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Coronavirus Tele-Town Hall: Coping and Maintaining Your Well-Being

Experts share information about how to handle stress, uncertainty and fear during the pandemic

Coping and Maintaining Your Well-Being

Bill Walsh: Hello. I am a AARP Vice President, Bill Walsh, and I want to welcome you to this important discussion about the coronavirus. AARP, a nonprofit, nonpartisan member organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them. With the pandemic entering its eighth month, COVID-19 cases, hospitalizations and deaths from the disease are once again on the upswing, and there seems to be no relief in sight as the holiday season approaches. As we look to the end of this extremely trying year, Americans around the country are considering how, or if, they will celebrate with family and friends when the most prudent course continues to be keeping a safe distance. Today we'll talk with exerts who will answer some of your questions about staying safe and how to care for yourself and loved ones. 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 questions live. For those of you joining on the phone, if you'd like to ask a question about the coronavirus pandemic, press *3 on your telephone keypad to be connected with an AARP staff member. We'll note your name and question and place you in the queue to ask that question live. If you're joining on Facebook or YouTube, you can post your question in the comments section.

Joining us today are Gopi Patel, M.D., associate professor of infectious diseases in the Department of Medicine at Mount Sinai Hospital in New York. And Warren Hébert, doctor of nursing practice and nursing professor at Loyola University of New Orleans, and the CEO of the Home Care Association of Louisiana. We will also be joined by my AARP colleague, Jean Setzfand, who will help facilitate your calls today.

This event is being recorded, and you can access the recording at aarp.org/coronavirus 24 hours after we wrap up.

Now I'd like to welcome our first guest, Gopi Patel, M.D. is an associate professor of infectious diseases in the Department of Medicine at Mount Sinai Hospital. She specializes in the treatment of infections in immune-compromised patients. Welcome, Dr. Patel.

Gopi Patel: Thank you for having me.

Bill Walsh: All right. Great to have you here in the show. And Warren P. Hébert Jr. is an assistant professor at Loyola University in New Orleans. He has more than 40 years of nursing experience, is an outspoken leader in home health care and health policy at the federal and state levels. Welcome back to the show, Dr. Hébert.

Warren Hébert: Thank you, Bill. It's good to be back with you.

Bill Walsh: All right. Good to have you. Let's get started with the discussion. Dr. Patel, let's start with you. Eight months into the pandemic we are setting single day records for positive COVID cases. What does this mean for the holidays and the winter?

Gopi Patel: So it's unfortunate that we're in the predicament that we're in right now, and one of the things that I think all of us are thinking about is seeing our families or getting together for the holidays. It's been a long 11 months for many of us. Unfortunately, the winter brings us going back indoors. We took a lot of solace in being able to social distance outdoors, but once we start going indoors, it's a little bit more difficult to social distance and, obviously, deal with some of the circulation in that environment.

Bill Walsh: And of course, flu season, with winter comes flu season, right?

Gopi Patel: Absolutely. So we do recommend that everybody does get their flu vaccine, one, because it's still the best way to defend against the flu, but also a way to not overwhelm clinics, hospitals, emergency departments with flu on top of COVID-19.

Bill Walsh: All right. Let me follow up on that. Despite the discouraging news about the pace of the pandemic, it appears there are substantial advances in treatment. What are the most noteworthy advances to help people survive COVID-19?

Gopi Patel: Oh, we know so much more than we did at the beginning of this pandemic. Also, I think early on we couldn't test. The tests were slow to roll out, and now testing is a key factor; testing and tracing, making sure people know that they've been exposed and to not minimize symptoms and get tested early, especially if you've had a known exposure or potential exposure. We do ask patients to come in sooner rather than later. I think a lot of individuals were concerned about coming to emergency rooms or to medical care, and we do encourage that individuals come in when they're becoming short of breath, when they have that cough and can't catch their breath. Steroids have been pivotal. We've learned so much from trials coming out of Europe and throughout the United States about the importance of steroids if someone does require oxygen. We're learning more about antivirals, so Remdesivir, that when it works, and experts in the field meet frequently to talk about updating guidance and offering that guidance to health care workers across the country to be able to treat patients in the various stages of COVID-19.

The other thing is we know about the nonpharmaceutical interventions, right, the washing of the hands, the wearing of the mask and the social distancing. And that really helps sort of prevent the transmission if we continue to follow it closely.

Bill Walsh: It seems so simple, but really continues to be very effective, doesn't it?

Gopi Patel: Absolutely. And we do understand that people are getting very fatigued by all of this.

Bill Walsh: Right. All right. Well, thank you for that. Let's turn to you, Dr. Hébert. As we've discussed, we're eight months into this pandemic and many family caregivers, already stretched before the pandemic, are juggling childcare, work, caring for older loved ones, what advice do you have for people who are struggling with this balance?

Warren Hébert: Bill, the role of the family caregiver is challenging even in the best of times. Isolation, and I would add the word “physical” to that. Our friends with the World Health Organization have changed their language; instead of using “social distancing,” they're now using “physical distancing.” So the challenge that we have as caregivers in the midst of this to try to get some balance, is to find other ways to connect socially, ways that are not in one another's physical presence. Some things that we've done with our grandkids and with friends, and I would add friends from around the world, and that is to use the virtual connections if those are available to you, and if the place that you live has broadband, that can certainly make a difference. One of my favorite acronyms when it comes to care at home is PLTS, and that stands for the “plain old telephone system.” So making phone calls more frequently can really help with a person's resilience and their balancing. There are people who are in my life that I am able to connect with on a daily basis that really helped me to recalibrate. They're people who are genuine and authentic, and I don't have to worry about them bringing extra drama to me.

So when it comes to our better balancing, I think that making choices as to who you're going to be connecting with, because we know that certain people that we connect with are going to have more stress, more turmoil in the connection, so the opportunity to connect with people who are going to help you to be more whole is a conscious choice that you can make.

And the other thing is to ask for help. You know, within my own family, we've had a few people who have tested positive, and a son who's dealing with it right now. And I was on the phone with my daughter-in-law right before starting the call with y'all, Bill. And they've got three sons ages, eight, six and four. So she's got her hands full. So reaching out to others to offer help, but also being willing to accept help, I think is just vital during these challenges that we're having.

Bill Walsh: Right. Some great advice there. What do you think are the best ways to substitute for the special moments over the holidays if we're not able to be in person?

Warren Hébert: So this is an opportunity for us to maybe go retro. Handwritten cards is something that seems overly simple, but for the most part, people have gotten away from that. I think that that's a really good way to do it. One of the things that we did early in the experience with COVID is to be leaving little packages. We have the good fortune that 9 of our 12 grandchildren live within 10 minutes of us. So even though we weren't visiting with them personally, my wife, who is the ultimate grandmother, you'd love to have her as a grandmother, she put together little gift packages and dropped them off at the door for the children. Doing that from a holiday perspective is another thing that you could do.

The other thing, Bill, that I'd suggest for everybody is to be focused on aspects of gratitude. Last Christmas, our family all got together, before COVID-19, and we exchanged gifts, and while we thought we were finished, our 29-year-old daughter is our youngest of five children, and she has Down Syndrome. So she stands up and she says, "I have something I want to say." So I said, "OK." Well she knew that it was my wife and I's 40th anniversary the following week, and she said, "I want to thank mom and dad." And she said a few nice things about us. And then she pointed to her oldest brother and she said, "Now it's your turn." And they went around the family. So as we talk about not being in person, finding ways to do something similar, whether you can do that virtually or even put together a group phone call, some of those things to recognize family members who have done some things that help to bring the rest of the family, joy and celebrating that. Those are some of the things that I think that focus on gratitude can really make a difference.

Bill Walsh: Oh, some wonderful advice. Thank you for that Dr. Hébert. I want to update [our listeners] on AARP's continuing fight for residents and staff in nursing homes and other long-term care facilities. Since the start of the pandemic, more than 84,000 nursing home residents and staff have died from COVID-19. It's a tragedy. And with recent spikes in cases nationwide and colder weather approaching, experts are sounding the alarm on the dire situation in these facilities. Action is needed now to prevent even more COVID-19 deaths in these facilities. And AARP is continuing to fight at all levels of government. We're calling on federal and state leaders to pass legislation that includes a five-point plan.

First, facilities must provide regular ongoing testing and adequate personal protective equipment for residents and staff. Second, we need transparency and accountability with daily public reporting of cases and deaths in facilities and better communication with families. Third, family members need the ability to visit virtually with their loved ones in nursing homes, even as nursing homes allow in-person visits. Fourth, residents need better care. That means adequate staffing and access to in-person advocates known as long-term care ombudsman. And finally, nursing homes and long-term care facilities that harm residents should be held accountable. They should not be given blanket immunity.

Thousands of AARP members, volunteers and activists have made their voices heard on this issue. For more, make your voice heard. Please visit aarp.org/nursinghomes. That's aarp.org/nursing homes. We hope that you connect now to help save lives and help stop this national tragedy.

Now it's time to get to some of [your] questions about the coronavirus with Dr. Patel and Dr. Hébert. 

Now I'd like to welcome my AARP colleague, Jean Setzfand, who will help facilitate your calls today. Welcome Jean.

Jean Setzfand: Thanks, Bill. Delighted to be here.

Bill Walsh: OK. Who is our first caller?

Jean Setzfand: Our first caller is David from Michigan.

Bill Walsh: Hey, David, welcome to the show. Go ahead with your question.

David: My question is, I was tested back in May, which is six months ago, and luckily, it was a negative. And it's been six months, so I was just wondering how often, I have no symptoms that I know of. Should I get tested again or what, or not? Or just wait and see?

Bill Walsh: All right. Thank you, David. Dr. Patel, do you want to talk about kind of what are the signs people should be looking for that might trigger the need for a test?

Gopi Patel: Sure. If you know or have been told that you were in contact with someone who had COVID-19 or has been diagnosed with COVID-19, that obviously should prompt you to go get tested. In terms of symptoms, we've learned a lot about the symptoms of COVID-19, everything from a sore throat, muscle aches, the unique loss of taste and smell. So if there are symptoms that you normally would say, ‘Oh, this is just a cold, or this is kind of like the flu,’ we don't want you to minimize those symptoms. That should also prompt testing. In certain health care settings or certain work settings, especially if the rates in where you live are going up, there may be some guidance from your public health authorities for more frequent testing because of the risks of exposure. So you sort of hinted about nursing homes and skilled nursing facilities. Those health care workers and those residents are likely at higher risk and are tested more frequently based on recommendations from public health authorities. It's obviously regional. If you work, or provide care to someone, there may be a reason to go get tested more frequently if you don't have symptoms. But I would offer you to look at what your public health authorities in Michigan are stating in terms of their testing algorithms. We do want to make sure testing is still limited — it's widespread, but limited in many areas, especially if they're seeing an increase in the number of cases, they're trying to direct the testing toward curbing transmission.

Bill Walsh: OK, thank you for that, Dr. Patel. Jean, who is our next caller?

Jean Setzfand: Our next caller is Juanita from Maryland.

Bill Walsh: Hey, Juanita, welcome to the show. Go ahead with your question.

Juanita: OK. My question is, my granddaughter is in Winston-Salem in college, and her mom wants me to ride down with her to pick her up. And I want to know, is that OK to do, because I'm going to another state.

Bill Walsh: Dr. Patel, do you want to weigh in on that? Should Juanita go pick her granddaughter up at college? And if so, what precautions should she take?

Gopi Patel: So I think, this is an interesting question. A lot of what we recommend in terms of public health or from infectious diseases physicians, is making sure everything is done in a safe manner. Being in a car with some that you already spend time with is very safe. You know, sometimes if you're in a car and you don't spend a lot of time with that individual, that's not someone that you live with, not a household member, we ask that you mask and roll down the windows. If the travel is not absolutely necessary, and this is really important as we come upon the holidays, you really need to know what other people are doing. What are those individuals that you are going to be spending time with together in close contact within a confined space, what have they been doing? Have they been monitoring themselves? Have they been tested? Do they have symptoms? Have they been following those three Ws that people talk about: wearing a mask, watching their distance and washing their hands? And I think this is something that we’ll be speaking a lot more about as the holidays approach. I think that's a family conversation that you need to have, Juanita. And if it's absolutely not necessary, traveling in a confined space wouldn't be recommended, but also knowing what your granddaughter has been doing. Many colleges, and I don't know the details of that specific college, many colleges are testing and testing frequently because, again, it's an effort to curb transmission amongst young college students. So that would be a family conversation, but if you don't feel safe, my recommendation would be you pass on this trip.

Bill Walsh: OK. All right, Jean, who is our next caller?

Jean Setzfand: Our next caller is Marge from Massachusetts.

Bill Walsh: Hey Marge, go ahead with your question.

Marge: I was just wondering if you have any recommendations for an almost 80-year-old woman who lives alone and is getting very lonely. You know, I'm usually out swimming and volunteering and things like that in Massachusetts, and everything's been canceled.

Bill Walsh: Sure. Sure. Do you go out at all, Marge?

Marge: Oh, I go and get the mail, and I live in an elderly neighborhood, so I'm not too crazy about seeing too many people because they're more prone to this virus than other people. And I do go out and get groceries, you know, and stuff like that. But the days are awful long. And I've (inaudible), I've cleaned, you know, it's like, OK, what's next? Take a nap?

Bill Walsh: Right. So let's ask Dr. Hébert about that, if he has any suggestions for you. Dr. Hébert, what can you say to Marge?

Warren Hébert: Marge, you're not alone. The challenges that we have around loneliness were well documented before COVID-19 and our pandemic experience. So what you're experiencing now is something that a lot of people have had challenges with before. Loneliness is something that has a lot of difficult health effects. So it's wonderful that you're recognizing that you're seeing some changes in yourself. Some things that you could do to help with that is to consider the possibility of visiting with someone across the yard. You know, you've got a nice distance between you. We actually started, about three months in when our numbers went down, our grandkids would come into the backyard, and we would visit with them through the fence. Another thing for you to do is more phone connections. The calls, as I indicated a little bit earlier, with someone that you know, helps you to feel better, someone who's authentic and genuine, who doesn't bring a lot of drama. But if you can have phone calls with people who help you to settle and to help with your mood, that's a really good thing to do, too.

And some other things that you would do to help with your mood is seeing what exercises you might be able to do in the house. My daughter, who I mentioned earlier who has Down Syndrome, was part of a fitness group. And within a matter of a few weeks, they changed their in-person exercise gathering to something that they're doing virtually. So if you have access to the internet, and you have a device that allows you to do that, Marge, that's another good thing to do is to see other people's faces. And then some good things to do in general are occasionally reading a good book, perhaps watching a comedy. The science makes it very clear that the more we laugh, there are a lot of good, positive physiologic effects to that. Thanks for asking, Marge. A lot of people are having that challenge right now.

Bill Walsh: They sure are. Thanks for those words of advice, Dr. Hébert. One other thing that AARP offers Marge or others who are on the line who might be feeling isolated or know somebody who is, is that last year we created something called the AARP Friendly Voices Program. Basically trained hundreds of our staffers simply to reach out to people and chat with them. It's free, and you can access it on a toll-free line. Let me give you that number. It's (888) 281-0145. That's the AARP Friendly Voices Program at (888) 281-0145. And again, that's a free service. If you want to have one of our volunteers reach out to a loved one or a neighbor or someone you know is struggling during this time and just wants to hear a friendly voice. OK Jean, who is next up in the queue?

Jean Setzfand: We have several questions coming in from YouTube. And this one's coming from Jean on YouTube. And she's asking, "How is the U.S. planning on dispensing the vaccine?"

Bill Walsh: Dispensing the vaccine. That's a timely question. Dr. Patel, do you have any insight into that?

Gopi Patel: Sure, there's some preliminary information that if a vaccine were to become available, how the United States would be dispensing the vaccine is very similar to how they have been dispensing other medications that have come to emergency use. They do want transparent, equitable distribution, and many of the vaccine trials have included individuals who are older and obviously from the backgrounds that were hit so hard with COVID-19 during the pandemic. So a very diverse group of individuals. They don't think they'll be able to meet the demand at first in terms of vaccinating all Americans, so it will be a tiered vaccine distribution starting with, as you mentioned before, long-term care facilities and skilled nursing facilities, as well as frontline health care workers, with the next tier of being other essential workers and those with medical conditions that put them at very high risk for COVID-19. So there is a plan that's coming together across the country, as well as state and local public health authorities, that if a vaccine were to get allocated under an emergency use authorization and then subsequently licensed the vaccine through the FDA, that they would be able to distribute it across the country to meet the needs, to help be one of the things that prevents transmission, and end the pandemic.

Bill Walsh: Yeah, and I think Dr. Patel, the operative words there were, the plan is coming together. A lot of this stuff really needs to be figured out, I think. Do you know a timetable for when some of those decisions might be made?

Gopi Patel: I think there's a lot of individuals, and you can actually, if you do have access to the internet, you can actually watch the ACIP sort of discuss vaccines and vaccine safety. It is thought based on the current trajectory that vaccine, a small allotment will be available toward the end of this year, which is unheard of for vaccine development. Toward the end of this year for that first year, which will be offered to those long-term care facilities and the health care workers, but a larger distribution will be available in 2021, probably toward the spring. So I think some of it has to do with the evaluation of the safety and efficacy of these vaccines. So independent data, safety monitoring boards evaluate this, then the FDA Advisory Committee on Vaccines, which are all private citizens, evaluate the data. And then they make a recommendation to issue an emergency use authorization that then will go to the CDC Advisory Panel about recommendations of who that initial allotment would go to. So a lot of steps, but a lot of exciting news about vaccines and the potential efficacy. And people are looking very closely at the safety data to make sure that it is an efficacious and safe vaccine. So hopefully, by the end of the year, and in terms of vaccine science, it's pretty amazing how fast this is coming.

Bill Walsh: It sure is. And we'll talk more about the vaccine development process a little bit later. Jean, do we have another question in the queue?

Jean Setzfand: Yes, we do. This is Harriet from New York.

Bill Walsh: Hey, Harriet. Hey, how are you? Go ahead with your question.

Harriet: I'm fine, thank you. My question to you is I have two great grandchildren, six and nine, and they have a mother and a father, that's my grandchildren, and they want to come to our house to bring dinner for Thanksgiving. My 9-year-old is a special needs child, who desperately wants to come, because we have seen them on the outside, never within the house. They both are in school. My grandson is a police officer. My granddaughter runs a gym for special needs children, which has been very poorly attended these days, but they do have people. And I do want to tell you that I'm 90 and my husband's 98, and we'd love them to come. So what do you think? They want to come so desperately.

Bill Walsh: Yeah, and I bet you want to have them come and visit.

Harriet: I sure do. I sure do.

Bill Walsh: All right, Harriet, thank you. Let's ask Dr. Hébert about that. What do you think of Harriet's situation, and if you think the great grandkids should visit, what precautions do you think Harriet and her family should take?

Warren Hébert: Oh, Harriet, I heard a little catch in your voice, and I love you. It's one of the most difficult experiences we've had with the pandemic is not engaging our grandchildren. So we started, as you suggested, you know, visiting with them through the window and outside, and that really is something that was such a gift for us even to be able to do that. But the fact that you're dealing with a special needs’ grandchild, certainly connects at the heart in an even greater way.

So with regards to mitigating risks, what we did with our grandchildren was we made sure to visit outside. So Harriet, I'm not sure what part of the country you live in, or what the weather's going to be like, but as Dr. Patel said a little bit earlier, anytime you're able to visit outside, you significantly mitigate the risk. The other things that you and your family will need to discuss is, is there an opportunity for you to be well-distanced even when you're outside. If you're going to be inside, as Dr. Patel indicated a little bit earlier, your risk increases significantly. Even if you're wearing masks it still increases significantly.

So, as Dr. Patel suggested a few minutes ago, it is almost miraculous that we're seeing a vaccine that's been developed so very quickly. You know, the things I had heard in the past, the record was four years, and we're talking just a few months here. So while you want to be together, I would suggest that it seems that with vaccines coming forward so quickly, we may be in a very, very different situation in just a few months. Obviously, there are a number of other challenges, it's not only developing the vaccine, but convincing people to take it. We also need to do a better job at convincing people of those three Ws, thank you Dr. Patel — making sure we're wearing masks, watching our distance and washing hands, because there are things we can do to significantly lower the spread of the COVID-19, even without the vaccine.

So I really feel with you, your desire to want to be close, but know that there are going to be some risks that you'll be taking, and it might just be a matter of being a little more patient for a few more months, not being overly optimistic in my language, but just be aware that your health and well-being is vitally important and finding other ways to be close might be the best thing for you to do for this holiday season.

Bill Walsh: Thank you, Dr. Hébert. I mean, Harriet is from New York, so outdoor visits toward the end of November might be a little chilly. I guess it could depend on the weather, but your point is well taken that outside is better than inside. A number of our callers have been wondering about the idea of getting a test before they go visit or having the folks that they're visiting get tested. Do either of you, Dr. Patel or Dr. Hébert think that that is a best practice people should be thinking about?

Gopi Patel: So I think testing is very important to tell you where you're at that moment in time, but it's really what were you doing prior to the visit that's also equally important, right? So if I was exposed, and my test is negative two days after that exposure, that might be a little bit early before the test becomes positive. And so, you know, this is the perfect time if you are bringing family together and, again, outdoors is best, but really making sure everybody's doing those three things that we keep talking about: the wearing of the mask, the watching the distance, and washing their hands. That protective planning is equally important to the test. So can you make sure that those potential exposure events are not occurring, so then it makes it a much more safe interaction. So you sort of know the behaviors that people were having before they come, and then that test is much more meaningful. I'm finding many individuals use the test as sort of a ticket to ride, ‘Oh, I have a negative test, now I can go to this gathering,’ but then forgetting all of those other things that they need to do to continue to protect each other.

Bill Walsh: Good point. All right, well, thank you both for that. Jean, who is our next caller?

Jean Setzfand: Dr. Patel, just addressed this question, but there were a couple of questions on YouTube basically asking somewhat of the same theme. Ernie, for example, is asking, "After being exposed, how long does it take to start experiencing symptoms?" And then, similarly, Michelle's asking, "How soon after being exposed to COVID should you wait to get tested to avoid false negative test results?"

Bill Walsh: Dr. Patel, can you address those questions?

Gopi Patel: Sure it's really unknown. Sort of the rule of thumb that we've been using here in the health care setting is about five to seven days is probably the best time to get tested if you're not having symptoms. If you know about an exposure, so you've been told you've been exposed, and you desire to know if you convert to positive. I think what's very interesting about COVID-19 is that many individuals are asymptomatic and clearly transmitting. So I think a lot of people don't have symptoms or minimize symptoms. And so we say about five to seven days is probably the best time to get a test from the exposure.

In terms of symptoms, often, if your symptoms are not abating, and you don't have an alternative reason, and you have a negative test, we would recommend getting tested again. Sort of "if it looks like a duck, smells like a duck, quacks like a duck, it's probably a duck" mentality. I usually say one to two days after symptom onset. Obviously if your pre-test probability, you know you had an exposure, you were told you had an exposure, other people at the event or whatever it was have tested positive, that comes into account. Many different tests are out there because they were all released also under an emergency authorization. It's unclear what some people may know what's called the sensitivity of a test, so all of this should be taken into account. So around day two of symptom onset is a good time to take a test to get a diagnosis. And then if you had an exposure around day five from the exposure, seems to be a good time to take the test.

Bill Walsh: Now after you've been exposed, and you've known you've had that exposure, should you be quarantining yourself even though you may wait five days to get tested?

Gopi Patel: Absolutely. So that's some of what we've noted as well. Often it depends on where you are and what you have access to. Sometimes the tests don't come back right away. So not only should you be quarantining yourself after the exposure, but also quarantine yourself as you're waiting for the test results. The guidance pretty much is standard — if you have been exposed, it can be up to 14 days before you develop symptoms or have a positive test, more likely at day five or seven, but every person's immune system and response is very different. So we know what we know now, but that quarantine period for 14 days after the exposure still stands.

Any public health authority, the guidance, of course, is changing with travel advisory's changing, so pay attention to that as well. Every jurisdiction or state has different guidance in place.

Bill Walsh: Right. OK. Thank you very much for that. Jean, who is our next caller?

Jean Setzfand: Our next caller is Aleva from South Carolina.

Bill Walsh: Hi Aleva, go ahead with your question.

Aleva: Yes. My husband is in a nursing facility and he was diagnosed with COVID. What is his chance of taking it again, and what dangers is it for me to go visit him in the (inaudible).

Bill Walsh: I'm sorry to hear that. Did you say, what are the chances of him contracting it again?

Aleva: Yes.

Bill Walsh: OK, so he's recovered from his first bout of COVID it sounds like, and you're wondering about ... yeah. And does the nursing home allow visitation at this point?

Aleva: No, they don't allow visitation, but they allow me to come in at one time to see him. But the question I was asking, what is my chance of being exposed? Even though I have mask and stuff on.

Bill Walsh: Yeah, you had personal protective equipment. OK. Dr. Patel, do you want to take a stab at that question?

Gopi Patel: Sure. So the reinfection rate is exquisitely low. There's definitely been reports from the United States, as well as other countries, of individuals who had a diagnosis of COVID-19, who had either symptomatic or asymptomatic, meaning they felt sick or they didn't feel sick, and were diagnosed with COVID-19 again. It is very rare considering how many diagnoses of COVID-19 have been made worldwide. In terms of visiting your loved one, again, every nursing facility in every state has different rules about what is requested of nursing facilities and nursing homes in terms of testing of staff and routine testing of patients. I do think if there is a concern, these facilities are taking this very seriously and obviously limiting visitation, and making sure that both the resident, the employee, as well as the visitor is masked and distanced. It's incredibly difficult, and in terms of you feeling uncomfortable visiting, I would assume not just from your husband potentially having COVID-19, but also the staff and the other patients, that every facility is taking this very seriously and have recommendations and guidelines that they're required to follow in terms of making sure the employees are not working sick and wearing masks and have access to that personal protective equipment, that the patients are either being tested or being asked to wear personal protective equipment like masks, and that the visitors themselves are also being screened for symptoms or travel or exposures, and being masked as well. You can always distance yourself from your loved one. I know it's really hard, but sit six feet away and keep the visit short.

A lot of places have video visits available. I know technology can be difficult at times, but sometimes they can set up an iPad or some sort of video visits where you're able to have that quality time and converse with your loved one in that setting. And, of course, that minimizes your risk and their risk as well.

Bill Walsh: Thanks for that. Dr. Hébert, I mean I wonder if you have any insights on what questions Aleva should ask the facility or precautions she should take as she thinks about visiting her husband.

Warren Hébert: So, Aleva, thank you. Being separated from the people that we love has been one of the most difficult experiences throughout this. And Aleva, one of the things that you want to be aware of is how you're doing too. Not just from a standpoint of your physical well-being, but how you're doing emotionally, because it really takes its toll being separated, even though he was in the nursing home already, you're inability to visit.

The things that I think would be prudent to do is to your best find out what precautions are being taken in the nursing home. While nursing homes across the United States are supposed to follow similar protocols and have similar regulations and guidelines, the truth of the matter is there's very broad variation. Some states have much better performance with regards to this, others not so good. So learn a little bit about your state, but also go to the web, and if you can access the internet, that's great, if not someone else in your family can help you to see what the rates have been in that nursing home. And it will give you a clearer picture of what sort of protocols they're following and the success that they're having. Congregant living settings are not safe places for people to be today, and they're also not safe for the people that are in those settings.

However, there are exceptions. We talked about these virtual gatherings. There was a virtual gathering of a dear friend of a lot of us who's 90 years old, and she happens to be in a nursing home, and we all gathered with her virtually. And since March, nobody in that nursing home has had COVID-19. And this is a well-educated woman, and she knows how to get the right answers. But the point is gathering information related to that nursing home, recognize that you're going to be going in, if you do that, you're going to be putting yourself at risk, and finding other ways to try to connect. Those are the suggestions I would make. Thank you, Aleva, That's an important question.

Bill Walsh: OK, and thank you for all the questions. We’re going to get to more of them in a moment. Let me turn back to our experts for a moment here. Dr. Patel, we were just talking a little bit about vaccines, and there's been news recently, some promising news about vaccine development. But on the whole, can you talk a little bit about where we are in terms of the clinical trials and the whole development process. In particular, what consumers can expect in terms of safety and efficacy of anything that emerges onto the market.

Gopi Patel: Sure. So there are four vaccine candidates in advanced clinical trials here in the United States. Two of them are fairly advanced, and one of them is the Pfizer vaccine, which made a lot of waves this week in terms of some early promising data that has come out from their clinical trials. These are large clinical trials that started in terms of the phase three or the trials where they actually give some individuals vaccine, and some individuals saltwater, or what we call placebo. Those started in July. And to date, many of these trials have enrolled 30,000 to 43,000, I think is the number for Pfizer, individuals. And over 50 percent of the individuals that have been enrolled in the Pfizer trial have completed both vaccine doses. So these are two-dose vaccine series.

And what they're looking at in terms of efficacy is how many individuals in each group, the group that got the vaccine and the group that didn't get the vaccine but got the placebo or the saltwater, actually developed COVID-19. And this early data is very, very promising. It is early data. The other thing that they're looking at is the safety profile. Did anybody have any side effects that would be considered unusual. You know, side effects like soreness of the arm and pain in the area of the injection, that's not considered unusual with any type of vaccine, but is there something else that's unusual? So that's what we're waiting for in terms of Pfizer going and asking the FDA for an emergency use authorization. This is very different than having the FDA approve a vaccine. That will take much more time.

But as I said earlier, the people who are looking at vaccines, and they're being very transparent about what they're looking at, are really private citizens looking at all of those datas, that does include scientists, infectious diseases experts, other individuals that are not those companies, looking at the data, making sure that they have met these metrics of safety and efficacy and then forwarding that on to an immunization advisory committee to take a look. That ACIP peer immunization advisory committee is also private citizens. So this should not be considered anything that's being politicized. It really is something that the process that's being put in place is really to make sure that there's a safe and efficacious vaccine that is offered to the public.

Bill Walsh: Dr. Patel, following up on that point, and you've referenced it a couple of times here today, this is an expedited development and review process. Reviews by the FDA of drugs often take years to carry out, and this one is being done much quicker through this emergency use authorization. How much confidence should consumers have in the safety of that expedited emergency use process?

Gopi Patel: I think it should be reassuring that no one is taking vaccine safety and efficacy lightly. This is to get something out to the public sooner than normal, but also part of doing it this way was to remove some of the risks that pharmaceutical companies take in vaccine development. So all of this happening very rapidly, but some of it is taking out some of the risks that pharmaceutical companies put in place. It could take years to make vaccines. So one of the things that, I think people refer to it as Operation Warp Speed put into place, is removing some of the financial risks and some of the delays that come from manufacturing and distribution of vaccines. And as they are being looked at, they're being manufactured, and a distribution plan, as we talked about, is being looked at.

I think the goal of the FDA, the CDC and all of the public health authorities that are hopeful about vaccines, is to make sure that this is safe and efficacious, because this is one of the most promising developments we have in terms of curbing this pandemic. So I think I would take a lot more stock into the FDA Vaccine Advisory Committee and the ACIP, and what recommendations they're going to make. Everyone is being very careful and cautious here, but we are being a little more optimistic than we've been in the past couple of weeks with this exciting news that has come out about efficacy.

Bill Walsh: Yeah, OK. Thank you for that, Dr. Patel. And just to follow up, we were talking to Aleva from North Carolina just a moment ago, and she was wondering about the conditions inside the nursing facility where her husband resides. I just want to give you a resource to check out. On AARP’s website, we've created a tool that is tracking coronavirus cases, the numbers and rates in nursing facilities around the country. You could check that out if you have access to the internet at aarp.org/nursing homes, aarp.org/nursing homes. You can also find out a lot more there about our work on the nursing home front, questions to ask the nursing home or long-term care providers, so some terrific resources there.

Dr. Hébert, I want to swing back to you. As cases rise across the country, are there precautions or extra steps that people need to take if they have someone coming into their home to help with caregiving needs?

Warren Hébert: Yes. And this is an important question, and I'm going to divide that into two if I may, Bill. The first is formal caregivers. The formal caregiver is someone who might be with hospice, the home health organization or in the case of my daughter, she receives nonmedical care through direct support professionals. Those organizations all have protocols that they're obligated to follow. And those protocols for the formal organizations include regular testing, it includes regular surveys related to whether those staff members have been exposed or not and it includes temperature checks, and that sort of thing. So essentially, those folks who are from the formal caregiver setting are doing these things that are part of the protocol and the things that they have to be doing.

It is vital that the family caregivers, perhaps someone is offering you respite, you as a family caregiver have been providing someone's needs, and somebody who regularly comes in to give you a break is doing that. I've got a friend that traveled from Massachusetts to Indiana just a couple of days ago, and we talked about the fact that she needs to be quarantined before she goes to provide care. She needs to be certain that no one in her family unit that she's living with, as Dr. Patel indicated a little bit earlier, someone that you're living with, and you're both taking those very seriously, the need to avoid crowds, then that person that you're living with is a good risk for you. But when you're going out to care for someone else, that period of quarantine is very important for you as a family caregiver before you go out to provide assistance to someone else. And I really think that it deserves repeating because it's so easy to remember and so important, and that's the three Ws that Dr. Patel said a little bit earlier: wearing a mask, watching your distance and washing your hands. These are things that are really important. And my sense as I watch people in circles that I move in here in south Louisiana and watching television, I think that, in my mind, we can be much more serious about mitigating the risks with these three simple steps.

Bill Walsh: And Dr. Hébert, I've heard you talk about the importance of being an advocate for your loved ones at this time. So whether it's going into a nursing home, whether it's having care professionals come to your home, this is a time for you to step up and press those companies and ask them the questions. This is the time when you need to be that advocate and get the answers for the safety of your loved ones. Is that right?

Warren Hébert: Absolutely. The care providers generally are going to be understanding, and they're going to appreciate that you're playing that role of advocate. For example, one of my daughter's caregivers, there was a tragedy in her very young friends. They all graduated from high school last year. And one of the young friends died. She wanted to go to the funeral, and she made the decision to do that. So we had conversations with her about how she was going to be engaging people at the funeral, whether there were opportunities for her to be at a distance from them, whether she was wearing a mask, and then even if she took all of those precautions, to be sure she's wearing a mask for a period of time when she comes back in.

So yes, as a family caregiver, it's vital that you play that role of advocate, and that you ask the formal caregivers what they've been doing. So these are good steps to take, Bill. And I appreciate you asking that question.

Bill Walsh: All right. Thank you very much, Dr. Hébert and Dr. Patel, and we're going to get to more listener questions shortly. But before we do that, I wanted to give a quick AARP Fraud Watch alert. Scammers continue to use the headlines as opportunities to steal money or sensitive personal information. The Federal Trade Commission has logged nearly 243,000 consumer complaints, as of Nov. 4, related to COVID-19. Scammers are using the full suite of scam tools, phishing emails and texts, bogus social media posts, robo calls, and posture schemes, and more, and closely following the headlines and adapting their messages and tactics as new medical and economic issues arise.

Here's some tips to help you avoid coronavirus scams. Avoid online offers for coronavirus-related vaccines and cures. Be wary of emails, calls and social media posts advertising free or government ordered COVID-19 tests. Don't click on links or download files from unexpected emails, even if the address looks like a company or person you recognize. Don't share personal information, such as Social Security, Medicare and credit card numbers in response to an unsolicited call, text or email. And finally, be skeptical of fundraising calls or emails from COVID-19 victims or virus research, especially if they pressure you to act fast and request payment by prepaid debit cards or gift cards. Visit aarp.org/fraudwatchnetwork to learn more about these and other scams, or call the Fraud Watch Network Helpline at (877) 908-3360. That's (877) 908-3360.

Bill Walsh: Jean, who do we have on the line?

Jean Setzfand: Our next caller is Cynthia from California.

Bill Walsh: Hey, Cynthia. Welcome to the show. Go ahead with your question.

Cynthia: Yes, my question is for Dr. Patel. Yesterday, as often happens, I encountered a man in the grocery store who was not wearing a mask. He was standing behind me in the line for the cashier. And I engaged him in a discussion about why he wasn't wearing a mask. And his response was the same response I've gotten from a number of people, and that is, it doesn't do that much in the way of protecting me anyway. And I'd like to know what your response to that specific comment would be.

Bill Walsh: OK, Dr. Patel, can you provide some information on that?

Gopi Patel: No. 1, thank you for being a safety advocate. I know it's not easy and educating individuals who are very staunch about their beliefs about masks is not easy. Two things. No. 1, sometimes it's best just to walk away, that's also for your safety. I think about sort of not having that mask-to-mask interaction, and there are risks in that. We have found that masks not only protect you from me, but also protects me from you. So it is a protection mechanism, as much as it's keeping the droplets in mechanism. And there's more and more data coming about that. Actually the CDC just released that they feel very strongly the mask is protective in a bidirectional fashion. So it protects you from my droplets, and me from spreading my droplets. So I think that's all you can say is there's data that has emerged that the masks are protective, and also protect you from me. So I wear my mask for you. You wear your mask for me.

But I also am concerned about your safety. And so those interactions, it's best try to just distance yourself. And if you have a relationship with that store, to let them know that that's an unsafe practice, and that they should require their patrons to wear masks. A lot of states are moving in that direction. I'm from New York and I live in a mask-up state. And I do think there's some people who are getting fatigued with the masks, but in order to protect yourself, I would also invite you to sort of make sure you have your distance. But I applaud your attempt to educate others. But we do now have one of our public health authorities sort of putting it out there: it's bidirectional, so everyone should wear a mask and obviously distance if they can.

Bill Walsh: OK, very good. Jean, who is our next caller?

Jean Setzfand: Our next caller is Gloria from New York.

Bill Walsh: Hey, Gloria, go ahead with your question.

Gloria: Hi, oh, I'm so excited about AARP. As a 26-year member, I am just, I'm loving you AARP people that I don't even see.

Bill Walsh: Well, thank you. We love you too, Gloria.

Gloria: Thank you. I'm 85 going on 35, and I'm taking care of a great-grandson who's 14. I've had him since he was five years old, and I'm trying to talk fast because I want to make sure I get everything in. He has been doing remote since middle school, and he just started high school this September. And just on Monday, we've been receiving that he's been absent, and his grades are really low. He has never had low grades ever, ever, ever. And I'm so concerned. So I decided instead of just talking on the phone over and over, I took him and the tablet that he's using, that he was using at the time, actually his laptop went out, and but I let him use my tablet that was given to me by my caregivers' group, and the guidance counselor went in into it, and he's looking in it and he's saying, "I don't understand why you're being marked absent all the time. I don't understand why you say you submit your work and nothing's there." So, long story short, the guidance counselor found that day, which was Monday the 9th, that he is not submitting his work to every class. So I said, "OK, then that's his fault." So I said, "OK, maybe that day, maybe I'll let them do blended, and then have remote a couple of days." However it's scattered out. Now I'm concerned because I hear there's going to be a spike and he's never been sick. I haven't been sick, but I have underlying issues. I have a heart condition and I had stents put in my heart just recently, last month, and they're looking at my aortic valve, and so, but I'm feeling great. I'm in God's hands, and I talk to people. I don't wait for people to call me, I call people if I begin to feel a little bit lonely because I miss a lot of people. I'm blessed. I have good friends, but I'm concerned because of his work, and I don't know that blended would be good at this time because of this spike that you're talking about.

And then other quick thing …Thanksgiving, I wanted to have great-grandson, my grandson, and my son is my backbone. I don't have a lot of family, I don't have a big village, but I wanted to have the four around me for Thanksgiving. We have our mask on and just be together with lots of food, but we'll have our mask and gloves and anything that we need. I wanted to know if that's a good idea.

Bill Walsh: All right. Well, Gloria, thanks so much for the call. And let's ask Dr. Hébert about that. You raised two really important issues, I think, that are on people's minds these days. One is about this remote learning, and it's just not an ideal situation for anyone, and you talked about some of the technical issues. Dr. Hébert, given that Gloria is 85, what do you think about this trade-off between remote education for her great-grandson and sending him into school. And I guess related to that, what about a visit from the family? What, we've talked about this a little bit, but can you give her some advice about precautions she should take if she thinks that's a good idea?

Warren Hébert: Gloria, let's start with the education questions. My wife is a high school teacher, and she is doing the blended version at this point. My son-in-law has a doctorate in education, forgive me for bragging on him, but he's the chief academic officer for the school system here in Lafayette, Louisiana. The challenges that they've both dealt with are significant. It's not easy for the folks who are running the school system to so quickly change their protocols related to learning. But across the country, these school systems have done extraordinary work in making that happen. We have a dozen grandkids, as I mentioned a little bit earlier, and some of our grandchildren are doing fine with the new transition to a more blended system, others not so. So your grandson's not alone. My wife's got some of the high school students who she has were just stellar in the past, but doing the majority of their work online right now, their grades have been lower than they have been in the past.

I think you did the right thing by first checking with the technology, because the truth of the matter is sometimes our technology, as good as it is, may be missing something here or there. So the fact that you checked to make sure that his technology was working was a really good first step. I think with regards to the spike that you're having there in New York, and the fact that he may be going to complete online, sitting and just talking with him, because the reality is our situation may change or it may be something that we're with for a while. We're all optimistic about the vaccines, but it may be with him for a while. So it may just be an opportunity for him to grow in this particular area. To your question related ...

Bill Walsh: Let me actually put a finer point on that. I mean, if there is an opportunity for Gloria's great-grandson to go back to school maybe for a couple of days a week, what should she expect? I mean, what does she have the right to expect from the school system? What questions should she ask to give herself some peace of mind that the boy is going to be in a safe environment and not bring any virus back to her?

Warren Hébert: Excellent, Bill, because we're not only just thinking about the educational perspective of it, but you should be certain that the staff and all those students are wearing masks. The school that my wife's in is getting guidance from the local physician who heads up public health. They're all wearing masks. They're all staying distant. And the ones that are on campus, they're spreading them out. Some of the students are coming in Monday and Wednesday, some are coming on Tuesday and Thursday. That way there are fewer students in the room, and the desks are distanced so that there is much more distance between the students than there would be. And as Dr. Patel said a little bit earlier, hand washing stations are present throughout the school, but wearing masks is not an option, and being sure that they're finding ways to keep distance between the students. Those are some of the things in my wife's school, it's a private school. They actually spent like $100,000 on a special unit for air conditioning that was cleaning the air more frequently than it had been before. So those are some of the facts, some of the mitigation approaches that can be taken.

Bill Walsh: We heard in our own school district, that they're going to be washing down classrooms twice a day, after class, and then when the kids have their lunch, they'll wash them down again so there's that constant disinfecting. I guess every school system's a little different, but I think those are, Gloria, some of the things you can ask about. And Dr. Hébert, obviously she's looking forward to Thanksgiving with her family. We've talked about this a little before, but maybe you can just remind our listeners of if they decide to do something in person, what precautions should they take?

Warren Hébert: Gloria, I'll go back to saying, it really touches my heart. We have a big family and our get-togethers involve a lot of food and a lot of laughter, and on occasion some singing. So when we think about the increased risk, we know that there is an increased risk of somebody spreading the virus when they're laughing together or when they're singing. Or if your family's anything like mine, the conversations are not always at a low volume. So the more exuberant we are in the way we express ourselves, the more of those aspects of the air that we're breathing out are going to impact people. So being aware of these things is just vital. And, again, the three Ws. I think Dr. Patel, we didn't plan on repeating this six times, but I just think it's so very important, is watching the distance. I went to the soccer game for one of my grandsons this past Saturday, and I love my son dearly, but we stayed well apart from one another, well-distanced, and I'm glad we did because he just recently told me he tested positive.

So being outside, if that is at all a possibility for you, Gloria, and I know you're in New York, so the temperatures, the wearing the mask and washing hands frequently. If you're going to eat together, there are steps that you need to take to make sure that people aren't using the same utensils, using the same serving utensils, etc. That's a little more detailed than we can get into on the call, but we can get you some information related to steps that are good, prudent steps to take if you happen to be in a place where people are eating. Actually, the better thing to do would be for everybody to bring their own meal. But it sounds to me like you've got a lot of food and that's not likely to happen because you want to cook for everybody. These are difficult times, because all of these traditions that are just so vital to us as families and are so important; sometimes we have to change those traditions and create new ones to make sure that we're being safe. Because as I said a little bit earlier, we're moving really fast with these vaccines, and this may only be a matter of a few more months. Maybe next year we're back to our traditions as they were. And you certainly want to be around for that.

Bill Walsh: All right. Thank you, Dr. Hébert. Let's go ahead and take some more questions, Jean.

Jean Setzfand: Yeah, we have some questions coming in from Facebook, two that are related. The first one's coming from Millie asking about vaccines. "Have any of the test subjects for the vaccine been people of color and/or over the age of 55? Is that information available now, and will that be available before the vaccine is released to the public?" A related question from Jim on Facebook is asking, "I'm 65 years old, is it recommended that I take the first vaccine approved?"

Bill Walsh: Dr. Patel, do you want to tackle those very good questions about who is part of these clinical trials? People of color, people over the age of 55, and maybe we start there.

Gopi Patel: Absolutely. So if you go to the websites, the individual candidate vaccines, No. 1, they were all asked for these trials to specifically enroll individuals at high risk for COVID-19, acknowledging the disparities that were in place when we started to look at who was getting infected with COVID-19. So, for example, for Pfizer, 45 percent of the individuals enrolled in the clinical trial are above the age of 55. And many, I think it's about 40 percent if not more, are individuals who identified as being of non-white backgrounds. So they did make an effort, and a pretty substantial effort considering the numbers of individuals who are enrolled in these trials, to make sure they enriched it with the populations at the highest risk.

In terms of, should I take the first vaccine that is available? You know, it will be a tiered model of distribution. So some of the first vaccines that are likely to be available are two-dose series vs. a single dose, which is what you're used to for, let's say, the flu vaccine every year. We also don't know at this point, is it going to be a vaccine we need to take every year like the flu vaccine, or is it going to be something that you would take once, and then five years later, like the pneumococcal vaccine? So those things are yet to be answered.

But I am of the belief, and this is my opinion and the opinion of my own, I am of the belief that if something that has been proven to be safe and efficacious might get us to a place where transmission is diminished, and you are offered that vaccine, have a discussion with your provider. Review any information that's set forth ahead of you and have that discussion with whether or not you and your beliefs and your health require you getting that vaccine at that moment. And then what are the next steps. So always be an informed consumer and an informed patient and an informed person to make sure you're making the best decision for you.

Personally, if my parents were offered the vaccine, I would tell them to get it because I also have not seen them in 11 months, and they are older, and I would love for them to see their grandchild, too.

Bill Walsh: Right. Right. So it's going to be a tricky time, right, as people weigh those kinds of personal concerns against, are there any side effects? How effective is any vaccine that emerges on the market? So, I think the admonition to talk to your doctor who knows your health better than anyone is probably a great place to start. Jean, who's our next caller?

Jean Setzfand: Next call is from Judy in New York.

Bill Walsh: Hey Judy, go ahead with your question. 

Jean Setzfand: I think we just lost Judy. I'm so sorry. Let's go to Holly from Kentucky.

Bill Walsh: All right. Holly, welcome to the show.

Holly: Thank you. I have a son who is in college, it's a university, and, they're going to be closing down right before Thanksgiving through the end of January. And so I'm wondering if you have any suggestions on how to help him transition to coming back home and living with us for a couple of months.

Bill Walsh: Good question. I think a lot of people are facing that a challenge. Dr. Hébert, do you have any words of advice for Holly with a son coming home from college?

Warren Hébert: Yeah, our family ties are still very important, and AARP's doing extraordinary work recognizing that that needs to be part of our decision-making process. You know, Holly, having a family member back to live with you, taking certain steps again, to mitigate your risk would be very important. A quarantine period is something that we hear often. So having him, as he's coming back from the university, knowing that he's been in a different setting, probably exposed to a lot more people, a quarantine period would be a good step to take. Obviously, that means that you've got to be quarantining him during perhaps Thanksgiving. I know a lot of universities are deciding to end their year at Thanksgiving breaks now and not come back in December. So if he's coming back at a time when you're getting ready to have a family gathering, that makes it a little more difficult. I know you're in Kentucky, and you guys still, everybody on the phone today are having temperatures that are going to be far lower than mine, but again, if you have the option of visiting outside. For example, we just had a family gathering at a state park, and we spent much of our time outside distanced around the fireplace, excuse me, around the fire. And that was something that family members who are all medical said that distance is important. Being outside is also very important, as well.

So those are steps that I would take, Holly, just to make sure you find a way to try to work in a quarantine period for him before he comes back. And when he does come back following those three Ws again, watching the distance, washing hands frequently and wearing a mask.

Bill Walsh: OK. All right, Jean, who is next on the line?

Jean Setzfand: We have another question coming from YouTube, and this one's coming from Evelyn, and she's asking, "How are therapeutics helping? Do they lower the mortality rate? How available are they?"

Bill Walsh: Dr. Patel, can you talk to us a little bit about therapeutics?

Gopi Patel: Sure. I think one of the issues, and we talked about this earlier, is individuals are coming in earlier. So supportive care that can be provided in the hospitalized setting — oxygen, steroids, etc., — those seem to be decreasing, in this sort of juncture, the mortality rates. Once someone is on a ventilator, it's a little bit more difficult, and then you add sort of the things that come with an individual being in an ICU on a ventilator, and some of, we call it morbidity, but the effects and the side effects of being on a ventilator, etc., and being in the hospital for a long period of time.

So, data is very early in terms of comparing, you know, it's hard to say when the first part of the pandemic was, and are we in the second wave, or is it just sort of still the first wave and we haven't finished the first wave. But it does look like, and this is not just in New York where I am, but across the world, that individuals are faring better because of early oxygen delivery and not intubating patients or putting them on a ventilator right away, and the use of steroids. And we learned a lot more about the fact that there seems to be a lot of clotting with this particular virus, not like any other virus we've ever seen. So many of you may know someone, or yourself, to be on blood thinners, things like Apixaban or Eliquis, and I'm not involved in any of these companies, or Heparin, or other types of blood thinners — that seems to help in the treatment of COVID-19, especially in the sick patient that requires a hospitalization.

So if people are faring better, we are still learning about the long-term side effects of severe COVID-19, and so I think we're going to learn more about that as we get more data and more and more studies are being published, looking at how individuals, especially if they're older, of a certain background, or with other medical conditions, are faring. But people are seeming to do better, and I think a lot of it is because they're presenting a lot earlier in illness, and we're able to diagnose them and start those therapeutics.

Bill Walsh: OK, very good. Thank you, Dr. Patel. And Dr. Patel and Dr. Hébert, we're coming to the close of our time together here. I wonder if you have any closing thoughts or recommendations that AARP members should understand most from our conversation today? Dr. Patel, do you want to start?

Gopi Patel: I'm sorry, I lost you for one second. Can you repeat that?

Bill Walsh: Oh, OK. So yeah, sure. I was just wondering if you have any closing thoughts or recommendations that folks should understand from our conversation here today.

Gopi Patel: I think one, we are in a very interesting space, and I think we have to end with, please care for yourself and think about the protective planning that Dr. Hébert sort of outlined in terms of the holidays. I know it's hard, but it's important to keep us all safe. Wearing the mask, socially distancing and watching your distance, and being very thoughtful about protective planning as we get closer to these times where some of you may elect to see family that you haven't seen in a long time. There is some promising news with vaccines, so we'll all keep our fingers and our toes crossed, and just keep working with your health care providers and paying attention to what's coming out from your states and public health authorities about next steps in terms of indoors and outdoors and the rest.

Bill Walsh: Very good, some glimmers of light on the horizon. Dr. Hébert, any closing thoughts?

Warren Hébert: Well, I want to acknowledge Dr. Patel's suggesting about crossing our toes, too. I'm working on that right now, but thank you for that bit of humor. Our well-being is so very important, and most of our conversation today has been about our physiologic well-being. But I would add that we talked a lot about our emotional well-being, and I think that that's a critical piece of this conversation, Bill, because if we are burned out, if we're exhausted, if we're fearful, then our judgment is impaired. So our emotional well-being is vital.

So a couple of steps that I think are important for everyone is, first, decrease, the amount of time that you're spending with the television and with technology. Just like any other medications or things that we take, you can overdose. So even though keeping up with what's going on and the changes are very good, making sure you're limiting time in front of the television and with your technology. The second thing is to know that guidelines are changing. As Dr. Patel indicated earlier, we're learning so rapidly about this novel new virus. We're learning about how to better mitigate the likelihood of spread. We're also learning a lot about treatment. So be aware that the guidelines may change. If you accept that they're going to change because we're getting smarter about how to handle it, then there'll be less anxiety with that.

Another thing that I mentioned a little bit earlier is be choosy about who you're going to connect with? Because we need to be connecting with family, we need to be connecting with friends, but we know that some people that we connect with are going to bring additional anxiety and drama, and you can actually choose not only who are you going to connect with, but how much you're going to connect with them. And I don't mean to sound mean in any way, but we're talking about your well-being.

And last thing is to acknowledge family caregivers. You know, we have 54 million family caregivers across the country, 1 in 5 people in the United States are family caregivers. So the likelihood is if you're listening right now, you know someone who's a family caregiver. Take the time to thank them and acknowledge them as we get close to Thanksgiving. Thank you, Bill.

Bill Walsh: Well, thank you, and thanks to both of you for answering our questions today. It's been a really informative discussion. And thank you, our AARP members, volunteers and listeners for participating in the discussion. AARP, a nonprofit, nonpartisan member organization has been working to promote the health and well-being of older Americans for more than 60 years. In 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, prevent its spread to others while taking care of themselves. All of the resources referenced today, including a recording of the Q&A event can be found at aarp.org/coronavirus beginning tomorrow, Nov. 13. Again, that web address is aarp.org/coronavirus. Go there if your question was not addressed and you will find the latest updates, as well as information created specifically for older adults and family caregivers. We hope you learned something that can help you and your loved ones stay healthy, especially during this holiday season. Please be sure to tune in next Thursday, Nov. 19, at 1:00 p.m. ET for another coronavirus discussion focused on vaccines and staying safe during the holidays. Thank you all and have a good day. This concludes our call.

Tele-Town Hall 1 PM Coping and Maintaining Your Well-Being 

Bill Walsh:  Hello. I am a AARP Vice President, Bill Walsh, and I want to welcome you to this important discussion about the coronavirus. AARP, a nonprofit, nonpartisan member organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them. With the pandemic entering its eighth month, COVID-19 cases, hospitalizations and deaths from the disease are once again on the upswing, and there seems to be no relief in sight as the holiday season approaches. As we look to the end of this extremely trying year, Americans around the country are considering how, or if, they will celebrate with family and friends when the most prudent course continues to be keeping a safe distance. Today we'll talk with exerts who will answer some of your questions about staying safe and how to care for yourself and loved ones. 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 questions live. For those of you joining on the phone, if you'd like to ask a question about the coronavirus pandemic, press *3 on your telephone keypad to be connected with an AARP staff member. We'll note your name and question and place you in the queue to ask that question live. If you're joining on Facebook or YouTube, you can post your question in the comments section.

[00:02:01] Joining us today are Gopi Patel, M.D., associate professor of infectious diseases in the Department of Medicine at Mount Sinai Hospital in New York. And Warren Hébert, doctor of nursing practice and nursing professor at Loyola University of New Orleans, and the CEO of the Home Care Association of Louisiana. We will also be joined by my AARP colleague, Jean Setzfand, who will help facilitate your calls today.

[00:02:29] This event is being recorded, and you can access the recording at aarp.org/coronavirus 24 hours after we wrap up.

[00:02:55] Now I'd like to welcome our first guest, Gopi Patel, M.D. is an associate professor of infectious diseases in the Department of Medicine at Mount Sinai Hospital. She specializes in the treatment of infections in immune-compromised patients. Welcome, Dr. Patel.

[00:03:13]Gopi Patel:  Thank you for having me.

[00:03:15]Bill Walsh:  All right. Great to have you here in the show. And Warren P. Hébert Jr. is an assistant professor at Loyola University in New Orleans. He has more than 40 years of nursing experience, is an outspoken leader in home health care and health policy at the federal and state levels. Welcome back to the show, Dr. Hébert.

[00:03:34] Warren Hébert: Thank you, Bill. It's good to be back with you.

[00:03:37] All right. Good to have you. Let's get started with the discussion. Dr. Patel, let's start with you. Eight months into the pandemic we are setting single day records for positive COVID cases. What does this mean for the holidays and the winter?

[00:04:03]Gopi Patel:  So it's unfortunate that we're in the predicament that we're in right now, and one of the things that I think all of us are thinking about is seeing our families or getting together for the holidays. It's been a long 11 months for many of us. Unfortunately, the winter brings us going back indoors. We took a lot of solace in being able to social distance outdoors, but once we start going indoors, it's a little bit more difficult to social distance and, obviously, deal with some of the circulation in that environment.

[00:04:36]Bill Walsh:  And of course, flu season, with winter comes flu season, right?

[00:04:41]Gopi Patel:  Absolutely. So we do recommend that everybody does get their flu vaccine, one, because it's still the best way to defend against the flu, but also a way to not overwhelm clinics, hospitals, emergency departments with flu on top of COVID-19.

[00:04:57]Bill Walsh:  All right. Let me follow up on that. Despite the discouraging news about the pace of the pandemic, it appears there are substantial advances in treatment. What are the most noteworthy advances to help people survive COVID-19?

[00:05:14]Gopi Patel:  Oh, we know so much more than we did at the beginning of this pandemic. Also, I think early on we couldn't test. The tests were slow to roll out, and now testing is a key factor; testing and tracing, making sure people know that they've been exposed and to not minimize symptoms and get tested early, especially if you've had a known exposure or potential exposure. We do ask patients to come in sooner rather than later. I think a lot of individuals were concerned about coming to emergency rooms or to medical care, and we do encourage that individuals come in when they're becoming short of breath, when they have that cough and can't catch their breath. Steroids have been pivotal. We've learned so much from trials coming out of Europe and throughout the United States about the importance of steroids if someone does require oxygen. We're learning more about antivirals, so Remdesivir, that when it works, and experts in the field meet frequently to talk about updating guidance and offering that guidance to health care workers across the country to be able to treat patients in the various stages of COVID-19.

[00:06:25] The other thing is we know about the nonpharmaceutical interventions, right, the washing of the hands, the wearing of the mask and the social distancing. And that really helps sort of prevent the transmission if we continue to follow it closely.

[00:06:41]Bill Walsh:  It seems so simple, but really continues to be very effective, doesn't it?

[00:06:45]Gopi Patel:  Absolutely. And we do understand that people are getting very fatigued by all of this.

[00:06:52]Bill Walsh:  Right. All right. Well, thank you for that. Let's turn to you, Dr. Hébert. As we've discussed, we're eight months into this pandemic and many family caregivers, already stretched before the pandemic, are juggling childcare, work, caring for older loved ones, what advice do you have for people who are struggling with this balance?

[00:07:15] Warren Hébert: Bill, the role of the family caregiver is challenging even in the best of times. Isolation, and I would add the word “physical” to that. Our friends with the World Health Organization have changed their language; instead of using “social distancing,” they're now using “physical distancing.” So the challenge that we have as caregivers in the midst of this to try to get some balance, is to find other ways to connect socially, ways that are not in one another's physical presence. Some things that we've done with our grandkids and with friends, and I would add friends from around the world, and that is to use the virtual connections if those are available to you, and if the place that you live has broadband, that can certainly make a difference. One of my favorite acronyms when it comes to care at home is PLTS, and that stands for the “plain old telephone system.” So making phone calls more frequently can really help with a person's resilience and their balancing. There are people who are in my life that I am able to connect with on a daily basis that really helped me to recalibrate. They're people who are genuine and authentic, and I don't have to worry about them bringing extra drama to me.

[00:08:39] So when it comes to our better balancing, I think that making choices as to who you're going to be connecting with, because we know that certain people that we connect with are going to have more stress, more turmoil in the connection, so the opportunity to connect with people who are going to help you to be more whole is a conscious choice that you can make.

[00:09:03] And the other thing is to ask for help. You know, within my own family, we've had a few people who have tested positive, and a son who's dealing with it right now. And I was on the phone with my daughter-in-law right before starting the call with y'all, Bill. And they've got three sons ages, eight, six and four. So she's got her hands full. So reaching out to others to offer help, but also being willing to accept help, I think is just vital during these challenges that we're having.

[00:09:34] Right. Some great advice there. What do you think are the best ways to substitute for the special moments over the holidays if we're not able to be in person?

[00:09:44] Warren Hébert: So this is an opportunity for us to maybe go retro. Handwritten cards is something that seems overly simple, but for the most part, people have gotten away from that. I think that that's a really good way to do it. One of the things that we did early in the experience with COVID is to be leaving little packages. We have the good fortune that 9 of our 12 grandchildren live within 10 minutes of us. So even though we weren't visiting with them personally, my wife, who is the ultimate grandmother, you'd love to have her as a grandmother, she put together little gift packages and dropped them off at the door for the children. Doing that from a holiday perspective is another thing that you could do.

[00:10:31] The other thing, Bill, that I'd suggest for everybody is to be focused on aspects of gratitude. Last Christmas, our family all got together, before COVID-19, and we exchanged gifts, and while we thought we were finished, our 29-year-old daughter is our youngest of five children, and she has Down Syndrome. So she stands up and she says, "I have something I want to say." So I said, "OK." Well she knew that it was my wife and I's 40th anniversary the following week, and she said, "I want to thank mom and dad." And she said a few nice things about us. And then she pointed to her oldest brother and she said, "Now it's your turn." And they went around the family. So as we talk about not being in person, finding ways to do something similar, whether you can do that virtually or even put together a group phone call, some of those things to recognize family members who have done some things that help to bring the rest of the family, joy and celebrating that. Those are some of the things that I think that focus on gratitude can really make a difference.

[00:11:38] Oh, some wonderful advice. Thank you for that Dr. Hébert. I want to update [our listeners] on AARP's continuing fight for residents and staff in nursing homes and other long-term care facilities. Since the start of the pandemic, more than 84,000 nursing home residents and staff have died from COVID-19. It's a tragedy. And with recent spikes in cases nationwide and colder weather approaching, experts are sounding the alarm on the dire situation in these facilities. Action is needed now to prevent even more COVID-19 deaths in these facilities. And AARP is continuing to fight at all levels of government. We're calling on federal and state leaders to pass legislation that includes a five-point plan.

[00:12:36] First, facilities must provide regular ongoing testing and adequate personal protective equipment for residents and staff. Second, we need transparency and accountability with daily public reporting of cases and deaths in facilities and better communication with families. Third, family members need the ability to visit virtually with their loved ones in nursing homes, even as nursing homes allow in-person visits. Fourth, residents need better care. That means adequate staffing and access to in-person advocates known as long-term care ombudsman. And finally, nursing homes and long-term care facilities that harm residents should be held accountable. They should not be given blanket immunity.

[00:13:23] Thousands of AARP members, volunteers and activists have made their voices heard on this issue. For more, make your voice heard. Please visit aarp.org/nursinghomes. That's aarp.org/nursing homes. We hope that you connect now to help save lives and help stop this national tragedy.

[00:13:51] Now it's time to get to some of [your] questions about the coronavirus with Dr. Patel and Dr. Hébert.

[00:14:07] Now I'd like to welcome my AARP colleague, Jean Setzfand, who will help facilitate your calls today. Welcome Jean.

[00:14:15]Jean Setzfand:  Thanks, Bill. Delighted to be here.

[00:14:17]Bill Walsh:  OK. Who is our first caller?

[00:14:21]Jean Setzfand:  Our first caller is David from Michigan.

[00:14:24]Bill Walsh:  Hey, David, welcome to the show. Go ahead with your question.

[00:14:28]David:  My question is, I was tested back in May, which is six months ago, and luckily, it was a negative. And it's been six months, so I was just wondering how often, I have no symptoms that I know of. Should I get tested again or what, or not? Or just wait and see?

[00:14:49]Bill Walsh:  All right. Thank you, David. Dr. Patel, do you want to talk about kind of what are the signs people should be looking for that might trigger the need for a test?

[00:14:58]Gopi Patel:  Sure. If you know or have been told that you were in contact with someone who had COVID-19 or has been diagnosed with COVID-19, that obviously should prompt you to go get tested. In terms of symptoms, we've learned a lot about the symptoms of COVID-19, everything from a sore throat, muscle aches, the unique loss of taste and smell. So if there are symptoms that you normally would say, ‘Oh, this is just a cold, or this is kind of like the flu,’ we don't want you to minimize those symptoms. That should also prompt testing. In certain health care settings or certain work settings, especially if the rates in where you live are going up, there may be some guidance from your public health authorities for more frequent testing because of the risks of exposure. So you sort of hinted about nursing homes and skilled nursing facilities. Those health care workers and those residents are likely at higher risk and are tested more frequently based on recommendations from public health authorities. It's obviously regional. If you work, or provide care to someone, there may be a reason to go get tested more frequently if you don't have symptoms. But I would offer you to look at what your public health authorities in Michigan are stating in terms of their testing algorithms. We do want to make sure testing is still limited — it's widespread, but limited in many areas, especially if they're seeing an increase in the number of cases, they're trying to direct the testing toward curbing transmission.

[00:16:37]Bill Walsh:  OK, thank you for that, Dr. Patel. Jean, who is our next caller?

[00:16:41]Jean Setzfand:  Our next caller is Juanita from Maryland.

[00:16:45]Bill Walsh:  Hey, Juanita, welcome to the show. Go ahead with your question.

[00:16:49]Juanita:  OK. My question is, my granddaughter is in Winston-Salem in college, and her mom wants me to ride down with her to pick her up. And I want to know, is that OK to do, because I'm going to another state.

[00:17:05]Bill Walsh:  Dr. Patel, do you want to weigh in on that? Should Juanita go pick her granddaughter up at college? And if so, what precautions should she take?

[00:17:15]Gopi Patel:  So I think, this is an interesting question. A lot of what we recommend in terms of public health or from infectious diseases physicians, is making sure everything is done in a safe manner. Being in a car with some that you already spend time with is very safe. You know, sometimes if you're in a car and you don't spend a lot of time with that individual, that's not someone that you live with, not a household member, we ask that you mask and roll down the windows. If the travel is not absolutely necessary, and this is really important as we come upon the holidays, you really need to know what other people are doing. What are those individuals that you are going to be spending time with together in close contact within a confined space, what have they been doing? Have they been monitoring themselves? Have they been tested? Do they have symptoms? Have they been following those three Ws that people talk about: wearing a mask, watching their distance and washing their hands? And I think this is something that we’ll be speaking a lot more about as the holidays approach. I think that's a family conversation that you need to have, Juanita. And if it's absolutely not necessary, traveling in a confined space wouldn't be recommended, but also knowing what your granddaughter has been doing. Many colleges, and I don't know the details of that specific college, many colleges are testing and testing frequently because, again, it's an effort to curb transmission amongst young college students. So that would be a family conversation, but if you don't feel safe, my recommendation would be you pass on this trip.

[00:19:00]Bill Walsh:  OK. All right, Jean, who is our next caller?

[00:19:04]Jean Setzfand:  Our next caller is Marge from Massachusetts.

[00:19:08]Bill Walsh:  Hey Marge, go ahead with your question.

[00:19:11]Marge:  I was just wondering if you have any recommendations for an almost 80-year-old woman who lives alone and is getting very lonely. You know, I'm usually out swimming and volunteering and things like that in Massachusetts, and everything's been canceled.

[00:19:30]Bill Walsh:  Sure. Sure. Do you go out at all, Marge?

[00:19:33]Marge:  Oh, I go and get the mail, and I live in an elderly neighborhood, so I'm not too crazy about seeing too many people because they're more prone to this virus than other people. And I do go out and get groceries, you know, and stuff like that. But the days are awful long. And I've [inaudible], I've cleaned, you know, it's like, OK, what's next? Take a nap?

[00:19:59]Bill Walsh:  Right. So let's ask Dr. Hébert about that, if he has any suggestions for you. Dr. Hébert, what can you say to Marge?

[00:20:08] Warren Hébert: Marge, you're not alone. The challenges that we have around loneliness were well documented before COVID-19 and our pandemic experience. So what you're experiencing now is something that a lot of people have had challenges with before. Loneliness is something that has a lot of difficult health effects. So it's wonderful that you're recognizing that you're seeing some changes in yourself. Some things that you could do to help with that is to consider the possibility of visiting with someone across the yard. You know, you've got a nice distance between you. We actually started, about three months in when our numbers went down, our grandkids would come into the backyard, and we would visit with them through the fence. Another thing for you to do is more phone connections. The calls, as I indicated a little bit earlier, with someone that you know, helps you to feel better, someone who's authentic and genuine, who doesn't bring a lot of drama. But if you can have phone calls with people who help you to settle and to help with your mood, that's a really good thing to do, too.

[00:21:28] And some other things that you would do to help with your mood is seeing what exercises you might be able to do in the house. My daughter, who I mentioned earlier who has Down Syndrome, was part of a fitness group. And within a matter of a few weeks, they changed their in-person exercise gathering to something that they're doing virtually. So if you have access to the internet, and you have a device that allows you to do that, Marge, that's another good thing to do is to see other people's faces. And then some good things to do in general are occasionally reading a good book, perhaps watching a comedy. The science makes it very clear that the more we laugh, there are a lot of good, positive physiologic effects to that. Thanks for asking, Marge. A lot of people are having that challenge right now.

[00:22:17] They sure are. Thanks for those words of advice, Dr. Hébert. One other thing that AARP offers Marge or others who are on the line who might be feeling isolated or know somebody who is, is that last year we created something called the AARP Friendly Voices Program. Basically trained hundreds of our staffers simply to reach out to people and chat with them. It's free, and you can access it on a toll-free line. Let me give you that number. It's [888] 281-0145. That's the AARP Friendly Voices Program at [888] 281-0145. And again, that's a free service. If you want to have one of our volunteers reach out to a loved one or a neighbor or someone you know is struggling during this time and just wants to hear a friendly voice. OK Jean, who is next up in the queue?

[00:23:18]Jean Setzfand:  We have several questions coming in from YouTube. And this one's coming from Jean on YouTube. And she's asking, "How is the U.S. planning on dispensing the vaccine?"

[00:23:29]Bill Walsh:  Dispensing the vaccine. That's a timely question. Dr. Patel, do you have any insight into that?

[00:23:37]Gopi Patel:  Sure, there's some preliminary information that if a vaccine were to become available, how the United States would be dispensing the vaccine is very similar to how they have been dispensing other medications that have come to emergency use. They do want transparent, equitable distribution, and many of the vaccine trials have included individuals who are older and obviously from the backgrounds that were hit so hard with COVID-19 during the pandemic. So a very diverse group of individuals. They don't think they'll be able to meet the demand at first in terms of vaccinating all Americans, so it will be a tiered vaccine distribution starting with, as you mentioned before, long-term care facilities and skilled nursing facilities, as well as frontline health care workers, with the next tier of being other essential workers and those with medical conditions that put them at very high risk for COVID-19. So there is a plan that's coming together across the country, as well as state and local public health authorities, that if a vaccine were to get allocated under an emergency use authorization and then subsequently licensed the vaccine through the FDA, that they would be able to distribute it across the country to meet the needs, to help be one of the things that prevents transmission, and end the pandemic.

[00:25:12]Bill Walsh:  Yeah, and I think Dr. Patel, the operative words there were, the plan is coming together. A lot of this stuff really needs to be figured out, I think. Do you know a timetable for when some of those decisions might be made?

[00:25:27]Gopi Patel:  I think there's a lot of individuals, and you can actually, if you do have access to the internet, you can actually watch the ACIP sort of discuss vaccines and vaccine safety. It is thought based on the current trajectory that vaccine, a small allotment will be available toward the end of this year, which is unheard of for vaccine development. Toward the end of this year for that first year, which will be offered to those long-term care facilities and the health care workers, but a larger distribution will be available in 2021, probably toward the spring. So I think some of it has to do with the evaluation of the safety and efficacy of these vaccines. So independent data, safety monitoring boards evaluate this, then the FDA Advisory Committee on Vaccines, which are all private citizens, evaluate the data. And then they make a recommendation to issue an emergency use authorization that then will go to the CDC Advisory Panel about recommendations of who that initial allotment would go to. So a lot of steps, but a lot of exciting news about vaccines and the potential efficacy. And people are looking very closely at the safety data to make sure that it is an efficacious and safe vaccine. So hopefully, by the end of the year, and in terms of vaccine science, it's pretty amazing how fast this is coming.

[00:27:06]Bill Walsh:  It sure is. And we'll talk more about the vaccine development process a little bit later. Jean, do we have another question in the queue?

[00:27:15]Jean Setzfand:  Yes, we do. This is Harriet from New York.

[00:27:18]Bill Walsh:  Hey, Harriet. Hey, how are you? Go ahead with your question.

[00:27:21]Harriet:  I'm fine, thank you. My question to you is I have two great grandchildren, six and nine, and they have a mother and a father, that's my grandchildren, and they want to come to our house to bring dinner for Thanksgiving. My 9-year-old is a special needs child, who desperately wants to come, because we have seen them on the outside, never within the house. They both are in school. My grandson is a police officer. My granddaughter runs a gym for special needs children, which has been very poorly attended these days, but they do have people. And I do want to tell you that I'm 90 and my husband's 98, and we'd love them to come. So what do you think? They want to come so desperately.

[00:28:14]Bill Walsh:  Yeah, and I bet you want to have them come and visit.

[00:28:15]Harriet:  I sure do. I sure do.

[00:28:15]Bill Walsh:  All right, Harriet, thank you. Let's ask Dr. Hébert about that. What do you think of Harriet's situation, and if you think the great grandkids should visit, what precautions do you think Harriet and her family should take?

[00:28:34] Warren Hébert: Oh, Harriet, I heard a little catch in your voice, and I love you. It's one of the most difficult experiences we've had with the pandemic is not engaging our grandchildren. So we started, as you suggested, you know, visiting with them through the window and outside, and that really is something that was such a gift for us even to be able to do that. But the fact that you're dealing with a special needs’ grandchild, certainly connects at the heart in an even greater way.

[00:29:08] So with regards to mitigating risks, what we did with our grandchildren was we made sure to visit outside. So Harriet, I'm not sure what part of the country you live in, or what the weather's going to be like, but as Dr. Patel said a little bit earlier, anytime you're able to visit outside, you significantly mitigate the risk. The other things that you and your family will need to discuss is, is there an opportunity for you to be well-distanced even when you're outside. If you're going to be inside, as Dr. Patel indicated a little bit earlier, your risk increases significantly. Even if you're wearing masks it still increases significantly.

[00:29:52] So, as Dr. Patel suggested a few minutes ago, it is almost miraculous that we're seeing a vaccine that's been developed so very quickly. You know, the things I had heard in the past, the record was four years, and we're talking just a few months here. So while you want to be together, I would suggest that it seems that with vaccines coming forward so quickly, we may be in a very, very different situation in just a few months. Obviously, there are a number of other challenges, it's not only developing the vaccine, but convincing people to take it. We also need to do a better job at convincing people of those three Ws, thank you Dr. Patel — making sure we're wearing masks, watching our distance and washing hands, because there are things we can do to significantly lower the spread of the COVID-19, even without the vaccine.

[00:30:51] So I really feel with you, your desire to want to be close, but know that there are going to be some risks that you'll be taking, and it might just be a matter of being a little more patient for a few more months, not being overly optimistic in my language, but just be aware that your health and well-being is vitally important and finding other ways to be close might be the best thing for you to do for this holiday season.

[00:31:21] Thank you, Dr. Hébert. I mean, Harriet is from New York, so outdoor visits toward the end of November might be a little chilly. I guess it could depend on the weather, but your point is well taken that outside is better than inside. A number of our callers have been wondering about the idea of getting a test before they go visit or having the folks that they're visiting get tested. Do either of you, Dr. Patel or Dr. Hébert think that that is a best practice people should be thinking about?

[00:31:54]Gopi Patel:  So I think testing is very important to tell you where you're at that moment in time, but it's really what were you doing prior to the visit that's also equally important, right? So if I was exposed, and my test is negative two days after that exposure, that might be a little bit early before the test becomes positive. And so, you know, this is the perfect time if you are bringing family together and, again, outdoors is best, but really making sure everybody's doing those three things that we keep talking about: the wearing of the mask, the watching the distance, and washing their hands. That protective planning is equally important to the test. So can you make sure that those potential exposure events are not occurring, so then it makes it a much more safe interaction. So you sort of know the behaviors that people were having before they come, and then that test is much more meaningful. I'm finding many individuals use the test as sort of a ticket to ride, ‘Oh, I have a negative test, now I can go to this gathering,’ but then forgetting all of those other things that they need to do to continue to protect each other.

[00:33:12]Bill Walsh:  Good point. All right, well, thank you both for that. Jean, who is our next caller?

[00:33:20]Jean Setzfand:  Dr. Patel, just addressed this question, but there were a couple of questions on YouTube basically asking somewhat of the same theme. Ernie, for example, is asking, "After being exposed, how long does it take to start experiencing symptoms?" And then, similarly, Michelle's asking, "How soon after being exposed to COVID should you wait to get tested to avoid false negative test results?"

[00:33:48]Bill Walsh:  Dr. Patel, can you address those questions?

[00:33:50]Gopi Patel:  Sure it's really unknown. Sort of the rule of thumb that we've been using here in the health care setting is about five to seven days is probably the best time to get tested if you're not having symptoms. If you know about an exposure, so you've been told you've been exposed, and you desire to know if you convert to positive. I think what's very interesting about COVID-19 is that many individuals are asymptomatic and clearly transmitting. So I think a lot of people don't have symptoms or minimize symptoms. And so we say about five to seven days is probably the best time to get a test from the exposure.

[00:34:30] In terms of symptoms, often, if your symptoms are not abating, and you don't have an alternative reason, and you have a negative test, we would recommend getting tested again. Sort of "if it looks like a duck, smells like a duck, quacks like a duck, it's probably a duck" mentality. I usually say one to two days after symptom onset. Obviously if your pre-test probability, you know you had an exposure, you were told you had an exposure, other people at the event or whatever it was have tested positive, that comes into account. Many different tests are out there because they were all released also under an emergency authorization. It's unclear what some people may know what's called the sensitivity of a test, so all of this should be taken into account. So around day two of symptom onset is a good time to take a test to get a diagnosis. And then if you had an exposure around day five from the exposure, seems to be a good time to take the test.

[00:35:40]Bill Walsh:  Now after you've been exposed, and you've known you've had that exposure, should you be quarantining yourself even though you may wait five days to get tested?

[00:35:48]Gopi Patel:  Absolutely. So that's some of what we've noted as well. Often it depends on where you are and what you have access to. Sometimes the tests don't come back right away. So not only should you be quarantining yourself after the exposure, but also quarantine yourself as you're waiting for the test results. The guidance pretty much is standard — if you have been exposed, it can be up to 14 days before you develop symptoms or have a positive test, more likely at day five or seven, but every person's immune system and response is very different. So we know what we know now, but that quarantine period for 14 days after the exposure still stands.

[00:36:39] Any public health authority, the guidance, of course, is changing with travel advisory's changing, so pay attention to that as well. Every jurisdiction or state has different guidance in place.

[00:36:52]Bill Walsh:  Right. OK. Thank you very much for that. Jean, who is our next caller?

[00:36:58]Jean Setzfand:  Our next caller is Aleva from South Carolina.

[00:37:02]Bill Walsh:  Hi Aleva, go ahead with your question.

[00:37:05]Aleva:  Yes. My husband is in a nursing facility and he was diagnosed with COVID. What is his chance of taking it again, and what dangers is it for me to go visit him in the [inaudible].

[00:37:23]Bill Walsh:  I'm sorry to hear that. Did you say, what are the chances of him contracting it again?

[00:37:28]Aleva:  Yes.

[00:37:30]Bill Walsh:  OK, so he's recovered from his first bout of COVID it sounds like, and you're wondering about ... yeah. And does the nursing home allow visitation at this point?

[00:37:41]Aleva:  No, they don't allow visitation, but they allow me to come in at one time to see him. But the question I was asking, what is my chance of being exposed? Even though I have mask and stuff on.

[00:37:54]Bill Walsh:  Yeah, you had personal protective equipment. OK. Dr. Patel, do you want to take a stab at that question?

[00:38:07]Gopi Patel:  Sure. So the reinfection rate is exquisitely low. There's definitely been reports from the United States, as well as other countries, of individuals who had a diagnosis of COVID-19, who had either symptomatic or asymptomatic, meaning they felt sick or they didn't feel sick, and were diagnosed with COVID-19 again. It is very rare considering how many diagnoses of COVID-19 have been made worldwide. In terms of visiting your loved one, again, every nursing facility in every state has different rules about what is requested of nursing facilities and nursing homes in terms of testing of staff and routine testing of patients. I do think if there is a concern, these facilities are taking this very seriously and obviously limiting visitation, and making sure that both the resident, the employee, as well as the visitor is masked and distanced. It's incredibly difficult, and in terms of you feeling uncomfortable visiting, I would assume not just from your husband potentially having COVID-19, but also the staff and the other patients, that every facility is taking this very seriously and have recommendations and guidelines that they're required to follow in terms of making sure the employees are not working sick and wearing masks and have access to that personal protective equipment, that the patients are either being tested or being asked to wear personal protective equipment like masks, and that the visitors themselves are also being screened for symptoms or travel or exposures, and being masked as well. You can always distance yourself from your loved one. I know it's really hard, but sit six feet away and keep the visit short.

[00:40:12] A lot of places have video visits available. I know technology can be difficult at times, but sometimes they can set up an iPad or some sort of video visits where you're able to have that quality time and converse with your loved one in that setting. And, of course, that minimizes your risk and their risk as well.

[00:40:32]Bill Walsh:  Thanks for that. Dr. Hébert, I mean I wonder if you have any insights on what questions Aleva should ask the facility or precautions she should take as she thinks about visiting her husband.

[00:40:43] Warren Hébert: So, Aleva, thank you. Being separated from the people that we love has been one of the most difficult experiences throughout this. And Aleva, one of the things that you want to be aware of is how you're doing too. Not just from a standpoint of your physical well-being, but how you're doing emotionally, because it really takes its toll being separated, even though he was in the nursing home already, you're inability to visit.

[00:41:12] The things that I think would be prudent to do is to your best find out what precautions are being taken in the nursing home. While nursing homes across the United States are supposed to follow similar protocols and have similar regulations and guidelines, the truth of the matter is there's very broad variation. Some states have much better performance with regards to this, others not so good. So learn a little bit about your state, but also go to the web, and if you can access the internet, that's great, if not someone else in your family can help you to see what the rates have been in that nursing home. And it will give you a clearer picture of what sort of protocols they're following and the success that they're having. Congregant living settings are not safe places for people to be today, and they're also not safe for the people that are in those settings.

[00:42:15] However, there are exceptions. We talked about these virtual gatherings. There was a virtual gathering of a dear friend of a lot of us who's 90 years old, and she happens to be in a nursing home, and we all gathered with her virtually. And since March, nobody in that nursing home has had COVID-19. And this is a well-educated woman, and she knows how to get the right answers. But the point is gathering information related to that nursing home, recognize that you're going to be going in, if you do that, you're going to be putting yourself at risk, and finding other ways to try to connect. Those are the suggestions I would make. Thank you, Aleva, That's an important question.

[00:42:59] OK, and thank you for all the questions. We’re going to get to more of them in a moment. Let me turn back to our experts for a moment here. Dr. Patel, we were just talking a little bit about vaccines, and there's been news recently, some promising news about vaccine development. But on the whole, can you talk a little bit about where we are in terms of the clinical trials and the whole development process. In particular, what consumers can expect in terms of safety and efficacy of anything that emerges onto the market.

[00:43:40]Gopi Patel:  Sure. So there are four vaccine candidates in advanced clinical trials here in the United States. Two of them are fairly advanced, and one of them is the Pfizer vaccine, which made a lot of waves this week in terms of some early promising data that has come out from their clinical trials. These are large clinical trials that started in terms of the phase three or the trials where they actually give some individuals vaccine, and some individuals saltwater, or what we call placebo. Those started in July. And to date, many of these trials have enrolled 30,000 to 43,000, I think is the number for Pfizer, individuals. And over 50 percent of the individuals that have been enrolled in the Pfizer trial have completed both vaccine doses. So these are two-dose vaccine series.

[00:44:46] And what they're looking at in terms of efficacy is how many individuals in each group, the group that got the vaccine and the group that didn't get the vaccine but got the placebo or the saltwater, actually developed COVID-19. And this early data is very, very promising. It is early data. The other thing that they're looking at is the safety profile. Did anybody have any side effects that would be considered unusual. You know, side effects like soreness of the arm and pain in the area of the injection, that's not considered unusual with any type of vaccine, but is there something else that's unusual? So that's what we're waiting for in terms of Pfizer going and asking the FDA for an emergency use authorization. This is very different than having the FDA approve a vaccine. That will take much more time.

[00:45:49] But as I said earlier, the people who are looking at vaccines, and they're being very transparent about what they're looking at, are really private citizens looking at all of those datas, that does include scientists, infectious diseases experts, other individuals that are not those companies, looking at the data, making sure that they have met these metrics of safety and efficacy and then forwarding that on to an immunization advisory committee to take a look. That ACIP peer immunization advisory committee is also private citizens. So this should not be considered anything that's being politicized. It really is something that the process that's being put in place is really to make sure that there's a safe and efficacious vaccine that is offered to the public.

[00:46:46]Bill Walsh:  Dr. Patel, following up on that point, and you've referenced it a couple of times here today, this is an expedited development and review process. Reviews by the FDA of drugs often take years to carry out, and this one is being done much quicker through this emergency use authorization. How much confidence should consumers have in the safety of that expedited emergency use process?

[00:47:18]Gopi Patel:  I think it should be reassuring that no one is taking vaccine safety and efficacy lightly. This is to get something out to the public sooner than normal, but also part of doing it this way was to remove some of the risks that pharmaceutical companies take in vaccine development. So all of this happening very rapidly, but some of it is taking out some of the risks that pharmaceutical companies put in place. It could take years to make vaccines. So one of the things that, I think people refer to it as Operation Warp Speed put into place, is removing some of the financial risks and some of the delays that come from manufacturing and distribution of vaccines. And as they are being looked at, they're being manufactured, and a distribution plan, as we talked about, is being looked at.

[00:48:27] I think the goal of the FDA, the CDC and all of the public health authorities that are hopeful about vaccines, is to make sure that this is safe and efficacious, because this is one of the most promising developments we have in terms of curbing this pandemic. So I think I would take a lot more stock into the FDA Vaccine Advisory Committee and the ACIP, and what recommendations they're going to make. Everyone is being very careful and cautious here, but we are being a little more optimistic than we've been in the past couple of weeks with this exciting news that has come out about efficacy.

[00:49:13]Bill Walsh:  Yeah, OK. Thank you for that, Dr. Patel. And just to follow up, we were talking to Aleva from North Carolina just a moment ago, and she was wondering about the conditions inside the nursing facility where her husband resides. I just want to give you a resource to check out. On AARP’s website, we've created a tool that is tracking coronavirus cases, the numbers and rates in nursing facilities around the country. You could check that out if you have access to the internet at aarp.org/nursing homes, aarp.org/nursing homes. You can also find out a lot more there about our work on the nursing home front, questions to ask the nursing home or long-term care providers, so some terrific resources there.

[00:50:10] Dr. Hébert, I want to swing back to you. As cases rise across the country, are there precautions or extra steps that people need to take if they have someone coming into their home to help with caregiving needs?

[00:50:25] Warren Hébert: Yes. And this is an important question, and I'm going to divide that into two if I may, Bill. The first is formal caregivers. The formal caregiver is someone who might be with hospice, the home health organization or in the case of my daughter, she receives nonmedical care through direct support professionals. Those organizations all have protocols that they're obligated to follow. And those protocols for the formal organizations include regular testing, it includes regular surveys related to whether those staff members have been exposed or not and it includes temperature checks, and that sort of thing. So essentially, those folks who are from the formal caregiver setting are doing these things that are part of the protocol and the things that they have to be doing.

[00:51:25] It is vital that the family caregivers, perhaps someone is offering you respite, you as a family caregiver have been providing someone's needs, and somebody who regularly comes in to give you a break is doing that. I've got a friend that traveled from Massachusetts to Indiana just a couple of days ago, and we talked about the fact that she needs to be quarantined before she goes to provide care. She needs to be certain that no one in her family unit that she's living with, as Dr. Patel indicated a little bit earlier, someone that you're living with, and you're both taking those very seriously, the need to avoid crowds, then that person that you're living with is a good risk for you. But when you're going out to care for someone else, that period of quarantine is very important for you as a family caregiver before you go out to provide assistance to someone else. And I really think that it deserves repeating because it's so easy to remember and so important, and that's the three Ws that Dr. Patel said a little bit earlier: wearing a mask, watching your distance and washing your hands. These are things that are really important. And my sense as I watch people in circles that I move in here in south Louisiana and watching television, I think that, in my mind, we can be much more serious about mitigating the risks with these three simple steps.

[00:53:10] And Dr. Hébert, I've heard you talk about the importance of being an advocate for your loved ones at this time. So whether it's going into a nursing home, whether it's having care professionals come to your home, this is a time for you to step up and press those companies and ask them the questions. This is the time when you need to be that advocate and get the answers for the safety of your loved ones. Is that right?

[00:53:34] Warren Hébert: Absolutely. The care providers generally are going to be understanding, and they're going to appreciate that you're playing that role of advocate. For example, one of my daughter's caregivers, there was a tragedy in her very young friends. They all graduated from high school last year. And one of the young friends died. She wanted to go to the funeral, and she made the decision to do that. So we had conversations with her about how she was going to be engaging people at the funeral, whether there were opportunities for her to be at a distance from them, whether she was wearing a mask, and then even if she took all of those precautions, to be sure she's wearing a mask for a period of time when she comes back in.

[00:54:23] So yes, as a family caregiver, it's vital that you play that role of advocate, and that you ask the formal caregivers what they've been doing. So these are good steps to take, Bill. And I appreciate you asking that question.

[00:54:40] All right. Thank you very much, Dr. Hébert and Dr. Patel, and we're going to get to more listener questions shortly. But before we do that, I wanted to give a quick AARP Fraud Watch alert. Scammers continue to use the headlines as opportunities to steal money or sensitive personal information. The Federal Trade Commission has logged nearly 243,000 consumer complaints, as of Nov. 4, related to COVID-19. Scammers are using the full suite of scam tools, phishing emails and texts, bogus social media posts, robo calls, and posture schemes, and more, and closely following the headlines and adapting their messages and tactics as new medical and economic issues arise.

[00:55:29] Here's some tips to help you avoid coronavirus scams. Avoid online offers for coronavirus-related vaccines and cures. Be wary of emails, calls and social media posts advertising free or government ordered COVID-19 tests. Don't click on links or download files from unexpected emails, even if the address looks like a company or person you recognize. Don't share personal information, such as Social Security, Medicare and credit card numbers in response to an unsolicited call, text or email. And finally, be skeptical of fundraising calls or emails from COVID-19 victims or virus research, especially if they pressure you to act fast and request payment by prepaid debit cards or gift cards. Visit aarp.org/fraudwatchnetwork to learn more about these and other scams, or call the Fraud Watch Network Helpline at [877] 908-3360. That's [877] 908-3360.

[00:56:55] Jean, who do we have on the line?

[00:56:59]Jean Setzfand:  Our next caller is Cynthia from California.

[00:57:01]Bill Walsh:  Hey, Cynthia. Welcome to the show. Go ahead with your question.

[00:57:07]Cynthia:  Yes, my question is for Dr. Patel. Yesterday, as often happens, I encountered a man in the grocery store who was not wearing a mask. He was standing behind me in the line for the cashier. And I engaged him in a discussion about why he wasn't wearing a mask. And his response was the same response I've gotten from a number of people, and that is, it doesn't do that much in the way of protecting me anyway. And I'd like to know what your response to that specific comment would be.

[00:57:46]Bill Walsh:  OK, Dr. Patel, can you provide some information on that?

[00:57:52]Gopi Patel:  No. 1, thank you for being a safety advocate. I know it's not easy and educating individuals who are very staunch about their beliefs about masks is not easy. Two things. No. 1, sometimes it's best just to walk away, that's also for your safety. I think about sort of not having that mask-to-mask interaction, and there are risks in that. We have found that masks not only protect you from me, but also protects me from you. So it is a protection mechanism, as much as it's keeping the droplets in mechanism. And there's more and more data coming about that. Actually the CDC just released that they feel very strongly the mask is protective in a bidirectional fashion. So it protects you from my droplets, and me from spreading my droplets. So I think that's all you can say is there's data that has emerged that the masks are protective, and also protect you from me. So I wear my mask for you. You wear your mask for me.

[00:59:06] But I also am concerned about your safety. And so those interactions, it's best try to just distance yourself. And if you have a relationship with that store, to let them know that that's an unsafe practice, and that they should require their patrons to wear masks. A lot of states are moving in that direction. I'm from New York and I live in a mask-up state. And I do think there's some people who are getting fatigued with the masks, but in order to protect yourself, I would also invite you to sort of make sure you have your distance. But I applaud your attempt to educate others. But we do now have one of our public health authorities sort of putting it out there: it's bidirectional, so everyone should wear a mask and obviously distance if they can.

[01:00:01]Bill Walsh:  OK, very good. Jean, who is our next caller?

[01:00:05]Jean Setzfand:  Our next caller is Gloria from New York.

[01:00:08]Bill Walsh:  Hey, Gloria, go ahead with your question.

[01:00:12]Gloria:  Hi, oh, I'm so excited about AARP. As a 26-year member, I am just, I'm loving you AARP people that I don't even see.

[01:00:21]Bill Walsh:  Well, thank you. We love you too, Gloria.

[01:00:26]Gloria:  Thank you. I'm 85 going on 35, and I'm taking care of a great-grandson who's 14. I've had him since he was five years old, and I'm trying to talk fast because I want to make sure I get everything in. He has been doing remote since middle school, and he just started high school this September. And just on Monday, we've been receiving that he's been absent, and his grades are really low. He has never had low grades ever, ever, ever. And I'm so concerned. So I decided instead of just talking on the phone over and over, I took him and the tablet that he's using, that he was using at the time, actually his laptop went out, and but I let him use my tablet that was given to me by my caregivers' group, and the guidance counselor went in into it, and he's looking in it and he's saying, "I don't understand why you're being marked absent all the time. I don't understand why you say you submit your work and nothing's there." So, long story short, the guidance counselor found that day, which was Monday the 9th, that he is not submitting his work to every class. So I said, "OK, then that's his fault." So I said, "OK, maybe that day, maybe I'll let them do blended, and then have remote a couple of days." However it's scattered out. Now I'm concerned because I hear there's going to be a spike and he's never been sick. I haven't been sick, but I have underlying issues. I have a heart condition and I had stents put in my heart just recently, last month, and they're looking at my aortic valve, and so, but I'm feeling great. I'm in God's hands, and I talk to people. I don't wait for people to call me, I call people if I begin to feel a little bit lonely because I miss a lot of people. I'm blessed. I have good friends, but I'm concerned because of his work, and I don't know that blended would be good at this time because of this spike that you're talking about.

[01:02:39] And then other quick thing …Thanksgiving, I wanted to have great-grandson, my grandson, and my son is my backbone. I don't have a lot of family, I don't have a big village, but I wanted to have the four around me for Thanksgiving. We have our mask on and just be together with lots of food, but we'll have our mask and gloves and anything that we need. I wanted to know if that's a good idea.

[01:03:07]Bill Walsh:  All right. Well, Gloria, thanks so much for the call. And let's ask Dr. Hébert about that. You raised two really important issues, I think, that are on people's minds these days. One is about this remote learning, and it's just not an ideal situation for anyone, and you talked about some of the technical issues. Dr. Hébert, given that Gloria is 85, what do you think about this trade-off between remote education for her great-grandson and sending him into school. And I guess related to that, what about a visit from the family? What, we've talked about this a little bit, but can you give her some advice about precautions she should take if she thinks that's a good idea?

[01:03:49] Warren Hébert: Gloria, let's start with the education questions. My wife is a high school teacher, and she is doing the blended version at this point. My son-in-law has a doctorate in education, forgive me for bragging on him, but he's the chief academic officer for the school system here in Lafayette, Louisiana. The challenges that they've both dealt with are significant. It's not easy for the folks who are running the school system to so quickly change their protocols related to learning. But across the country, these school systems have done extraordinary work in making that happen. We have a dozen grandkids, as I mentioned a little bit earlier, and some of our grandchildren are doing fine with the new transition to a more blended system, others not so. So your grandson's not alone. My wife's got some of the high school students who she has were just stellar in the past, but doing the majority of their work online right now, their grades have been lower than they have been in the past.

[01:04:58] I think you did the right thing by first checking with the technology, because the truth of the matter is sometimes our technology, as good as it is, may be missing something here or there. So the fact that you checked to make sure that his technology was working was a really good first step. I think with regards to the spike that you're having there in New York, and the fact that he may be going to complete online, sitting and just talking with him, because the reality is our situation may change or it may be something that we're with for a while. We're all optimistic about the vaccines, but it may be with him for a while. So it may just be an opportunity for him to grow in this particular area. To your question related ...

[01:05:46] Let me actually put a finer point on that. I mean, if there is an opportunity for Gloria's great-grandson to go back to school maybe for a couple of days a week, what should she expect? I mean, what does she have the right to expect from the school system? What questions should she ask to give herself some peace of mind that the boy is going to be in a safe environment and not bring any virus back to her?

[01:06:15] Warren Hébert: Excellent, Bill, because we're not only just thinking about the educational perspective of it, but you should be certain that the staff and all those students are wearing masks. The school that my wife's in is getting guidance from the local physician who heads up public health. They're all wearing masks. They're all staying distant. And the ones that are on campus, they're spreading them out. Some of the students are coming in Monday and Wednesday, some are coming on Tuesday and Thursday. That way there are fewer students in the room, and the desks are distanced so that there is much more distance between the students than there would be. And as Dr. Patel said a little bit earlier, hand washing stations are present throughout the school, but wearing masks is not an option, and being sure that they're finding ways to keep distance between the students. Those are some of the things in my wife's school, it's a private school. They actually spent like $100,000 on a special unit for air conditioning that was cleaning the air more frequently than it had been before. So those are some of the facts, some of the mitigation approaches that can be taken.

[01:07:37] We heard in our own school district, that they're going to be washing down classrooms twice a day, after class, and then when the kids have their lunch, they'll wash them down again so there's that constant disinfecting. I guess every school system's a little different, but I think those are, Gloria, some of the things you can ask about. And Dr. Hébert, obviously she's looking forward to Thanksgiving with her family. We've talked about this a little before, but maybe you can just remind our listeners of if they decide to do something in person, what precautions should they take?

[01:08:13] Warren Hébert: Gloria, I'll go back to saying, it really touches my heart. We have a big family and our get-togethers involve a lot of food and a lot of laughter, and on occasion some singing. So when we think about the increased risk, we know that there is an increased risk of somebody spreading the virus when they're laughing together or when they're singing. Or if your family's anything like mine, the conversations are not always at a low volume. So the more exuberant we are in the way we express ourselves, the more of those aspects of the air that we're breathing out are going to impact people. So being aware of these things is just vital. And, again, the three Ws. I think Dr. Patel, we didn't plan on repeating this six times, but I just think it's so very important, is watching the distance. I went to the soccer game for one of my grandsons this past Saturday, and I love my son dearly, but we stayed well apart from one another, well-distanced, and I'm glad we did because he just recently told me he tested positive.

[01:09:27] So being outside, if that is at all a possibility for you, Gloria, and I know you're in New York, so the temperatures, the wearing the mask and washing hands frequently. If you're going to eat together, there are steps that you need to take to make sure that people aren't using the same utensils, using the same serving utensils, etc. That's a little more detailed than we can get into on the call, but we can get you some information related to steps that are good, prudent steps to take if you happen to be in a place where people are eating. Actually, the better thing to do would be for everybody to bring their own meal. But it sounds to me like you've got a lot of food and that's not likely to happen because you want to cook for everybody. These are difficult times, because all of these traditions that are just so vital to us as families and are so important; sometimes we have to change those traditions and create new ones to make sure that we're being safe. Because as I said a little bit earlier, we're moving really fast with these vaccines, and this may only be a matter of a few more months. Maybe next year we're back to our traditions as they were. And you certainly want to be around for that.

[01:10:45] All right. Thank you, Dr. Hébert. Let's go ahead and take some more questions, Jean.

[01:11:01]Jean Setzfand:  Yeah, we have some questions coming in from Facebook, two that are related. The first one's coming from Millie asking about vaccines. "Have any of the test subjects for the vaccine been people of color and/or over the age of 55? Is that information available now, and will that be available before the vaccine is released to the public?" A related question from Jim on Facebook is asking, "I'm 65 years old, is it recommended that I take the first vaccine approved?"

[01:11:29]Bill Walsh:  Dr. Patel, do you want to tackle those very good questions about who is part of these clinical trials? People of color, people over the age of 55, and maybe we start there.

[01:11:43]Gopi Patel:  Absolutely. So if you go to the websites, the individual candidate vaccines, No. 1, they were all asked for these trials to specifically enroll individuals at high risk for COVID-19, acknowledging the disparities that were in place when we started to look at who was getting infected with COVID-19. So, for example, for Pfizer, 45 percent of the individuals enrolled in the clinical trial are above the age of 55. And many, I think it's about 40 percent if not more, are individuals who identified as being of non-white backgrounds. So they did make an effort, and a pretty substantial effort considering the numbers of individuals who are enrolled in these trials, to make sure they enriched it with the populations at the highest risk.

[01:12:46] In terms of, should I take the first vaccine that is available? You know, it will be a tiered model of distribution. So some of the first vaccines that are likely to be available are two-dose series vs. a single dose, which is what you're used to for, let's say, the flu vaccine every year. We also don't know at this point, is it going to be a vaccine we need to take every year like the flu vaccine, or is it going to be something that you would take once, and then five years later, like the pneumococcal vaccine? So those things are yet to be answered.

[01:13:22] But I am of the belief, and this is my opinion and the opinion of my own, I am of the belief that if something that has been proven to be safe and efficacious might get us to a place where transmission is diminished, and you are offered that vaccine, have a discussion with your provider. Review any information that's set forth ahead of you and have that discussion with whether or not you and your beliefs and your health require you getting that vaccine at that moment. And then what are the next steps. So always be an informed consumer and an informed patient and an informed person to make sure you're making the best decision for you.

[01:14:08] Personally, if my parents were offered the vaccine, I would tell them to get it because I also have not seen them in 11 months, and they are older, and I would love for them to see their grandchild, too.

[01:14:21]Bill Walsh:  Right. Right. So it's going to be a tricky time, right, as people weigh those kinds of personal concerns against, are there any side effects? How effective is any vaccine that emerges on the market? So, I think the admonition to talk to your doctor who knows your health better than anyone is probably a great place to start. Jean, who's our next caller?

[01:14:48]Jean Setzfand:  Next call is from Judy in New York.

[01:14:53]Bill Walsh:  Hey Judy, go ahead with your question.

[01:15:03]Jean Setzfand:  I think we just lost Judy. I'm so sorry. Let's go to Holly from Kentucky.

[01:15:09]Bill Walsh:  All right. Holly, welcome to the show.

[01:15:13]Holly:  Thank you. I have a son who is in college, it's a university, and, they're going to be closing down right before Thanksgiving through the end of January. And so I'm wondering if you have any suggestions on how to help him transition to coming back home and living with us for a couple of months.

[01:15:35]Bill Walsh:  Good question. I think a lot of people are facing that a challenge. Dr. Hébert, do you have any words of advice for Holly with a son coming home from college?

[01:15:55] Warren Hébert: Yeah, our family ties are still very important, and AARP's doing extraordinary work recognizing that that needs to be part of our decision-making process. You know, Holly, having a family member back to live with you, taking certain steps again, to mitigate your risk would be very important. A quarantine period is something that we hear often. So having him, as he's coming back from the university, knowing that he's been in a different setting, probably exposed to a lot more people, a quarantine period would be a good step to take. Obviously, that means that you've got to be quarantining him during perhaps Thanksgiving. I know a lot of universities are deciding to end their year at Thanksgiving breaks now and not come back in December. So if he's coming back at a time when you're getting ready to have a family gathering, that makes it a little more difficult. I know you're in Kentucky, and you guys still, everybody on the phone today are having temperatures that are going to be far lower than mine, but again, if you have the option of visiting outside. For example, we just had a family gathering at a state park, and we spent much of our time outside distanced around the fireplace, excuse me, around the fire. And that was something that family members who are all medical said that distance is important. Being outside is also very important, as well.

[01:17:27] So those are steps that I would take, Holly, just to make sure you find a way to try to work in a quarantine period for him before he comes back. And when he does come back following those three Ws again, watching the distance, washing hands frequently and wearing a mask.

[01:17:46] OK. All right, Jean, who is next on the line?

[01:17:51]Jean Setzfand:  We have another question coming from YouTube, and this one's coming from Evelyn, and she's asking, "How are therapeutics helping? Do they lower the mortality rate? How available are they?"

[01:18:02]Bill Walsh:  Dr. Patel, can you talk to us a little bit about therapeutics?

[01:18:06]Gopi Patel:  Sure. I think one of the issues, and we talked about this earlier, is individuals are coming in earlier. So supportive care that can be provided in the hospitalized setting — oxygen, steroids, etc., — those seem to be decreasing, in this sort of juncture, the mortality rates. Once someone is on a ventilator, it's a little bit more difficult, and then you add sort of the things that come with an individual being in an ICU on a ventilator, and some of, we call it morbidity, but the effects and the side effects of being on a ventilator, etc., and being in the hospital for a long period of time.

[01:18:57] So, data is very early in terms of comparing, you know, it's hard to say when the first part of the pandemic was, and are we in the second wave, or is it just sort of still the first wave and we haven't finished the first wave. But it does look like, and this is not just in New York where I am, but across the world, that individuals are faring better because of early oxygen delivery and not intubating patients or putting them on a ventilator right away, and the use of steroids. And we learned a lot more about the fact that there seems to be a lot of clotting with this particular virus, not like any other virus we've ever seen. So many of you may know someone, or yourself, to be on blood thinners, things like Apixaban or Eliquis, and I'm not involved in any of these companies, or Heparin, or other types of blood thinners — that seems to help in the treatment of COVID-19, especially in the sick patient that requires a hospitalization.

[01:20:01] So if people are faring better, we are still learning about the long-term side effects of severe COVID-19, and so I think we're going to learn more about that as we get more data and more and more studies are being published, looking at how individuals, especially if they're older, of a certain background, or with other medical conditions, are faring. But people are seeming to do better, and I think a lot of it is because they're presenting a lot earlier in illness, and we're able to diagnose them and start those therapeutics.

[01:20:36]Bill Walsh:  OK, very good. Thank you, Dr. Patel. And Dr. Patel and Dr. Hébert, we're coming to the close of our time together here. I wonder if you have any closing thoughts or recommendations that AARP members should understand most from our conversation today? Dr. Patel, do you want to start?

[01:21:01]Gopi Patel:  I'm sorry, I lost you for one second. Can you repeat that?

[01:21:03]Bill Walsh:  Oh, OK. So yeah, sure. I was just wondering if you have any closing thoughts or recommendations that folks should understand from our conversation here today.

[01:21:13]Gopi Patel:  I think one, we are in a very interesting space, and I think we have to end with, please care for yourself and think about the protective planning that Dr. Hébert sort of outlined in terms of the holidays. I know it's hard, but it's important to keep us all safe. Wearing the mask, socially distancing and watching your distance, and being very thoughtful about protective planning as we get closer to these times where some of you may elect to see family that you haven't seen in a long time. There is some promising news with vaccines, so we'll all keep our fingers and our toes crossed, and just keep working with your health care providers and paying attention to what's coming out from your states and public health authorities about next steps in terms of indoors and outdoors and the rest.

[01:22:10]Bill Walsh:  Very good, some glimmers of light on the horizon. Dr. Hébert, any closing thoughts?

[01:22:16] Warren Hébert: Well, I want to acknowledge Dr. Patel's suggesting about crossing our toes, too. I'm working on that right now, but thank you for that bit of humor. Our well-being is so very important, and most of our conversation today has been about our physiologic well-being. But I would add that we talked a lot about our emotional well-being, and I think that that's a critical piece of this conversation, Bill, because if we are burned out, if we're exhausted, if we're fearful, then our judgment is impaired. So our emotional well-being is vital.

[01:22:54] So a couple of steps that I think are important for everyone is, first, decrease, the amount of time that you're spending with the television and with technology. Just like any other medications or things that we take, you can overdose. So even though keeping up with what's going on and the changes are very good, making sure you're limiting time in front of the television and with your technology. The second thing is to know that guidelines are changing. As Dr. Patel indicated earlier, we're learning so rapidly about this novel new virus. We're learning about how to better mitigate the likelihood of spread. We're also learning a lot about treatment. So be aware that the guidelines may change. If you accept that they're going to change because we're getting smarter about how to handle it, then there'll be less anxiety with that.

[01:23:49] Another thing that I mentioned a little bit earlier is be choosy about who you're going to connect with? Because we need to be connecting with family, we need to be connecting with friends, but we know that some people that we connect with are going to bring additional anxiety and drama, and you can actually choose not only who are you going to connect with, but how much you're going to connect with them. And I don't mean to sound mean in any way, but we're talking about your well-being.

[01:24:17] And last thing is to acknowledge family caregivers. You know, we have 54 million family caregivers across the country, 1 in 5 people in the United States are family caregivers. So the likelihood is if you're listening right now, you know someone who's a family caregiver. Take the time to thank them and acknowledge them as we get close to Thanksgiving. Thank you, Bill.

[01:24:40] Well, thank you, and thanks to both of you for answering our questions today. It's been a really informative discussion. And thank you, our AARP members, volunteers and listeners for participating in the discussion. AARP, a nonprofit, nonpartisan member organization has been working to promote the health and well-being of older Americans for more than 60 years. In 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, prevent its spread to others while taking care of themselves. All of the resources referenced today, including a recording of the Q&A event can be found at aarp.org/coronavirus beginning tomorrow, Nov. 13. Again, that web address is aarp.org/coronavirus. Go there if your question was not addressed and you will find the latest updates, as well as information created specifically for older adults and family caregivers. We hope you learned something that can help you and your loved ones stay healthy, especially during this holiday season. Please be sure to tune in next Thursday, Nov. 19, at 1:00 p.m. ET for another coronavirus discussion focused on vaccines and staying safe during the holidays. Thank you all and have a good day. This concludes our call.

[01:26:14]

Bill Walsh: Hola. Soy Bill Walsh, vicepresidente de AARP. Y quiero darles la bienvenida a este importante debate sobre el coronavirus. AARP, una organización sin fines de lucro y no partidista, ha estado trabajando para promover la salud y el bienestar de los adultos mayores del país durante más de 60 años.

Ante la pandemia global por coronavirus, AARP está proporcionando información y recursos para ayudar a las personas mayores y a quienes cuidan de ellos. Con la pandemia entrando ya en su octavo mes, los casos de COVID-19, las hospitalizaciones y las muertes a causa de la enfermedad, nuevamente, están en aumento.

No parece haber una solución a la vista, y ya se acercan las fiestas de fin de año. Estamos llegando al final de este año extremadamente difícil, y las personas en todo el país están considerando cómo van a celebrar con sus amigos y familiares, o si lo harán siquiera, cuando lo más seguro sigue siendo mantener una distancia segura.

Hoy hablaremos con expertos, que responderán algunas de sus preguntas con relación a cómo estar a salvo y cómo cuidarte, tanto tú, como tus seres queridos. Si ya participaste de alguna de nuestras teleasambleas, ya sabrás que esto es similar a un programa de radio, y tienes la oportunidad de hacer preguntas en vivo. Para quienes se unan por teléfono, si quieres hacer una pregunta sobre la pandemia por coronavirus, presiona *3 en tu teléfono para conectarte con un miembro del equipo de AARP. Tomaremos nota de tu nombre y pregunta, y te pondremos en una lista para que puedas hacerla en vivo. Si nos estás viendo a través de Facebook o YouTube, puedes dejarnos tu pregunta en los comentarios.

Hola. Para quienes recién se estén uniendo, soy Bill Walsh, en nombre de AARP, y quiero darles la bienvenida a este importante debate sobre la pandemia global por coronavirus. Hablaremos con un panel de expertos y responderemos sus preguntas en vivo. Para hacer sus preguntas, presionen *3 en su teléfono. Y, si nos ven a través de Facebook o YouTube, dejen sus preguntas en los comentarios.

Nos acompaña la doctora Gopi Patel, profesora adjunta de Enfermedades Infecciosas del Departamento de Medicina, en Mount Sinai Hospital, Nueva York. Y el doctor Warren Hébert, profesor de Enfermería de Loyola University, en Nueva Orleans, y director ejecutivo de HomeCare Association of Louisiana. También nos acompañará mi colega de AARP, Jean Setzfand, quien nos ayudará con sus llamadas. Este evento está siendo grabado, y podrán acceder a la grabación en AARP.org/coronavirus 24 horas después de que hayamos terminado. Una vez más, para hacer una pregunta, presiona *3 en el teclado de tu teléfono en cualquier momento para conectarte con un miembro del equipo de AARP o, si nos miras por Facebook o YouTube, deja tu pregunta en la sección de comentarios.

Ahora quiero darle la bienvenida a nuestra primera invitada. La doctora Gopi Patel es profesora adjunta de Enfermedades Infecciosas en el Departamento de Medicina, en Mount Sinai Hospital. Se especializa en el tratamiento de infecciones en pacientes inmunocomprometidos. Bienvenida, doctora Patel.

Gopi Patel: Gracias por la invitación.

Bill Walsh: Muy bien. Es un placer tenerla aquí. Y Warren P. Hébert Jr. Él es profesor de Enfermería en Loyola University, en Nueva Orleans. Tiene más de 40 años de experiencia en enfermería y es un líder indiscutido en política de salud y cuidado en el hogar a nivel estatal y federal. Bienvenido nuevamente, doctor Hérbert.

Warren Hébert: Gracias, Bill. Es un placer volver a acompañarlos.

Bill Walsh: Muy bien. En un placer que nos acompañe. Comencemos con este debate. Y les recuerdo a nuestros oyentes que, para hacer preguntas, deben presionar *3 en el teclado de su teléfono o dejarla en la sección de comentarios en Facebook o YouTube.

Doctora Patel, comencemos con usted. Llevamos ocho meses en pandemia. Estamos llevando registros diarios de casos positivos de COVID-19. ¿Qué implica eso para las fiestas de fin de año y el invierno?

Gopi Patel: Estamos en un dilema muy desafortunado en este momento. Y una de las cosas en las que, creo yo, todos estamos pensando es ver a nuestros familiares y juntarnos para las fiestas. Fueron unos largos 11 meses para muchos de nosotros. Lamentablemente, el invierno nos hace estar adentro. Nos consolaba mucho el hecho de poder mantener el distanciamiento social al aire libre. Pero, cuando comenzamos a vernos adentro, es más difícil mantener el distanciamiento social y, obviamente, lidiar con la circulación dentro del entorno.

Bill Walsh: Muy bien. Y, además, la temporada de gripe. Con el invierno, viene la temporada de gripe, ¿cierto?

Gopi Patel: Totalmente. Y recomendamos que todos se vacunen contra la gripe. Primero, porque sigue siendo la mejor manera de defendernos contra la gripe, pero también porque es una forma de no desbordar clínicas, hospitales y centros de urgencias con gripe, además de la COVID-19.

Bill Walsh: Muy bien. Coincidimos con eso. Pese a las noticias desalentadoras sobre el ritmo de la pandemia, parece haber avances substanciales en el tratamiento. ¿Cuáles son los avances más notables para ayudar a que la gente sobreviva a la COVID-19?

Gopi Patel: Que sabemos mucho más de lo que sabíamos al comienzo de la pandemia. Además, al principio, no teníamos pruebas, después las pruebas llevaban tiempo para llegar al resultado, y ahora las pruebas son un factor determinante. Las pruebas y el rastreo de contactos, para que las personas sepan que estuvieron expuestas, no minimicen los síntomas y se hagan una prueba temprano. Especialmente, si sabes que estuviste expuesto o sospechas que estuviste expuesto.

Les decimos a los pacientes que es mejor consultar antes que tarde. Pienso que muchas personas tenían miedo de asistir a centros de emergencia o centros de salud. Les pedimos que asistan cuando les esté faltado el aire, si tienen tos y les cuesta respirar. Los esteroides han sido cruciales. Hemos aprendido mucho de ensayos realizados en Europa y en todo Estados Unidos sobre la importancia de los esteroides.

Si alguien necesita oxígeno, estamos aprendiendo más sobre antivirales en casos graves y cuándo funciona, y los expertos del campo se reúnen con frecuencia para hablar sobre actualizaciones en la orientación y ofrecer esa orientación a los trabajadores de la salud de todo el país para que sean capaces de tratar pacientes en las diferentes etapas de la COVID-19. Por otra parte, conocemos las intervenciones no farmacéuticas, ¿cierto? El lavado de las manos, el uso de mascarillas y el distanciamiento social. Y eso realmente ayuda a prevenir la transmisión si las seguimos rigurosamente.

Bill Walsh: Parece tan simple, pero sigue siendo muy efectivo, ¿no es así?

Gopi Patel: Totalmente. Y entendemos que la gente ya se está cansando de todo esto.

Bill Walsh: Cierto. Muy bien. Bueno, muchas gracias. Pasemos con usted, doctor Hébert. Como ya dijimos, hace ocho meses que estamos en pandemia, y muchas familias y cuidadores ya tenían dificultades antes de la pandemia para ocuparse del trabajo, el cuidado de los niños, de los seres queridos. ¿Qué consejo tiene para esas personas que tienen dificultades para lograr ese balance?

Warren Hébert: Armar los roles de la familia. Los cuidadores tienen ese desafío incluso en los mejores momentos. El aislamiento; y yo le agregaría a eso la palabra "físico". Nuestros amigos de la Organización Mundial de la Salud han cambiado su vocabulario y, en vez de hablar de distanciamiento social, ahora hablan de distanciamiento físico. El desafío que tenemos como cuidadores en medio de todo esto es tratar de lograr un balance para hallar otras formas de conectarnos socialmente, otras formas que no impliquen la presencia física del otro.

Algunas cosas que hemos hecho con nuestros nietos y amigos, y con amigos de todo el mundo, es usar las comunicaciones virtuales. Si están disponibles para ustedes, si viven en un lugar con conexión a internet, eso sin duda hará la diferencia. Una de mis siglas favoritas, cuando se trata de cuidados en casa, es EVST, que es el viejo sistema telefónico. Hacer llamadas telefónicas con más frecuencia puede ayudar mucho a la resiliencia y balance de una persona.

Hay personas de mi vida con las que puedo conectarme a diario, y eso realmente me ayudó a recalibrar. Hay personas que son genuinas y auténticas, y no tengo que preocuparme por que me agreguen más drama. Así que, cuando se trata de lograr un mejor balance, creo que tenemos que tomar decisiones sobre con quiénes nos conectamos, porque sabemos que hay ciertas personas nos aumentan el estrés, nos alteran cuando hablamos.

La oportunidad de conectarnos con personas que nos ayuden a estar más enteros es una elección consciente que podemos tomar. Y la otra cosa es pedir ayuda. Dentro de mi propia familia, un par de personas dieron positivo, y uno de mis hijos está pasando por eso en este momento. Estaba hablando con mi nuera justo antes… justo antes de comenzar esta llamada con ustedes, Bill. Ellos tienen tres hijos, de ocho, seis y cuatro años. Ella está abrumada. Así que hay que ofrecer ayuda a otros, pero también hay que saber aceptar la ayuda de los otros. Creo que eso es algo fundamental en estos momentos tan desafiantes.

Bill Walsh: Exacto. Muy buen consejo. ¿Cuál cree que sean las mejores formas de sustituir esos momentos especiales de estas fiestas si no podemos estar en persona?

Warren Hébert: Pienso que esta es una oportunidad para volver a las viejas costumbres. Escribir tarjetas es algo que parece tan simple, pero es una práctica que quedó en el pasado para la mayoría. Pienso que es un muy buen recurso. Otra cosa que hicimos cuando comenzó la pandemia era dejar paquetitos. Tenemos la suerte de tener a nueve de nuestros 12 nietos a no más de diez minutos de casa. Entonces, aunque no los visitábamos personalmente, mi esposa, que es la mejor abuela… … a ustedes les encantaría tenerla como abuela… armaba regalitos y los dejaba en la puerta para los chicos. Hacer eso para las fiestas puede ser buena idea.

Y otra cosa, Bill, que les recomiendo es centrarse en el agradecimiento. La Navidad pasada, antes de la pandemia, toda mi familia se reunió. Intercambiamos regalos y, cuando pensamos que ya habíamos terminado, nuestra hija de 29 años, que es la menor de nuestros cinco hijos y tiene síndrome de Down, se levantó y dijo: "Quiero decir algo". Dijimos: "Bueno". Ella sabía que mi esposa y yo celebrábamos nuestro aniversario la semana siguiente. Y dijo: "Quiero agradecerles a mamá y papá". Y nos dijo cosas lindas. Y después señaló a su hermano mayor y dijo: "Ahora es tu turno". Y lo hizo toda la familia.

Entonces, cuando hablamos de no estar en persona, hallar la forma de hacer algo similar, ya sea de forma virtual o incluso armar una llamada grupal, o algo así para reconocer a los familiares que hayan hecho algo para ayudarnos al resto de la familia, y que todos celebremos eso. Esas son algunas de las cosas que se centran en el agradecimiento y, pienso, pueden marcar la diferencia.

Bill Walsh: Hermoso consejo. Gracias, doctor Hébert. Les recuerdo a nuestros oyentes que, para hacer preguntas, deben presionar *3 en el teclado de su teléfono, y responderemos esas preguntas en breve. Antes de hacerlo, quiero informarles sobre la lucha continua de AARP A favor de los residentes y personal en hogares de ancianos y otros centros de cuidados prolongados.

Desde el comienzo de la pandemia, 84,000 residentes y trabajadores han muerto por la COVID-19. Es una tragedia. Y con los picos de casos en todo el país y el clima frío que se aproxima, los expertos están alertando sobre la terrible situación que atraviesan en estos lugares. Se necesita tomar medidas ahora para evitar más muertes por COVID-19 en estos centros. Y AARP está actuando, luchando continuamente en todos los niveles del Gobierno. Estamos apelando a los líderes estatales y federales para que aprueben leyes que incluyen un plan de cinco puntos.

En primer lugar, los centros deben realizar pruebas periódicas y contar con equipo de protección personal para los residentes y empleados. Segundo, necesitamos transparencia y responsabilidad con el reporte público diario de casos, muertes, y centros, y una mejor comunicación con las familias. Tercero, los familiares tienen que poder visitar virtualmente a sus seres queridos que están en hogares de ancianos aunque los hogares permitan las visitas en persona. Cuarto, los residentes necesitan mejores cuidados. Y eso incluye personal idóneo y acceso en persona a defensores de derechos, las llamadas “ombudsman” de cuidados a largo plazo. Y, por último, los hogares de ancianos y centros de cuidados a largo plazo que lastimen a los residentes deben responsabilizarse de sus actos. No se les debe conceder inmunidad total.

Miles de socios, voluntarios y activistas de AARP han levantado sus voces sobre esta problemática. Para saber más y levantar tu voz también, visita aarp.org/nursinghomes. Otra vez, aarp.org/nursinghomes. Esperamos que puedan actuar para ayudar a salvar vidas y a detener esta tragedia nacional. Les recuerdo que, para hacer preguntas, deben presionar *3.

Ahora, es hora de pasar a algunas de esas preguntas sobre el coronavirus con la doctora Patel y el doctor Hébert. Presionen *3 en el teclado de su teléfono en cualquier momento para ser conectados con un miembro del personal de AARP para estar en la lista para hacer sus preguntas. Ahora, quiero darle la bienvenida a mi colega de AARP Jean Setzfand, quien nos facilitará sus llamadas en el día de hoy. Bienvenida, Jean.

Jean Setzfand: Gracias, Bill Un placer estar con ustedes.

Bill Walsh: Bien. ¿De quién es nuestra primera llamada?

Jean Setzfand: La primera llamada es de David, de Míchigan.

Bill Walsh: Hola, David, bienvenido al programa Adelante con tu pregunta.

David: Mi pregunta es… Me hice una prueba en mayo, hace seis meses ya, y afortunadamente dio negativo. Pasaron seis meses. Y me pregunta con qué frecuencia… (no tengo ningún síntoma) …¿debería volver a hacerme una prueba? ¿O solo esperar y ver qué pasa?

Bill Walsh: Muy bien. Gracias, David. Doctora Patel, ¿quisiera hablar sobre las señales a las que la gente debería estar alerta y por las que debería hacerse una prueba?

Gopi Patel: Claro. Si sabes, o te han dicho, que tuviste contacto con alguien que tuvo COVID-19 o fue diagnosticado COVID-19, obviamente, deberías ir a hacerte una prueba. En cuanto a los síntomas, hemos aprendido bastante sobre los síntomas de la COVID-19, desde dolor de garganta, dolor muscular, la singular pérdida del gusto y el olfato. Hay síntomas por los que normalmente dirías: "Es solo un resfrío" o "Es una gripe". No queremos que minimicen esos síntomas. Por eso también deberían hacerse una prueba.

En ciertos lugares de atención médica o lugares de trabajo, especialmente si la tasa de contagio donde vives está en aumento, debe haber guía por parte de las autoridades de salud en cuanto a testeos más frecuentes por el riesgo de exposición. Mencionaste a los hogares de ancianos y centros de cuidados especializados. Esos trabajadores de salud y esos residentes probablemente estén en mayor riego y se tengan que realizar pruebas frecuentemente por recomendación de las autoridades de salud pública. Obviamente, es regional. Si trabajas o brindas servicios de atención a alguien, quizá tendrías que realizarte pruebas con frecuencia, aunque no tengas síntomas, pero te recomendaría que veas qué dicen las autoridades de salud pública de Míchigan en cuanto a sus algoritmos de pruebas. Queremos asegurarnos de que las pruebas sigan siendo limitadas. Están generalizadas, pero limitadas en muchas áreas, especialmente si están enfrentando un aumento en la cantidad de casos o tratan de direccionar las pruebas a frenar la transmisión.

Bill Walsh: Bien. Muchas gracias, doctora Patel. Jean, ¿de quién es la siguiente llamada?

Jean Setzfand: La siguiente llamada es de Juanita, de Maryland.

Bill Walsh: Hola, Juanita. Bienvenida al programa. Adelante con tu pregunta.

Juanita: Bueno. Mi pregunta es… mi nieta está en la universidad, en Western State College, y su mamá quiere que vaya con ella a buscarla. Y quiero saber si está bien hacer eso, porque estaría yendo a otro estado.

Bill Walsh: Hmm. Bien. Doctora Patel, ¿quiere opinar al respecto? ¿Qué…? ¿Juanita debería ir a buscar a su nieta de la universidad? Y, si lo hace, ¿qué precauciones debería tomar?

Gopi Patel: Creo que es una pregunta interesante. Gran parte de lo que recomendamos los médicos en cuanto a la salud pública o enfermedades infecciosas, es asegurarse de que todo lo que hacen sea de la manera más segura. Estar en un auto con alguien con quien ya pasas tiempo es muy seguro. Si estás en el auto con alguien con quien no compartes mucho habitualmente, alguien con quien no convives, no es parte de tu familia, recomendamos que uses mascarilla y bajes las ventanillas.

Si compartir el viaje no es absolutamente necesario y es muy importante para las visitas de fin de año, realmente necesitas saber qué hacen los demás. Esas personas con las que estarás compartiendo el rato y en contacto estrecho dentro de un espacio restringido, ¿qué han estado haciendo? ¿Se han estado cuidando? ¿Se han realizado pruebas? ¿Tienen síntomas? ¿Han estado cumpliendo con las tres cosas básicas que siempre se dicen?

Usar mascarilla, mantener la distancia y lavarse las manos. Y pienso que esto es algo de lo que estaremos hablando mucho a medida que se acerquen las fiestas. Creo que debes tener una charla familiar, Juanita. Y, si no es absolutamente necesario que viajes en un espacio restringido, no es recomendable. Pero también debes saber lo que estuvo haciendo tu nieta. Muchas facultades… No sé el caso de la facultad a la que va ella. Muchas facultades están realizando pruebas regularmente con el fin de frenar la transmisión entre los estudiantes. Así que deberían tener una charla familiar. Pero, si no te sientes segura, mi recomendación sería que no hagas el viaje.

Bill Walsh: Bien. Muy bien, Jean, ¿de quién es la siguiente llamada?

Jean Setzfand: La siguiente llamada es de Marge, de Massachusetts.

Bill Walsh: Hola, Marge, adelante con tu pregunta.

Marge: Me preguntaba si tienen alguna recomendación para una mujer de casi 80 años que vive sola y está muy solitaria. Habitualmente, voy a nadar, a hacer voluntariado y cosas así en Massachusetts. Y todo eso está cancelado.

Bill Walsh: Claro, claro. ¿No sales nada, Marge?

Marge: Bueno, voy a buscar la correspondencia y… en mi barrio, hay mucha gente mayor, así que no muero de ganas de ver a los vecinos, porque son más propensos al virus que otra gente. Y voy a hacer las compras y cosas así. Pero los días se me hacen muy largos.

Bill Walsh: Sí.

Marge: Hay días en que hago limpieza, y después digo: "¿Y ahora qué? ¿Duermo una siesta?".

Bill Walsh: Claro. Preguntémosle…

Marge: No veo a nadie.

Bill Walsh: Preguntémosle al doctor Hérbert sobre eso, si tiene alguna sugerencia. Doctor Hérbert, ¿qué puede decirle a Marge?

Warren Hébert: Marge, no estás sola. Los desafíos que tenemos por la soledad ya los teníamos antes de la COVID-19 y de la pandemia. Así que lo que estás experimentando es algo a lo que muchas personas se enfrentaron antes. La soledad es algo que tiene muchos efectos negativos sobre la salud. Y es bueno que reconozcas los cambios en ti. Algo que puedes hacer es considerar la posibilidad de visitarte con alguien en el jardín. Así hay bastante distancia entre ustedes.

Nosotros comenzamos a hacer eso hace unos tres meses, cuando los números bajaron. Nuestros nietos venían a nuestro jardín y nos visitábamos a través de la cerca. Otra cosa que puedes hacer son más conexiones telefónicas. Las llamadas, como dije antes, con alguien que conoces ayudan a que te sientas mejor. Alguien que sea auténtico y genuino, y que no te cargue de drama y ocupaciones. Hablar por teléfono con personas que te ayuden a sentirte bien y te ayuden con tu estado de ánimo es algo muy bueno también.

Otra cosa que puedes hacer y que te ayudará con tu estado de ánimo es ver qué ejercicios puedes hacer en casa. Mi hija, como mencioné antes, tiene síndrome de Down, era parte de un grupo de entrenamiento y, en cuestión de semanas, tuvieron que cambiar sus reuniones para hacer ejercicio por encuentros virtuales. Entonces, si tienes acceso al internet y un dispositivo que te permita hacerlo, Marge, eso es algo bueno para ver otras personas. Hay buenas cosas para hacer, en general. También puedes leer algún libro o mirar alguna comedia. La ciencia ha dejado bien en claro que cuanto más reímos más beneficios fisiológicos tenemos. Gracias por preguntar, Marge. Muchas personas están pasando por eso.

Bill Walsh: Sin duda. Gracias por los consejos, doctor Hérbert. Otra cosa que ofrece AARP, Marge, y también para otros que estén escuchando y se puedan sentir aislados o conozcan a alguien que esté pasando por eso, es que creamos un programa llamado La Voz Amigable de AARP. Básicamente, entrenamos a cientos de nuestros socios simplemente para que se contacten con las personas y hablen con ellas. Es gratis, y pueden acceder a través de una línea gratuita. Les daré el número. Es (888) 281-0145. El número de La Voz Amiga de AARP es (888) 281-0145. Y, una vez más, es un servicio gratuito. Si quieren que uno de nuestros voluntarios se contacte con un ser querido o un vecino, alguien que sepan que la esté pasando mal en este momento y que puedan necesitar escuchar una voz amigable. Bien. Jean, ¿quién sigue?

Jean Setzfand: Nos llegan varias preguntas a través de YouTube, y esta es de Jean, por YouTube. Nos pregunta: "¿Cómo planea Estados Unidos suministrar la vacuna?".

Bill Walsh: ¿Suministrar la vacuna? Es una pregunta oportuna. Doctora Patel, ¿quiere opinar al respecto?

Gopi Patel: Claro. Según información preliminar, si una vacuna funciona y se aprueba, Estados Unidos la suministraría de manera muy similar a como suministran otros medicamentos que han llegado al uso de emergencia. Quieren una distribución transparente y justa, y muchos de los ensayos de vacunas incluyeron personas que son mayores, a quienes afectó muchísimo la COVID-18 en esta pandemia. Grupos de personas muy diversos.

No creen poder lograr satisfacer la demanda inicialmente en cuanto a vacunar a todos los habitantes del país. Así que habrá una distribución escalonada, como se mencionó antes. Primero, en los centros de cuidados prolongados y centros de cuidados especializados, al igual que el personal sanitario de primera línea. El próximo año, otros trabajadores esenciales y aquellas personas que tengan afecciones médicas que las conviertan en personas de alto riesgo. Se está armando un plan a nivel nacional y entre las autoridades de salud pública para que, si una vacuna fuera autorizada para uso de emergencia, y posteriormente vacunas aprobadas por la FDA, puedan distribuirla en todo el país y satisfacer las necesidades, ayudar… que sea una de las cosas que evite la transmisión y termine con la pandemia.

Bill Walsh: Sí. Pienso, doctora Patel, que las palabras clave fueron que el plan se está armando. Hay muchas cosas que todavía se tienen que descifrar. ¿Tiene algún calendario o idea sobre cuándo se tomarán esas decisiones?

Gopi Patel: Pienso que hay muchas personas involucradas. Y, si tienes acceso a Internet, puedes ver al ACIP debatiendo sobre vacunas y la seguridad de las vacunas. Se piensa, por la trayectoria actual, que un lote de la vacuna va a estar disponible hacia fines de este año, lo que sería algo sin precedentes en el desarrollo de vacunas. Hacia fines de año para el primer lote, que se suministrará a quienes estén en centros de atención prolongada y trabajadores de salud, y habría una mayor cantidad disponible en 2021, probablemente cerca de la primavera.

Pienso que parte de esto tiene que ver con la evaluación de la seguridad y la eficacia de estas vacunas. Hay juntas de monitoreo de datos que evalúan esto, y el Comité Asesor de Vacunas de la FDA, que son todos integrantes privados, evalúa los datos. Y luego hacen una recomendación para autorizar el uso de emergencia. Eso luego irá al panel de expertos de los CDC para que se debata a quién debería suministrarse el primer lote. Así que hay muchas personas involucradas, pero hay buenas noticias sobre las vacunas y su potencial eficacia, y esas personas están analizando los datos en detalle para garantizar que sea una vacuna eficaz y segura. Así que esperamos que para fines de este año. Y en cuanto al desarrollo de la vacuna, es increíble lo rápido que se está llevando a cabo.

Bill Walsh: Sin duda. Y hablaremos más sobre el proceso de desarrollo de vacunas en breve. Jean, ¿tenemos alguna otra pregunta en espera?

Jean Setzfand: Sí, así es. Habla Harriet, de Nueva York.

Bill Walsh: Hola, Harriet. Hola, ¿cómo estás? Adelante con tu pregunta.

Harriet: Estoy bien. Gracias. Mi pregunta para ustedes es… Tengo dos bisnietos, de seis y nueve, tienen a su madre y a su padre, que son mis nietos, y quieren venir a nuestra casa a traernos la cena del Día de Acción de Gracias. El de nueve es un niño con necesidades especiales y está desesperado por venir porque los hemos visto al aire libre, pero nunca en la casa. Ambos están en la escuela. Mi nieto es un agente de policía. Mi nieta dirige un gimnasio para chicos con necesidades especiales al que van muy pocos chicos últimamente, pero sí va gente. Yo tengo 90 años y mi esposo, 98. Y nos encantaría que vinieran. ¿Qué opinan? Están desesperados por venir.

Bill Walsh: Sí. Y apuesto a que ustedes quieren que vayan a visitarlos.

Harriet: Claro que sí. Claro que sí.

Bill Walsh: Muy bien, Harriet. Gracias. Preguntémosle al doctor Hébert. ¿Qué opina sobre la situación de Harriet? Y, si opina que los bisnietos deberían visitarlos, ¿qué precauciones deberían tomar Harriet y su familia?

Warren Hébert: Harriet, noté cómo se te quebraba la voz, y te quiero. Una de las experiencias más difíciles que hemos tenido con la pandemia es no juntarnos con nuestros nietos. Comenzamos, como dijiste, visitándonos a través de la ventana o al aire libre. Y eso fue algo grandioso para nosotros, solo poder hacer eso. El hecho de que tengas un niño con necesidades especiales, por así decirlo, hace que haya una conexión aún mayor. En cuanto a atenuar los riesgos, lo que hicimos con nuestros nietos fue asegurarnos de encontrarnos al aire libre.

Harriet, no sé en qué parte del país vives o cómo estará el clima. Pero, como dijo la doctora Patel hace un rato, siempre que los encuentros sean al aire libre, atenúas significativamente los riesgos. Otra cosa que tú y tu familia deben analizar es si es posible mantener una distancia prudente, incluso estando al aire libre. Si van a estar adentro, como dijo la doctora Patel antes, el riesgo aumenta significantemente. Incluso si usan mascarilla, aumenta significativamente. Como dijo la doctora Patel hace unos minutos, es casi un milagro que una vacuna que esté desarrollando tan rápidamente. Por lo que tengo entendido, suele tomar unos cuatro años. Y estamos hablando solo de meses en este caso.

Entiendo que quieran estar juntos, pero yo recomendaría… Parece que la vacuna se está desarrollando tan rápidamente que estaremos en una situación muy diferente en solo unos meses. Obviamente, aún hay desafíos por delante. No solo se trata de desarrollar la vacuna, sino también de convencer a la gente de que se la aplique. Nosotros también tenemos que hacer un mejor trabajo convenciendo a la gente de que cumpla con los cuidados básicos. Gracias, doctora Patel. Asegurarse de usar mascarilla, mantener la distancia y lavarse las manos. Porque hay cosas que podemos hacer para reducir significativamente la propagación de la COVID-19, incluso sin la vacuna.

Entiendo tus deseos de querer estar cerca de ellos, pero ten presente que estarás corriendo riegos y que puede ser cuestión de ser un poquito más pacientes por unos meses más. No, no quiero ser demasiado optimista, pero ten presente que tu salud y bienestar es sumamente importante y encontrar otras formas de estar cerca puede ser lo mejor para esta temporada de fiestas.

Bill Walsh: Gracias, doctor Hébert. Harriet es de Nueva York, así que el clima a fines de noviembre puede estar un poco frío. Supongo que dependerá del clima, pero agradecemos su punto de vista de que estar al aire libre es mejor que adentro. Muchos de nuestros oyentes han estado considerando la idea de hacerse una prueba antes de ir a visitar a alguien o de recibir visitas. Alguno de ustedes, doctora Patel o doctor Hébert, cree que sea una buena práctica para tener en consideración.

Gopi Patel: Pienso que las pruebas son muy importantes para saber dónde estamos parados en determinado momento, pero prestarle atención a lo que estamos haciendo antes de la visita es igualmente importante, ¿cierto? Si uno está expuesto y la prueba da negativo a dos días después de esa exposición, quizá solo era temprano para que la prueba dé positivo.

Este es el momento perfecto, si van a recibir gente en casa, aunque al aire libre sería mejor, para asegurarse de que todos cumplan con esas tres cosas básicas de las que tanto hablamos: usar mascarilla, mantener la distancia y lavarse las manos. Ese plan de protección es tan importante como la prueba. Así que debemos asegurarnos de evitar que ocurra esa posible exposición. Así la interacción será más segura.

Debemos saber en cierta medida los comportamientos de esas personas antes de que nos visiten. Y, luego, la prueba es mucho más significativa. Noto que muchas personas usan la prueba como un boleto para viajar: "Mi prueba dio negativo, así que puedo ir a la reunión". Pero se olvidan de todas las demás cosas que deben hacer para seguirse protegiendo el uno al otro.

Bill Walsh: Sí. Buen punto. Muy bien. Bueno, gracias a los dos. Jean, ¿quién sigue en línea?

Jean Setzfand: La doctora Patel acaba de responder esta pregunta, pero había varias preguntas en YouTube relativamente similares. Ernie, por ejemplo, pregunta: "Después de estar expuesto, ¿cuánto tiempo pasa hasta que se comienza a tener síntomas?". Y, muy similar, Michelle pregunta: "¿En qué plazo, después de estar expuesto a la COVID-19, no deberíamos hacernos la prueba para evitar un falso negativo?".

Bill Walsh: Hmm. Doctora Patel, ¿puede responder esas preguntas?

Gopi Patel: Claro. No se sabe con certeza. La regla general que hemos estado usando aquí en los establecimientos de salud es que entre los cinco a siete días probablemente sea el mejor momento para hacerse la prueba si no hay síntomas. Si sabes que estuviste expuesta, o te han dicho que estuviste expuesta, y quieres saber si eres positivo. Algo muy interesante sobre la COVID-19 es que muchas personas son asintomáticas y transmiten el virus. Creo que muchas personas no tienen síntomas o los minimizan. Así que decimos que entre los cinco y siete días posteriores a la exposición probablemente sea el mejor momento. En cuanto a los síntomas, si los síntomas no se reducen y no hay otra causa y tienes un resultado negativo, lo recomendable es volver a hacer la prueba. Si se ve como un pato, huele como un pato y hace cuac como un pato, probablemente sea un pato. Yo diría que uno o dos días después del inicio de los síntomas.

Obviamente, las probabilidades previas a la prueba, como saber que estuviste expuesto, que te dijeran que estuviste expuesto, o que otras personas con las que estuviste hayan dado positivo, deben tenerse en consideración. Hay muchas clases de pruebas porque fueran aprobadas con una autorización de emergencia. No se sabe con certeza cuál es, algunos deben saber qué es, la sensibilidad de cada prueba. Todo eso debe tenerse en consideración. Así que yo diría que al segundo día de tener síntomas es el momento de hacer la prueba y tener un diagnóstico. Y si tienes una exposición, al quinto día de la exposición sería el mejor momento para hacerte la prueba.

Bill Walsh: Ahora, después de una exposición, si uno sabe que estuvo expuesto, ¿debería ponerse en cuarentena aunque tenga que esperar al quinto día para hacerse la prueba?

Gopi Patel: Definitivamente. Eso es algo que también notamos con frecuencia. Depende de dónde estés y a qué tengas acceso. En algunos casos, no obtienes los resultados de inmediato. Entonces, no solo deberías ponerte en cuarentena después de haber estado expuesto, sino también mientras esperas los resultados de la prueba. Si sabes que estuviste expuesto… La orientación médica es bastante estándar. Si estuviste expuesto, puedes no tener síntomas o un resultado positivo por 14 días.

Lo más probable es que sea entre el quinto y el séptimo día, pero el sistema inmunitario de cada persona es diferente y responde diferente. Así que sabemos lo que sabemos ahora, pero ese período de cuarentena de 14 días después de la exposición sigue siendo igual. Cualquier autoridad sanitaria… La orientación, por supuesto, está cambiando. Con los viajes, los consejos están cambiando. Así que hay que prestarle atención a eso también. Cada jurisdicción o estado tiene una guía diferente en vigor.

Bill Walsh: Cierto. Bien. Muchas gracias por eso. Jean, ¿quién sigue?

Jean Setzfand: Sigue Alleva, de Carolina del Sur.

Bill Walsh: Hola, Alleva. Adelante con tu pregunta.

Alleva: Sí. Mi esposo está en un hogar de ancianos, y le diagnosticaron COVID-19. ¿Cuáles son sus probabilidades de volver a contagiarse y qué chances tengo de visitarlo?

Bill Walsh: Lo lamento. Sí. Siento mucho oír eso. ¿Preguntas cuáles son las probabilidades de volver a contagiarse?

Alleva: Sí.

Bill Walsh: Bien. Entonces, se recuperó de su lucha contra la COVID-19, según entiendo. Y quieres saber… Sí. ¿Y el centro permite visitas a esta altura?

Alleva: No, no permiten visitas, pero me permitieron ir una vez a hablar con él. ¿Pero mi pregunta era cuáles son mis chances de haber estado expuesta?

Bill Walsh: Sí. Bien.

Alleva Aunque usé mascarilla.

Bill Walsh: Tenías… Bien, sí, equipo de protección personal. Bien. Bien, ¿por qué no…? Doctora Patel, ¿quiere abordar esa pregunta?

Gopi Patel: Claro. La tasa de reinfección es muy baja. Sin duda, se han reportado casos, en Estados Unidos y en otros países, de personas que fueron diagnosticadas COVID-19 con síntomas o siendo asintomáticos, es decir que se sentían o no enfermos, y fueron diagnosticados con COVID-19 nuevamente. Es muy poco probable, teniendo en consideración la cantidad de diagnósticos de COVID-19 que se realizaron a nivel mundial.

En cuanto a visitar a tu ser querido, una vez más, cada hogar de ancianos y cada estado tiene diferentes reglas sobre qué se necesita en cada hogar de ancianos en cuanto a testeo de personal y pruebas de rutina a los pacientes. Pienso que, si hay una preocupación y los hogares toman esto con seriedad, obviamente, limitan las visitas y se aseguran de que los residentes y los empleados, al igual que los visitantes, usen mascarilla y mantengan distancia. Es muy difícil, desde tu posición, sentirse incómoda al ir a visitarlo porque… Probablemente tu esposo no vaya a tener COVID-19, pero quizá alguien del personal u otros pacientes. Todos los centros están tomando esto en serio y tienen recomendaciones y pautas que exigen cumplir para garantizar que sus empleados no trabajen enfermos, usen mascarilla y tengan acceso al equipo de protección personal, que los pacientes sean testeados o usen equipo de protección personal, como las mascarillas. Y que también se interrogue a los visitantes en cuanto a síntomas, viajes o exposición y usen mascarilla también.

Siempre puedes distanciarte de tu ser querido si es… Es muy difícil, pero hay que mantener una distancia de seis pies y una visita corta. Muchos lugares también ofrecen visitas virtuales. Sé que la tecnología puede ser complicada a veces, pero a veces pueden usar un iPad o algo más para una visita virtual, en la que puedes disfrutar de ese tiempo de calidad y conversar con tu ser querido que está en ese lugar. Y eso, por supuesto, minimiza los riesgos para ti y para ellos también.

Bill Walsh: Muchas gracias. Y, doctor Hébert, me pregunto si tiene algo que aportar en cuanto a las preguntas que Alleva debería hacerle al hogar o las precauciones que debería tomar si considera ir a visitar a su esposo.

Warren Hébert: Bien, Alleva, gracias. Estar separados de la gente que queremos es una de las partes más difíciles de esto. Y, Alleva, una de las cosas que debes tener presente es cómo estás tú. No solo en cuanto al bienestar físico, sino también emocionalmente. Porque realmente nos afecta estar separados, aunque él ya estaba en un hogar de ancianos, no puedes visitarlo.

Lo que pienso que sería lo más prudente de hacer es tratar de averiguar qué medidas se están tomando en el hogar de ancianos. Si bien los centros para adultos mayores en todo Estados Unidos deberían seguir protocolos similares y tener regulaciones y reglamentos similares, la verdad es que hay de todo. Algunos estados cumplen muy bien con eso, y otros no tanto. Entonces, un poco sobre tu estado, pero también consulta Internet si tienes a alguien… Si puedes acceder a Internet, genial. Si no, alguien más en tu familia puede ayudarte a ver la tasa que hubo en ese geriátrico. Y eso te dará una idea de qué clase de protocolos tienen y qué tan bien les ha ido.

Los entornos de convivencia multitudinaria no son seguros para la gente hoy en día. Y tampoco son seguros para las personas que están en esos entornos. Sin embargo, hay excepciones. Hablamos de las reuniones virtuales. Tuvimos una reunión virtual con una amiga muy querida de muchos de nosotros, que tiene 90 años y está en un hogar de ancianos. Todos nos reunimos de manera virtual con ella, y desde marzo no hubo casos de COVID-19 en ese hogar de ancianos. Y ella es una mujer muy educada y sabe escribir cartas… Pero el punto es que tienes que conseguir información sobre ese asilo, reconocer que vas a ir a ese lugar y que, si lo haces, te pondrás en riesgo y es mejor hallar otras formas de estar conectados. Esas son mis recomendaciones. Gracias, Alleva. Es una pregunta importante.

Bill Walsh: Bien. Y gracias por todas las preguntas. Volveremos a las preguntas en un momento. Y recuerden que, para hacer preguntas, deben presionar *3 en el teclado del teléfono. Volvamos con nuestros expertos por un momento. Doctora Patel, hablamos un poco sobre las vacunas. Y hubo noticias muy alentadoras recientemente sobre el desarrollo de una vacuna. Pero, en general, ¿puede hablarnos un poquito sobre dónde estamos parados en cuanto a los ensayos clínicos y todo el proceso de desarrollo? En particular, qué pueden esperar los consumidores en cuanto a la seguridad y la eficacia de cualquier cosa que salga al mercado.

Gopi Patel: Claro. Hay cuatro vacunas candidatas y ensayos clínicos avanzados aquí en los Estados Unidos. Dos de ellos están bastante avanzados, y uno de ellos es la vacuna de Pfizer, la que se escuchó nombrar mucho esta semana por unos datos iniciales muy prometedores que surgieron de sus ensayos clínicos. Estos son grandes ensayos clínicos que comenzaron en la fase tres, y son de los ensayos en que les suministran la vacuna a algunas personas y solución salina, lo que llamamos placebo, a otras. Comenzaron en julio. Y, hasta la fecha, muchos de estos ensayos inscribieron a entre 30 y 43 mil personas, creo que en el caso de Pfizer. Y más del 50% de las personas que se inscribieron en el ensayo de Pfizer han completado las dos dosis de la vacuna. Son vacunas de dos dosis. Y lo que están analizando, en cuanto a la eficacia, es cuántas personas de cada grupo, el grupo que recibió la vacuna y el grupo que no recibió la vacuna y recibió el placebo o solución salina tuvo COVID-19. Y los datos iniciales son muy muy prometedores. Son datos preliminares.

La otra cosa que están analizando es el perfil Spacey. Si alguien tuvo efectos secundarios que se consideren inusuales. Los efectos secundarios como molestia en el brazo y dolor en la zona de la aplicación no son considerados inusuales para ningún tipo de vacuna, pero si hay algo más que sea inusual. Eso es lo que estamos esperando en cuanto a la vacuna de Pfizer para obtener una autorización para uso de emergencia por parte de la FDA. Esto es muy diferente a obtener la aprobación de la FDA para una vacuna que lleva mucho más tiempo. Pero, como dije antes, las personas que están investigando las vacunas son muy transparentes sobre lo que están analizando y son personas que están analizando todos esos datos, que incluyen científicos, expertos en enfermedades infeccionas, otros individuos que no son de la empresa analizan esos datos para asegurarse de que se haya cumplido con estas métricas de seguridad y eficiencia, y luego envían eso a un comité asesor para que lo vea. Y ese comité asesor también está formado por personas privadas. Así que no debe considerarse la idea de que esté políticamente manipulado. Realmente, el proceso es algo que se estableció para garantizar que sea una vacuna segura y eficiente cuando se ofrezca al público.

Bill Walsh: Doctora Patel, siguiendo ese punto, se mencionó varias veces hoy que es un desarrollo acelerado y proceso de revisión acelerado. Las revisiones por parte de la FDA para aprobar medicamentes suelen tomar años, y este se está haciendo mucho más rápido mediante esta autorización para uso de emergencia. ¿Qué tanto deberían confiar los consumidores en la seguridad del resultado de un proceso acelerado como este?

Gopi Patel: Pienso que debería ser tranquilizador el hecho de que nadie toma el asunto de la seguridad y eficacia de la vacuna a la ligera. Esto es para que llegue al público antes de lo habitual. Y, además, hacerlo así elimina el riesgo de que compañías farmacéuticas se involucren en el desarrollo de la vacuna. El desarrollo de una vacuna normalmente… Creo que el doctor… No recuerdo si fuiste tú o el doctor Hérbert que mencionó lo rápido que todo esto está sucediendo, pero eso está eliminando parte del riesgo que las empresas farmacéuticas agregan y que podría hacer que una vacuna tarde años.

Así que una de las cosas a las que la gente hace referencia como procedimiento en vigor elimina parte de los riesgos financieros y parte de las demoras que se originan por la manufactura y distribución de las vacunas, y como están estudiando, se están desarrollando y también se está analizando un plan de distribución. Pienso que el objetivo de la FDA, de los CDC y todas las autoridades de salud pública, que tienen esperanzas en las vacunas, es garantizar que sea algo seguro y eficaz porque este es uno de los avances más prometedores que tenemos en cuanto a frenar esta pandemia. Así que yo estudiaría más al Comité Asesor de Vacunas de la FDA y el ACIP y las recomendaciones que haremos. Todos son muy cuidadosos y precavidos, pero estamos un poco más optimistas de lo que hemos estado en las semanas anteriores. La noticia que salió sobre la eficacia es muy emocionante.

Bill Walsh: Sí. Bien. Muchas gracias, doctora Patel. Y en seguimiento a… Hablamos con Alleva, de Carolina del Norte, hace un momento. Y le intrigaban las condiciones dentro del hogar de ancianos donde está su esposo. Solo quiero compartir contigo un recurso disponible en el sitio web de AARP. Hemos creado una herramienta que hace un seguimiento de los casos de coronavirus, las cantidades y tasas en los diferentes hogares de ancianos en el país. Podrías echarle un vistazo, si tienes acceso al internet, en aarp.org/nursinghomes. Es aarp.org/nursinghomes. Puedes hallar mucha más información allí sobre nuestro trabajo en relación con hogares de ancianos, preguntas que debería hacerse a los hogares de ancianos o cuidadores a largo plazo. Es un gran recurso.

Doctor Hébert, quiero volver con usted. A medida que los casos aumentan en todo el país, ¿hay precauciones o pasos extra que deba tomarse si alguien asiste a nuestro hogar para ayudarnos con las necesidades de cuidado?

Warren Hébert: Sí. Y es una pregunta importante, y la voy a dividir en dos, si me permiten elaborar. Primero, los cuidadores formales. El cuidador formal es alguien que puede estar con un hospital o centro de cuidado en el hogar o, como en el caso de mi hija… bueno, nosotros recibimos atención no médica mediante profesionales de atención directa. Todas esas organizaciones tienen protocolos que deben cumplir. Y esos protocolos para las organizaciones formales incluyen testeos regulares y encuestas periódicas sobre si esos miembros del personal estuvieron expuestos o no. También incluyen el control de la temperatura y esa clase de cosas. Así que, esencialmente, esas personas que son cuidadores formales hacen esas cosas como parte de su protocolo y son las cosas que deben hacer.

También tenemos con frecuencia cuidadores familiares, quizá alguien que nos ofrece su ayuda, alguien que nos asiste cuidador familiar y viene regularmente para darnos una mano. Una amiga mía viajó de Massachusetts a Indiana hace unos días. Y hablamos sobre el hecho de que tiene que ponerse en cuarentena antes de prestar cuidados. Tiene que estar segura de que nadie en su familia, de las personas con quienes convive… Como dijo la doctora Patel antes, quien vive contigo y tú, ambos deben tomar en serio la necesidad de evitar las multitudes, o esa persona con la que vives se convierte en un riesgo para ti.

Pero cuando viajas para cuidar de alguien más, ese período de cuarentena es muy importante para ti como cuidador familiar, antes de ir a prestar cuidados a alguien más. Y algo que realmente creo que vale la pena repetir porque es fácil recordar y muy importante de hacer son las tres cosas básicas que mencionó la doctora Patel: usar mascarilla, mantener la distancia y lavarse las manos. Son cosas muy importantes. Y la sensación que tengo por ver a la gente por donde ando en el sur de Luisiana y por mirar televisión, es que, me parece, podemos reducir mucho los riesgos si tomamos en serio estos tres simples pasos.

Bill Walsh: Sí. Doctor Hébert, habló sobre la importancia de abogar por los seres queridos en este momento, ya sea yendo a un hogar de ancianos o recibiendo profesionales de cuidado en casa. Este es el momento en que debemos ponernos de pie y presionar a las empresas y hacerles preguntas. Este es el momento en que debemos ser el defensor y obtener respuestas por la seguridad de nuestros seres queridos. ¿Es así?

Warren Hébert: Totalmente. Y los cuidadores, en general, van a ser comprensivos y apreciarán el hecho de que hagas el papel de defensor. Por ejemplo, una de las cuidadoras de mi hija vivió una tragedia dentro de su grupo de amigas. Todas se graduaron de la secundaria el año pasado. Y una de esas jóvenes amigas murió. Ella quería ir al funeral y decidió ir. Entonces, tuvimos una conversación con ella sobre cómo se iba a relacionar con la gente en el funeral, si iba a poder mantener la distancia con ellos, si iba a usar mascarilla. Y después, aunque haya tomado todas esas precauciones, para quedarnos tranquilos, le pedimos que use mascarilla cuando venía a casa por un tiempo. Así que sí, como cuidador familiar, es fundamental que ocupes el papel de defensor y que les hagas preguntas a los cuidadores formales sobre qué han estado haciendo. Son buenos pasos a seguir, Bill. Y te agradezco la pregunta.

Bill Walsh: Muy bien. Muchas gracias, doctor Hébert y doctora Patel. Volveremos con las preguntas de nuestros oyentes en breve. Pero, antes de eso, quiero hacerles un recordatorio de AARP contra el fraude.

Los estafadores siguen sacando provecho de la situación actual para robar dinero o información personal. La Comisión Federal de Comercio ha recibido cerca de 243,000 quejas de consumidores en relación con la COVID-19 hasta el 4 de noviembre. Los estafadores usan un conjunto de herramientas para realizar estafas, como correos electrónicos de suplantación de identidad, mensajes de texto, publicaciones falsas en redes sociales, llamadas automáticas, carteles y más. Están muy atentos a las noticias y adaptan sus mensaje y tácticas de acuerdo a las novedades médicas o económicas.

Un consejo para evitar estafas en relación con el coronavirus: eviten las ofertas en línea que ofrezcan vacunas y curas relacionadas con el coronavirus. Desconfíen de correos electrónicos, llamadas y publicaciones en redes sociales que ofrezcan pruebas de COVID-19 gratis o cubierto por el Gobierno. No hagan clic en enlaces ni descarguen archivos de correos inesperados, incluso si la dirección parece ser de una empresa o persona que conocen. No compartan información personal, como el número de seguro social, Medicare o números de tarjetas de crédito en respuesta a una llamada, mensaje de texto o correo electrónico no solicitado. Y, por último, desconfíen de llamadas o correos electrónicos que digan recaudar fondos para víctimas de COVID-19 o para investigaciones sobre el virus, especialmente si los presionan para actuar rápido y piden pagos con tarjetas de débito prepagas o tarjetas de regalo. Visiten aarp.org/fraude para saber más sobre estas y otras estafas o llamen a la red contra el fraude al (877) 908-3360. Es (877) 908-3360.

Ahora, es momento de responder más de sus preguntas con la doctora Patel y el doctor Hébert. Presiona *3 en el teclado de tu teléfono en cualquier momento para ser comunicado con un miembro del personal de AARP. Jean, ¿a quién tenemos en línea?

Jean Setzfand: La siguiente llamada es de Cynthia, de California.

Bill Walsh: Hola, Cynthia. Bienvenida al programa.

Cynthia: Muchas gracias.

Bill Walsh: Adelante con tu pregunta.

Cynthia: Sí, mi pregunta es para la doctora Patel. Ayer, como suele pasar a menudo, me encontré con un hombre en el supermercado que no usaba mascarilla. Estaba detrás de mí en la fila para la caja. Iniciamos un debate sin fin sobre por qué no estaba usando mascarilla. Y su respuesta fue la misma que recibí de muchas personas. Me dijo: "No es que sirva de mucho para protegerme de todos modos". Y me gustaría saber cuál sería su respuesta ante eso.

Bill Walsh: Bien. Doctora Patel, ¿puede responder eso?

Gopi Patel: En primer lugar, gracias por abogar por la seguridad de todos. Sé que no es fácil educar a personas que están tan convencidos de sus ideas del uso de mascarillas. Dos cosas, a veces es mejor simplemente alejarse. Es lo mejor para tu seguridad. Si no tienen mascarilla e interactúas con ellos, hay riesgos. Descubrimos que las mascarillas no solo te protege a ti de mí, sino que también me protege a mí de ti. Así que es un mecanismo de protección, ya que retiene las microgotas. Y cada vez hay más datos que respaldan eso.

De hecho, los CDC recientemente dijeron que sostienen con firmeza que las mascarillas nos protegen de manera bidireccional: me protege a mí de tus microgotas y te protege a ti porque evita que yo esparza mis microgotas. Así que todo lo que puedes decir es que hay datos que respaldan el hecho de que las mascarillas nos protegen y también te protegen de mí. Así que yo uso mi mascarilla por ti, usa tu mascarilla por mí. Pero me preocupa tu seguridad en esas interacciones. Es mejor que te alejes. Y si tienes una relación con la tienda, hazles saber que eso no es seguro y que deberían exigir el uso de mascarilla para ingresar.

Muchas tiendas ya lo están haciendo. Yo vivo en… Soy de Nueva York y vivo en un estado que exige el uso de mascarillas. Pienso que hay personas que se están cansando del uso de mascarillas, pero para protegerte, te diría que te preocupes por mantener la distancia, pero también te aplaudo por tratar de educar a otro. Pero es… Tenemos una de las autoridades de salud pública haciendo hincapié en eso. Es bidireccional, así que todo el mundo debería usarla y, obviamente, también mantener la distancia si es posible.

Bill Walsh: Bien. Muy bien. Jean, ¿quién sigue?

Jean Setzfand: La siguiente llamada es de Gloria, de Nueva York.

Bill Walsh: Hola, Gloria. Adelante con tu pregunta.

Gloria: Hola. Estoy muy emocionada con AARP. Soy socia desde hace 26 años. Solo… Amo a la gente de AARP que conozco.

Bill Walsh: Bueno, gracias. También te amamos, Gloria.

Gloria: Gracias. Tengo 85, a punto de cumplir los 35, y estoy a cargo de mi bisnieto de 14. Lo tengo a cargo desde que tiene cinco años. Y trato de hablar rápido para asegurarme de poder decir todo. Está con clases a distancia desde la escuela intermedia y comenzó la secundaria en septiembre. Y el lunes, nos notifican que venía estando ausente. Sus notas están muy bajas. Y nunca, nunca tuvo notas bajas. Me preocupé mucho y decidí, en vez de llamar por teléfono, ir a hablar. Lo llevé a él y a la tableta que estaba usando en ese momento porque su computadora portátil se rompió y le permití usar mi tableta, que me dieron mi grupo de cuidadores, y el tutor se fijó y dice: "No entiendo por qué estás tanto ausente. No entiendo por qué dices que envías los trabajos, pero no hay nada aquí". Entonces… Resumiendo la historia, el tutor descubrió ese día, que fue el lunes 9, que no estaba entregando los trabajos de todas las clases. Y yo dije: "Bueno, entonces es culpa de él". Entonces, dejé que pase el día y decidí que fuera a algunas clases y siguiera de manera remota algunos días. Y se terminó.

Ahora estoy preocupada porque oí que habrá un pico, y él nunca estuvo enfermo. Yo tampoco he estado enferma, pero tengo algunos problemas subyacentes. Tengo una afección cardíaca, y me pusieron una endoprótesis vascular en el corazón recientemente, el mes pasado. Están estudiando mi válvula aórtica. Con todo eso, me siento fantástica, pero estoy en manos de Dios. Y hablo con la gente. No espero a que me llamen, yo los llamo si me siento un poco sola, porque extraño a muchas personas. Estoy bendecida, tengo buenos amigos. Pero me preocupa su trabajo. Y no sé si es buena idea que vaya a clases presenciales en este momento por este pico del que se está hablando.

Y otra cosita rápida, el Día de Acción de Gracias. Es algo rápido, perdón. En el Día de Acción de Gracias, quería reunir a mi bisnieto, mi nieto y mi hijo es mi soporte. No tengo muchos familiares. No tengo un caserón, pero quería estar rodeada de ellos para el Día de Acción de Gracias. Usar mascarilla y solo estar juntos. Con mucha comida, pero con mascarillas y guantes, todo lo que necesitamos. Y quería saber si es una buena idea.

Bill Walsh: Muy bien. Bueno, Gloria, muchas gracias por tu llamada. Y preguntémosle al doctor Hébert al respecto. Tocaste dos temas muy importantes que, creo, están en la cabeza de todos en estos días. Uno es la enseñanza a distancia, que no es una situación ideal para nadie. Y mencionaste los problemas técnicos. Doctor Hébert, teniendo en cuenta que Gloria tiene 85 años, ¿qué opina de que cambie las clases a distancia de su bisnieto por mandarlo a clases presenciales? Y, en relación con eso, ¿qué opina de la reunión familiar? ya hemos hablado del tema hoy, pero ¿cree que pueda darle algún consejo sobre las precauciones que debería tomar si decide hacerlo?

Warren Hébert: Gloria, comencemos con la pregunta relacionada con la educación. Mi esposa es profesora de escuela secundaria y se ocupa de las clases semipresenciales ahora. Mi yerno tiene educación doctrinaria, perdón por presumir de él, pero es director académico del sistema escolar aquí en Lafayette, Luisiana. Ambos se enfrentaron a grandes desafíos. No es fácil para las personas que están a cargo del sistema escolar cambiar de repente sus protocolos relacionados con el aprendizaje, pero en todo el país, los sistemas escolares han hecho un trabajo extraordinario para que funcionara. Tenemos 12 nietos, como ya mencioné antes, y a algunos de nuestros nietos les va bien con la nueva transición al sistema semipresencial. A otros no. Así que tu bisnieto no está solo. Mi esposa tiene alumnos que han sido muy buenos en el pasado, pero ahora haciendo la mayor parte de las tareas en línea, sus notas están más bajas de lo que siempre han estado.

Pienso que hiciste lo correcto viendo si era un problema tecnológico porque la verdad es que, a veces, la tecnología puede fallar aquí o allá. Así que el hecho de que te hayas asegurado de que la herramienta estaba funcionando fue un muy buen primer paso. En cuanto al pico que tienen en Nueva York, y el hecho de que pueda seguir trabajando en línea, deberías sentarte a hablar con él porque la realidad es que nuestra situación puede cambiar o puede que sigamos así por un buen tiempo. Todos somos optimistas sobre las vacunas, pero puede pasar un tiempo. Así que puede que sea una oportunidad para que crezca en esa área en particular.

Bill Walsh: Doctor Hébert, permítame dejarlo más en claro. Si existe la posibilidad de que el bisnieto de Gloria vaya a la escuela, quizá un par de días a la semana, ¿qué debería esperar? Es decir, ¿qué puede esperar por parte del sistema escolar o qué preguntas debería hacer para quedarse tranquila de que el chico va a estar en un entorno seguro y que no llevará el virus a casa?

Warren Hébert: Excelente, Bill, porque no solo estamos pensando en la perspectiva de la educación. Hay que asegurarse de que el personal y todos los alumnos usen mascarilla. La escuela en la que está mi esposa recibe orientación por parte de médicos locales que encabezan la salud pública. Todos usan mascarilla y mantienen la distancia. Y esparcen a los alumnos que asisten de manera presencial. Algunos alumnos van los lunes y miércoles. Otros van los martes y jueves. De esa manera, hay menos alumnos en la sala y los escritorios están distanciados para que haya mucha más distancia entre los alumnos. Y, como la doctora Patel mencionó antes, hay espacios para lavarse las manos. Usar mascarilla no es opcional. Y se aseguran de que se mantenga la distancia entre los alumnos. Esa son algunas de las cosas. Y la escuela de mi esposa es una escuela privada. Gastaron como cien mil dólares en un sistema de aire acondicionado que purifica el aire con mayor frecuencia de lo que se hacía antes. Así que esas son algunas de las medidas que pueden tomarse.

Bill Walsh: Oímos en nuestro distrito escolar que van a limpiar los salones dos veces al día, después de clases y, cuando los chicos estén almorzando, las volverán a limpiar. Así que hay desinfección constante. Supongo que los sistemas escolares varían, pero pienso, Gloria, que son cosas que puedes pedir. Y, doctor Hébert, claramente ella está esperando el Día de Acción de Gracias en familia. Ya hablamos sobre esto, pero quizá pueda recordarles a nuestros oyentes, si deciden reunirse en persona, cuáles son las precauciones que deberían tomar.

Warren Hébert: Gloria, vuelvo a decir que realmente me llega al corazón. Nosotros tenemos una gran familia, y en las reuniones hay mucha comida y muchas risas. Y, en algunas ocasiones, cantamos también. Entonces, cuando pensamos en los mayores riesgos, sabemos que hay riesgos de que alguien esparza el virus cuando se comparten risas, cuando se canta o, si tu familia se parece a la mía, las conversaciones no siempre son en voz baja. Cuando más exuberantes estemos en la forma de expresarnos, más de esos aspectos del aire que expulsamos del cuerpo impactarán en otros. Ser consciente de eso es fundamental. Y, una vez más, las tres cosas básicas. Doctora Patel, creo que no era la idea repetirlas seis veces, pero pienso que es muy importante. Hay que mantener la distancia.

Fui a un partido de fútbol de uno de mis nietos el sábado pasado. Realmente amo mucho a mi nieto, pero nos mantuvimos a una buena distancia. Y me alegra que lo hayamos hecho, porque me dijo hace poco que dio positivo. Así que reunirse al aire libre, si es que es posible, Gloria… Sé que estás en Nueva York, y la temperatura… hay que usar mascarilla y lavarse las manos con frecuencia. Si van a comer juntos, hay pasos que debes seguir para garantizar que las personas a tu alrededor no estén usando los mismos utensilios, las mismas servilletas, etc. Eso es más detallado de lo que podemos abarcar en la llamada, pero podemos hacerte llegar información sobre los pasos que sería prudente que siguieras.

Si vas a estar en un lugar donde van a comer, lo más prudente sería que cada uno lleve su propia comida, pero no creo que ese sea el plan. No creo que vaya a suceder porque quieres cocinar para todos. Estos son tiempos difíciles por todas estas tradiciones que son tan importantes para nosotros como familias. A veces, tenemos que cambiar esas tradiciones y crear nuevas que nos garanticen que estemos seguros. Porque, como dije antes, se está avanzando muy rápido con las vacunas. Y puede que esto solo sea cuestión de unos meses más. Quizá el año próximo volvamos a las viejas tradiciones, y sin duda querrás estar.

Bill Walsh: Muy bien. Gracias, doctor Hébert. Y les recuerdo a nuestros oyentes que presionen *3 en el teclado de su teléfono en cualquier momento para ser conectados con un miembro de AARP que nos facilitará sus preguntas. Pasemos a otras preguntas, Jean.

Jean Setzfand: Sí, tenemos algunas preguntas a través de Facebook, que están relacionadas. La primera es de Millie, que consulta sobre las vacunas: "¿Algunos de los sujetos de prueba para la vacuna fueron personas de color o mayores de 55? ¿Está disponible esa información? Si no, ¿estará disponible antes de que la vacuna esté disponible al público?". Tenemos una pregunta relacionada, de Jim a través de Facebook: "Tengo 65 años. ¿Es recomendable que reciba la vacuna?".

Bill Walsh: Doctora Patel, ¿quiere responder estas muy buenas preguntas sobre quiénes forman parte de los ensayos clínicos, personas de color o mayores de 55? Empecemos por ahí.

Gopi Patel: Por supuesto. Si van a… lamentablemente, hay que contar con tecnología, pero si visitan los sitios web, las vacunas candidatas… En primer lugar, a todas se les pidió específicamente que incluyan individuos con alto riesgo de COVID-19 reconociendo las disparidades que había cuando comenzamos a analizar quiénes se estaban infectando con COVID-19. Por ejemplo, para Pfizer, el 45% de los individuos que participan en el ensayo clínico son mayores de 55. Y muchos, creo que cerca del 40% si no más, son personas que se identificaron como no de raza blanca. Así que sí hicieron el esfuerzo, un esfuerzo notable, considerando la cantidad de personas que se inscribieron para formar parte de estos ensayos, para que reflejara a las poblaciones en mayor riesgo en cuanto a si deberíamos aplicarnos la primera vacuna que esté disponible.

Habrá una distribución escalonada. Así que algunas de las primeras vacunas que estén disponibles serán en dos dosis, y luego llegará la de una sola dosis, como es la de la gripe que nos aplicamos todos los años. Tampoco sabemos a este punto si será una vacuna que deba aplicarse todos los años, como la de la gripe, o si será algo que se aplique cada cinco años, como la vacuna antineumococo. Estas cosas aún no tienen respuesta, pero yo pienso, es mi opinión propia, que es algo que ha probado ser seguro y eficaz y que puede llevarnos a un lugar en el que la transmisión haya disminuido. Y cuando te ofrezcan la vacuna, debatas con tu proveedor, vean todos los detalles y decidan si es recomendable para ti aplicarte la vacuna en ese momento. Y cuáles son los pasos siguientes.

Siempre hay que ser un consumidor y paciente informado, y una persona informada, para asegurarte de tomar la mejor decisión para ti. Personalmente, si les ofrecieran la vacuna a mis padres, yo les diría que se la aplicaran porque yo tampoco los he visto en los últimos once meses y son mayores. Y también quisiera que vean a su nieta.

Bill Walsh: Exacto. va a ser un momento complicado, ¿no? Todas las personas tendrán sus preocupaciones personales sobre si hay efectos secundarios, si será efectiva la vacuna que salga al mercado. Así que pienso que la advertencia de hablar con tu médico, que conoce tu salud más que cualquiera, probablemente sea por donde comenzar. Jean, ¿quién sigue?

Jean Setzfand: Sigue Judy, de Nueva York.

Bill Walsh: Hola, Judy. Adelante con tu pregunta. Hola, Judy. Bienvenida al programa. Adelante con tu pregunta.

Jean Setzfand: Creo que perdimos a Judy. Lo siento.

Bill Walsh: Bueno.

Jean Setzfand: Pasemos a Holly, de Kentucky.

Bill Walsh: Muy bien. Holly, bienvenida al programa.

Holly: Gracias. Tengo un hijo que está en la facultad, en la universidad. Van a cerrar justo antes del Día de Acción de Gracias, hasta fines de enero. Me pregunto si tienen alguna sugerencia sobre cómo ayudarlo en la transición de volver a casa a vivir con nosotros durante unos meses.

Bill Walsh: Buena pregunta. Pienso que muchas personas están enfrentando ese desafío. Doctor Hébert, ¿tiene algún…?

Holly: Están…

Bill Walsh: Adelante, Holly. Perdón. Bueno. Doctor Hébert, ¿algún consejo para Holly con su hijo que vuelve de la facultad?

Warren Hébert: Sí, los lazos familiares son muy importantes, y AARP está haciendo un reconocimiento extraordinario que tiene que ser parte de nuestro proceso de toma de decisiones. Holly, que un miembro de la familia vuelva a vivir con ustedes, tomar ciertas medidas para reducir los riesgos sería muy importante. Un período de cuarentena es algo que oímos a menudo. Hacerle saber que, como vuelve de la universidad, estuvo en un espacio diferente y probablemente en contacto con mucha gente, sería bueno que se pusiera en cuarentena.

Obviamente, eso significa que quizá esté en cuarentena durante el Día de Acción de Gracias. Sé que muchas universidades están tomando la decisión de terminar el año con el Día de Acción de Gracias y no volver hasta diciembre. Así que volverá en un momento en que te estés preparando para una reunión familiar, y eso lo hace más difícil. una vez más, sé que estás en Kentucky, y las temperaturas allá son mucho más bajas que la mía, pero si tuvieras la opción de reunirse al aire libre.

Por ejemplo, recientemente tuvimos una reunión familiar en un parque estatal y pasamos la mayor parte del tiempo al aire libre, distanciados alrededor de la fogata. Y es algo que los miembros de la familia que son médicos dijeron que el distanciamiento es importante. Estar al aire libre también es importante. Esas son las medidas que yo tomaría, Holly. Asegurarme de hallar la forma que funcione en su período de cuarentena para él antes de que vuelva. Y cuando vuelva, que siga las tres cosas básicas: mantener la distancia, lavarse las manos y usar mascarilla.

Bill Walsh: Bien. Muy bien. Jean, ¿quién sigue?

Jean Setzfand: Tenemos otra pregunta que nos llega a través de YouTube, y es de Evelyn. Nos pregunta: "¿Cómo ayudan las terapias? ¿Reducen la tasa de mortalidad? ¿Qué tan disponibles están?".

Bill Walsh: Doctora Patel, ¿puede decirnos algo sobre las terapias?

Gopi Patel: Claro. Creo que uno de los problemas que ya mencionamos es que las personas acuden a consulta antes de tiempo. Los cuidados de apoyo que puedan brindarse en los hospitales, junto con el oxígeno, los esteroides, etc. Parecen estar ayudando a reducir la tasa de mortalidad. Y, una vez que alguien está con respirador artificial, ya es un poco más difícil. Y a eso se suman las cosas que vienen con una persona en terapia intensiva con respirador.

Lo llamamos morbilidad, pero los efectos y efectos secundarios de estar con respirador y demás y de estar hospitalizado por mucho tiempo. Los datos son muy recientes como para comparar. Es difícil decir cuándo fue la primera ola de la pandemia y si estamos en una segunda ola o si aún es parte de la primera. Pero pareciera que esto no es en Nueva York, donde estoy yo, en todo el mundo las personas se sienten mejor por recibir oxígeno a tiempo y no incubar pacientes o ponerlos con respirador de inmediato, y el uso de esteroides.

Y aprendimos mucho más sobre el hecho de que hay mucha coagulación con este virus en particular. No se compara con ningún virus que hayamos visto antes. Muchos de ustedes deben conocer a alguien o puede que hayan estado en centros de sangre, cosas como apixabán o Eliquis, y no tengo relación alguna con ninguna de estas empresas. O heparina u otras clases de anticoagulantes que parecen ayudar en el tratamiento de la COVID-19, especialmente en pacientes enfermos que requieren internación. La gente se siente mejor.

Aún estamos aprendiendo sobre los efectos secundarios a largo plazo de la COVID-19 severa. Y pienso que vamos a aprender más sobre eso a medida que obtengamos más datos y que más estudios sean publicados, en vista a cómo las personas, especialmente las personas mayores, tienen ciertos antecedentes médicos o tienen otras enfermedades que interfieran, pero las personas se sienten mejor. Y pienso que en gran parte se debe a que se presentan antes en la enfermedad, y entonces podemos diagnosticarlos y comenzar con la terapia.

Bill Walsh: Bien. Muy bien. Gracias, doctora Patel. Doctora Patel y doctor Hébert, estamos llegando al final de este encuentro. Me pregunto si tienen alguna reflexión final o recomendación que los socios de AARP puedan llevarse de nuestra charla de hoy. Doctora Patel, ¿quiere comenzar?

Gopi Patel: Perdón. Te perdí por un segundo. ¿Podrías repetir eso?

Bill Walsh: Bien. Sí, claro. Me preguntaba si tienen alguna reflexión final o alguna recomendación para cerrar nuestra conversación de hoy.

Gopi Patel: Creo que estamos en un momento especial en el que tenemos que dejar un poco de lado lo que nos gusta hacer y pensar en cuidarnos, como nos dijo el doctor Hébert, en vista de las fiestas que se aproximan. Sé que es difícil, pero es importante que estemos todos seguros. Usar mascarilla, mantener la distancia y ser muy conscientes sobre los planes de protección a medida que nos acerquemos a las fiestas, en las que algunos elegirán reunirse con los familiares que no ven hace tiempo. Hay avances muy prometedores en cuanto a las vacunas, así que crucemos los dedos, de las manos y los pies. Y sigan trabajando con sus proveedores de atención médica y estén atentos a las novedades que haya en su estado y a las autoridades sanitarias sobre las próximas medidas dentro de casa y al aire libre.

Bill Walsh: Muy bien. Hay luz en el horizonte. Doctor Hébert, ¿alguna reflexión final?

Warren Hébert: Bueno, respecto a lo que dijo la doctora Patel sobre cruzar los dedos del pie, me está costando hacerlo. Gracias por el toque de humor. Nuestro bienestar es muy importante y gran parte de nuestro debate estuvo relacionado con nuestro bienestar fisiológico. Pero también hablamos sobre nuestro bienestar emocional. Y pienso que eso balance es algo muy importante de la conversación de hoy, Bill, porque si estamos quemados, si estamos cansados y temerosos, no tenemos un buen juicio. Así que nuestro bienestar emocional es fundamental. Y una medida que me parecen importante es reducir el tiempo que pasamos viendo televisión o con la tecnología. Al igual que con los medicamentos, podemos tener una sobredosis. Aunque sea difícil enfrentar lo que está pasando, intenten limitar el tiempo que pasan viendo televisión o haciendo uso de la tecnología.

Y, en segundo lugar, saber que las directrices cambian. Como dijo la doctora Patel, estamos aprendiendo rápidamente sobre este virus. Estamos aprendiendo cómo medicarlo y tratarlo mejor. Estamos aprendiendo mucho sobre su tratamiento. Así que tengan presente que las directrices pueden cambiar. Si aceptan que van a cambiar porque estamos más informados sobre cómo manejarlo, habrá menos ansiedad al respecto.

Otra cosa que ya mencioné antes es elegir con quién conectarse porque necesitamos conectarnos con la familia. Necesitamos estar conectados, pero sabemos que hay personas que nos sobrecargan de ansiedad y drama, así que puedes elegir no conectarte con esas personas o qué tanto te conectas con ellas. Y no quiero sonar malo, para nada, pero debes ocuparte de tu bienestar.

Y, por último, reconocer a los cuidadores familiares. Tenemos 54 millones de cuidadores en el país. Una de cada cinco personas en Estados Unidos es cuidador. Así que si nos estás escuchando y sabes de alguien que es cuidador, tómate un momento para agradecerle, ya que nos acercamos al Día de Acción de Gracias. Gracias, Bill.

Bill Walsh: Bien. Bueno, gracias. Gracias a ambos por responder nuestras preguntas. Ha sido un debate muy informativo. Gracias a los socios y voluntarios de AARP y a nuestros oyentes por participar de este debate.

AARP es una organización sin fines de lucro, no partidaria, que ha trabajado para promover la salud y el bienestar de adultos mayores en el país durante más de 60 años. De cara a esta crisis, AARP está brindando información y recursos, para ayudar a los adultos mayores y a quienes cuidan de ellos a protegerse del virus, prevenir el contagio mientras los cuidan.

Todos los recursos a los que hicimos referencia, incluyendo la grabación de este evento de preguntas y respuestas, están disponibles e aarp.og/elcoronarivus a partir del 13 de noviembre. Nuevamente, el sitio web es aarp.org/elcoronavirus. Visiten el sitio si sus preguntas no tuvieron respuesta, y encontrarán allí las últimas actualizaciones e información creada especialmente para adultos mayores y sus cuidadores.

Esperamos que hayan aprendido algo que les sea de utilidad para que ustedes y sus seres queridos se mantengan saludables, especialmente en las fiestas. Asegúrense de escucharnos el próximo jueves, 19 de noviembre a la 1:00 p. m., hora del este, para un debate sobre vacunas y la seguridad durante las fiestas. Gracias a todos y que tenga un buen día. Esto concluye nuestra teleasamblea.


For the latest coronavirus news and advice, go to AARP.org/coronavirus.


Replay previous AARP Coronavirus Tele-Town Halls

  • April 22 - Your Vaccine Questions Answered and Coronavirus: Vaccines and Asian American and Pacific Islanders
  • April 8 - Coronavirus and Latinos: Safety, Protection and Prevention and Vaccines and Caring for Grandkids and Loved Ones
  • April 1Coronavirus and The Black Community: Your Vaccine Questions Answered
  • March 25Coronavirus: The Stimulus, Taxes and Vaccine
  • March 11 - One Year of the Pandemic and Managing Personal Finances and Taxes
  • February 25Coronavirus Vaccines and You
  • February 11 - Coronavirus Vaccines: Your Questions Answered`
  • January 7 - Coronavirus: Vaccines, Stimulus & Staying Safe
  • January 14 - Coronavirus: Vaccines, Staying Safe & Coping and Prevention, Vaccines & the Black Community
  • January 28 - Coronavirus: Vaccine Distribution and Protecting Yourself
    & A Virtual World Awaits: Finding Fun, Community and Connections
  • Dec 3 - Coronavirus: Staying Safe & Coping This Winter
  • Nov 19 - Coronavirus: Vaccines, Staying and A Caregiver's Thanksgiving
  • Nov 12 - Coronavirus: Coping and Maintaining Your Well-Being
  • Oct 1 - Coronavirus: Vaccines & Coping During the Pandemic
  • Sept 17 - Coronavirus: Prevention, Treatments, Vaccines & Avoiding Scams
  • Sept 3 - Coronavirus: Your Finances, Health & Family (6 months in)
  • Aug 20 - Your Health and Staying Protected
  • Aug 6 - Coronavirus: Answering Your Most Frequent Questions
  • July 23 - Coronavirus: Navigating the New Normal
  • July 16 - The Health and Financial Security of Latinos
  • July 9 - Coronavirus: Your Most Frequently Asked Questions
  • June 18 and 20 - Strengthening Relationships Over Time and  LGBTQ Non-Discrimination Protections
  • June 11 – Coronavirus: Personal Resilience in the New Normal