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AARP Coronavirus Tele-Townhall: Staying Safe and Coping This Winter

Expert answers on vaccines, mental health and staying connected

Bill Walsh:  Hello. I am 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. As coronavirus cases, hospitalizations and deaths continue to rise in almost every state, Americans have entered a new and dangerous phase of the pandemic. Particularly around the holidays it can be difficult to stay connected with family and friends, while also staying socially distanced and safe. But the good news is there are signs of hope as more progress is being made on vaccines and treatments. Today, we’ll talk to two expert guests about all of these issues.

 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 us 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 who will 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 Steven C. Johnson, M.D., professor of medicine in the Division of Infectious Diseases at the University of Colorado School of Medicine and Anschutz Medical Campus, Multidisciplinary Center on Aging. Also joining us is Altha Stewart, M.D., past-president of the American Psychiatric Association and Associate Professor of Psychiatry at the University of Tennessee Health Science Center. We’ll also be joined by my AARP colleague Jean Setzfand, who will help facilitate your calls today. My AARP colleague Bill Sweeney will also join us a bit later to provide an update on how AARP is fighting for you during the pandemic.

 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 guests. First is Steven C. Johnson, M.D. He is a professor of medicine in the Division of Infectious Diseases at the University of Colorado School of Medicine and Anschutz Medical Campus’s Multidisciplinary Center on Aging. He has decades of experience treating infectious diseases and is a member of the Health and Human Services Panel on Antiretroviral Guidelines in Adults and Adolescents Living with HIV. His is also a member of the National Institutes of Health Panel on the Management of COVID-19. Welcome back to the program, Dr. Johnson.

Steven Johnson:  Thank you.

Bill Walsh:  Great to have you here. We’re also joined by Altha Stewart, M.D. She is a past-president of the American Psychiatric Association. She’s a senior associate dean for community health engagement and associate professor and chief of social and public psychiatry at the University of Tennessee Health Science Center in Memphis. Her career spans three decades of work as the CEO of a large public mental health systems in Michigan, Pennsylvania and New York. Welcome back, Dr. Stewart.

Altha Stewart:  Thank you Bill. Glad to be here.

Bill Walsh:  We’re glad to have you. Let’s get started with the discussion Dr. Johnson, let’s go ahead and start with you. You know, we continue to see positive news about vaccine development, and we’re seeing news that vaccines could be available as soon as mid-December. What’s the latest expected timeframe for a vaccine to become widely available?

Steven Johnson:  Thank you Bill. And again, happy to be back on this show. I’ll focus my comments on the two vaccines that are farthest along: a vaccine by Pfizer and one by Moderna. These vaccines have the same technology, and they are the farthest along in development. We expect the FDA to meet about the Pfizer vaccine next week, Dec. 10, and then the Moderna vaccine, Dec. 17. And then I think soon we expect the FDA to authorize, which is allowing the kind of early use of these vaccines. So we’re really looking at the second half of December to get the first set of doses. We think that number will be in the millions nationwide, but I think the … rollout will probably take a process of up to six months as the vaccines are produced.

 I did see earlier this week, I mentioned from Operation Warp Speed, which is the federal government program, hoping to be able to vaccinate a hundred million people by the end of February. But this will be a phased approach over time. And again, I think the whole process may take up to six months.

Bill Walsh:  OK. A quick follow-up to that. We hear about 90 percent and 95 percent efficacy rates for vaccines in the initial data that’s been reported. What does this mean? And should we expect these numbers to change?

Steven Johnson:  First of all, this is spectacular news on both of these vaccines. We certainly have other vaccines that are this effective, but we also have many vaccines that are approved that are not this effective, including the influenza vaccine. I expect these numbers could change a little bit over time, but I don’t expect the conclusion that these are highly effective vaccines to change. I want to emphasize one part of these efficacy results, or effectiveness results, and that is that the 94 or 95 percent is preventing infection. But with both of these vaccines, there have been very few, if any, severe cases of COVID-19 in the group that has gotten the vaccine, and it illustrates that vaccines can work in two ways. They can prevent the infection entirely, or they can modify the infection so it’s not as severe if it occurs.

Bill Walsh:  Those efficacy rates are much higher than what we see for the seasonal flu vaccine. Isn’t that right?

Steven Johnson:  These are dramatically higher. The effectiveness of the influenza vaccine varies from year to year, but might be 40, 50, 60 percent, something like this. So this is really dramatic, and I think if we can implement these vaccines and have a public that is confident in the safety and effectiveness of these vaccines, this is really what will turn the corner on this epidemic.

Bill Walsh:  Thanks very much for that. Dr. Stewart, let’s turn to you. Thanksgiving was last week and for many it was a different type of holiday. And just this week, the CDC urged people not to travel during the upcoming holidays. Looking forward, what are the best ways to substitute for the special moments over the holiday without being there in person?

Altha Stewart:  I’ve been encouraging people because I know how important holiday gatherings are for our psychological health and well-being for reconnecting — and particularly this year, when there’s been so much apart time, I’ve been encouraging people to really make use of technology, whether it’s your smartphone or an iPad or anything else. But there’s enough technology that we can still connect. It’s not the same. You don’t get that hug from grandma, you don’t smell the smells in the kitchen with everything that’s going on, you don’t have that fun that you normally have in person, but we can recreate through technology a lot of the best times. And just remember that we have to help some of us more seasoned people — who may not be as tech savvy — learn how to use some of these devices, but there are many things you can do by gathering on video. You can continue the traditions. You know, you can host a celebration of trimming the tree and have everyone connected sharing the memories of what it’s like when you’re together. You can play games. You can actually have joint baking sessions. If that’s one of those things that you enjoy when you’re together, cooking and baking, just set it up on video and let everybody participate that way.

 We’ve heard stories of people who are gathering to do their gift wrapping, and play games with the kids, and host their ugly sweater and white elephant parties by sending things early and letting everyone participate online. So there are many ways that we can recreate the feelings without having to endanger ourselves and others by being in close proximity during this time.

Bill Walsh:  Thank you. Those are some excellent suggestions. Some I hadn’t even thought about … cooking and trimming a tree together. I personally had hoped that COVID would mean the end of the ugly holiday sweater, but I guess not.

Altha Stewart:  No, it’s still with us.

Bill Walsh:  It’s still with us. Maybe there’ll be a vaccine for that ultimately. You know, we’ve talked about this when you’ve been on the show with us before, but can you talk to our listeners about the signs of stress and isolation, particularly during the holidays; what they should look out for in their loved ones and in themselves?

Altha Stewart:  I think there are two approaches to this. One is for the people that you’re around, the people in your household, the people in your bubble, as it were: Watch out for signs that they’re not sleeping or that their eating habits have changed, or that they’re appearing to be more withdrawn, not as engaged or not talking or communicating as much, not joining in for those things that we can still enjoy if we’re careful. And for the people that you don’t see on a regular basis that you’re also not going to see because of the restrictions that we are all living with, stay in touch by phone, by using that technology that I just talked about. I’ve got folks who are going back to writing letters and enjoying as part of their continuing to try to find a new normal, walking to the mailbox and mailing something. Now it does require a little planning because you gotta have stamps and you gotta have all of that stuff, but that’s part of the joy of the season, to look for creative ways to stay engaged. And a grandparent getting a letter or a Christmas card from a grandchild that they can’t give a hug to … means the world. And the same thing for the child who gets something from a grandparent, or siblings who are used to getting together, or all of those clusters of people; look out for the things that signal to you that there is something different, and ask. Don’t ever be afraid to ask, are you OK? Is everything OK? And for the people who have trouble asking for help, now more than ever, we need to set aside all of those reservations and say, I’m not doing so well today. I need to talk, or I may need to visit, or something. Now is the time where we’ve got to overcome all of that stigma around asking for help, around feeling depressed or anxious or worried, and let people help us. Let them in because the holidays are going to be difficult for a lot of people, and the more we can put ourselves out there and both ask for help and offer help, the better we will all be.

Bill Walsh:  That’s some great advice. Thanks for that, Dr. Stewart. And you remind me to mention to our listeners about a resource AARP created, called the AARP Friendly Voices Program. This is a free service. We created it because we know that during this pandemic so many people are isolated, and that becomes even worse during the holiday season. So we’ve trained hundreds of our volunteers to reach out to folks who might be isolated and just call them and chat with them, and let them hear from a friendly voice. Let me give that number out. It’s a toll-free number. It’s 888-281-0145. Again, that’s a free service. If you know someone who is isolated or you suspect might be isolated, maybe they would enjoy hearing from a friendly voice, an AARP volunteer.

 Dr. Johnson, I want to turn back to you. We were just talking about the terrific news on the vaccine front. The problem is, it appears we’re going in the wrong direction on almost every other statistic as it relates to COVID-19. You know the cases are up, hospitalizations are up, we’re seeing more deaths, and the experts are warning that getting together over Thanksgiving last week and possibly with the Christmas holidays, those numbers could get worse. What do we need to do to turn the tide?

Steven Johnson:  I think the first thing probably is to remember the basics that we’ve been talking about over the last nine months. Just to review: Stay at home if possible; wear a mask to protect yourself and to protect others; socially distance; wash your hands; keep surfaces in the home clean; avoid touching your mouth, nose and eyes; avoid higher risk areas, including most indoor spaces, crowds, bars, restaurants. When you’re ill, isolate yourself. If you are going to meet somebody, ask if they are ill. These are all kind of basic things, but I believe because we’ve been having to do this for such a long time, a certain amount of fatigue has settled in, and people may not be as interested in following these rules or guidelines that we have talked about. The difficulty is, is that because of the amount of infection now in the community, these measures are actually more important than ever.

 Our governor in the State of Colorado at one point here recently stated that actually 2 percent of the Colorado population was infected with COVID-19. So any kind of activities you do, you’re much more likely to come in contact with somebody who has the infection than for example, three months ago. One other thing of course is to limit travel, and that’s really difficult for Thanksgiving. And it’s really difficult for Christmas and other holidays.

Bill Walsh:  Right. I mean, you may be right. It may be fatigue of continuing to wear masks and socially distance. It may be disbelief that things that are really so simple could be as effective. But they are effective, aren’t they? I mean these are the basics, preventative measures we need to take to stop the spread of any virus.

Steven Johnson:  We’ve been in this pandemic for roughly nine months or so, and so if you’re in a situation where you have not developed the infection, you probably have developed a strategy that works. And so I think it’s important to think about how you’ve protected yourself over the last nine months, and then double-down, and while we wait on a vaccine and get that rolled out, really protect yourself in the remaining hopefully three to six months of this pandemic.

Bill Walsh:  Right. Great advice. Thank you, Dr. Johnson. We’re going to get to those questions shortly. Before we do, I want to bring in my AARP colleague Bill Sweeney to discuss what AARP has been doing. Bill is AARP senior vice president for governmental affairs. Welcome to the show, Bill.

Bill Sweeney:  Thanks. It’s great to be here.

Bill Walsh:  Great to have you. I know this is a really important stretch for AARP advocates across the country. Can you share a few ways that AARP is stepping up our fight for older Americans as we close out the year?

Bill Sweeney:  Thanks, Bill, and I’m happy to. This week we are kicking off a nationwide virtual lobby week where we’re meeting with members of Congress virtually on the internet … just like families should do for the holidays. We’re … having these meetings to urge them to really take action on a few important priorities. First, with nursing homes and other long-term care facilities representing 40 percent of all COVID-19 deaths, we are continuing to work to help save lives in these facilities. We’re urging Congress to ensure that facilities have adequate staffing levels, are testing staff and residents, providing personal protective equipment, facilitating virtual visitation for the residents and families, and reporting daily and publicly whether they have confirmed COVID-19 cases and deaths.

 Second, more than 4 million workers are likely to face a big drop in Social Security benefits if Congress does not fix the pandemic’s impact on how the benefits are calculated. We’re urging Congress to pass bipartisan legislation to address this COVID cut, which if not addressed would result in a $45,000 reduction in benefits over 20 years for workers who are turning 60 in 2020.

 And third, as people struggle to make ends meet during this incredibly challenging time at this holiday season, it’s getting even harder for millions of Americans to put food on the table. To address this urgent need, we’re urging Congress to temporarily increase food assistance so people in need aren’t going hungry over these holidays.

 These are just some of the ways that we’re fighting for you, and our AARP teams across the country are meeting with members of Congress and their staff over the next few weeks to help make some progress. And, of course, none of this work would be possible without the thousands of AARP members, volunteers and activists who have made their voices heard. To learn more, you can visit aarp.org/coronavirus. Thanks, Bill.

Bill Walsh:  Thank you, Bill, and I know you have to run, but we really appreciate you sharing that update with us. Now let’s get to your questions. … Our experts, Dr. Steven Johnson and Dr. Altha Stewart, will be responding to those questions. I’d now like to bring in my AARP colleague Jean Setzfand to help facilitate your calls. Welcome, Jean.

Jean Setzfand:  Thanks, Bill. Really delighted to be here for this important conversation.

Bill Walsh:  Who is our first caller today?

Jean Setzfand:  Our first caller is Harriet from New York.

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

Harriet:  Hello. My question is, I am 90 years old, and they said that the elderly will be getting this, at some time, we don’t have a date as yet. Who is going to administer it?

Bill Walsh:  Who is going to administer the vaccine?

Harriet:  Yes.

Bill Walsh:  And where would you go to get it?

Harriet:  That’s exactly right. Where?

Bill Walsh:  All right, Harriet. Let’s ask Dr. Johnson about that. So Dr. Johnson, can you help us out?

Steven Johnson:  Sure. The vaccine, as mentioned, is initially going to roll out here late December. There are some groups that will likely be prioritized, and that prioritization is really defined by a federal group that is an advisory group about vaccines. Certainly, older individuals will be a high priority. What I’ve heard is that the first tier is going to involve health care workers to try to keep the workforce that’s caring for people with COVID-19 intact. And then, certainly individuals whose immune system are weakened, older individuals, residents of nursing homes. There’ll be groups that will be prioritized, and precisely, when a vaccine would be available for you, I can’t really calculate, but I imagine that when that becomes available, it will be given in hospital settings, clinic settings, and as the vaccine becomes more widely available, there’ll be more places to get it.

 One thing to mention is the vaccines are a little bit different in how they have to be stored. And so certain vaccines may be in hospital-based settings, certain vaccines may be in the clinic. So what I would recommend is that you express an interest in the vaccine with your primary care physician and also watch the news, and I think you’ll have an opportunity — probably the first half of 2021.

Bill Walsh:  Let me follow up to that. You know for health care workers or folks who are in residential care settings, I can understand how the vaccine would be administered on a priority basis. What about someone like Harriet, who may not be in those situations? Could she expect a call from her doctor or a local public health official, or is the onus on her to reach out and ask for the vaccine and schedule an appointment?

Steven Johnson:  That’s a good question. I think probably with health care in general, it always pays for the person to be proactive. So I may not use the term ‘put the onus on the person,’ but I think it’s important to kind of touch base regularly. I provide primary care for people living with HIV, and I am now getting frequent emails asking about the vaccine, asking me to notify them when it’s available and so on. I do think individual clinical programs are likely going to have ways to reach out to the people that they take care of. So, for example, at our hospital, we have an electronic health record that many people are part of, and we can send out messages and say things like the vaccine will be available, and so on. But I think there’ll probably be some unique situations that people have to respond to. So I think it’s important to be proactive as a consumer.

Bill Walsh:  Thanks for that, Dr. Johnson. Jean, who is our next caller?

Jean Setzfand:  We have a lot of questions coming in from YouTube and Facebook, and this question I think is for Dr. Stuart. Norma is asking: What suggestions do you have to help an elderly parent who lives alone to deal with isolation and cope with staying at home?

Altha Stewart:  That’s a really excellent question, Norma, and thank you for asking, because I think there’s some specific things that we all agree are important for folks in that situation. One is to have some system, and it may require multiple family members or neighbors or others who are regularly checking in on that person. And the check-in can be direct — through a door or a window just to kind of eyeball them, if you will. It can be by phone to hear their voice and to get a sense of how well they’re handling the isolation. If they are going out for visits, to make use of those times that they’re going to see the doctor or something else that requires them to leave the home, to make sure that the person who is helping them with that, whether it’s an aide or a family member or a family friend, understands the importance of asking a few specific questions. How are you doing? How are you sleeping? Are you eating? Someone should be routinely checking in on them in their home, checking the refrigerator, making sure that things look to be in order.

 And if this is an elderly relative who before the pandemic showed signs of having challenges living alone, handling life alone — everything from moving around the house comfortably and safely to preparing meals, to maintaining the household in a way that is safe and healthy, if there were any questions about that, now more than ever we need to maintain an almost vigilance check-in with them about these things. Because the slippage can be very sudden, and before we know it, they’re in trouble from a health standpoint or a safety standpoint. So if you’ve got elderly relatives or family, friends or neighbors, these are the kinds of things we really do encourage families and friends and neighbors to think about as they’re checking in. And to just phone them, talk to them. If you can supply them with a device so that you can actually eyeball them without that face-to-face, do that. But if not, have someone who’s making contact and looking at them every day.

Bill Walsh:  Thank you for that, Dr. Stewart. Jean, who is our next caller?

Jean Setzfand:  Our next caller is Roberta from Missouri.

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

Roberta:  Oh, I was wondering now when you take this vaccine, how long will it be before it starts taking effect?

Bill Walsh:  Dr. Johnson, do you want to handle that? I think, correct me if I’m wrong, but both of these two early vaccines require two doses, is that correct? How quickly would they start taking effect?

Steven Johnson:  First of all, that’s a great question. Both of these vaccines are two shots. One of them is two shots three weeks apart, and the other is two shots four weeks apart. And the companies are really kind of evaluating the effectiveness about a week or two after the second shot. So probably within the first four to six weeks of getting the vaccine, we would then begin to see protection. One of the things that I think we’ll learn once these studies are actually published is what happens if somebody develops COVID-19 just after getting one shot? Is the illness milder or is there any kind of difference? But … in terms of the effectiveness of the vaccine, I think we’re probably looking a couple of weeks after the second dose, which would be about five or six weeks into the vaccine implementation.

Bill Walsh:  Thank you for that, Dr. Johnson. Jean, who is our next caller?

Jean Setzfand:  Our next caller is Ann from Alabama.

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

Ann:  Thank you, and I appreciate this town hall meeting. I had several questions, but I understand I can only ask maybe one. I’m 77, and my husband is 80, and we live about two hours away from the rest of our family, and one of whom is my 100-year-old mother. And I missed at Thanksgiving, and I missed her birthday, and I’m so lonely for her, and I just wondered about seeing her at Christmas. Would it be safe for us? And would it be safe for her? And I’m a little depressed about this situation now. And plus, I have three granddaughters who are in the medical field.

Bill Walsh:  How is your mother’s health?

Ann:  My mother’s health is really good except she has arthritis. Her mind is good, her physical health is good. As far as her heart, her lungs, and that sort of thing, but she has arthritis really badly.

Bill Walsh:  Have you been staying in touch with her, I assume by phone. Have you done any Zoom meetings or anything like that?

Ann:  Well, it’s by phone and she lives with my sister, so I stay in touch with my sister to make sure she’s doing good.

Bill Walsh:  OK. Let’s ask the experts and see what they have to say. Dr. Stewart, do you have any advice?

Altha Stewart:  I’ll let Dr. Johnson respond to the question about whether she should try to visit. What I will share, Miss Ann, is that I can certainly hear in your voice how sad you are about this separation. And, you know, there’s no comfort in this, but please understand that part of the reason that we are stressing staying apart is because we want everyone to remain healthy. And depending on your age and her age, and your health and her health, and all of those things, there are so many things that can impact her staying healthy and you stay in healthy, that we really do advise staying separate. And if your sister who lives with her can help connect you, not just by phone, because hearing her voice, obviously, hasn’t been enough. You want to see her; you want to see her smile. You want to see the twinkle in her eye. You want to have all of those things, and you can’t have the touching that goes with them. Maybe your sister can help you connect with her, or maybe one of the young people in the family can help connect you to show that you all can at least have some FaceTime. I know how important that is to your emotional health and well-being, and we don’t want you sad and depressed because of it. But we really are stressing that people right now, particularly people of a certain age and with certain underlying conditions, stay apart until we’ve got a better handle on the timeline for vaccine treatments and other things. And I’ll let Dr. Johnson talk a little bit more about that.

Steven Johnson:  Thank you, Dr. Stewart, and caller, thanks for your question. One of the things, of course, that we associate with COVID-19 is that the older you are, even in the absence of other health conditions, the riskier it is … the riskier it is that you will get more ill, be in the hospital, or even pass away from this infection. So we’re always very cautious with questions like this. And I really support what Dr. Stewart said, the degree to which … visits can be virtual in terms of phone calls, video and so on, is really optimal for this holiday season. The good news is it sounds like your mother is in good health. I do feel that we have a finite time period left where we will have to have these kind of dire circumstances of separation. And I think it’s important to be careful, and then when we get to the point where people are vaccinated and the pandemic is under control, we can get back to regular visits and maybe you can have a holiday celebration in a different month.

Bill Walsh:  Thank you both for that. Jean who is our next caller?

Jean Setzfand:  Our next caller is Alan from New Hampshire.

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

Alan:  Thanks, thanks an awful lot. My question is regarding vaccine side effects. I’ve read that short-term side effects are minimal, that we have done modeling on mid-term side effects, and they do not appear to be real serious. But apparently, we have no idea of what long-term side effects may be. And I was wondering if you can speak to the potential long-term side effects and the risks associated with them.

Bill Walsh:  OK, thanks for that question, Allen. Dr. Johnson, do you want to address that for both the two vaccines we’ve been talking about, but [also] others that are in the pipeline, like the AstraZeneca candidate, and Johnson & Johnson I believe has another candidate out there. What can we say about long-term side effects of any of these?

Steven Johnson:  In terms of long-term side effects, of course we don’t know because these are new vaccines, and if you count phase one trials and things like that, we still have less than a year of experience with these vaccines. With the Pfizer vaccine and the Moderna vaccine, which are the two vaccines which will first be available, the side effects have been relatively straightforward — fatigue, headache, some folks have had fever, there can be pain or redness at the site of the injection — but these are self-limited side effects that have not had a long-term consequence. Bill mentioned the AstraZeneca trial. There was a neurologic event in one of the study volunteers and we’re still waiting to learn more about that, although the studies have been restarted. But I think your question is a common one.

 I would say that if you look at the vaccines that are approved and we routinely give for influenza, tetanus, hepatitis and other conditions, we don’t really have long-term toxicities that we can measure. And part of this phased rollout of vaccines is that by the time many people will get the vaccine, we’re going to have six months or more of safety data and so on. But ultimately, people are going to have to make the decision whether or not to get the vaccine. I would, I personally would be first in line, because I trust the way that these studies are being done and so on, but it’s important. And like any vaccine-preventable disease, the downside of not getting the vaccine is getting the infection, and of course, we’ve had just a tremendous number of deaths in the United States that continues to climb. But if you ask, could there be side effects 10 years from now, I could answer that question about 10 years from now.

Bill Walsh:  Well, [inaudible] question about long-term effects, if he’s thinking more like six months or a year, how will he or any of us really know about those kinds of long-term side effects? Would they be published in medical journals? Would they be carried in the press? How would we know? How would we hear about those?

Steven Johnson:  That’s a really good question. First of all, the vaccines in question, those trials are still going on. So even while a drug may be available for an emergency use authorization, the companies that make these vaccines will continue to monitor safety data for several years, I believe. So the people who have volunteered to be part of these trials will continue to be seen for study visits and reports and so on. So that will be one mechanism.

 Once these vaccines are approved by the FDA, then there is a vaccine adverse event reporting system. So that if, for example, I provide a vaccine to one of my patients and they develop a complication, I’ll report that complication. And so there is what we call kind of post-marketing monitoring for side effects. And certainly if a particular vaccine has a side effect that’s important, that will make it into public health bulletins and medical journals, and so on. So I’m actually confident that if there is an unexpected toxicity, we’ll detect it.

Bill Walsh:  And to Alan and others, just to let you know that AARP is going to continue to monitor the vaccine situation in the long term, and you can follow that news on aarp.org/coronavirus. Jean, who is our next caller?

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

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

Lee:  Thank you for having these types of conference calls. I love AARP and their magazine. I’m 85 years old. My concern is helping the nurses and doctors who cannot give the time that they would like to to those that are hospitalized for a new way of handling it, to let one of the family members come into the hospital dressed from the bottom of their shoes to the top of their head as doctors and nurses are, so that they can help by sitting with a loved one who is suffering from loneliness, and finally just giving up, and then when they deceased, they’re not being able to take care of or buried properly. Thank you.

Bill Walsh:  OK, Lee. Thank you. Dr. Stewart, maybe you can address this at the outset. It seems like she was suggesting that members of a family be allowed to visit if they take extreme precautions with PPE and other things. What do you think about that approach?

Altha Stewart:  I think in principle it’s a wonderful idea. I think the unfortunate thing is that there are so many complications with respect to people in close quarters when major medical care is being provided, that it just could become a logistical problem. There might be opportunities, however, once people are no longer in a critical condition where there isn’t as much activity that needs to be going on around them, where those kinds of setups might actually be helpful and might relieve some of the staff from some of those support needs and support services that they provide. I just think that given the climate in many of our treatment settings, especially hospitals and especially when people are either critically ill or are still in the process of being evaluated for the level of severity of need, that it just becomes a logistical problem. Dr. Johnson may have another perspective on that. I’m all in favor of families being able to support loved ones, being able to be there, to show that support, but in the near future, we may just need to be much more facile about the use of technology and providing those things as a mechanism for communicating. Because these are tight spaces sometimes. So, I’ll let Dr. Johnson weigh in.

Steven Johnson:  I think this is one of the great tragedies of COVID-19 is that not only are people sick and critically ill and potentially dying, but — because of the nature of this illness and how it’s spread — that hospitals have had to limit visitation. And … it’s really, I think, a difficult tragedy to try to kind of find that balance between having family members and friends provide support but then also have a safe environment in a hospital that is potentially overwhelmed with this care.

 I do think what Dr. Stewart mentioned — of certain technologies that can kind of bring people in by video and things like that — is one solution. Some hospitals, including ours, do have certain circumstances where visitors are allowed if somebody is very ill and end-of-life type of issues and so on, but it’s not optimal. And I think we should still keep thinking about how we can support not only the person living with COVID-19, but their families.

Bill Walsh:  OK, thank you both for that. Let’s hear more questions. Jean, who is next on the line?

Jean Setzfand:  We have, again, several questions coming in from both YouTube and Facebook, and there’s a trend that’s happening on some of these questions related to the safety of vaccines for individuals either with allergies or autoimmune deficiencies or diseases. I think there’s some general questions related to that.

Bill Walsh:  Dr. Johnson, can you address that? How safe would any of these vaccine candidates be for somebody with a preexisting condition, like an autoimmune disease or allergies?

Steven Johnson:  That is a great question. Let me just say, we’ve focused on these two vaccines that are nearly available — the Pfizer vaccine and the Moderna vaccine, but there actually are a number of other vaccines that are in clinical trials. Bill mentioned the AstraZeneca trial. There’s one by Johnson & Johnson. There is one by Novavax, and then there are a number of other candidates. And the reason I mentioned that, is that each of these vaccines has its own kind of unique technology, and it could be that we see different safety profiles and different effectiveness profiles with these different vaccine products. These vaccine trials were very carefully orchestrated by the federal government to be very large trials, very similar study designs, so that they could be compared. And so for example, most of the large trials have at least 30,000 people. The Pfizer has close to 45,000 people. And what that means is that within each vaccine trial, there are younger individuals, there are older individuals, there are individuals with some health problems. We’ve been able to refer, for example, persons living with well-controlled HIV infection to these trials.

 And so we’ll learn something from the initial trials about safety across the board, effectiveness across the board. One of the interesting reports from Pfizer is that it’s 94 percent effective in persons over age 65. That’s really great news because some of our other vaccines that we use in clinical practice are less effective in older people. But when you get to individuals that have autoimmune conditions, a weakened immune system, transplant patients and so on, there will very likely need to be additional studies within those populations to define both the effectiveness and the safety. And that just brings up a very important point that once a vaccine is approved, the study of the vaccine is not done, and that additional studies need to be done so that we know how to use it in the entire population.

Bill Walsh:  Do we think if these two near-term vaccines get approval, we’ll have enough information for people who have autoimmune diseases or weakened immune systems for the reasons that they can take the vaccine with some confidence, or is it going to be too early to tell?

Steven Johnson:  I think that’s going to be a mixed picture. I don’t think we’re going to have the answers completely. I talked primarily about safety, but of course the other aspect of it is, if your immune system is weakened, will you respond to the vaccine like individuals that have a stronger immune system? So it’s possible within certain subgroups, the vaccine will not be as effective as we’ve found in the general population. Really ...

Bill Walsh:  OK, just wanted to follow ... oh, go ahead. I’m sorry.

Steven Johnson:  I was just going to say, what we know about these vaccines right now is mostly press releases. So we actually do need to see these large vaccine trials finished, published in medical journals with sufficient detail, so that we can answer the question that you’re asking.

Bill Walsh:  Right, and going forward, what do you think is going to be the best source of information for people on the profiles of these various vaccines so they can decide for themselves which one is the best for them?

Steven Johnson:  So this may be getting too far into the weeds, but there is a National Advisory Panel called the ACIP, that’s the Advisory Committee on Immunization Practices, that gives vaccine advice. So when you … get your tetanus vaccine booster at 10 years, that’s because this committee has said, this is what makes sense. And this committee is the one that’s really going to define how these vaccines are used, and whether certain vaccines are used preferentially in certain populations, whether older individuals get one vaccine over another. We’re just kind of starting the studies of these vaccines in children. The Pfizer vaccine has been studied in people that are 12 years and older; the Moderna vaccine is just being started. But I think that will be the national body that kind of determines the guidelines for using the vaccines. And then, of course, we would always want individuals to work with their primary care physician to kind of help make these decisions.

Bill Walsh:  Right, OK. Thank you for that … Dr. Johnson, I wanted to come back to you on the issue of vaccines. We’ve heard a lot of great news about the advances in the development of the vaccines, but it appears there’s also substantial advances in the treatment of COVID-19. Can you talk a little bit about those?

Steven Johnson:  I think we’ve certainly made advances in the treatment, and I would kind of put this into several different areas. We have one antiviral medication that inhibits the virus itself that was approved by the FDA on Oct. 22. It’s a medication called remdesivir, and it’s actually an intravenous medication, and it’s just given for the subset of people who are in the hospital with COVID-19. So that’s one of the advances.

 One of the other advances is the use of anti-inflammatory medications, because one of the concerns with COVID-19 is that people get the viral infection and then the body’s immune cells respond, and they respond in an exaggerated way, and paradoxically, can cause illness and damage the lungs and lead to failure of the lungs to work. So the drug that we primarily use is a drug called dexamethasone, which is a steroid medication. So many of the people that I take care of in the hospital are on both of those medications.

 There are some additional medications that are under study. One [is] a group of medications called monoclonal antibodies. So these antibodies are proteins that your body makes to fight infection. And these are antibodies that are made in the laboratory and then target an important part of the virus that causes COVID-19. And those are being studied both as an outpatient treatment and as an inpatient treatment. And similar in concept to that is the use of something called convalescent plasma, which is actually taking plasma, which is a liquid part of blood, from individuals who have had COVID-19; and that plasma then contains antibodies against the virus that causes COVID-19, and then that plasma is infused into someone else. So I think in terms of specific medication interventions, those are the things to think about.

 I want to make one other point: That our medical profession has learned a lot about managing this disease over the last nine months. The hospital here at the University of Colorado has hospitalized over 2,000 patients with COVID-19 since March. And so physicians, nurses, respiratory therapists, other providers have developed really an expertise in providing what we call supportive care — providing the oxygen, intravenous fluids and other kinds of supports, and maybe blood thinners to prevent clots, all these kind of things so that we can shorten hospital stay, reduce the number of people that go to the intensive care unit, and reduce the death rate. So I think the U.S. workforce is more experienced now than they were in March.

Bill Walsh:  Thank you, Dr. Johnson, for that. And before we get back to our listener questions, I had a few other questions for our experts. Dr. Stewart, I was wondering about the long-term effects of this crisis. Many of us have loved ones who lived through the Great Depression of the 1930s, and they were significantly changed by that time, even if they were just children. They became very frugal and not wasteful. Is it possible to hope that we’ll be more appreciative of quiet time and family time as a result of COVID-19, or more likely, will we be adversely affected for many years to come?

Altha Stewart:  That, right now, Bill, is the great unknown. We’re still dealing so much with the uncertainty, day-to-day literally, of this evolving pandemic in our lifetime. We hope, of course, from the mental health standpoint, that people will remember and take from this experience some of those more positive things like understanding the importance of quiet time and family time, and doing simple things with each other. Understanding better the means of communicating in close quarters and how we relate to each other when we’re together, when we don’t have that busy life that existed for many pre-COVID. And we hope that many people will look back on this, not just remembering the limitations and restrictions and the sadness, but also some of the things that they remembered as a part of this experience. The families who are now spending time in the evenings, instead of in their individual little pockets of video games and Netflix and other things, doing board games or playing cards, or going outside for walks because they want to be outside. They want to be together, and there is actually time for that. But we just don’t know. We’re hopeful that if we handle this well, and we are mindful of the potential for some positive outcome, that we can actually make those things happen. But time will tell.

Bill Walsh:  OK, thanks for that. And earlier, Dr. Stewart, you had talked about using technology to stay in touch with loved ones. We know that a lot more people are using telehealth for medical appointments. I wanted to ask, how can telehealth help those who are struggling, and how does someone take the first step to talk to someone? And what expectations should they have?

Altha Stewart:  Telehealth has been a very positive outcome, or the expanded use of telehealth has been a very positive outcome, of this very unfortunate set of circumstances that came with the pandemic. And I think the first step is to actually make the outreach. Depending on your situation, depending on what level of health care you have access to, there are insured programs that offer these services. There are public programs. There are crisis lines for people. The National Alliance on Mental Illness, for example, has a crisis text line for people who need to talk, particularly about psychological stress and depression, and anybody can text the letters N-A-M-I to 741741 and get a live person 24/7, and it’s all confidential for people who are really struggling and stressed out. If you have, say, employee insurance, you should check with your EAP and find out what services there are that you can access, and mostly, it would be access through telehealth except for emergencies. If you are on public assistance of some kind or some other government-sponsored program, they also have access to those things. And this is both for the medical as well as the psychiatric, psychological mental health services. But the important first step is to acknowledge that you need help, that you need to talk with someone, and then understand that the talking itself may be helpful, but a long-range plan may also be indicated — and just hang in there and stick with it.

Bill Walsh:  Thank you for that. And just to repeat some of those resources that Dr. Stewart mentioned, you can text NAMI, the National Alliance on Mental Illness at 741741. They can also be reached Monday through Friday 10 a.m. to 6 p.m. at 800-950-6264. They can also be reached at info@nami.org. Thank you very much. We are going to return to our listeners’ questions in just a moment.

 Before we do that, I’d like to take a second to alert our listeners about COVID-related fraud. You know, as if everything we’ve been through in 2020 weren’t enough, we also see that scammers are continuing to use the headlines as opportunities to steal money or sensitive personal information. As of Nov. 24, the Federal Trade Commission had logged nearly 258,000 consumer complaints related to COVID-19 and stimulus payments, more than two-thirds of them involving fraud or identity theft. Victims have reported losing $190 million with a median loss of $323. With recent reports of significant progress in the race for a vaccine, crooks have stepped up malicious email campaigns with subject lines like urgent information — COVID-19 new approved vaccines, according to the software security firm CheckPoint. The FBI warns that scammers are posing as charity fundraisers, soliciting donations to supposedly help individuals/organizations in areas affected by the virus.

 I wanted to give you a few tips so you can protect yourself from coronavirus-related scams. Avoid online offers for coronavirus-related vaccines or cures. They aren’t legitimate. Be aware of emails, calls and social media posts advertising free or government-ordered COVID-19 tests. Check the FDA website for a list of approved tests and testing companies. Don’t click on links or download files from unexpected emails, even if the email address looks like a company or person you recognize. And finally, visit aarp.org/fraudwatchnetwork to learn more about these and other scams. You can also call the Fraud Watch Network Helpline at 877-908-3360.

 Now it’s time to address more of your questions with Dr. Johnson and Dr. Stewart. Jean, who do we have on the line?

Jean Setzfand:  Our next caller is Quita from Alabama.

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

Quita:  Thank you. I’ve been trying to do this forever, but I know it’s late now, but I was wanting just some questions about the mask that I feel like that COVID is not dying down as far or as well as it should because people aren’t being careful, and part of it’s the mask. So I’d like to know what mask or … little blue mask that you can get anywhere in any store and all of that. [Do] those actually keep you from getting COVID-19?

Bill Walsh:  Let’s ask Dr. Johnson about that. Dr. Johnson, can you talk about masks? Which ones are the most effective? And if there are any out there that you would not recommend?

Steven Johnson:  So first of all, that’s a great question, and I think the approach to masks is relatively straightforward. We do recommend that the masks be a cloth mask that has a tightly woven fabric, so … cotton is a good mask. It probably is better if there’s a couple layers of cotton. The mask should be snug to your face because it’s important that you breathe through the mask and not breathe around the mask. And then related to that, it’s important that the mask covers both your mouth and nose. I’ve certainly seen common situations where people wear the mask just on their mouth. And then the other feature of a mask is that it ideally would be something that you can wash regularly and kind of decontaminate. We think masks, if worn like that, are helpful in both directions. So if you are ill — and remember that a portion of people with COVID-19 might not have symptoms — you can prevent transmission to others, and then, of course, if you come into contact with COVID-19, the mask will help to protect you as well. So I think those are the features that are important with a mask. We certainly recommend it.

Bill Walsh:  I’ve seen a number of people wearing these neck gaiters that they pull up over their face when they’re near people. I’ve also seen a number of masks now with like the little plastic vent on the front. Do you have any thoughts on either one of those?

Steven Johnson:  … I think it probably would depend a bit on the fabric that’s used for the neck gaiter. My concern with neck gaiters — by the way, the CDC website does not recommend neck gaiters — I think what happens with those is that you may tend to breathe around the gaiter, whereas a mask that has an elastic strap that holds the mask tightly to your face really means that you’re actually breathing through the mask itself and using it effectively as a filter. Similarly, if you have kind of a vent of a certain size, then that may defeat the filtering aspects of the mask. So I think I would avoid those two circumstances.

Bill Walsh:  Thank you very much. Jean, who is next on the line?

Jean Setzfand:  Our next caller is Naomi from Indiana.

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

Naomi:  My news [is] that I was a very, very active person by December of ’19. And then in February, I was just fine. I’m 86 years old, very active. My husband died 33 years ago, and I live alone. I still live in a three-story house that I raised my son in, and I’ve been here 56 years, and I still live here. But in February, I went in Feb. 4, I went into the hospital with a heart infraction, and it turned out to be a heart attack. And then I was there five days and I had a stroke. They don’t know why my health was almost perfect before, but that happened. So I’m here. I’m locked in the house. I haven’t left. I’ve outlived all of my friends. When you’re ... I live in a very small, farm community and this was not my home. This was my husband’s home. I was French Canadian and I married Tim, and I was left here when he died. And so, I don’t have the connection that I would have perhaps if I was from here … and the depression, my daughter-in-law buys my food. She brings it to the garage, or my son does, brings it to the garage. They go home. I then go out and wipe everything down and bring it into the house. The only place I’ve been in these eight months or so has been to my medical doctor and to my stroke and heart doctor, and that was in the hospital OK, here. They have offices there. So I’m not … the weather now has just turned bad. It’s been good enough that I could stay out most of the day; I could walk or I could sit in the garage or on the driveway or under the tree or whatever, but now I’m locked in the house. And the depression is beginning to really tell on me. And I just wonder if there’s any kind of secret or something that I could do that would help me through the next three months.

Bill Walsh:  Let’s ask Dr. Stewart about that. Thanks, Naomi. I hope you’re feeling better, and I can hear that depression in your voice. Dr. Stewart, do you have any words of advice for Naomi?

Altha Stewart:  Well, first I really do want to congratulate you and commend you for your willingness to say out loud things that I think a lot of people in your situation are feeling. And I appreciate your asking this very good question. A couple of things come to mind and I don’t know how workable they are, but just to throw them out. You do have contact with your son and daughter-in-law, and I wonder if there are opportunities within their circle for you to have … and I don’t know what your situation is in terms of devices and internet access and other things, but I wonder if there’s an opportunity there for you to get connected with a larger social circle of people to just talk to and look at and see you and interact with you as the first step. If you are going out to your doctor appointments, I would actually mention to my doctor or to the nurse or social worker or someone in that office that you really are looking for some outlets for social interaction. Because many times, if we don’t ask those things of our health care providers, they don’t really know that we need them. And many of them have access to organizations in groups, whether it’s the senior citizens center or something. And I heard you say you live in kind of a rural area, so there may not be a lot there, but I think it’s probably worth asking them what is available. If there are other things, churches or other organizations that may sponsor things where even if you can’t meet in person, again, that connection [is there] through phone or FaceTime or video or something. And a lot of this, I realize, hinges on your ability to access those things. So I think the first thing, since you are actively interested in doing this, is just to explore what’s available in your community that would meet your need, and to pull out all the stops asking. You don’t sound like a shy person, so I’m assuming that you’re willing to ask the questions and get some answers. And I would just encourage you to do what it appears comes natural to you, which is to look for ways to help yourself. You’ve done a magnificent job of living long and staying relatively healthy. And I see no reason why you can’t add on to that through some of these ideas and doing some of these things. And I wish you good luck in it.

Bill Walsh:  Dr. Stewart, thanks for those suggestions. I’ll also mention something I talked about earlier in the program. It’s the AARP Friendly Voices Program. Naomi and others, this is a free service where you can call our toll-free number and speak to or get a call from an AARP volunteer, just to have them check in on you from time to time. If you’re interested in that service, the number is 888-281-0145.

Jean, who is our next caller?

Jean Setzfand:  We have a question on YouTube from Susan and she’s asking: Can you still be an asymptomatic spreader after getting the vaccine?

Bill Walsh:  Hmm. That’s an interesting question. Dr. Johnson, do you have any insight into that?

Steven Johnson:  That’s a good question. I guess the way I would answer that is that it’s likely possible just because we know that the vaccines have not been a 100 percent effective, maybe 95 percent effective, but there have been cases of infection in individuals who have received the vaccine. And, of course, a portion of the people that develop infection could be asymptomatic. I would say, once we have … rolled out the vaccine I think that phenomenon would probably be uncommon. But you raise actually an important kind of set of infection prevention issues that I’ve thought about. And that is … are we going to be able to relax some of these social distancing and masking standards once people get vaccines? And I think we’re going to have to wait to kind of see the combined effect of a certain portion of the population getting COVID-19 and a certain portion of the population getting vaccine, and then see what that does to the number of cases. So I’ve given a long answer without really answering the question, but I do think that phenomena will be possible, and we’ll just have to kind of learn how good these vaccines are, how long the protection lasts, how we can predict who is protected by maybe doing blood tests or antibody tests. There’s still a lot of unknowns even once these vaccines are approved.

Bill Walsh:  Thanks for that, Dr. Johnson. Jean, who is our next caller?

Jean Setzfand:  Our next caller is Lisa from Connecticut.

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

Lisa:  I was curious, you said that the vaccines were tested on a wide range of ages, but I wondered for my father’s sake, and a lot of the people that have called in, has it been tested on the over-70 crowd? I mean, my dad’s 88. I heard a woman who was 90. I’ve heard other people in their 80s … it’s this older of the old crowd involved in the study test.

Bill Walsh:  Thanks for that question, Lisa. And we know that oftentimes clinical trials … have a hard time attracting older subjects. So Dr. Johnson, can you address that question?

Steven Johnson:  Sure. I think it was a priority with both of the … with all of the vaccines, but certainly with the Pfizer and the Moderna vaccine to enroll people at risk of developing more severe COVID-19. So people with certain health conditions, but also people who are older. I don’t have access — in fact, I’m not sure if it’s in the public domain, it might be — to what percentage of people within these clinical trials are over 60, over 70, over 80, over 90. I did mention that we do know with the report from Pfizer that they were reporting an excellent effectiveness rate of, I’m sorry, efficacy rate of 94 percent among persons greater than 65. I just don’t know what that number is. But I think that information will become available, and that will be one of the factors to consider. Because the death rate of COVID-19 is so directly correlated with age, I think the clinical trials will adequately include older individuals, and older individuals will be a high priority for vaccination.

Bill Walsh:  Thank you for that. Jean who is our next caller?

Jean Setzfand:  Our next caller is a question from Facebook, and Jenny is asking: “I’d like to know your thoughts about the hug tents that are in some nursing homes now.” She apologizes if this was discussed earlier, but is interested in learning about those hug tents.

Bill Walsh:  Pup tents in nursing homes. Dr. Johnson and Dr. Stewart, either one of you could weigh in on that one.

Steven Johnson:  I’m trying to understand the question. Dr. Stewart, are you ...

Altha Stewart:  I didn’t quite get that. I’m not sure what was discussed early. Is it tents?

Bill Walsh:  Jean, was there any more information on that?

Jean Setzfand:  No, but I suspect it’s probably the film that you can use to put a barrier between individuals, so that you can still have some connection but not transmit. That’s what I’m assuming is a hug tent, but I may be wrong.

Bill Walsh:  OK, oh a hug tent. I’m sorry. I thought you said a pup tent.

Steven Johnson:  I heard it as pup tent, so that’s why I was confused. But I think any kind of a device that is a barrier — and is a barrier from coming into contact with respiratory secretions or contamination on the hands or things like that — is going to be effective to a significant degree. … I have heard of these hug tents, and I think it’s an ideal or interesting solution to be able to get close to people. We certainly heard about people kind of visiting people in nursing homes by being outside the window, things like that. So I think there are some strategies to … get close safely. Dr. Stewart, any other thoughts about that?

Altha Stewart:  No, I didn’t … I’ve actually not heard about the hug tents. I’m going to have to look into that as one option … in addition to video visits. But I think you’re right … any of those things that safely allow people to interact and maintain that social connection is so important to the individual patient as well as to their recovery, and to maintaining that relationship. Anything that we can do safely that does not interfere with good medical care, I’m all for it.

Bill Walsh:  Thank you both for that. And Lisa from Connecticut had asked about the number or proportion of people of much older ages in some of these clinical trials. And our excellent staff here at AARP has been able to pull some of that data. It looks like 23 percent of Moderna’s trial participants were 65 and older, and Pfizer reports that 48 percent of its enrollees are between the ages of 56 and 85. So, Dr. Johnson, as you were suggesting earlier, that it does seem that older people were represented to a fair degree in these trials.

Steven Johnson:  And a credit to your staff for getting that information so quickly. The other characteristic of the trials is they’ve also been able to recruit people from a diverse racial and ethnic background, because that’s the other sense of confidence that we want … that this works in all persons.

Bill Walsh:  Absolutely. That’s a great point. Thanks for that. Jean, let’s take another question.

Jean Setzfand:  Our next caller is Barbara from New Hampshire.

Bill Walsh:  Hey, Barbara. Welcome to the show, and go ahead with your question.

Barbara:  In a way, in some ways you may have already answered my question. I was asking, do we have a choice of which vaccine when ready? And it seems as though the vaccine may choose us or your age, and if you have COPD or significant reasons such as that. Am I correct?

Bill Walsh:  I think that’s right. Dr. Johnson, can you respond to Barbara’s comment?

Steven Johnson:  Yes, so I think it may be that — for example, between the two vaccines that are almost available, because they have very similar effectiveness rates, very similar side effect rates, the same technology, and so on — it may be that an advisory committee may view those as somewhat interchangeable. But some of the other vaccines that are coming along are different technologies and might have a different side effect profile. So what we’ll have to see with each of the vaccines is how effective they are. We do know, for example, that the reports from the AstraZeneca trial are not quite as promising as the two that I just mentioned, and we may be able to learn that this vaccine is better in this population of individuals, so for example, people over age 65 or so on. This is kind of getting back to this advisory committee that I mentioned that really is going to tell us … what the best vaccine is for which population. We already have that to some degree with some of our standard vaccines. So, for example, the hepatitis B vaccine, certain types of dosing [are] recommended … and certain might be recommended for health care workers. So we might get to that specificity where there might be a particular vaccine that’s recommended to you.

 The other issue that has come up is because some of these vaccines require really cold storage. It may be that certain vaccines that require this cold storage are going to be better in hospital settings, whereas other vaccines that don’t have those requirements may be better in clinic-based settings or public health departments. So it also may depend on where you go to get your vaccine.

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

Jean Setzfand:  Our next caller is Jacque from Illinois.

Bill Walsh:  Hey Jacque. Go ahead with your question.

Jacque:  It’s Jackie, actually.

Bill Walsh:  Oh, I apologize.

Jackie:  My question is, I spent Thanksgiving with my son, daughter-in-law and grandson. Shortly after I arrived, we got a phone call saying that my grandson had tested positive for the COVID virus. He was quarantined to his upstairs bedroom. His mother would take food to his door … but the rest of us were quarantined also. Should we be tested, or what should we do?

Bill Walsh:  Dr. Johnson, can you help Jackie with that?

Steven Johnson:  Sure. And it reminds me that when we talked about masks, I wanted to mention something I like to mention, which is the CDC is a good site for information about the quality of masks. And the reason I said that is the CDC also has some advice on how you socially distance within the home, where one individual is sick, and the others are not. And so it sounds like your family really went to some measure to try to prevent transmission of the virus. And so having somebody in a separate room, having somebody using separate bathroom facilities, not sharing meals and things like that, all of those measures … would reduce the risk of acquiring the virus in that setting. But, of course, it doesn’t eliminate that. And so certainly there was a period of time over the next 10 to 14 days where you could be at risk, for developing COVID-19, even if it’s a small risk. You could get tested, and you know testing is more widely available now than it was a few months ago. The other thing that you could do is let your primary care physician know about this, monitor your symptoms very carefully, and then get tested if you develop symptoms. I think it’s probably reasonable for you to maybe quarantine from others while you monitor your situation. You probably heard in the news that the CDC is reducing the days that people should be quarantined. It’s down to 10 days if you don’t have a test, and it’s down to seven days if you get tested after seven days and are negative. But I don’t think it’s mandatory that you get testing, if you don’t have symptoms. But I would quarantine, and I would monitor your symptoms very carefully.

Bill Walsh:  Thank you, Dr. Johnson, and thanks to both of our experts. We’re coming up to the end of our show. I wanted to ask you both whether you had any closing thoughts or recommendations that AARP members could understand most from our conversation today. Dr. Johnson.

Steven Johnson:  Yes. First of all, Bill, thank you for having me back on the show. I really enjoy this, and I really like talking to all of you. I think one thing I would say is that we are about nine months into this pandemic, and I feel like we’re over halfway to the solution. When we emerge from this is unclear, whether it’s March, April, May, or June, but I think there is light at the end of the tunnel, primarily because of the spectacular vaccine news. And what I’d like people to do is to kind of, as I mentioned before, kind of double-down on safe measures to protect yourself while we get to the end of the tunnel.

Bill Walsh:  Thank you for that, Dr. Johnson, and thank you for being with us today. Dr. Stewart, any closing thoughts or recommendations?

Altha Stewart:  Let me add my thanks, also, to the invitation to join you and your audience again. And I think Dr. Johnson sums it up well, that I believe we can see light at the end of the tunnel, thanks to the good news about the vaccine, but we must remain vigilant, we must maintain a sense of hope and positivity. We must be mindful of the slippery slope that we can quickly slip into with the depression, anxiety and uncertainty, and look out for those who are vulnerable to these kinds of issues, including yourself.

Bill Walsh:  Thanks to each of you for answering our questions. This has been a really informative discussion, and thank you, our AARP members, volunteers and listeners for participating today. 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 are 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 today’s Q&A event, can be founded at aarp.org/coronavirus beginning Dec. 4. 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 keep you and your loved ones healthy. Please be sure to tune in on Dec. 17 at 1 p.m. ET for another important coronavirus discussion. Thank you, and have a good day. This concludes our call.

Bill Walsh:  Hello. I am 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. As coronavirus cases, hospitalizations and deaths continue to rise in almost every state, Americans have entered a new and dangerous phase of the pandemic. Particularly around the holidays it can be difficult to stay connected with family and friends, while also staying socially distanced and safe. But the good news is there are signs of hope as more progress is being made on vaccines and treatments. Today, we’ll talk to two expert guests about all of these issues.

[00:01:00] 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 us 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 who will 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.

[00:01:51] Joining us today are Steven C. Johnson, M.D., professor of medicine in the Division of Infectious Diseases at the University of Colorado School of Medicine and Anschutz Medical Campus, Multidisciplinary Center on Aging. Also joining us is Altha Stewart, M.D., past-president of the American Psychiatric Association and Associate Professor of Psychiatry at the University of Tennessee Health Science Center. We’ll also be joined by my AARP colleague Jean Setzfand, who will help facilitate your calls today. My AARP colleague Bill Sweeney will also join us a bit later to provide an update on how AARP is fighting for you during the pandemic.

[00:02:36] This event is being recorded, and you can access the recording at aarp.org/coronavirus 24 hours after we wrap up.

[00:02:58] Now I’d like to welcome our guests. First is Steven C. Johnson, M.D. He is a professor of medicine in the Division of Infectious Diseases at the University of Colorado School of Medicine and Anschutz Medical Campus’s Multidisciplinary Center on Aging. He has decades of experience treating infectious diseases and is a member of the Health and Human Services Panel on Antiretroviral Guidelines in Adults and Adolescents Living with HIV. His is also a member of the National Institutes of Health Panel on the Management of COVID-19. Welcome back to the program, Dr. Johnson.

[00:03:35]Steven Johnson:  Thank you.

[00:03:37]Bill Walsh:  Great to have you here. We’re also joined by Altha Stewart, M.D. She is a past-president of the American Psychiatric Association. She’s a senior associate dean for community health engagement and associate professor and chief of social and public psychiatry at the University of Tennessee Health Science Center in Memphis. Her career spans three decades of work as the CEO of a large public mental health systems in Michigan, Pennsylvania and New York. Welcome back, Dr. Stewart.

[00:04:09]Altha Stewart:  Thank you Bill. Glad to be here.

[00:04:11]Bill Walsh:  We’re glad to have you. Let’s get started with the discussion Dr. Johnson, let’s go ahead and start with you. You know, we continue to see positive news about vaccine development, and we’re seeing news that vaccines could be available as soon as mid-December. What’s the latest expected timeframe for a vaccine to become widely available?

[00:04:41]Steven Johnson:  Thank you Bill. And again, happy to be back on this show. I’ll focus my comments on the two vaccines that are farthest along: a vaccine by Pfizer and one by Moderna. These vaccines have the same technology, and they are the farthest along in development. We expect the FDA to meet about the Pfizer vaccine next week, Dec. 10, and then the Moderna vaccine, Dec. 17. And then I think soon we expect the FDA to authorize, which is allowing the kind of early use of these vaccines. So we’re really looking at the second half of December to get the first set of doses. We think that number will be in the millions nationwide, but I think the … rollout will probably take a process of up to six months as the vaccines are produced.

[00:05:43] I did see earlier this week, I mentioned from Operation Warp Speed, which is the federal government program, hoping to be able to vaccinate a hundred million people by the end of February. But this will be a phased approach over time. And again, I think the whole process may take up to six months.

[00:06:00]Bill Walsh:  OK. A quick follow-up to that. We hear about 90 percent and 95 percent efficacy rates for vaccines in the initial data that’s been reported. What does this mean? And should we expect these numbers to change?

[00:06:18]Steven Johnson:  First of all, this is spectacular news on both of these vaccines. We certainly have other vaccines that are this effective, but we also have many vaccines that are approved that are not this effective, including the influenza vaccine. I expect these numbers could change a little bit over time, but I don’t expect the conclusion that these are highly effective vaccines to change. I want to emphasize one part of these efficacy results, or effectiveness results, and that is that the 94 or 95 percent is preventing infection. But with both of these vaccines, there have been very few, if any, severe cases of COVID-19 in the group that has gotten the vaccine, and it illustrates that vaccines can work in two ways. They can prevent the infection entirely, or they can modify the infection so it’s not as severe if it occurs.

[00:07:23]Bill Walsh:  Those efficacy rates are much higher than what we see for the seasonal flu vaccine. Isn’t that right?

[00:07:31]Steven Johnson:  These are dramatically higher. The effectiveness of the influenza vaccine varies from year to year, but might be 40, 50, 60 percent, something like this. So this is really dramatic, and I think if we can implement these vaccines and have a public that is confident in the safety and effectiveness of these vaccines, this is really what will turn the corner on this epidemic.

[00:08:01]Bill Walsh:  Thanks very much for that. Dr. Stewart, let’s turn to you. Thanksgiving was last week and for many it was a different type of holiday. And just this week, the CDC urged people not to travel during the upcoming holidays. Looking forward, what are the best ways to substitute for the special moments over the holiday without being there in person?

[00:08:27]Altha Stewart:  I’ve been encouraging people because I know how important holiday gatherings are for our psychological health and well-being for reconnecting — and particularly this year, when there’s been so much apart time, I’ve been encouraging people to really make use of technology, whether it’s your smartphone or an iPad or anything else. But there’s enough technology that we can still connect. It’s not the same. You don’t get that hug from grandma, you don’t smell the smells in the kitchen with everything that’s going on, you don’t have that fun that you normally have in person, but we can recreate through technology a lot of the best times. And just remember that we have to help some of us more seasoned people — who may not be as tech savvy — learn how to use some of these devices, but there are many things you can do by gathering on video. You can continue the traditions. You know, you can host a celebration of trimming the tree and have everyone connected sharing the memories of what it’s like when you’re together. You can play games. You can actually have joint baking sessions. If that’s one of those things that you enjoy when you’re together, cooking and baking, just set it up on video and let everybody participate that way.

[00:09:51] We’ve heard stories of people who are gathering to do their gift wrapping, and play games with the kids, and host their ugly sweater and white elephant parties by sending things early and letting everyone participate online. So there are many ways that we can recreate the feelings without having to endanger ourselves and others by being in close proximity during this time.

[00:10:18]Bill Walsh:  Thank you. Those are some excellent suggestions. Some I hadn’t even thought about … cooking and trimming a tree together. I personally had hoped that COVID would mean the end of the ugly holiday sweater, but I guess not.

[00:10:30]Altha Stewart:  No, it’s still with us.

[00:10:30]Bill Walsh:  It’s still with us. Maybe there’ll be a vaccine for that ultimately. You know, we’ve talked about this when you’ve been on the show with us before, but can you talk to our listeners about the signs of stress and isolation, particularly during the holidays; what they should look out for in their loved ones and in themselves?

[00:10:53]Altha Stewart:  I think there are two approaches to this. One is for the people that you’re around, the people in your household, the people in your bubble, as it were: Watch out for signs that they’re not sleeping or that their eating habits have changed, or that they’re appearing to be more withdrawn, not as engaged or not talking or communicating as much, not joining in for those things that we can still enjoy if we’re careful. And for the people that you don’t see on a regular basis that you’re also not going to see because of the restrictions that we are all living with, stay in touch by phone, by using that technology that I just talked about. I’ve got folks who are going back to writing letters and enjoying as part of their continuing to try to find a new normal, walking to the mailbox and mailing something. Now it does require a little planning because you gotta have stamps and you gotta have all of that stuff, but that’s part of the joy of the season, to look for creative ways to stay engaged. And a grandparent getting a letter or a Christmas card from a grandchild that they can’t give a hug to … means the world. And the same thing for the child who gets something from a grandparent, or siblings who are used to getting together, or all of those clusters of people; look out for the things that signal to you that there is something different, and ask. Don’t ever be afraid to ask, are you OK? Is everything OK? And for the people who have trouble asking for help, now more than ever, we need to set aside all of those reservations and say, I’m not doing so well today. I need to talk, or I may need to visit, or something. Now is the time where we’ve got to overcome all of that stigma around asking for help, around feeling depressed or anxious or worried, and let people help us. Let them in because the holidays are going to be difficult for a lot of people, and the more we can put ourselves out there and both ask for help and offer help, the better we will all be.

[00:13:09]Bill Walsh:  That’s some great advice. Thanks for that, Dr. Stewart. And you remind me to mention to our listeners about a resource AARP created, called the AARP Friendly Voices Program. This is a free service. We created it because we know that during this pandemic so many people are isolated, and that becomes even worse during the holiday season. So we’ve trained hundreds of our volunteers to reach out to folks who might be isolated and just call them and chat with them, and let them hear from a friendly voice. Let me give that number out. It’s a toll-free number. It’s 888-281-0145. Again, that’s a free service. If you know someone who is isolated or you suspect might be isolated, maybe they would enjoy hearing from a friendly voice, an AARP volunteer.

[00:14:11] Dr. Johnson, I want to turn back to you. We were just talking about the terrific news on the vaccine front. The problem is, it appears we’re going in the wrong direction on almost every other statistic as it relates to COVID-19. You know the cases are up, hospitalizations are up, we’re seeing more deaths, and the experts are warning that getting together over Thanksgiving last week and possibly with the Christmas holidays, those numbers could get worse. What do we need to do to turn the tide?

[00:14:43]Steven Johnson:  I think the first thing probably is to remember the basics that we’ve been talking about over the last nine months. Just to review: Stay at home if possible; wear a mask to protect yourself and to protect others; socially distance; wash your hands; keep surfaces in the home clean; avoid touching your mouth, nose and eyes; avoid higher risk areas, including most indoor spaces, crowds, bars, restaurants. When you’re ill, isolate yourself. If you are going to meet somebody, ask if they are ill. These are all kind of basic things, but I believe because we’ve been having to do this for such a long time, a certain amount of fatigue has settled in, and people may not be as interested in following these rules or guidelines that we have talked about. The difficulty is, is that because of the amount of infection now in the community, these measures are actually more important than ever.

[00:15:54] Our governor in the State of Colorado at one point here recently stated that actually 2 percent of the Colorado population was infected with COVID-19. So any kind of activities you do, you’re much more likely to come in contact with somebody who has the infection than for example, three months ago. One other thing of course is to limit travel, and that’s really difficult for Thanksgiving. And it’s really difficult for Christmas and other holidays.

[00:16:31]Bill Walsh:  Right. I mean, you may be right. It may be fatigue of continuing to wear masks and socially distance. It may be disbelief that things that are really so simple could be as effective. But they are effective, aren’t they? I mean these are the basics, preventative measures we need to take to stop the spread of any virus.

[00:16:54]Steven Johnson:  We’ve been in this pandemic for roughly nine months or so, and so if you’re in a situation where you have not developed the infection, you probably have developed a strategy that works. And so I think it’s important to think about how you’ve protected yourself over the last nine months, and then double-down, and while we wait on a vaccine and get that rolled out, really protect yourself in the remaining hopefully three to six months of this pandemic.

[00:17:29]Bill Walsh:  Right. Great advice. Thank you, Dr. Johnson. We’re going to get to those questions shortly. Before we do, I want to bring in my AARP colleague Bill Sweeney to discuss what AARP has been doing. Bill is AARP senior vice president for governmental affairs. Welcome to the show, Bill.

[00:17:55]Bill Sweeney:  Thanks. It’s great to be here.

[00:17:57]Bill Walsh:  Great to have you. I know this is a really important stretch for AARP advocates across the country. Can you share a few ways that AARP is stepping up our fight for older Americans as we close out the year?

[00:18:11]Bill Sweeney:  Thanks, Bill, and I’m happy to. This week we are kicking off a nationwide virtual lobby week where we’re meeting with members of Congress virtually on the internet … just like families should do for the holidays. We’re … having these meetings to urge them to really take action on a few important priorities. First, with nursing homes and other long-term care facilities representing 40 percent of all COVID-19 deaths, we are continuing to work to help save lives in these facilities. We’re urging Congress to ensure that facilities have adequate staffing levels, are testing staff and residents, providing personal protective equipment, facilitating virtual visitation for the residents and families, and reporting daily and publicly whether they have confirmed COVID-19 cases and deaths.

[00:19:01] Second, more than 4 million workers are likely to face a big drop in Social Security benefits if Congress does not fix the pandemic’s impact on how the benefits are calculated. We’re urging Congress to pass bipartisan legislation to address this COVID cut, which if not addressed would result in a $45,000 reduction in benefits over 20 years for workers who are turning 60 in 2020.

[00:19:25] And third, as people struggle to make ends meet during this incredibly challenging time at this holiday season, it’s getting even harder for millions of Americans to put food on the table. To address this urgent need, we’re urging Congress to temporarily increase food assistance so people in need aren’t going hungry over these holidays.

[00:19:45] These are just some of the ways that we’re fighting for you, and our AARP teams across the country are meeting with members of Congress and their staff over the next few weeks to help make some progress. And, of course, none of this work would be possible without the thousands of AARP members, volunteers and activists who have made their voices heard. To learn more, you can visit aarp.org/coronavirus. Thanks, Bill.

[00:20:11]Bill Walsh:  Thank you, Bill, and I know you have to run, but we really appreciate you sharing that update with us. Now let’s get to your questions. … Our experts, Dr. Steven Johnson and Dr. Altha Stewart, will be responding to those questions. I’d now like to bring in my AARP colleague Jean Setzfand to help facilitate your calls. Welcome, Jean.

[00:20:41]Jean Setzfand:  Thanks, Bill. Really delighted to be here for this important conversation.

[00:20:45]Bill Walsh:  Who is our first caller today?

[00:20:48]Jean Setzfand:  Our first caller is Harriet from New York.

[00:20:52]Bill Walsh:  Hey, Harriet. Welcome to the program. Go ahead with your question.

[00:20:55]Harriet:  Hello. My question is, I am 90 years old, and they said that the elderly will be getting this, at some time, we don’t have a date as yet. Who is going to administer it?

[00:21:12]Bill Walsh:  Who is going to administer the vaccine?

[00:21:14]Harriet:  Yes.

[00:21:16]Bill Walsh:  And where would you go to get it?

[00:21:18]Harriet:  That’s exactly right. Where?

[00:21:21]Bill Walsh:  All right, Harriet. Let’s ask Dr. Johnson about that. So Dr. Johnson, can you help us out?

[00:21:27]Steven Johnson:  Sure. The vaccine, as mentioned, is initially going to roll out here late December. There are some groups that will likely be prioritized, and that prioritization is really defined by a federal group that is an advisory group about vaccines. Certainly, older individuals will be a high priority. What I’ve heard is that the first tier is going to involve health care workers to try to keep the workforce that’s caring for people with COVID-19 intact. And then, certainly individuals whose immune system are weakened, older individuals, residents of nursing homes. There’ll be groups that will be prioritized, and precisely, when a vaccine would be available for you, I can’t really calculate, but I imagine that when that becomes available, it will be given in hospital settings, clinic settings, and as the vaccine becomes more widely available, there’ll be more places to get it.

[00:22:49] One thing to mention is the vaccines are a little bit different in how they have to be stored. And so certain vaccines may be in hospital-based settings, certain vaccines may be in the clinic. So what I would recommend is that you express an interest in the vaccine with your primary care physician and also watch the news, and I think you’ll have an opportunity — probably the first half of 2021.

[00:23:22]Bill Walsh:  Let me follow up to that. You know for health care workers or folks who are in residential care settings, I can understand how the vaccine would be administered on a priority basis. What about someone like Harriet, who may not be in those situations? Could she expect a call from her doctor or a local public health official, or is the onus on her to reach out and ask for the vaccine and schedule an appointment?

[00:23:51]Steven Johnson:  That’s a good question. I think probably with health care in general, it always pays for the person to be proactive. So I may not use the term ‘put the onus on the person,’ but I think it’s important to kind of touch base regularly. I provide primary care for people living with HIV, and I am now getting frequent emails asking about the vaccine, asking me to notify them when it’s available and so on. I do think individual clinical programs are likely going to have ways to reach out to the people that they take care of. So, for example, at our hospital, we have an electronic health record that many people are part of, and we can send out messages and say things like the vaccine will be available, and so on. But I think there’ll probably be some unique situations that people have to respond to. So I think it’s important to be proactive as a consumer.

[00:24:56]Bill Walsh:  Thanks for that, Dr. Johnson. Jean, who is our next caller?

[00:25:00]Jean Setzfand:  We have a lot of questions coming in from YouTube and Facebook, and this question I think is for Dr. Stuart. Norma is asking: What suggestions do you have to help an elderly parent who lives alone to deal with isolation and cope with staying at home?

[00:25:18]Altha Stewart:  That’s a really excellent question, Norma, and thank you for asking, because I think there’s some specific things that we all agree are important for folks in that situation. One is to have some system, and it may require multiple family members or neighbors or others who are regularly checking in on that person. And the check-in can be direct — through a door or a window just to kind of eyeball them, if you will. It can be by phone to hear their voice and to get a sense of how well they’re handling the isolation. If they are going out for visits, to make use of those times that they’re going to see the doctor or something else that requires them to leave the home, to make sure that the person who is helping them with that, whether it’s an aide or a family member or a family friend, understands the importance of asking a few specific questions. How are you doing? How are you sleeping? Are you eating? Someone should be routinely checking in on them in their home, checking the refrigerator, making sure that things look to be in order.

[00:26:36] And if this is an elderly relative who before the pandemic showed signs of having challenges living alone, handling life alone — everything from moving around the house comfortably and safely to preparing meals, to maintaining the household in a way that is safe and healthy, if there were any questions about that, now more than ever we need to maintain an almost vigilance check-in with them about these things. Because the slippage can be very sudden, and before we know it, they’re in trouble from a health standpoint or a safety standpoint. So if you’ve got elderly relatives or family, friends or neighbors, these are the kinds of things we really do encourage families and friends and neighbors to think about as they’re checking in. And to just phone them, talk to them. If you can supply them with a device so that you can actually eyeball them without that face-to-face, do that. But if not, have someone who’s making contact and looking at them every day.

[00:27:52]Bill Walsh:  Thank you for that, Dr. Stewart. Jean, who is our next caller?

[00:27:57]Jean Setzfand:  Our next caller is Roberta from Missouri.

[00:28:01]Bill Walsh:  Hey Roberta, go ahead with your question.

[00:28:04]Roberta:  Oh, I was wondering now when you take this vaccine, how long will it be before it starts taking effect?

[00:28:15]Bill Walsh:  Dr. Johnson, do you want to handle that? I think, correct me if I’m wrong, but both of these two early vaccines require two doses, is that correct? How quickly would they start taking effect?

[00:28:29]Steven Johnson:  First of all, that’s a great question. Both of these vaccines are two shots. One of them is two shots three weeks apart, and the other is two shots four weeks apart. And the companies are really kind of evaluating the effectiveness about a week or two after the second shot. So probably within the first four to six weeks of getting the vaccine, we would then begin to see protection. One of the things that I think we’ll learn once these studies are actually published is what happens if somebody develops COVID-19 just after getting one shot? Is the illness milder or is there any kind of difference? But … in terms of the effectiveness of the vaccine, I think we’re probably looking a couple of weeks after the second dose, which would be about five or six weeks into the vaccine implementation.

[00:29:33]Bill Walsh:  Thank you for that, Dr. Johnson. Jean, who is our next caller?

[00:29:39]Jean Setzfand:  Our next caller is Ann from Alabama.

[00:29:43]Bill Walsh:  Hey, welcome to the show. Go ahead with your question.

[00:29:46]Ann:  Thank you, and I appreciate this town hall meeting. I had several questions, but I understand I can only ask maybe one. I’m 77, and my husband is 80, and we live about two hours away from the rest of our family, and one of whom is my 100-year-old mother. And I missed at Thanksgiving, and I missed her birthday, and I’m so lonely for her, and I just wondered about seeing her at Christmas. Would it be safe for us? And would it be safe for her? And I’m a little depressed about this situation now. And plus, I have three granddaughters who are in the medical field.

[00:30:43]Bill Walsh:  How is your mother’s health?

[00:30:45]Ann:  My mother’s health is really good except she has arthritis. Her mind is good, her physical health is good. As far as her heart, her lungs, and that sort of thing, but she has arthritis really badly.

[00:31:05]Bill Walsh:  Have you been staying in touch with her, I assume by phone. Have you done any Zoom meetings or anything like that?

[00:31:12]Ann:  Well, it’s by phone and she lives with my sister, so I stay in touch with my sister to make sure she’s doing good.

[00:31:22]Bill Walsh:  OK. Let’s ask the experts and see what they have to say. Dr. Stewart, do you have any advice?

[00:31:30]Altha Stewart:  I’ll let Dr. Johnson respond to the question about whether she should try to visit. What I will share, Miss Ann, is that I can certainly hear in your voice how sad you are about this separation. And, you know, there’s no comfort in this, but please understand that part of the reason that we are stressing staying apart is because we want everyone to remain healthy. And depending on your age and her age, and your health and her health, and all of those things, there are so many things that can impact her staying healthy and you stay in healthy, that we really do advise staying separate. And if your sister who lives with her can help connect you, not just by phone, because hearing her voice, obviously, hasn’t been enough. You want to see her; you want to see her smile. You want to see the twinkle in her eye. You want to have all of those things, and you can’t have the touching that goes with them. Maybe your sister can help you connect with her, or maybe one of the young people in the family can help connect you to show that you all can at least have some FaceTime. I know how important that is to your emotional health and well-being, and we don’t want you sad and depressed because of it. But we really are stressing that people right now, particularly people of a certain age and with certain underlying conditions, stay apart until we’ve got a better handle on the timeline for vaccine treatments and other things. And I’ll let Dr. Johnson talk a little bit more about that.

[00:33:16]Steven Johnson:  Thank you, Dr. Stewart, and caller, thanks for your question. One of the things, of course, that we associate with COVID-19 is that the older you are, even in the absence of other health conditions, the riskier it is … the riskier it is that you will get more ill, be in the hospital, or even pass away from this infection. So we’re always very cautious with questions like this. And I really support what Dr. Stewart said, the degree to which … visits can be virtual in terms of phone calls, video and so on, is really optimal for this holiday season. The good news is it sounds like your mother is in good health. I do feel that we have a finite time period left where we will have to have these kind of dire circumstances of separation. And I think it’s important to be careful, and then when we get to the point where people are vaccinated and the pandemic is under control, we can get back to regular visits and maybe you can have a holiday celebration in a different month.

[00:34:42]Bill Walsh:  Thank you both for that. Jean who is our next caller?

[00:34:47]Jean Setzfand:  Our next caller is Alan from New Hampshire.

[00:34:50]Bill Walsh:  Hey Alan, welcome to the show. Go ahead with your question.

[00:34:55]Alan:  Thanks, thanks an awful lot. My question is regarding vaccine side effects. I’ve read that short-term side effects are minimal, that we have done modeling on mid-term side effects, and they do not appear to be real serious. But apparently, we have no idea of what long-term side effects may be. And I was wondering if you can speak to the potential long-term side effects and the risks associated with them.

[00:35:24]Bill Walsh:  OK, thanks for that question, Allen. Dr. Johnson, do you want to address that for both the two vaccines we’ve been talking about, but [also] others that are in the pipeline, like the AstraZeneca candidate, and Johnson & Johnson I believe has another candidate out there. What can we say about long-term side effects of any of these?

[00:35:47]Steven Johnson:  In terms of long-term side effects, of course we don’t know because these are new vaccines, and if you count phase one trials and things like that, we still have less than a year of experience with these vaccines. With the Pfizer vaccine and the Moderna vaccine, which are the two vaccines which will first be available, the side effects have been relatively straightforward — fatigue, headache, some folks have had fever, there can be pain or redness at the site of the injection — but these are self-limited side effects that have not had a long-term consequence. Bill mentioned the AstraZeneca trial. There was a neurologic event in one of the study volunteers and we’re still waiting to learn more about that, although the studies have been restarted. But I think your question is a common one.

[00:36:59] I would say that if you look at the vaccines that are approved and we routinely give for influenza, tetanus, hepatitis and other conditions, we don’t really have long-term toxicities that we can measure. And part of this phased rollout of vaccines is that by the time many people will get the vaccine, we’re going to have six months or more of safety data and so on. But ultimately, people are going to have to make the decision whether or not to get the vaccine. I would, I personally would be first in line, because I trust the way that these studies are being done and so on, but it’s important. And like any vaccine-preventable disease, the downside of not getting the vaccine is getting the infection, and of course, we’ve had just a tremendous number of deaths in the United States that continues to climb. But if you ask, could there be side effects 10 years from now, I could answer that question about 10 years from now.

[00:38:18]Bill Walsh:  Well, [inaudible] question about long-term effects, if he’s thinking more like six months or a year, how will he or any of us really know about those kinds of long-term side effects? Would they be published in medical journals? Would they be carried in the press? How would we know? How would we hear about those?

[00:38:42]Steven Johnson:  That’s a really good question. First of all, the vaccines in question, those trials are still going on. So even while a drug may be available for an emergency use authorization, the companies that make these vaccines will continue to monitor safety data for several years, I believe. So the people who have volunteered to be part of these trials will continue to be seen for study visits and reports and so on. So that will be one mechanism.

[00:39:17] Once these vaccines are approved by the FDA, then there is a vaccine adverse event reporting system. So that if, for example, I provide a vaccine to one of my patients and they develop a complication, I’ll report that complication. And so there is what we call kind of post-marketing monitoring for side effects. And certainly if a particular vaccine has a side effect that’s important, that will make it into public health bulletins and medical journals, and so on. So I’m actually confident that if there is an unexpected toxicity, we’ll detect it.

[00:40:05]Bill Walsh:  And to Alan and others, just to let you know that AARP is going to continue to monitor the vaccine situation in the long term, and you can follow that news on aarp.org/coronavirus. Jean, who is our next caller?

[00:40:25]Jean Setzfand:  Our next caller is Lee from New York.

[00:40:27]Bill Walsh:  Hey, Lee, welcome to the program. Go ahead with your question.

[00:40:32]Lee:  Thank you for having these types of conference calls. I love AARP and their magazine. I’m 85 years old. My concern is helping the nurses and doctors who cannot give the time that they would like to to those that are hospitalized for a new way of handling it, to let one of the family members come into the hospital dressed from the bottom of their shoes to the top of their head as doctors and nurses are, so that they can help by sitting with a loved one who is suffering from loneliness, and finally just giving up, and then when they deceased, they’re not being able to take care of or buried properly. Thank you.

[00:41:25]Bill Walsh:  OK, Lee. Thank you. Dr. Stewart, maybe you can address this at the outset. It seems like she was suggesting that members of a family be allowed to visit if they take extreme precautions with PPE and other things. What do you think about that approach?

[00:41:46]Altha Stewart:  I think in principle it’s a wonderful idea. I think the unfortunate thing is that there are so many complications with respect to people in close quarters when major medical care is being provided, that it just could become a logistical problem. There might be opportunities, however, once people are no longer in a critical condition where there isn’t as much activity that needs to be going on around them, where those kinds of setups might actually be helpful and might relieve some of the staff from some of those support needs and support services that they provide. I just think that given the climate in many of our treatment settings, especially hospitals and especially when people are either critically ill or are still in the process of being evaluated for the level of severity of need, that it just becomes a logistical problem. Dr. Johnson may have another perspective on that. I’m all in favor of families being able to support loved ones, being able to be there, to show that support, but in the near future, we may just need to be much more facile about the use of technology and providing those things as a mechanism for communicating. Because these are tight spaces sometimes. So, I’ll let Dr. Johnson weigh in.

[00:43:19]Steven Johnson:  I think this is one of the great tragedies of COVID-19 is that not only are people sick and critically ill and potentially dying, but — because of the nature of this illness and how it’s spread — that hospitals have had to limit visitation. And … it’s really, I think, a difficult tragedy to try to kind of find that balance between having family members and friends provide support but then also have a safe environment in a hospital that is potentially overwhelmed with this care.

[00:44:05] I do think what Dr. Stewart mentioned — of certain technologies that can kind of bring people in by video and things like that — is one solution. Some hospitals, including ours, do have certain circumstances where visitors are allowed if somebody is very ill and end-of-life type of issues and so on, but it’s not optimal. And I think we should still keep thinking about how we can support not only the person living with COVID-19, but their families.

[00:44:40]Bill Walsh:  OK, thank you both for that. Let’s hear more questions. Jean, who is next on the line?

[00:44:49]Jean Setzfand:  We have, again, several questions coming in from both YouTube and Facebook, and there’s a trend that’s happening on some of these questions related to the safety of vaccines for individuals either with allergies or autoimmune deficiencies or diseases. I think there’s some general questions related to that.

[00:45:11]Bill Walsh:  Dr. Johnson, can you address that? How safe would any of these vaccine candidates be for somebody with a preexisting condition, like an autoimmune disease or allergies?

[00:45:24]Steven Johnson:  That is a great question. Let me just say, we’ve focused on these two vaccines that are nearly available — the Pfizer vaccine and the Moderna vaccine, but there actually are a number of other vaccines that are in clinical trials. Bill mentioned the AstraZeneca trial. There’s one by Johnson & Johnson. There is one by Novavax, and then there are a number of other candidates. And the reason I mentioned that, is that each of these vaccines has its own kind of unique technology, and it could be that we see different safety profiles and different effectiveness profiles with these different vaccine products. These vaccine trials were very carefully orchestrated by the federal government to be very large trials, very similar study designs, so that they could be compared. And so for example, most of the large trials have at least 30,000 people. The Pfizer has close to 45,000 people. And what that means is that within each vaccine trial, there are younger individuals, there are older individuals, there are individuals with some health problems. We’ve been able to refer, for example, persons living with well-controlled HIV infection to these trials.

[00:46:59] And so we’ll learn something from the initial trials about safety across the board, effectiveness across the board. One of the interesting reports from Pfizer is that it’s 94 percent effective in persons over age 65. That’s really great news because some of our other vaccines that we use in clinical practice are less effective in older people. But when you get to individuals that have autoimmune conditions, a weakened immune system, transplant patients and so on, there will very likely need to be additional studies within those populations to define both the effectiveness and the safety. And that just brings up a very important point that once a vaccine is approved, the study of the vaccine is not done, and that additional studies need to be done so that we know how to use it in the entire population.

[00:47:59]Bill Walsh:  Do we think if these two near-term vaccines get approval, we’ll have enough information for people who have autoimmune diseases or weakened immune systems for the reasons that they can take the vaccine with some confidence, or is it going to be too early to tell?

[00:48:19]Steven Johnson:  I think that’s going to be a mixed picture. I don’t think we’re going to have the answers completely. I talked primarily about safety, but of course the other aspect of it is, if your immune system is weakened, will you respond to the vaccine like individuals that have a stronger immune system? So it’s possible within certain subgroups, the vaccine will not be as effective as we’ve found in the general population. Really ...

[00:48:52]Bill Walsh:  OK, just wanted to follow ... oh, go ahead. I’m sorry.

[00:48:54]Steven Johnson:  I was just going to say, what we know about these vaccines right now is mostly press releases. So we actually do need to see these large vaccine trials finished, published in medical journals with sufficient detail, so that we can answer the question that you’re asking.

[00:49:17]Bill Walsh:  Right, and going forward, what do you think is going to be the best source of information for people on the profiles of these various vaccines so they can decide for themselves which one is the best for them?

[00:49:31]Steven Johnson:  So this may be getting too far into the weeds, but there is a National Advisory Panel called the ACIP, that’s the Advisory Committee on Immunization Practices, that gives vaccine advice. So when you … get your tetanus vaccine booster at 10 years, that’s because this committee has said, this is what makes sense. And this committee is the one that’s really going to define how these vaccines are used, and whether certain vaccines are used preferentially in certain populations, whether older individuals get one vaccine over another. We’re just kind of starting the studies of these vaccines in children. The Pfizer vaccine has been studied in people that are 12 years and older; the Moderna vaccine is just being started. But I think that will be the national body that kind of determines the guidelines for using the vaccines. And then, of course, we would always want individuals to work with their primary care physician to kind of help make these decisions.

[00:50:43]Bill Walsh:  Right, OK. Thank you for that … Dr. Johnson, I wanted to come back to you on the issue of vaccines. We’ve heard a lot of great news about the advances in the development of the vaccines, but it appears there’s also substantial advances in the treatment of COVID-19. Can you talk a little bit about those?

[00:51:17]Steven Johnson:  I think we’ve certainly made advances in the treatment, and I would kind of put this into several different areas. We have one antiviral medication that inhibits the virus itself that was approved by the FDA on Oct. 22. It’s a medication called remdesivir, and it’s actually an intravenous medication, and it’s just given for the subset of people who are in the hospital with COVID-19. So that’s one of the advances.

[00:51:51] One of the other advances is the use of anti-inflammatory medications, because one of the concerns with COVID-19 is that people get the viral infection and then the body’s immune cells respond, and they respond in an exaggerated way, and paradoxically, can cause illness and damage the lungs and lead to failure of the lungs to work. So the drug that we primarily use is a drug called dexamethasone, which is a steroid medication. So many of the people that I take care of in the hospital are on both of those medications.

[00:52:33] There are some additional medications that are under study. One [is] a group of medications called monoclonal antibodies. So these antibodies are proteins that your body makes to fight infection. And these are antibodies that are made in the laboratory and then target an important part of the virus that causes COVID-19. And those are being studied both as an outpatient treatment and as an inpatient treatment. And similar in concept to that is the use of something called convalescent plasma, which is actually taking plasma, which is a liquid part of blood, from individuals who have had COVID-19; and that plasma then contains antibodies against the virus that causes COVID-19, and then that plasma is infused into someone else. So I think in terms of specific medication interventions, those are the things to think about.

[00:53:40] I want to make one other point: That our medical profession has learned a lot about managing this disease over the last nine months. The hospital here at the University of Colorado has hospitalized over 2,000 patients with COVID-19 since March. And so physicians, nurses, respiratory therapists, other providers have developed really an expertise in providing what we call supportive care — providing the oxygen, intravenous fluids and other kinds of supports, and maybe blood thinners to prevent clots, all these kind of things so that we can shorten hospital stay, reduce the number of people that go to the intensive care unit, and reduce the death rate. So I think the U.S. workforce is more experienced now than they were in March.

[00:54:37]Bill Walsh:  Thank you, Dr. Johnson, for that. And before we get back to our listener questions, I had a few other questions for our experts. Dr. Stewart, I was wondering about the long-term effects of this crisis. Many of us have loved ones who lived through the Great Depression of the 1930s, and they were significantly changed by that time, even if they were just children. They became very frugal and not wasteful. Is it possible to hope that we’ll be more appreciative of quiet time and family time as a result of COVID-19, or more likely, will we be adversely affected for many years to come?

[00:55:20]Altha Stewart:  That, right now, Bill, is the great unknown. We’re still dealing so much with the uncertainty, day-to-day literally, of this evolving pandemic in our lifetime. We hope, of course, from the mental health standpoint, that people will remember and take from this experience some of those more positive things like understanding the importance of quiet time and family time, and doing simple things with each other. Understanding better the means of communicating in close quarters and how we relate to each other when we’re together, when we don’t have that busy life that existed for many pre-COVID. And we hope that many people will look back on this, not just remembering the limitations and restrictions and the sadness, but also some of the things that they remembered as a part of this experience. The families who are now spending time in the evenings, instead of in their individual little pockets of video games and Netflix and other things, doing board games or playing cards, or going outside for walks because they want to be outside. They want to be together, and there is actually time for that. But we just don’t know. We’re hopeful that if we handle this well, and we are mindful of the potential for some positive outcome, that we can actually make those things happen. But time will tell.

[00:57:02]Bill Walsh:  OK, thanks for that. And earlier, Dr. Stewart, you had talked about using technology to stay in touch with loved ones. We know that a lot more people are using telehealth for medical appointments. I wanted to ask, how can telehealth help those who are struggling, and how does someone take the first step to talk to someone? And what expectations should they have?

[00:57:26]Altha Stewart:  Telehealth has been a very positive outcome, or the expanded use of telehealth has been a very positive outcome, of this very unfortunate set of circumstances that came with the pandemic. And I think the first step is to actually make the outreach. Depending on your situation, depending on what level of health care you have access to, there are insured programs that offer these services. There are public programs. There are crisis lines for people. The National Alliance on Mental Illness, for example, has a crisis text line for people who need to talk, particularly about psychological stress and depression, and anybody can text the letters N-A-M-I to 741741 and get a live person 24/7, and it’s all confidential for people who are really struggling and stressed out. If you have, say, employee insurance, you should check with your EAP and find out what services there are that you can access, and mostly, it would be access through telehealth except for emergencies. If you are on public assistance of some kind or some other government-sponsored program, they also have access to those things. And this is both for the medical as well as the psychiatric, psychological mental health services. But the important first step is to acknowledge that you need help, that you need to talk with someone, and then understand that the talking itself may be helpful, but a long-range plan may also be indicated — and just hang in there and stick with it.

[00:59:23]Bill Walsh:  Thank you for that. And just to repeat some of those resources that Dr. Stewart mentioned, you can text NAMI, the National Alliance on Mental Illness at 741741. They can also be reached Monday through Friday 10 a.m. to 6 p.m. at 800-950-6264. They can also be reached at info@nami.org. Thank you very much. We are going to return to our listeners’ questions in just a moment.

[01:00:05] Before we do that, I’d like to take a second to alert our listeners about COVID-related fraud. You know, as if everything we’ve been through in 2020 weren’t enough, we also see that scammers are continuing to use the headlines as opportunities to steal money or sensitive personal information. As of Nov. 24, the Federal Trade Commission had logged nearly 258,000 consumer complaints related to COVID-19 and stimulus payments, more than two-thirds of them involving fraud or identity theft. Victims have reported losing $190 million with a median loss of $323. With recent reports of significant progress in the race for a vaccine, crooks have stepped up malicious email campaigns with subject lines like urgent information — COVID-19 new approved vaccines, according to the software security firm CheckPoint. The FBI warns that scammers are posing as charity fundraisers, soliciting donations to supposedly help individuals/organizations in areas affected by the virus.

[01:01:18] I wanted to give you a few tips so you can protect yourself from coronavirus-related scams. Avoid online offers for coronavirus-related vaccines or cures. They aren’t legitimate. Be aware of emails, calls and social media posts advertising free or government-ordered COVID-19 tests. Check the FDA website for a list of approved tests and testing companies. Don’t click on links or download files from unexpected emails, even if the email address looks like a company or person you recognize. And finally, visit aarp.org/fraudwatchnetwork to learn more about these and other scams. You can also call the Fraud Watch Network Helpline at 877-908-3360.

[01:02:18] Now it’s time to address more of your questions with Dr. Johnson and Dr. Stewart. Jean, who do we have on the line?

[01:02:33]Jean Setzfand:  Our next caller is Quita from Alabama.

[01:02:38]Bill Walsh:  Hey there, welcome to the program. Go ahead with your question.

[01:02:41]Quita:  Thank you. I’ve been trying to do this forever, but I know it’s late now, but I was wanting just some questions about the mask that I feel like that COVID is not dying down as far or as well as it should because people aren’t being careful, and part of it’s the mask. So I’d like to know what mask or … little blue mask that you can get anywhere in any store and all of that. [Do] those actually keep you from getting COVID-19?

[01:03:19]Bill Walsh:  Let’s ask Dr. Johnson about that. Dr. Johnson, can you talk about masks? Which ones are the most effective? And if there are any out there that you would not recommend?

[01:03:27]Steven Johnson:  So first of all, that’s a great question, and I think the approach to masks is relatively straightforward. We do recommend that the masks be a cloth mask that has a tightly woven fabric, so … cotton is a good mask. It probably is better if there’s a couple layers of cotton. The mask should be snug to your face because it’s important that you breathe through the mask and not breathe around the mask. And then related to that, it’s important that the mask covers both your mouth and nose. I’ve certainly seen common situations where people wear the mask just on their mouth. And then the other feature of a mask is that it ideally would be something that you can wash regularly and kind of decontaminate. We think masks, if worn like that, are helpful in both directions. So if you are ill — and remember that a portion of people with COVID-19 might not have symptoms — you can prevent transmission to others, and then, of course, if you come into contact with COVID-19, the mask will help to protect you as well. So I think those are the features that are important with a mask. We certainly recommend it.

[01:04:56]Bill Walsh:  I’ve seen a number of people wearing these neck gaiters that they pull up over their face when they’re near people. I’ve also seen a number of masks now with like the little plastic vent on the front. Do you have any thoughts on either one of those?

[01:05:15]Steven Johnson:  … I think it probably would depend a bit on the fabric that’s used for the neck gaiter. My concern with neck gaiters — by the way, the CDC website does not recommend neck gaiters — I think what happens with those is that you may tend to breathe around the gaiter, whereas a mask that has an elastic strap that holds the mask tightly to your face really means that you’re actually breathing through the mask itself and using it effectively as a filter. Similarly, if you have kind of a vent of a certain size, then that may defeat the filtering aspects of the mask. So I think I would avoid those two circumstances.

[01:06:05]Bill Walsh:  Thank you very much. Jean, who is next on the line?

[01:06:09]Jean Setzfand:  Our next caller is Naomi from Indiana.

[01:06:13]Bill Walsh:  Hey, Naomi. Welcome to the program. Go ahead with your question.

[01:06:18]Naomi:  My news [is] that I was a very, very active person by December of ’19. And then in February, I was just fine. I’m 86 years old, very active. My husband died 33 years ago, and I live alone. I still live in a three-story house that I raised my son in, and I’ve been here 56 years, and I still live here. But in February, I went in Feb. 4, I went into the hospital with a heart infraction, and it turned out to be a heart attack. And then I was there five days and I had a stroke. They don’t know why my health was almost perfect before, but that happened. So I’m here. I’m locked in the house. I haven’t left. I’ve outlived all of my friends. When you’re ... I live in a very small, farm community and this was not my home. This was my husband’s home. I was French Canadian and I married Tim, and I was left here when he died. And so, I don’t have the connection that I would have perhaps if I was from here … and the depression, my daughter-in-law buys my food. She brings it to the garage, or my son does, brings it to the garage. They go home. I then go out and wipe everything down and bring it into the house. The only place I’ve been in these eight months or so has been to my medical doctor and to my stroke and heart doctor, and that was in the hospital OK, here. They have offices there. So I’m not … the weather now has just turned bad. It’s been good enough that I could stay out most of the day; I could walk or I could sit in the garage or on the driveway or under the tree or whatever, but now I’m locked in the house. And the depression is beginning to really tell on me. And I just wonder if there’s any kind of secret or something that I could do that would help me through the next three months.

[01:08:57]Bill Walsh:  Let’s ask Dr. Stewart about that. Thanks, Naomi. I hope you’re feeling better, and I can hear that depression in your voice. Dr. Stewart, do you have any words of advice for Naomi?

[01:09:09]Altha Stewart:  Well, first I really do want to congratulate you and commend you for your willingness to say out loud things that I think a lot of people in your situation are feeling. And I appreciate your asking this very good question. A couple of things come to mind and I don’t know how workable they are, but just to throw them out. You do have contact with your son and daughter-in-law, and I wonder if there are opportunities within their circle for you to have … and I don’t know what your situation is in terms of devices and internet access and other things, but I wonder if there’s an opportunity there for you to get connected with a larger social circle of people to just talk to and look at and see you and interact with you as the first step. If you are going out to your doctor appointments, I would actually mention to my doctor or to the nurse or social worker or someone in that office that you really are looking for some outlets for social interaction. Because many times, if we don’t ask those things of our health care providers, they don’t really know that we need them. And many of them have access to organizations in groups, whether it’s the senior citizens center or something. And I heard you say you live in kind of a rural area, so there may not be a lot there, but I think it’s probably worth asking them what is available. If there are other things, churches or other organizations that may sponsor things where even if you can’t meet in person, again, that connection [is there] through phone or FaceTime or video or something. And a lot of this, I realize, hinges on your ability to access those things. So I think the first thing, since you are actively interested in doing this, is just to explore what’s available in your community that would meet your need, and to pull out all the stops asking. You don’t sound like a shy person, so I’m assuming that you’re willing to ask the questions and get some answers. And I would just encourage you to do what it appears comes natural to you, which is to look for ways to help yourself. You’ve done a magnificent job of living long and staying relatively healthy. And I see no reason why you can’t add on to that through some of these ideas and doing some of these things. And I wish you good luck in it.

[01:11:55]Bill Walsh:  Dr. Stewart, thanks for those suggestions. I’ll also mention something I talked about earlier in the program. It’s the AARP Friendly Voices Program. Naomi and others, this is a free service where you can call our toll-free number and speak to or get a call from an AARP volunteer, just to have them check in on you from time to time. If you’re interested in that service, the number is 888-281-0145.

[01:12:45] Jean, who is our next caller?

[01:12:48]Jean Setzfand:  We have a question on YouTube from Susan and she’s asking: Can you still be an asymptomatic spreader after getting the vaccine?

[01:12:57]Bill Walsh:  Hmm. That’s an interesting question. Dr. Johnson, do you have any insight into that?

[01:13:04]Steven Johnson:  That’s a good question. I guess the way I would answer that is that it’s likely possible just because we know that the vaccines have not been a 100 percent effective, maybe 95 percent effective, but there have been cases of infection in individuals who have received the vaccine. And, of course, a portion of the people that develop infection could be asymptomatic. I would say, once we have … rolled out the vaccine I think that phenomenon would probably be uncommon. But you raise actually an important kind of set of infection prevention issues that I’ve thought about. And that is … are we going to be able to relax some of these social distancing and masking standards once people get vaccines? And I think we’re going to have to wait to kind of see the combined effect of a certain portion of the population getting COVID-19 and a certain portion of the population getting vaccine, and then see what that does to the number of cases. So I’ve given a long answer without really answering the question, but I do think that phenomena will be possible, and we’ll just have to kind of learn how good these vaccines are, how long the protection lasts, how we can predict who is protected by maybe doing blood tests or antibody tests. There’s still a lot of unknowns even once these vaccines are approved.

[01:14:49]Bill Walsh:  Thanks for that, Dr. Johnson. Jean, who is our next caller?

[01:14:53]Jean Setzfand:  Our next caller is Lisa from Connecticut.

[01:14:57]Bill Walsh:  Hey, Lisa, go ahead with your question.

[01:15:00]Lisa:  I was curious, you said that the vaccines were tested on a wide range of ages, but I wondered for my father’s sake, and a lot of the people that have called in, has it been tested on the over-70 crowd? I mean, my dad’s 88. I heard a woman who was 90. I’ve heard other people in their 80s … it’s this older of the old crowd involved in the study test.

[01:15:23]Bill Walsh:  Thanks for that question, Lisa. And we know that oftentimes clinical trials … have a hard time attracting older subjects. So Dr. Johnson, can you address that question?

[01:15:35]Steven Johnson:  Sure. I think it was a priority with both of the … with all of the vaccines, but certainly with the Pfizer and the Moderna vaccine to enroll people at risk of developing more severe COVID-19. So people with certain health conditions, but also people who are older. I don’t have access — in fact, I’m not sure if it’s in the public domain, it might be — to what percentage of people within these clinical trials are over 60, over 70, over 80, over 90. I did mention that we do know with the report from Pfizer that they were reporting an excellent effectiveness rate of, I’m sorry, efficacy rate of 94 percent among persons greater than 65. I just don’t know what that number is. But I think that information will become available, and that will be one of the factors to consider. Because the death rate of COVID-19 is so directly correlated with age, I think the clinical trials will adequately include older individuals, and older individuals will be a high priority for vaccination.

[01:17:02]Bill Walsh:  Thank you for that. Jean who is our next caller?

[01:17:10]Jean Setzfand:  Our next caller is a question from Facebook, and Jenny is asking: “I’d like to know your thoughts about the hug tents that are in some nursing homes now.” She apologizes if this was discussed earlier, but is interested in learning about those hug tents.

[01:17:28]Bill Walsh:  Pup tents in nursing homes. Dr. Johnson and Dr. Stewart, either one of you could weigh in on that one.

[01:17:41]Steven Johnson:  I’m trying to understand the question. Dr. Stewart, are you ...

[01:17:44]Altha Stewart:  I didn’t quite get that. I’m not sure what was discussed early. Is it tents?

[01:17:51]Bill Walsh:  Jean, was there any more information on that?

[01:17:54]Jean Setzfand:  No, but I suspect it’s probably the film that you can use to put a barrier between individuals, so that you can still have some connection but not transmit. That’s what I’m assuming is a hug tent, but I may be wrong.

[01:18:10]Bill Walsh:  OK, oh a hug tent. I’m sorry. I thought you said a pup tent.

[01:18:13]Steven Johnson:  I heard it as pup tent, so that’s why I was confused. But I think any kind of a device that is a barrier — and is a barrier from coming into contact with respiratory secretions or contamination on the hands or things like that — is going to be effective to a significant degree. … I have heard of these hug tents, and I think it’s an ideal or interesting solution to be able to get close to people. We certainly heard about people kind of visiting people in nursing homes by being outside the window, things like that. So I think there are some strategies to … get close safely. Dr. Stewart, any other thoughts about that?

[01:19:06]Altha Stewart:  No, I didn’t … I’ve actually not heard about the hug tents. I’m going to have to look into that as one option … in addition to video visits. But I think you’re right … any of those things that safely allow people to interact and maintain that social connection is so important to the individual patient as well as to their recovery, and to maintaining that relationship. Anything that we can do safely that does not interfere with good medical care, I’m all for it.

[01:19:40]Bill Walsh:  Thank you both for that. And Lisa from Connecticut had asked about the number or proportion of people of much older ages in some of these clinical trials. And our excellent staff here at AARP has been able to pull some of that data. It looks like 23 percent of Moderna’s trial participants were 65 and older, and Pfizer reports that 48 percent of its enrollees are between the ages of 56 and 85. So, Dr. Johnson, as you were suggesting earlier, that it does seem that older people were represented to a fair degree in these trials.

[01:20:25]Steven Johnson:  And a credit to your staff for getting that information so quickly. The other characteristic of the trials is they’ve also been able to recruit people from a diverse racial and ethnic background, because that’s the other sense of confidence that we want … that this works in all persons.

[01:20:46]Bill Walsh:  Absolutely. That’s a great point. Thanks for that. Jean, let’s take another question.

[01:20:52]Jean Setzfand:  Our next caller is Barbara from New Hampshire.

[01:20:56]Bill Walsh:  Hey, Barbara. Welcome to the show, and go ahead with your question.

[01:21:01]Barbara:  In a way, in some ways you may have already answered my question. I was asking, do we have a choice of which vaccine when ready? And it seems as though the vaccine may choose us or your age, and if you have COPD or significant reasons such as that. Am I correct?

[01:21:27]Bill Walsh:  I think that’s right. Dr. Johnson, can you respond to Barbara’s comment?

[01:21:33]Steven Johnson:  Yes, so I think it may be that — for example, between the two vaccines that are almost available, because they have very similar effectiveness rates, very similar side effect rates, the same technology, and so on — it may be that an advisory committee may view those as somewhat interchangeable. But some of the other vaccines that are coming along are different technologies and might have a different side effect profile. So what we’ll have to see with each of the vaccines is how effective they are. We do know, for example, that the reports from the AstraZeneca trial are not quite as promising as the two that I just mentioned, and we may be able to learn that this vaccine is better in this population of individuals, so for example, people over age 65 or so on. This is kind of getting back to this advisory committee that I mentioned that really is going to tell us … what the best vaccine is for which population. We already have that to some degree with some of our standard vaccines. So, for example, the hepatitis B vaccine, certain types of dosing [are] recommended … and certain might be recommended for health care workers. So we might get to that specificity where there might be a particular vaccine that’s recommended to you.

[01:23:13] The other issue that has come up is because some of these vaccines require really cold storage. It may be that certain vaccines that require this cold storage are going to be better in hospital settings, whereas other vaccines that don’t have those requirements may be better in clinic-based settings or public health departments. So it also may depend on where you go to get your vaccine.

[01:23:42]Bill Walsh:  OK, thank you for that. Jean who is our next caller?

[01:23:48]Jean Setzfand:  Our next caller is Jacque from Illinois.

[01:23:50]Bill Walsh:  Hey Jacque. Go ahead with your question.

[01:23:53]Jacque:  It’s Jackie, actually.

[01:23:55]Bill Walsh:  Oh, I apologize.

[01:23:56]Jackie:  My question is, I spent Thanksgiving with my son, daughter-in-law and grandson. Shortly after I arrived, we got a phone call saying that my grandson had tested positive for the COVID virus. He was quarantined to his upstairs bedroom. His mother would take food to his door … but the rest of us were quarantined also. Should we be tested, or what should we do?

[01:24:38]Bill Walsh:  Dr. Johnson, can you help Jackie with that?

[01:24:41]Steven Johnson:  Sure. And it reminds me that when we talked about masks, I wanted to mention something I like to mention, which is the CDC is a good site for information about the quality of masks. And the reason I said that is the CDC also has some advice on how you socially distance within the home, where one individual is sick, and the others are not. And so it sounds like your family really went to some measure to try to prevent transmission of the virus. And so having somebody in a separate room, having somebody using separate bathroom facilities, not sharing meals and things like that, all of those measures … would reduce the risk of acquiring the virus in that setting. But, of course, it doesn’t eliminate that. And so certainly there was a period of time over the next 10 to 14 days where you could be at risk, for developing COVID-19, even if it’s a small risk. You could get tested, and you know testing is more widely available now than it was a few months ago. The other thing that you could do is let your primary care physician know about this, monitor your symptoms very carefully, and then get tested if you develop symptoms. I think it’s probably reasonable for you to maybe quarantine from others while you monitor your situation. You probably heard in the news that the CDC is reducing the days that people should be quarantined. It’s down to 10 days if you don’t have a test, and it’s down to seven days if you get tested after seven days and are negative. But I don’t think it’s mandatory that you get testing, if you don’t have symptoms. But I would quarantine, and I would monitor your symptoms very carefully.

[01:26:58]Bill Walsh:  Thank you, Dr. Johnson, and thanks to both of our experts. We’re coming up to the end of our show. I wanted to ask you both whether you had any closing thoughts or recommendations that AARP members could understand most from our conversation today. Dr. Johnson.

[01:27:15]Steven Johnson:  Yes. First of all, Bill, thank you for having me back on the show. I really enjoy this, and I really like talking to all of you. I think one thing I would say is that we are about nine months into this pandemic, and I feel like we’re over halfway to the solution. When we emerge from this is unclear, whether it’s March, April, May, or June, but I think there is light at the end of the tunnel, primarily because of the spectacular vaccine news. And what I’d like people to do is to kind of, as I mentioned before, kind of double-down on safe measures to protect yourself while we get to the end of the tunnel.

[01:28:02]Bill Walsh:  Thank you for that, Dr. Johnson, and thank you for being with us today. Dr. Stewart, any closing thoughts or recommendations?

[01:28:11]Altha Stewart:  Let me add my thanks, also, to the invitation to join you and your audience again. And I think Dr. Johnson sums it up well, that I believe we can see light at the end of the tunnel, thanks to the good news about the vaccine, but we must remain vigilant, we must maintain a sense of hope and positivity. We must be mindful of the slippery slope that we can quickly slip into with the depression, anxiety and uncertainty, and look out for those who are vulnerable to these kinds of issues, including yourself.

[01:28:56]Bill Walsh:  Thanks to each of you for answering our questions. This has been a really informative discussion, and thank you, our AARP members, volunteers and listeners for participating today. 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 are 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 today’s Q&A event, can be founded at aarp.org/coronavirus beginning Dec. 4. 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 keep you and your loved ones healthy. Please be sure to tune in on Dec. 17 at 1 p.m. ET for another important coronavirus discussion. Thank you, and have a good day. This concludes our call.

[01:30:39]

Coronavirus Tele-Townhall:
Staying Safe and Coping This Winter

Thursday, Dec. 3, at 1pm ET
Listen to a replay of the live event above.

As cases, hospitalizations and deaths from the coronavirus continue to spike nationwide and pandemic fatigue continues, this Q&A event provided the latest information on staying safe, vaccines, testing and risks related to specific activities. Our experts addressed how to maintain social connections and focus on mental wellness, including guidance to combat the underlying factors of social isolation and caring for yourself and family members. 

 

Our experts:

Altha Stewart, M.D.
Immediate Past President
American Psychiatric Association

Steven C. Johnson, M.D.
Professor of Medicine, Division of Infectious Diseases
Anschutz Medical Campus Multidisciplinary Center on Aging
University of Colorado School of Medicine

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


Replay previous AARP Coronavirus Tele-Town Halls

  • 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