

Katie Passaretti: Yeah, so great question. So obviously we're relatively, um, you know, early on in the booster journey, but what the studies that have been done so far on booster show is that the side effects are very similar to what we saw with second doses. So, you know, arm pain, uh, 24, 48 hours of feeling run down a little bit achy, but no change in significant side effects, severe side effects or anything like that.

So, um, you know, typically short-lived, you feel crummy for 24 or 48 hours and then kind of back to normal for most individuals with.

Bill Walsh: Okay. Thanks doctor for that, Mike. Let's take another question,

Mike Watson: All right. Our next question is going to be Jan from Illinois.

Bill Walsh: Hey Jan, welcome to the program. Go ahead with your question.

Jan: Hi, I'm very concerned about people who are in nursing homes. They have the least amount of, uh, protection as far as I'm concerned, because they don't have any one to come in to check on them like family members and they don't have any way to really protect themselves. And I'd like to see more unannounced visits from the health department to check on conditions, because anyone that I've talked to that is in a nursing home or assisted living say the same thing, there's not enough help. And I just feel that they are the most vulnerable to not getting the proper care that they really need at this time. And I'd like to see more money go into protecting the people that need the most protection.

Bill Walsh: Right. Uh, Lori let's, let's talk about Jan's Jan's point here. Um, one is, you know, uh, she's pointing out what I think a lot of us who have been in nursing homes and assisted living facilities have seen, which is a labor shortage and that's part of a national labor shortage.

Um, but she also asks about, you know, inspection, surprise inspections, how much oversight is there of nursing homes. These days, one would think there's more than there has ever been, but is that actually the case?

Lori Smetanka: So, um, unfortunately nursing homes historically have been short-staffed and that's been an even bigger problem during the pandemic when a number of staff, um, left because of their own health concerns or themselves got sick. Um, there have been many people that have left the field, and so that's been a real issue and, and.

We're in close to a crisis situation with respect to staffing. And so, um, you know, it's really important that we look at efforts to support staff, um, support efforts to recruit and retrain train people, retain people, um, to keep them in this industry. Um, we've been working with, uh, members of Congress to provide supports, um, for facilities to, to, um, help them, um, recruit and retain staff as well.

So that's, that's certainly been a very critical issue right now. And we do need to try to bring as many people into this field as possible and to support those that are there with the living wage and benefits and proper training. Those are all things that are lacking for many staff right now, and leads to much of their frustrations. And causes many people to leave. So that definitely is a big issue. Um, you would think that there's more oversight in nursing homes right now during this pandemic? Um, unfortunately we had not seen that to be true at the height of the pandemic when so many people, um, not just family members, but ombudsmen and surveyors were not going in on a regular basis.

Um, A lot of the oversight functions have resumed in nursing homes, many ombudsmen long-term care ombudsman who are advocates for residents are going back in to, they respond to complaints. They try to improve conditions and work with staff and residents to, um, not only help people understand rights, um, but understand that, um, people need to be properly cared for and, um, to do what they're supposed to do to provide care for residents.

Um, surveyors are going back in to ensure that they're meeting standards. Um, so definitely we want to make sure that those folks, as well as family members are able to go back in and monitor conditions, um, and be advocating on behalf of the residents. I think if people have concerns about the conditions in long-term care facilities, they certainly should have.

Um, contact their long-term care ombudsman program for assistance and file a complaint with their state licensing agency that oversees nursing homes, um, to, uh, trigger an investigation into what's going on there. Um, but I think you're absolutely right that we need to have more oversight. We need to pay more attention to conditions of facilities and make sure that residents are being properly cared for.

Bill Walsh: Okay, Lori, thanks so much for that. And thanks for all your questions. We're going to take more of your questions shortly as a reminder, if you'd like to ask a question, please press star three on your telephone keypad or drop it in the comments section on Facebook or YouTube. And if you'd like to listen to this program in Spanish, go ahead and press star zero on your telephone keypad.


All right. Now let's turn back to our experts, Dr. Passaretti, we've been talking about vaccines and boosters. But, but there's another piece to the puzzle here. And the drug company Merck has asked the us food and drug administration for emergency use approval of its COVID-19 antiviral pill. This is a treatment for COVID-19, um, and the clinical trials have exceeded expectations.

So if approved, how quickly will this oral drug become available and how will it along with Pfizer's antiviral pill changed the approach for treating people with COVID-19?

Katie Passaretti: Yeah, this is a great question. And it's super exciting. You know, all our treatments for COVID up till now have been intravenous treatments and, or primarily utilized with people that are sick enough to be in the hospital. So Merck's Drug Mona pure, severe, um, that is slated to go in front of the FDA for potential emergency use authorization.

At the end of November, um, has released information suggesting it is very effective. If given within the first five days of symptom onset at decreasing risk of hospitalization and more severe disease. So that ability to have an outpatient treatment, that's a pill that's potentially more accessible than the current treatment could certainly be a game changer.

The only thing I would say is a, the study. Suggest that it is most impactful if the infection is caught early. So it will be super important if that is improved to seek treatment early. And that I would advise people not to kind of put all their hopes on a medication for treatment. It's still remained exquisitely important that people get vaccinated.

So it's not just, oh, we have a treatment. This will fix everything. We don't need vaccines anymore. We need vaccines. It's great to have a treatment option for these instances in both are going to be really, really important. Um, the earliest, you know, that potentially will get approved is end of November, beginning of December, and then we'll have to kind of be distributed.

So hopefully if all continues to look good by end of the year that Merck, uh, medication will be available. The Pfizer, um, antiviral medication is a little bit further out, so they're still looking at that. It doesn't have a date to go in front of the FDA that works by a little bit, a different mechanism, although in kind of exciting news Pfizer's, anti-viral, they're looking at also for potential prevention, not just treatment, but preventing exposed people from getting ill, but that will most certainly be next year before that kind of gets reviewed and is potentially accessible.

Bill Walsh: Very good. Thanks for that. Dr. Passaretti uh, and a moment ago, we were just talking about how consumers, how families can keep an eye on nursing homes, where they have loved ones in Lori. Taka mentioned, um, you know, calling you a long-term care ombudsman. I wanted to give our listeners a link, uh, online to find those resources and it's through Lori's organization.

Uh, you can find the ombudsmen in your state at www. Dot the consumer backslash get underscore help. That's the consumer backslash get underscore help. All right. Uh, Dr. Pastori let me ask you another question. Um, you know, with season seasonal allergies and a return to cold and flu season, how do we distinguish between COVID and the common cold?

Katie Passaretti: Yeah. So that's been tricky. That was tricky last year. And it's going to continue to be tricky that your many of the symptoms of COVID are very similar to the symptoms of the common cold or influence the congestion, runny nose feeling, achy fevers. The one symptom of COVID that is relatively specific to COVID is loss of casement smells.

Yeah. Typically get that symptom. So if you have that, absolutely, you know, concerned for COVID need to talk to your physician, I would kind of encourage people to have a low threshold for talking to your doctor about getting tested for COVID to help figure that out because the symptoms can be so similar.

You know, I've had a number of people say, oh, I just have a cold that ended up having COVID. So, because there's so much overlap, that testing piece is going to continue to be important through this is kind of cold and flu season. And, you know, allergies are the bane of our existence, right? The seasonal allergies that congestion runny nose, it's very tricky sometimes to distinguish, but, you know, we will continue to have to err on the side of caution and have low threshold for testing so that we can identify those cases, you know, make sure that spread is, is aborted as much as possible.

Bill Walsh: let me ask you about testing our home-based COVID tests effective.

Katie Passaretti: Yeah. So all tests, you know, tests for diagnosis of infections or anything are, have pluses and minuses. So the home based. Ken to be a type of test called antigen testing. Those are most useful if you have a high clinical suspicion. So most useful, if someone has symptoms suggestive of COVID a little bit less useful if you're asymptomatic and just want to, you know, quote unquote know that you're positive.

Um, it is important to know that you can have both false negatives. And false positives with those tests. So if it, if the result isn't matching up with how you're feeling, so if you have symptoms, you know, and specifically if you have loss of taste and smell, shortness of breath, um, and that test is negative, then talk to your doctor about whether a, another type of test that's more sensitive may be useful.

And equally, if you use that test because of workplace screening or, you know, you want to go travel and it comes back positive, there is that risk, especially in someone without symptoms of a false positive. So again, it might be something you want to get. What's called a PCR test, you know, the more sensitive tasks that's only done in labs to make sure that it's truly positive.

So, you know, I think these tests absolutely are convenient. They absolutely have a role they're most useful if you have symptoms and just know that no test is perfect. And if it's not matched, if the rebuilt isn't met. Talk to your doctor about whether some other type of test makes sense.

Bill Walsh: Okay, very good. Thank you very much, Dr. Laurie, let's turn back to you. Um, the government announced in August that it will make vaccines mandatory for nursing home staff across the country and facilities that don't comply will be at risk of losing Medicare funding. So they have a pretty powerful incentive to ensure their staff gets vaccinated.

When do you expect this to go into effect? And what's it going to mean for nursing home residents?

Lori Smetanka: Yeah, we are expecting to see rules from the centers for Medicare and Medicaid services. Any time. Now, some reports are saying by later this month, we should see the rules come out. Um, the original mandate that they issued had applied just to nursing homes, but it was broadened afterwards to apply to all healthcare workers.

And that does seem to be a factor in why the rules may not have been published yet. Um, but we do know that they're coming, um, and facilities do need to do everything they can. In the meantime, to work with staff, to educate them, to try to meet them where they are, um, in terms of identifying what their concerns or hesitations are for getting vaccinated.

And the more they can do that, um, in advance of this mandate, I think the better. Um, chance we stand of ensuring that people will continue to stay in the field and work in this field. Moving forward. We've already seen a couple of state mandates go into effect already in New York, for example, um, their state mandate has gone into effect.

And, um, we are seeing that the mandates are having an effect in increasing the numbers of staff being vaccinated. Um, and that definitely is what we want to see. Um, but we, uh, we still have a long way to go, as we had talked about earlier, um, where the numbers are not even quite at 70% yet, but, um, the, the vaccines have made the biggest difference.

It's been the most effective factor in stemming the spread of the virus in nursing homes and protecting those are who are most vulnerable. So we definitely want to, and see, we definitely want to see, um, big increases in the numbers of staff that are getting vaccinated. It's critical. Um, and we need to remind folks that not only is it safe, but the facilities will be safer places to work.

The more people that are vaccinated, they're not just the residents, but also the staff. And we are definitely hoping that. People who may have left because of concerns of their own health and safety. And the spread of the virus may come back to work in the field again. Um, if they feel that, um, the workplace will be a safer place for them.

So, um, we are hoping to see the rules soon. Um, and we really are encouraging people to get vaccinated as soon as possible.

Bill Walsh: Okay. Thanks Lori for that. And now it's time to address more of your questions with Dr.

Pesa ready and Lori Smith Tonka. Uh, please press star three at any time on your telephone keypad to be connected with an ARP staff member and ask your question live or drop it in the comments section on Facebook or YouTube. Mike, who do we have in the line? Okay,

Mike Watson: Our next caller is Mary from Texas.

Bill Walsh: Hey Mary. Welcome to our program. Go ahead with your question.

Mary: Thank you for taking me. I would like to know why these nursing homes are not compelled to be sure that every, uh, resident there has their shots. My daughter was in rehab and they were going to give her a shot. She was just missed before they gave her the shot. She went to the place that she was going to live.

Her caseworker assured her. She would have somebody come there and give her a shot. Well, they never showed up and she was there for a long, long time. And then she got sick and went to the hospital from there. She went to a new nursing home and in that nursing home, they had never given her the shot. She never got the shot at all.

And she took COVID and just in a few days she was gone. I lost daughter on the 30th of all. And she wanted to shot. The last words she ever said to me was mother. If I live through this, I will get the shots. Even if it's a Johnson, Johnson was, she didn't like, but she was willing to take it. She said, if I had somebody to put me in automobile and take me to a pharmacy, I'd go now.

But my daughter never had the chance

Bill Walsh: Oh, Mary. I'm so sorry to hear that. Let me, let me

Mary: I am too. And the reason I'm speaking out is because I can't bring my daughter back. But maybe if this is, uh, brought to people's attention that, uh, maybe they will enforce that these nursing homes will be sure that these little people had their shots.

Bill Walsh: well, let's ask about that. Laurie, um, are nursing homes required to give shots to patients, uh, residents rather can residents refuse them? What what's going on there?

Lori Smetanka: Well, first, I'd like to offer my condolences to you, Mary, on your loss. That's, that's such a big loss to have in a terrible thing. And so I'm really sorry about that. Um, nursing homes should be doing everything they can to ensure that residents have access to the vaccines, to the shots, um, for, um, uh, early on, um, when the vaccines were made available, there were specific partnerships that were developed with, um, with pharmacies, um, to ensure that pharmacists were coming onsite or people were coming on site to deliver the shots to residents.


they are

Required to be having relationships with pharmacies now, um, and, and providing access to vaccines for residents that want that they definitely should be offering it to them. Um, right now residents still are permitted to refuse, um, vaccines just as with any other treatment. Um, but for those people that do refuse the vaccine, um, there are certain. Maybe subjected to more frequent testing, um, required use of protective, um, masks for example, or other protective equipment, um, or have other restrictions placed on their ability to participate in activities or, um, In dining or in other events that might be going on, um, with other residents, um, because of the risk that it may pose to themselves and to others.

Um, but the bottom line is that every resident should be offered vaccines, um, should, um, have the right to them whenever they want to get vaccinated. And the facilities have a responsibility to ensure that that happens. And they have been working with CMS and the centers for disease control and state departments of public health to ensure that the nursing homes are having access to vaccines to the greatest extent possible.

So, um, what happened to your daughter? I'm again, very sorry about that, but that should not be happening for people right now.

Bill Walsh: I mean, it sounds like Laurie, it's really a time to be an advocate for your loved ones in nursing homes.

Lori Smetanka: Absolutely. And again, thanks for raising the website where people can contact the long-term care ombudsman, but they are a terrific resource for help. If you're having questions or concerns or need additional assistance, they can provide support to you as can your state licensing agency and your state department of health.

Bill Walsh: Okay. And that site again is the consumer voice.

Dot org backslash get underscore help. They can find, uh, links to the, uh, ombudsman program in your state and these folks it's their job every day to help advocate for, for people like, like us, like all of us consumers, uh, interacting with, with long-term care facilities to reach out to them, they're there to help.

Okay. Mike, who's our next caller.

Mike Watson: Our next caller is Craig from Minnesota.

Bill Walsh: Hey Craig. Welcome to the program. go ahead with your question, Craig.

Craig: Um, yeah. Hi, uh, thank you all for doing the. The town hall has been a lot of great information. And my condolences to Mary for her daughter, that's really sad and unfortunate it's this whole thing has been crazy, but


right at the beginning, you pretty much answered my question. Um, I've been, um, vaccinated with Pfizer booster for almost a month now, I guess.

And do you still recommend, and I wear masks when I go into stores into a lot of places where there's people and try to avoid people. Um, now do you recommend staying, uh, outside of restaurants and bars? I mean, not going, which we have not been doing my wife and I, um, do you recommend staying out. Out of the insides of those places and just staying on patios, if you can.

we're, we're traveling across, we're traveling across the country, um, in a few weeks to California to visit relatives and they're all vaccinated, they will be so, but we were going to be really careful in hotels and everywhere we'd go, but we'll have to get food places. Okay.

Bill Walsh: let, let, thank you, Craig. Let's ask Dr. Passaretti about this. I mean, people are thinking about holiday travel, even if they've been vaccinated and received a booster.

What advice would you give them about being safe? Uh, whether they're in homes where they're out at restaurants or, or other places.

Katie Passaretti: Yeah, really good question. So the things that we have seen that increase risk throughout the course of the pandemic, you know, looking at where you're traveling to and through and seeing where are areas that might be more concerning. So there's a lot of, there are resources on the CDC site. You know, local sites kind of giving you an idea of cases in communities and states and whatnot.

So is it an area with high amounts of transmission, low amounts of transmission and in those areas with higher transmission, even if you're vaccinated and boosted, when you're in higher risk setting. So indoors crowded, when you don't know if people are vaccinated, unvaccinated, especially kind of restaurants where you may or may not be masked, it may make sense to err, on the side of caution and, you know, pick those outdoor settings.

Um, you know, so it, it's going to continue to be like what the risk of where you're going to and chipping away at that risk for you personally. So myself, I'm still kind of. Savoring eating outside where there's open air, good air circulation, and wearing a mask when it's inside. Now, I'm in an area that still has a good amount of pre-admission and, you know, uh, uh, relatively mediocre kind of vaccination rate.

Um, so that may be different in an area where, you know, everything's under control. 90% of the population is vaccinated. Then my comfort level goes up with eating inside and whatnot. So unfortunately there's not one flat answer for that. It's going to kind of look at what's the risk of the settings. The lower risk settings are where you're comfortable.

The vaccination rates are high outside is safer than inside. And, you know, the density of people, air circulation, um, the higher kind of density of people in a space, the higher risks. So those are the situations to kind of, um, take into account and make an informed decision on kind of what protective measures.

Bill Walsh: Okay. Thanks for that, Mike. Let's think another question.

Mike Watson: All right. Our next question is going to be from Facebook. And Sandy is asking if requested are nursing homes required to tell me the vaccination status of my loved ones, caretaker.

Bill Walsh: Hmm.

That's an interesting question. Lori, can you help with that? And maybe talk about also just more broadly what the rights of families are in demanding, whether it's visibility or whether it's getting a shot for their loved one. Like Mary was talking about.

Lori Smetanka: Sure. So, um, the facilities should tell you the percentage rates of vaccinations among staff and residents, but they won't give you specific information about a particular caretaker or a particular resident. Um, so that's, um, information that is kept private for those individuals and is not made public or shared with others.

So, um, hopefully, uh, they are already sharing that information with you. And as I mentioned before, um, the percentages of vaccination rates are something that the nursing homes are required to report to the federal government and they are posted on the federal government's website right now on care compare, um, where you can get that specific.

Information. Um, certainly there's no reason to keep that secret. It's something that people want to know and it helps them make informed decisions about not only whether they want to have a loved one go into that nursing home. Um, but whether they want their loved one to stay in that nursing home or how they may respond to, um, visitation or interactions with that facility, um, during that time.

Bill Walsh: Okay. Thanks for that, Laurie. Mike, let's take another question.

Mike Watson: All right. Our next question is going to be Philip from Ohio.

Bill Walsh: Hey Philip. Welcome to the program. Go ahead with your question.

Philip: Thank you. Um, my question was, what, how long does the, a booster shot? Um, give you a good level protection and will we have to continue taking booster shots every months or eight months or, you know, one every year something like that?

Bill Walsh: Yeah, it's a good question. I'll ask Dr.Passaretti about it. My guess is you're going to say, we're not sure yet

Katie Passaretti: absolutely correct. And is a great question. It's a question we've been struggling with kind of, since the vaccine first became available. Um, but the reality is, you know, we just don't know yet. We have experience with plenty of vaccines in the past where a booster, you know, at one point in time is sufficient for kind of giving you the protection that is needed and you, you know, may not need another.

But I think the, my suspicion, the suspicion overall is that, you know, COVID is a respiratory virus and we've seen with Delta and other variants, the virus changes over time. So, you know, ultimately it may be something like the flu where we get. Uh, yearly vaccine because that virus is kind of constantly changing and we need to bump up our immune response, our protection.

Um, but you know, I think we just need simply need more time to be able to know for sure. And we will see as we've, you know, for the past two years, we will continue to learn and adapt response based on, um, the data as they evolve.

Bill Walsh: Well, and as it has been with this pandemic from the beginning, people just need to stay tuned and keep an eye on the news and listen to experts to find out what's happening next. Um, I'd like to thank, um, both of our experts for answering all our questions. This has been a really informative discussion and thank you or AARP members, volunteers and listeners for participating is discussion as well.

AARP and nonprofit nonpartisan membership organization has been working to promote the health and wellbeing of older Americans for more than 60 years. And the face of this crisis, we're providing information and resources to help older adults and those caring for them protect themselves from the virus, prevented spread to others, all taking care of themselves.

All of the resources referenced today, including a recording of the Q and a. Can be found at AARP dot org slash coronavirus starting tomorrow, October 22nd. Again, that web address is AARP dot O R G backslash coronavirus. Go there. If your question was not addressed and you'll find the latest updates as well as information created specifically for older adults and family caregivers, we hope you learned something that can help keep you and your loved ones healthy.

Please join us November 4th at 1:00 PM. Eastern time for another live event, answering your questions about the coronavirus. We hope you can join us. Thank you and have a good day. This concludes our call.

El coronavirus: Cómo proteger tu salud y cuidar de tus seres queridos

Jueves 21 de octubre a la 1 p.m., hora del este

Llama sin cargo al 855-274-9507 para hacer tu pregunta o escucha gratis el evento aquí (para escuchar en español marca el 833-946-1559).

Con la llegada de la temporada de gripe y la continua lucha contra la COVID-19, este evento de preguntas y respuestas en vivo abordó tus preocupaciones sobre las vacunas de refuerzo, las vacunas contra la gripe y cómo mantener seguros a nuestros seres queridos vulnerables que viven en hogares de ancianos. 

Si no pudiste acceder al evento en vivo, escucha una repetición en el video que está arriba (en inglés).

Conoce los expertos

  • Katie Passaretti, M.D.
    Jefa de Epidemiología, Atrium Health
    Profesora asociada, Departamento de Medicina, División de Enfermedades Infecciosas,
    Carolinas Medical Center
  • Lori Smetanka
    Directora ejecutiva,
    The National Consumer Voice for Quality Long-Term Care

Para más información visita

Escucha las teleasambleas anteriores

  • 17 de diciembre: Lo que necesitas saber sobre los tratamientos y las vacunas
  • 3 de diciembre: Cómo sobrellevar el invierno y permanecer seguros
  • 19 de noviembre: Dr. Anthony Fauci, Dr. Francis Collins y el chef Andrew Zimmern
  • 12 de noviembre: Cómo sobrellevar la pandemia y mantener tu bienestar 
  • 1 de octubre: Las vacunas y cómo sobrellevar la pandemia
  • 17 de septiembre: Prevención, tratamientos, vacunas y cómo evitar las estafas
  • 3 de septiembre: Tus finanzas, tu salud y tu familia
  • 20 de agosto: Tu salud y cómo mantenerte protegido
  • 6 de agosto: Contestamos tu preguntas más frecuentes
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  • 18 y 20 de junio: Comunidad LGBTQ, fortalecer las relaciones y el trabajo en tiempos inciertos
  • 11 de junio: Nuestra capacidad de adaptación
  • 21 de mayo: Susan Lucci y Jo Ann Jenkins
  • 14 de mayo: Quédate en casa con los expertos
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  • 30 de abril - El coronavirus: cuidar de padres, hijos y nietos
  • 23 de abril - Impacto desigual en comunidades y apoyo a los seres queridos en hogares
  • 16 de abril - El coronavirus y la telesalud
  • 9 de abril - Cómo sobrellevar las situaciones difíciles y tu bienestar
  • 2 de abril - Administrando tu dinero y protegiendo tu salud
  • 26 de marzo - Cómo proteger y cuidar de nuestros seres queridos
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