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Coronavirus Tele-Town Hall: Your Health & Staying Protected

Our live Q&A addressed questions on the potential treatments and vaccine trials for COVID-19

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. Since the early days of the pandemic in March, we all know that our lives are drastically different. Throughout this trying time we’ve all looked for guidance on how to stay safe and protected and how to separate fact from fiction when it comes to news around vaccines and treatments. Today, we’ll talk with experts who will be answering some of your questions on these important topics.

If you’ve participated in one of our tele-town halls, you know this is similar to a radio talk show and you have the opportunity to ask your questions live. For those of you joining us on the phone, if you’d like to ask and a question, 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 a queue to ask that question live. If you’re joining on Facebook or YouTube, you can post your question in the comments section.

Hello. If you’re just joining, I am Bill Walsh with AARP and I want to welcome you to this important coronavirus discussion on how to stay safe and protected, and how to separate fact from fiction around vaccines and treatments. We are talking with leading experts and taking your questions live. To ask your question, please press *3. And if you’re joining on Facebook or YouTube, you can post your question in the comments. Joining us today are Sheila Marie Young, M.D., assistant professor of medicine and science at the Charles R. Drew University in Los Angeles, California. Also joining us is Rochelle Walensky, M.D., chief of the Division of Infectious Diseases at Massachusetts General Hospital and professor of medicine at Harvard Medical School. Later, we’ll bring in Margaret Wallace Brown, director of the City of Houston’s Planning and Development Department. We’ll also be joined by my AARP colleague Jean Setzfand, who will help us facilitate your calls today.

AARP is convening this Tele-Town Hall to help you access information about the coronavirus. While we see an important role for AARP in providing information and advocacy related to the virus, you should be aware that the best source of health and medical information is the Centers for Disease Control and Prevention. It can be reached at cdc.gov/coronavirus. This event is being recorded and you can access the recording at aarp.org/coronavirus 24 hours after we wrap up. Again, to ask your question, please press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you’re joining on Facebook or YouTube, place your question in the comments.

Now I’d like to welcome our first guests. Sheila Marie Young, M.D., is an assistant professor at the Charles R. Drew University of Medicine and Science in Los Angeles, where she also runs a COVID-19 mobile testing site. Welcome, Dr. Young.

Sheila Marie Young: Hi, Bill. Thank you so much for inviting me on the show today.

Bill Walsh: All right, well, thanks for being with us, Dr. Rochelle Walensky, M.D., is a professor of medicine at Harvard Medical School. She is also chief of the Division of Infectious Diseases at Massachusetts General Hospital, where she has been nationally recognized for driving health policy, both in the U.S. and abroad, toward the promotion of HIV treatment. Welcome, Dr. Walensky.

Rochelle Walensky: Thanks so much for having me, Bill. I’m looking forward to talking.

Bill Walsh: All right. So are we. Let’s get started with the discussion. And just a reminder to our listeners, to ask your question, press *3 on your telephone keypad, or you can drop it in the comments section on Facebook or YouTube.

Dr. Young, let’s start with you. If you’ve not been tested,  what should people expect? Will you need to go to a doctor’s office or are there drive-up locations? And how long does it take and how quickly can you expect results?

Sheila Marie Young: Sure, Bill. Well, actually every state has a different process for testing, and so it’s really important to see what your local community has. Oftentimes folks can call their doctor’s office, who will be able to set up an appointment for them at a local laboratory. Otherwise, there are state-run or county-run testing sites that either offer walk-up testing, where someone can walk in, or places where folks can drive up to get tested. Oftentimes, you’ll need to make an appointment beforehand. And right now, because we’re progressing in the amount of testing that we’re doing, we’re asking folks to bring their insurance card so that we can ensure that we have funding for enough tests for everyone.

Bill Walsh: And how long does it usually take to get the results of those tests?

Sheila Marie Young: Well, it depends. Because this is a new pandemic, or because this is a new virus, because we’ve never run these types of tests before, there are times when we have lots of supplies and times when we’re running low. And so for some laboratories, we’ll be able to get results out in 18 to 72 hours, and sometimes it takes longer. Sometimes there can be a backup, but I want to encourage people that even if their test result doesn’t come back right away, it’s always important to remember to do what you should do to prevent the spread of coronavirus or SARS-CoV-2, which is always wear a mask when you’re outside of your home, or if someone is sick in your home with coronavirus, take the measures that are recommended to protect yourself and your family.

Bill Walsh: Right. Okay. Well, very, very good. Thank you for that. Dr. Walensky, we continue to hear encouraging news about a vaccine. Can you fill us in on the latest? When might a vaccine be widely available to the public?

Rochelle Walensky: Wow, isn’t that the million-dollar question. Thank you, Bill. I wanted to say that we’re in unprecedented times. The fastest vaccine we’ve ever had before for a communicable disease has been four years. So whatever it is that’s happening right now is truly unprecedented. Let me tell you a little bit about where we are. There are more than a hundred vaccine candidates that we have, and at least three, if not four, of them soon will be in the large scale, what we call phase 3, clinical trials. Those clinical trials will enroll about 30,000 people each, and ultimately the outcome is, did you get infected or did you not, given that you received the vaccine or that you might’ve received the placebo in these randomized clinical trials. I want to mention that several of these vaccine candidates have some side effects. They’re not terrible side effects, but people should expect that they may have low-grade muscle aches, low-grade fevers, headaches. So there are some side effects associated with these.

In terms of the timeline, the first clinical trials, the first large-scale clinical trials, two of them actually started enrollment on July 27th. So far, they’ve enrolled a little under a third of the people that they are hoping to enroll. And several of these clinical trials require two vaccine shots, two immunizations, before we expect any full efficacy. So I’m thinking that by the time they enroll all these folks, get two vaccines into them and then start looking at the outcomes that we might be able to see signal late this year, early next year. And that is signal of whether these vaccines have worked. And that is assuming they are working and working well. So that’s an, again, an unprecedented timeline, but I don’t necessarily think before the end of this year or early next year we will see any results. There are a couple of caveats to that, and one is that not all of these vaccine candidates are enrolling the spectrum of population. So many of them are not enrolling patients under 18; in fact, I’m not sure any of them are. And not all of them are, in fact, enrolling in people over 65. So we will have some efficacy data, some really important data to move forward on, but I want to manage expectations in terms of how much data we’ll have for all populations.

Bill Walsh: That seems to be a chronic problem when it comes to efficacy testing, particularly with older adults, right, getting them into clinical trials and seeing the results. Let me just follow up on that. What is the latest update on how physicians are treating COVID-19?

Rochelle Walensky: Yeah, that’s a really great question because there’s been so much in the lay press and it’s getting so confusing. The first thing I want to just mention is, again, unprecedented times. So much of the science that we’re reading is prepublished science. And so things that come out on prepublished literature is not necessarily vetted through peer review. And we get a lot of news through that, but then once it goes through peer review, things might change. And so what gets published may be a little bit different from what got reported in lay press.

What we’re doing right now, we have two clinical trials that demonstrate that there are two effective things. One is the drug remdesivir. This is an antiviral drug. We use it during the time of high viral replication, when people are getting sick, getting short of breath. It’s indicated for people who are hospitalized, who have an oxygen requirement. It is an IV drug, so it’s not something we can use as an outpatient. And the drug has shown a benefit in decreasing duration of disease, from 15 days to 11 days. That’s important because we, again, have to manage our expectations of what we’re going to get out of it. So far, there has not been a mortality signal in using remdesivir versus not. This signal is in the duration of disease. So that’s one proven treatment. The second is, as people progress with this disease, if they progress to get sicker and sicker, they tend to go into an immune phase. So at first the virus sort of attacks the lungs but then, secondly, the person’s immune system will kick in. And part of that immune response actually can also be damaging to the lungs. So the second treatment that we use is when you are in that sort of period of time when the immune system starts creating part of the problem; that’s when we used dexamethasone or steroids. So it’s again used in people who are quite sick, who have an oxygen requirement, who are progressing even further into their stages of disease, and that drug, dexamethasone, has demonstrated a mortality benefit of about 30 percent. So right now that’s all we have that’s been proven in large-scale clinical trials.

We have a lot of clinical trials that are up and running. There’s been some data on convalescent plasma; again, not in the clinical trial realm so far. And so one of the things I would say is, given what has happened in the early phases of this when we started using drugs that didn’t have clinical trial data and how confusing that picture got, right now the NIH guidelines on the treatment of COVID only recommend the use of remdesivir or dexamethasone in the treatment of patients with COVID-19, and they recommend that if you have an experimental therapy, yes, please enroll patients in clinical trials to use that therapy, but don’t use it without the context of a clinical trial.

Bill Walsh: Oh, thank you for that. Well, Dr. Young, back to you. Let me ask you a similar question from the consumer’s point of view. As Dr. Walensky was just saying, that our knowledge of how COVID-19 spreads among people continues to grow and evolve, frankly, our knowledge overall about this disease continues to grow and evolve. What are examples of high-risk activities, and what activities may not seem risky, but actually are for people?

Sheila Marie Young: Sure. I mean, there is a number of activities, but what I’d really like us to do is just take a step back and consider those who are most at risk for serious or critical illness from COVID-19. I think one of the issues that we’re having in addressing this pandemic is that there’s a large majority of folks who are not getting very, very sick, or if they get sick, then they recover, and they think it’s fine. However, my view is that we must protect those who are at high risk of severe or critical illness. Now, who are those individuals? They’re individuals who have a suppressed immune system due to a variety of reasons. One of the great things that we have in our country is advanced technology, advanced medical care, where we’re able to provide immunosuppressive medications to people who need them, such as those who’ve had transplants. And there’s still some data coming out on some of the drugs and who is at risk, but essentially what we know is that they suppress a portion of the immune system that is necessary to fight viruses. And so, those who have autoimmune diseases, so they’re inherently immunosuppressed because of the medication that they’re taking. Also, we have to look at those who have comorbid conditions or conditions that can lead to or are a result of immunosuppression, or that could result in immunosuppression. And, you know, the thing with medicine is that things are constantly changing, and our knowledge is constantly growing. We know, for example, that individuals who have a high level of stress, that that cortisol that’s released with stress actually suppresses the function of the immune system. Those who are depressed, as well, that decreases the function of the immune system. So it’s not as simple as they have diabetes, they have a high, they have cardiovascular disease. It’s not as simple as that. So when we’re seeing folks in different age groups who’ve succumbed to COVID-19, we have to be able to take those things in consideration.

So, in essence, my point is that it is our responsibility as Americans and as citizens of this world to do everything we can to protect everyone who may be at risk for serious or critical illness. So how do we do that? We assume everyone is infected and we protect ourselves and we protect our loved ones. I don’t think it’s all right, the mentality that’s been proposed, or sort of this idea that certain people are dispensable. That’s, you know, it’s only, it’s only the older adults who are passing away. That is so cryptic. And my mother, who is 63, she’s at risk. And so are we saying that I don’t want, you know, my mother to be able to see her great-grandchildren? No, that’s horrible. And so, again, we must do everything that we can to protect everyone who may be at risk. And we do that by doing everything we can to prevent the spread of COVID-19. So, it is so important to wear a mask at all times, and I keep going back to wearing a mask because we know that that, already, that that slows the spread, and Dr. Walensky, if you’d like to jump in on this as well, I know that you’ve done some research on the effectiveness of different masks. Would you like to talk about what you found?

Rochelle Walensky: Sure. So you know a lot of what we were looking at is really the mask efficacy is very much related to how well people are using that mask, how adherent they are to masking, essentially. So, certainly, we can look at all different levels of masks from a cloth mask to a surgical mask to an N95, but really among the most important things is whether the person was able to durably wear the mask or not.

Bill Walsh: Right. Okay. Well, thank you both for that. And as a reminder to our listeners, please press *3 on your telephone keypad to be connected with an AARP staff member and get into the queue to ask your question of these experts. And we’re going to get to those live questions shortly, but before we do, I want to take a moment to update you on a critical topic—the U.S. Postal Service.

The Postal Service is a lifeline for millions of Americans. It’s how older adults receive medicine and health and financial information and absentee ballots. But AARP has become increasingly concerned that recent changes could compromise the health and safety of millions of older Americans and restrict their ability to safely participate in upcoming elections. So AARP members made their voices heard and the U.S. Postal Service responded. They announced this week that any changes to operations would not be made until after the election. This is a good first step and it’s especially important to voters 50-plus. Americans 50 and older vote by absentee more than any other age group, and changes to our mail system at this time could have impacted the ability of many Americans to vote. AARP is helping older adults vote safely, whether they choose to vote from home or in person. And we won’t stop fighting to make sure their vote is counted. While this is an important victory for voting rights, we need to stay vigilant to protect the needs of people 50 and older. Americans stand firm against any changes that will disrupt postal operations, and we will keep fighting to protect Americans 50-plus who count on the post office for lifesaving medicines and health and financial information. We also remain vigilant to protect the people in rural communities as the USPS is often the only service that will even fulfill deliveries there. In addition, AARP will keep watching Washington to make sure that the USPS can continue to operate effectively and efficiently, including timely delivery of medicine, food and election-related material. Many thanks to all of our AARP members, activists and volunteers who made their voice heard on this important issue.

It’s now time to address your questions about the coronavirus with Dr. Sheila Young and Dr. Rochelle Walensky. Please press *3 at any time on your telephone keypad to be connected with an AARP staff member to share your question. I’d now like to bring in my AARP colleague Jean Setzfand to help facilitate your calls. Welcome, Jean.

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

Bill Walsh: All right, who is our first questioner?

Jean Setzfand: Our first question is coming from Nancy of Ohio.

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

Jean Setzfand: One second, we have a little technical difficulty.

Nancy: Okay. Can you hear me now?

Bill Walsh: Hi. Is that Nancy from Ohio?

Nancy: Yes, it is.

Bill Walsh: All right. Welcome to the show. We’re delighted to have you. What’s your question for our two experts?

Nancy: Thank you. Maybe this sounds a little simple, but I do get confused about how often I can wash my cloth mask. How often should I wash it? Or if I do happen to have a surgical mask, do I just throw it away every time I’ve used it no matter how brief that time has been? So in other words, how do I deal with both the surgical and the cloth mask?

Bill Walsh: Right. So, thank you for that question. Dr. Young, do you want to take a crack at that? Nancy was asking, of course, about how to protect her mask, how to get the most use out of it.

Sheila Marie Young: Sure. Yes. You should actually wash your mask after it’s used. So if you were wearing one cloth mask all day, then wash it afterwards, throw it in the washer, throw it in your hamper to be washed with your other clothing. One of the things that I do like to inform people of is that there was a study that was released about a month or two ago that demonstrated that, it was simulated UV light. UVB light actually has an effect to kill the virus. And so, it is possible to put your surgical mask out in the sun to—and it depends on the cloud covering, so if there’s a lot of cloud covering, it takes about 20 minutes. If there’s not a lot of cloud covering, it takes about 5 or 10 minutes. And then the mask can be reused. Of course, if there are tears in the mask, if there are, if the mask is soiled, of course you don’t want to use that. You want to make sure that essentially you have the protection that you need and the protection for everybody else as well. For cloth masks, I do recommend that you get a mask that you can put a filter in. So one of the things that a lot of our staff and our volunteers have done is they’ve taken a surgical mask and placed it inside of a cloth mask. And that actually provides really good protection against acquiring or infecting others with COVID-19.

Bill Walsh: Interesting. Okay. Well thank you for, yeah, thank you for that, Dr. Young. Jean, who is our next caller?

Jean Setzfand: We actually have quite a few questions coming in from YouTube. So this is coming from YouTube, from Mark, and he’s asking, “I see people on Facebook having success with hydroxychloroquine and symptoms within days. So why is it not being recommended as a treatment?”

Bill Walsh: Okay, Dr. Walensky, do you want to tackle that question?

Rochelle Walensky: I would be happy to. Thank you, Mark. This is one of the drugs that has been extraordinarily confusing because I feel like every day we wake up and there’s new news about hydroxychloroquine, some good, some bad. Let me tell you what I know. There have been numerous cohort studies early on that had some suggestion that people who’ve used hydroxychloroquine might be getting better or might have less virus. Ultimately what happened, and this is really where we need these randomized clinical trials, is hydroxychloroquine was put to the test in several randomized clinical trials, and all of them that have been randomized demonstrated either no effect or a negative effect in terms of increased toxicity for people who received hydroxychloroquine. So when compared head to head to not receiving hydroxychloroquine, it was very clear that, if anything, perhaps harm might be done by people who, for people who received it. That is when the FDA removed the emergency use authorization for hydroxychloroquine, and it has been removed from the NIH guidelines for the treatment of how to care for people with COVID-19. Soon thereafter, there was a large cohort study out of Detroit that demonstrated in a cohort, not a clinical trial, that people with hydroxychloroquine might have had some improvement, yet again opening the book as to whether we should use it or not. Importantly, for the most part, the people who received hydroxychloroquine in that cohort study also received dexamethasone—I think 70 percent overlap. So in fact, the benefit of hydroxychloroquine was likely the benefit of dexamethasone, which has been proven to improve mortality. So overall, hydroxychloroquine has not been demonstrated in clinical trials to show a benefit. If anything, it has shown a toxicity, a signal, and the NIH guidelines do not recommend it, and the FDA emergency use authorization to use it for this disease has been withdrawn.

Bill Walsh: Thank you very much, Dr. Walensky for that clear answer. It’s refreshing to hear people speak so definitively one way or the other on some of these issues, because there is so much confusion out there, as you can tell from the questioner. Jean, who do we have next in the queue?

Jean Setzfand: Our next caller is Thomas from Maryland.

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

Thomas: Hello. Sure, thank you. What are the latest findings on whether being a COVID-19 survivor grants immunity, temporary or long-term, or at all?

Bill Walsh: Hmm. Okay. Dr. Walensky, did you hear that one about—

Rochelle Walensky: Yeah, I sure did.

Bill Walsh: I wonder if you can address that?

Rochelle Walensky: You know, I’ve gotten two million-dollar questions now. I’d be so rich. So the other big thing we really need to understand is immunity. There was a paper, a preprint paper, published today and—actually posted today and reported in today’s New York Times about this, a really interesting study of a ship vessel out of the coast of Seattle. Three people, they looked—I think it was something like 147 people who went on this ship, and they all had viral testing and serology testing, antibody testing, done before they left. They all were negative in theory for disease when they left, but three had antibody. When they came back, I think 103 of them had disease, and several of the people who, the people who didn’t all were the ones who didn’t have antibody. Sorry, all were the ones who had antibody. So it was a very interesting suggestion that the people who left with antibody were somehow immune. Now, that is really promising information to suggest that maybe it’s that antibody that has protected them. Another paper that was just released today in JAMA looked at antibody responses from about 150 people and demonstrated that people were more likely to have antibody if they were older, if they were men, if they had potentially had more severe disease. And the issue is how much, and 10 people actually who had had disease didn’t get antibody at all.

So this is, unlike the clarity of the first answer I gave with regard to hydroxychloroquine, this picture’s really muddy. What we’re really starting to see is there have been some cases now where people have had demonstrated protective immunity when reexposed, we believe. And we’re trying to understand the levels of neutralizing antibody that have been demonstrated in people with disease, and whether that in the long term protects them from disease in the future. I’ll remind you that we’ve had seven months of history with this disease, so we really don’t know a lot about whether when you had it in January, whether you’ll get it again in November. We have not been living with this disease for that long. We also don’t know whether, how long, if you did have some protection, how long it might last. And then a final thing that we really don’t know is whether some of the conflicting, confusing data in children is a result of the fact that there are many other coronaviruses out there, and whether some of those might deliver some cross-protection to SARS-CoV-2.

Bill Walsh: Hmm, it sounds like the bottom line then is for everyone to continue taking the precautions that you discussed at the, that you both discussed at the outset.

Rochelle Walensky: Absolutely.

Bill Walsh: Yeah, okay. Jean, who is our next caller?

Jean Setzfand: Our next caller is Marlene from New York City.

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

Marlene: Thank you. I’m concerned, I’m going to become a great-grandmother in about 10 weeks; however, I live in New York and my granddaughter lives in Chicago. One, is it safe for me to fly? I’m 88 years old. And once I get to Chicago, will I be able to see the baby, hold the baby? My granddaughter is a type 1 diabetic. I don’t know if I’ll be able to see her. How awful if I go out there and then they don’t let me see them. Please help.

Bill Walsh: Yeah, well, first of all, Marlene, congratulations on about to become a great-grandmother.

Marlene: Thank you.

Bill Walsh: Let’s see if we can get some guidance for you. Dr. Young, do you want to address Marlene’s question?

Sheila Marie Young: Sure. Marlene, I completely understand wanting to be there with family, especially at such an important time in your granddaughter’s life and, again, congratulations on the birth of your grandchild. So I do want to say that, again, that certain activities are more risky, such as being on a plane with a number of individuals who may or may not be showing signs of active infection with COVID-19  or the SARS-CoV-2 virus. And so at this point in time because the rates of COVID-19 are continuing to rise, because we’re still seeing an increase in the mortality from COVID-19, I would actually recommend that you can find a way to connect with her via your Facebook or FaceTime, Facebook Live, the other mechanisms that we have. And one of the things that I’ve actually found that I think we should really be encouraged about during this time is that we are more connected at this point in time in our history than we’ve ever been before. We have these technologies that allow us to work from home, allow us to see our family members, allow us to be part of events. I remember just being a part of events that my family participated in, in other countries previous to COVID-19, and how I felt a part of that. And so as we’re going through this pandemic, I’d really like to encourage us to find ways to safely be together. If it were a different circumstance, I could possibly suggest otherwise, but we’re looking at multiple risk factors. And I would, again, just encourage you to find a way to connect with your granddaughter and your grandchild and her family through other ways and, again, just know that even if we can’t be there in person that we can still be connected. I know that many of us have attended funerals or weddings and also parties via this method. Or we’ve taught our classes, and we’re still able to make that connection, that connection as family and friends and professors and students. And so I would encourage you to do that during this time.

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

Jean Setzfand: Our next caller is Carolyn from Arkansas.

Bill Walsh: Hey, Caroline. Go ahead and ask your question.

Caroline: Sure. I have a comorbidity, I have COPD, and I was wondering if even after a vaccine, an effective vaccine is found, will it be advisable to still wear a mask for people like me? I am also 65 as well and out in public and stores and you know, things like that.

Bill Walsh: Sure, Caroline, thank you for the question. Dr. Walensky, do you want to try to address that? She’s thinking about steps to take after a vaccine emerges.

Rochelle Walensky: Thank you, Caroline. I want to be very clear about what we can expect in the weeks, months and years ahead. The FDA is probably going to approve a vaccine if it’s just even got 50 to 60 percent efficacy. So we may have a vaccine, and it may not be perfect but it’ll be a great incremental step forward. After that we can expect that not everybody who is going to be eligible for the vaccine is going to want it. We know year after year, in a very well tested and long history—flu vaccine—only about 50 percent, 45 percent of Americans choose to get a flu vaccine every year. So if you kind of do that math, we can perhaps expect that, you know with 50 percent efficacy and 50 percent of people getting it, only about a quarter of Americans might have protection against SARS-CoV-2. So I guess that’s a long-winded way of saying that I think we’re going to have to learn how to coexist with this virus for the, at least for the medium term. And by coexisting, I think that that does mean that taking someone like yourself, Caroline, with COPD and some increased risk by age, that masks are going to be part of our future for the medium term.

Bill Walsh: Let me just follow up on that, Dr. Walensky. Once, let’s fast-forward and imagine that FDA has in fact approved a vaccine at some point. What would you then say to people who are concerned about the safety of the treatment?

Rochelle Walensky: So I think—first of all, maybe let’s rewind, and say everybody should get a flu vaccine. This is going to be really—the flu vaccine is tried and true. We know it’s not always a hundred percent efficacious every year. We do know that going into flu season it’s going to be really hard to disentangle the symptoms of flu and the symptoms of COVID-19, and we know it’s likely the case that some people will be able to be infected with both at the same time. If it’s possible to take one of them off the table, that is, influenza, we should be doing so, and everybody who is eligible for a flu vaccine, in my mind, should get it. We know it’s got an amazing safety profile and that it can really prevent severe disease. So if we sort of say, let’s see if everybody, if we can get as many people vaccinated with influenza as possible.

Now let’s turn to the COVID-19 vaccine. I am really hopeful that we will be able to rely on our colleagues at the NIH who are in charge of all of these vaccine trials through the COVID Prevention Trials Network to give us and put forward something with true vaccine efficacy, with its caveats of, these are the risk factors, these are the groups that it showed most benefit to, and these are the potential side effects. And we’ll have to see those data as they emerge. And then we’ll have to use the vaccine gingerly in the populations that demonstrated the most efficacy and limited amount of toxicity. That’s a really, a hard step for the vaccine trials. One of the big challenges associated with the vaccine trials is enrolling underrepresented and vulnerable populations. For example, we know that 2½, the mortality of COVID-19 has been 2½ times-fold for Black Americans than for white Americans. However, we’re not overenrolling for some challenges in the vaccine trials, Black Americans versus white Americans. And this again relates to that issue of trust: Who is going to trust the vaccine, who is going to take the vaccine. And that’s on us, we scientists, we in the community to work together, to enroll, to ensure that when we have a vaccine that is deemed safe by the NIH and by the FDA, that not only are there enough data to make sure that it’s generalizable to the population, but then that people trust it so that we can get as many people vaccinated at risk as possible.

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

Jean Setzfand: We have another question coming from YouTube and this one’s coming from Dr. Baker who’s asking, “Are tests with fast results as accurate as those that take a few days to get results?”

Bill Walsh: Hmm. That’s an interesting question. Dr. Young, do you want to try to tackle that?

Sheila Marie Young: Sure, thank you so much. So for tests that take a few hours, it really just depends on the lab, to be honest, and what type of test they’re running. So we have to understand that there are what we call RT-PCR tests. That’s when we’re actually looking at the viral RNA and verifying that the correct sequence is there that identifies this particular strain of a virus, which is SARS-CoV-2. The other issue is that there are rapid tests, and so those are different tests. Those are antigen tests. So those tests look for what we call sort of pieces of the virus that would generate immunity, and that’s an antigen. And one of the issues that we’re seeing right now with the rapid test is that there are, at times, false negative or false positive rates. And so again, I would like to see the rapid tests used in a similar way that we do HIV screening, and we are very fortunate at CDU to have an expert who’s worked in the field with vulnerable populations, Professor Cynthia Davis, who was at the forefront of the HIV pandemic here in Southern California. And so she described her process that we currently use and that they initiated when HIV initially came into our populations. And so once they had a rapid test, if someone was positive, they then confirmed. Now, will we be able to do that with everyone? Possibly not, but should we do it with those who are high risk? Yes, we should.

Bill Walsh: And Dr. Young, let me just ...

Sheila Marie Young: And so when we have rapid tests available, we, as physicians, should look at each patient and, you know, their comorbidities or their underlying diseases, their age, their other risk factors and determine who should receive that follow-up test.

Bill Walsh: Thanks, Dr. Young. Let me just follow up on that, ’cause you threw around a fair amount of terminology that I certainly didn’t understand.

Sheila Marie Young: Sorry about that.

Bill Walsh: But I’m wondering from a consumer’s point of view, from a consumer’s point of view, if they’re interested in getting tested, should they be asking for a particular type of test or will they simply be administered a test that the lab or the doctor decides.

Sheila Marie Young: It can actually be both. And so again, a rapid test is a test that you can get results back sometimes between 5 and 15 minutes. There are a number of those rapid tests that are available and that’s different again, than what we call a PCR test. And what we need to realize as well is that it’s not the way that you collect the test. It’s not whether it’s a nasal sample or an oral sample or a saliva sample, it’s really the test processing that’s different. And so if you hear a test is, it takes a day or two, does that mean that it’s better than a test that takes a few minutes? Again, you can ask, is this what we call an antigen test? And so I’m going to give you that terminology. So antigen and an antigen test, those are the tests that take 5 to 15 minutes to get a result back right there on the spot. The other tests are the PCR tests and those tests you’ll have to receive results through your health care provider. If you’re using a system such as Healthvana, you will get—that we are using here in Southern California—you’ll receive a text message or an email indicating what your results are. For us, if you’re positive, you will also get a call back, and we check in on you and make sure that you have the resources necessary to manage the illness.

Bill Walsh: Okay. Let’s leave it there. Thank you, Dr. Young for that. And thanks for all of these questions. We’ll take more questions later. And just a reminder to our listeners to press *3 on your telephone keypad to be connected.

And before we get to our next guest, I want to take a moment to share how AARP is supporting cities, towns and villages around the country as they work to become places where people can thrive no matter their age. In support of this vision, I’m pleased to share that AARP is investing $2.4 million in grants to 184 organizations throughout—I’m sorry, through our AARP Community Challenge program. Grants will make tangible improvements in all 50 states, the District of Columbia, Puerto Rico and the Virgin Islands. These investments are important every year, but 2020 is a year that has challenged us in some distinct ways, with the coronavirus upending our norms and shining a light on the injustices in our country. In the face of these challenges and the unprecedented local needs, the program was expanded this year with a heightened focus on diversity and inclusion and helping local governments and organizations as they respond to the pandemic. Let me just give you a couple of examples. In Tulsa, Oklahoma, where a pilot program will help deliver groceries to older adults and people with disabilities. In Atlanta, another project will help build accessible garden beds and little free pantries to help older adults experiencing food insecurity in refugee and marginalized communities. To learn more and see a list of all the grantees in your state, visit aarp.org/livable.

Now I’m pleased to introduce our next guest, Margaret Wallace Brown. She is the director of the City of Houston’s Planning and Development Department, where she is Houston’s top planning and development official. She leads much of Houston’s transportation and community planning efforts, including the mayor’s signature Complete Communities Initiative. Welcome, Margaret.

Margaret Wallace Brown: Thank you. Thank you for having me today. I am pleased to be with you.

Bill Walsh: All right. We’re pleased to have you, and I know we have you only briefly. So let’s get to it. I understand that Houston just received an AARP Community Challenge grant. Can you share how this project will improve the city for people of all ages?

Margaret Wallace Brown: Absolutely. So we are very pleased to have received a $2,100 grant from the Challenge, from AARP Challenge grant system to create a demonstration project, a demonstration tool kit per se for creating bike lanes in Houston. As many of you know, Houston’s a car-centric Sun Belt city and so it is difficult to go back and retrofit safe and affordable transportation systems for pedestrians and bicyclists in a city that’s really kind of built around the car. And we applied for and received a grant that will help us conduct demonstrations and create a tool kit that is, that can carry us into several neighborhoods time after time after time. The first bike lane demonstration project will take place in Gulfton neighborhood.

So the mayor’s Complete Communities effort is an ongoing process. It’s a signature initiative to look at neighborhoods that have been underserved for decades, and to try to work with the community and develop plans and to develop relationships with both the neighborhoods and the business entities and create better resources for these neighborhoods. And the Gulfton area is unique in Houston in that it is one of our most dense communities, it is almost entirely apartment complexes, and it is primarily Houston immigrants. You know, three-fourths of all Houstonians were born outside of the state of Texas, but this area is primarily first-generation immigrants. And it’s kind of a landing spot, it’s Houston’s Ellis Island, it’s been called that for a number of times, and it has a population that is both old and young, I mean old and very young and very, very diverse. And so we will be able to do some demonstration projects for bike lanes in this community. Many of the people who live in the Gulfton area do not own cars. It is one of our highest areas of, or one of our lowest areas of car ownership in Houston. So these bike lanes will be really transformational for the people who live here in providing safe passage for them to get to transit or to their jobs or to the grocery stores without worrying about cars and accidents and risking their lives. So we’re thrilled about this.

Bill Walsh: Fantastic. Well, I wonder how the coronavirus has changed your plans for the project, if at all.

Margaret Wallace Brown: It’s actually, well, it has actually accelerated them. We have, because most cities have also, you know, slowed down and the traffic has waned a little bit, and we now have a little bit better access to our roads and to our sidewalks than we had back in February, we’ve been able to accelerate projects. And bike lanes have been one of those that we’ve really been able to accelerate, even created a few open-space roads where we have given them road diets, so to speak, choked back the traffic and opened up for pedestrians, and so having this virus has really illustrated to Houstonians, more than just policymakers like me, but has really illustrated to our residents how important safe passage for all ages and abilities is. And so we have really taken this opportunity to ramp up our effort to create safe and safe passage for both bicyclists and pedestrians of all ages across Houston.

Bill Walsh: Well, and it’s great that it’s providing more outdoor space that’s usable at this time. That’s so important if people choose to get out of the house, that they can do it in a safe way. Thanks so much, Margaret. Before you leave, do you want to provide any closing comments for our audience?

Margaret Wallace Brown: No, other than we have just had a wonderful relationship with the Houston area AARP offices for years. And this is just one more step in the right direction for our collaborations. And it’s been such a blessing to Houstonians to be able to collaborate with the team here in Houston, and we look forward to many more years of it.

Bill Walsh: Okay, as do we. Well, thanks again, I know you have to drop off. We appreciate your being here.

Margaret Wallace Brown: Thank you.

Bill Walsh: All right. Dr. Walensky and Dr. Young, I’d like to bring you back into the discussion. Dr. Walensky, September’s right around the corner and fall isn’t far behind. Do we anticipate any changes because of the cooler weather as it relates to the virus. Is COVID-19 more potent in colder weather, or is there a greater risk when more of our socializations are occurring inside?

Rochelle Walensky: Yeah, that’s a great question, Bill, and it’s actually one the opposite of which I got in May last year. Can we hope that this is all going to go away over the summer? Right? So there are several reasons why we think that weather matters. First of all, generally respiratory viruses thrive more in the winter than they do in the summer. Almost all respiratory viruses are circulating much at higher levels in the winter, including influenza, than they do in the summer. One of the reasons for that is related to the fact that the virus actually does better. There’s more humidity in the summer. And so, because of that humidity, the viral particles don’t last in the air for as long and they drop after shorter distances. So the humidity actually helps you out in the summer, the dry air in the heat of the winter doesn’t do us a service there. Some people would argue that people’s immunity is a little bit worse in the winter than it is in the summer. And then, of course, there’s the issue of close quarters. People being, you know, we know that the best thing to do with this virus is be outside. If you can do all of your activities outside, you’re in much better shape than if you do them all inside with regard to this virus and in greeting one another. So what we know in the winter is that there will be many more people inside. We need to then worry about the ventilation, circulation and filtration of air in these places. And it will be then all that much more important that people are wearing masks.

Bill Walsh: Thank you for that. And Dr. Young, let’s pick up on the discussion about masks. The effectiveness of masks has been in the news again, in part driven by recent tests conducted at Duke University. What masks work better than others and are masks needed in all situations or are they sometimes unnecessary?

Sheila Marie Young: Very good question. So one of the things I’ll say is that we know that the N95 masks that are fitted, where you have a fit test, this is a technique that they teach us in medical school where we put a bag over our head, they spray some really bitter material. And if your mask is on correctly, you won’t be able to smell or taste that bitter material. If it’s on incorrectly, you will. And so that is a process for fit-testing a mask. So fit-tested N95 masks by far are the best protection for preventing infection with COVID-19 or the SARS-CoV-2 virus. Of course, not everyone has access to that type of technology or those techniques, and it’s not necessarily what we’re calling everyone to do right now, but you asked what’s the best. And so that’s the best. So what can we do next? For people in the general community, again, it is important and, Dr. Walensky, we’ve discussed this prior to the call, it’s important that you wear a mask in general. The most effective masks after the N95 mask or the KN95 mask are surgical masks. There’s also different, better, widely available in our communities. There are other masks available such as KN95 masks that are from, being shipped over from China. So if it’s a K in front of it, that means it’s usually being shipped from another location. However, they have a certification and to make sure that you’re getting the correct mask, it’s a certification that should be on the bottom of the mask, And it’s called N-I-O-S-H, a NIOSH certification, that it’s either an N95 or a KN95 mask. If it doesn’t have that certification, and you’re going into an area that’s higher risk, say that you’re working in an environment where there is a lot of people, you’re working at the airports or there’s a high risk of exposure, you really should be wearing a higher level mask, especially if you are in contact with the public on a regular basis. And then for those who are going into places, really, having a mask that has multiple layers and cloth and then a non-cloth material in the mask will also make it a better mask. A lot of folks are making masks from home. If you can make a mask that has a place for a filter, you can put a surgical mask inside, and I think that that’s what we, that’s one of the best things that we can do right now to prevent the spread of the SARS-CoV-2 virus.

Bill Walsh: Let me just follow up on a couple of things you said there, Dr. Young. So if I’m wearing the KN95 mask, will it protect me if others are not wearing a mask?

Sheila Marie Young: It can protect you as long as you have it on properly. So the mask should cover your nose and your mouth, so, of course, we see folks who have their masks around their chin. They sort of wear it as a beard; that doesn’t help. It should fit properly. So sometimes the masks with the ear loops, they’re not as tightly fitted as masks that go around your head. And so again, I would encourage you if you’re going to be in a place that is indoors where the AC is running, make sure that you have a mask that fits tightly. And this also applies to office buildings. Just because you’re in your office, it doesn’t mean that the virus couldn’t per se go through the ventilation system. And there was a nice study that was done out of MIT demonstrating that. There’s a nice YouTube video, it’s 5.4 or five minutes four seconds, and it’s called Nothing to Sneeze At. And that shows you another instance of how viruses can travel.

Bill Walsh: Okay, let me just ask one other follow-up. You had mentioned a certification on masks, the NIOSH. Now, a lot of the cloth masks that people may be buying presumably don’t have that certification. What are your views on people wearing cloth masks?

Sheila Marie Young: I think again that the cloth mask has to be multiple-layered and that it should have a filter in it. And this is particularly important, I believe for those who are in areas where they have high contact with the public. This includes a lot of our essential workers, those who are working at grocery stores. We’ve actually been distributing higher level masks that have been donated to us to our essential workers in the South Los Angeles community, and we know that we have high rates of COVID-19 here and we also know that we have high morbidity and mortality rates from COVID-19. So it is our passion to protect those who are most at risk. And we also have to realize even if that person doesn’t succumb to critical or serious illness, it’s possible for them to pass on the virus to others. And so one of the things that we know in our community is that, and especially because of the rents are so high in Southern California, folks live in multigenerational households, they live with multiple families in one home, they live with, in places where they can’t self-isolate if needed or they can’t use their own restroom. And so again, we have to ensure again that everyone wears a mask so that those who are at risk can be protected.

Bill Walsh: Okay. Very good. Thank you very much, Dr. Young. Now it’s time to address more of your questions with Dr. Young and Dr. Walensky. And as a reminder, press *3 on your telephone keypad at any time to be connected with AARP staff. Jean, who is our next caller?

Jean Setzfand: Our next caller is Tim from Connecticut.

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

Tim: Yeah, I’m 64 with A-fib and some well-controlled heart failure but I don’t have diabetes. My family has been super protective, so I’ve gone nowhere in six months; store visits, doctor’s appointments, et cetera, have been continually pushed out. Is it, my first part of my question is, is it still too risky for me to venture out here in Connecticut even if I wear a mask, wash my hands and socially distance? And then the second part of my question is, my 33-year-old son was intensely ill back in December with what he thought was the worst flu he’d ever had. Is it, are the antibody, is the antibody testing developed enough, reliable enough now where he should go get a test to see if he indeed did have COVID or has the antibodies now?

Bill Walsh: Okay, Tim. All right, well, thanks very much for that. Let’s turn to Dr. Walensky. So his first question was, is it too risky for him to go out given that he’s 64, has A-fib and really hasn’t left the house much, if at all, in the last few months?

Rochelle Walensky: Great. It’s a great question, an important question. And thank you for that, Tim. A couple things to note. Connecticut is doing beautifully well. You can look at the map of the United States on, my favorite site is the New York Times website to see how many cases there are per hundred thousand in your state. Connecticut is at 1.8 per hundred thousand, among the lowest in the country. There’s very little disease circulating there. That doesn’t mean we don’t need to be cautious, it’s just to say that there’s not a lot of community spread all over. And if that’s the case, it’s the time when we should think about what is it that we can and cannot do. I would encourage you, urge you in fact, to go see your doctor. Our hospitals are really quite safe. And one of the things that we’re really starting to see in the hospital is the manifestations of people who have deferred their essential care because they didn’t get it because they were worried about their safety in the hospital. So I do think that you should, I presume you might be doing some video visits, but you should resume getting your routine medical care because hospitals are safe. They know how to handle this. We know how to, our infection-control policies are such that you can keep safe.

I would say now is the time to start thinking about who you might interact with either outside wearing a mask or even, and staying perhaps 6 feet apart, but could you, might you now socialize with people outside for a little while to just sort of try and get your life closer to a new normal than where you were. Because, you know, we’re about to head back indoors till the spring, like the, to the fall like the first question, the prior question commented. And, you know, you really want to see if you can do something to boost your morale a little bit. Being in the house for six months is really quite hard, but you can do that in Connecticut. I’m not sure I would do that right now in Atlanta.

Bill Walsh: Let me just ask a follow-up to that. A number of folks were asking about visiting their dentist. They’ve put off dentist visits and I wonder how you, what advice you would have for people thinking about going back to the dentist.

Rochelle Walensky: I think it’s a really important call to make. I would call your dentist and start thinking about what are the strategies that they’ve imposed to make sure that their patients are safe. I personally have been to the dentist; my entire family has been back to the dentist. But I know my dentist, and I was, felt incredibly safe when I saw the strategies that they have put in place. Not all of them are going to be the same, but I think if you’re in a low community, in a low case per hundred thousand setting, and you can call your dentist and understand exactly what it is that they’re doing to keep their patients safe, that that is definitely a place you could go.

Bill Walsh: Okay, and Dr. Walensky, Tim from Connecticut had also asked about his 33-year-old son who was ill some time ago. And he was asking about the accuracy of the antibody tests. What would you say to that, say to him about that?

Rochelle Walensky: I would say, you know, many people are curious as to whether the sniffles or the flu that they might’ve had earlier on might’ve been COVID. It would certainly be an appropriate test to get. I don’t know that I would necessarily pay the hundred bucks if you had to pay for it, to get it. The serology tests tend to be less expensive than that. So if somebody is asking you to pay a hundred bucks, I wouldn’t necessarily pay it. But yeah, I think that’s a very appropriate use for the antibody test. What I would say is, people are more often disappointed that they didn’t have it, than they did, and that what you need to be cautious about what you assume from the results. So for example, if your 33-year-old son were to have antibody, that doesn’t necessarily mean that he is not, does not have the potential to future shed virus. He doesn’t have the potential to get it again. We still don’t have data on that. And I would certainly recommend if you don’t live with each other that even if he does have antibody, you mask when you’re together.

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

Jean Setzfand: Our next caller is Paul from Virginia.

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

Paul: Yes. Good afternoon. Thanks for hosting this session. I have just what I hope to be a quick question regarding my brother who tested positive for the COVID-19 virus. And about four weeks till he got retested, he’s negative, but he continues to have a persistent cough. And I wonder if one of the doctors could maybe shed some light on what that’s all about.

Bill Walsh: Hmm. Okay. Dr. Young, do you want to take that? Brother tested positive but continues to have persistent cough. What do you make of that?

Sheila Marie Young: Yes, so he tested positive and then negative. And so I would, again,  I wouldn’t say that he’s completely clear and out of the woods. We know that not every laboratory test is a hundred percent accurate. I’m not saying that his was not. And then also realize that there are other viruses as well that could be causing his symptoms. Is it the same type of cough? Is it the, is it the same symptoms, the same virus? At this point we wouldn’t know unless he, unless we had more data for that. But again, overall, the most important thing to know is that we still have to make sure that he protects himself and that he protects others. And I understand that I keep saying that on this call; however, it is the thing that we can do, regardless of the details. And that’s sort of what I want to bring us, bring our focus to, is let’s get out of the details and let’s get into the overall strategy to prevent this virus from continuing to spread. Whether we have antibodies or not, whether we have, we tested positive and then negative and then positive again. There are many things that we don’t know. We’re not out of the woods, and so taking a national stance of protection for everyone is key. And so, let’s try to approach this virus this way to help decrease the spread, stop the transmission as much as possible, and stop our mortality and morbidity from COVID-19.

Bill Walsh: You know, it’s interesting. I was just going to, as I was listening to you talk, I mean, I wonder if people were kind of growing a little bit immune to that advice. You said you’ve repeated it a number of times; we’ve all heard it. Wash your hands, wear a mask, socially distance, and yet really, it’s the most important thing people can be doing. It might maybe lose its effect on people cause they’ve heard it so much, but it sounds like it continues to be the best piece of advice.

Rochelle Walensky: And, Bill, may I just time in for one minute about, for Paul and just say, of all our respiratory, when we have respiratory viruses, the last symptom to go away is the cough. It is the one that lingers the longest. So that wouldn’t necessarily surprise me even under normal circumstances, and especially under COVID-19. What we also know is that there are now numerous cases of patients who have been weeks, even months out of their primary illness who still have the nausea, I can’t smell, neurologic manifestations, cardiac manifestations. And so we are just starting to learn about this long-term survivor cohort of people who have persistent symptoms long after. There are some of those survivor cohorts in many medical centers throughout the country. So if the cough does persist, then I would say, perhaps pursue one of those, one of those centers as well.

Bill Walsh: Okay, thank you very much for that. Now let’s take more of your questions. And as a reminder, please press *3 at any time on your telephone keypad to be connected with an AARP staff member to share your question. Jean, who is next on the line?

Jean Setzfand: Oh, we have Jeanie from California.

Bill Walsh: Okay. Hey, Jeanie, go ahead with your question.

Jeanie: Yes. I was calling to see about, I hear about volunteers are needed and I wanted to know if they’re still needed, seniors, who should not do it, or who should do it, to give us some guidance. What’s the risk? Do you recommend it? And if so, where’s the best place to do it? I don’t, there’s different places that I’ve heard.

Bill Walsh: Jeanie, do you mean volunteers for clinical trials?

Jeanie: Yes. Volunteers for trials for the vaccine.

Bill Walsh: Got it. Dr. Walensky, maybe you can address that question.

Rochelle Walensky: Oh, that’s a really good question. I’d love to give you a resource, a centralized resource. The most important thing, Jeanie, and thank you so much for being among those to consider volunteering. The most important thing is to see whether there’s a site near you that is enrolling in a vaccine trial, because you likely don’t want to travel far and wide to enroll. So,  I would look at your largest academic medical centers. Most of that is where these trials, these vaccine trials are enrolling and to see you can even call them and ask them if they are enrolling in vaccine trials, if they are enrolling in any one of the three, I believe, enrolling vaccine trials. A fourth one is going to be up and running in September. So I can tell you here, you’re in California, but here in Boston, there would be one, you know, there’d be several different sites of different vaccine trials, and then you might ask them for their eligibility, and then you could see if you’re eligible and then you could further pursue.

Bill Walsh: Dr. Walensky, Jeanie had also asked about the risks associated with volunteering for a clinical trial. Could you talk a little bit about that?

Rochelle Walensky: Yeah, I think they’re going to lay them out for you when you get there, and it will be trial specific. They’re, you know, we have data on the hundreds along these lines of these vaccines, not along the thousands. So there will be risks of side effects that we know of, the fever, the headaches, the myalgias that I talked about, the muscle pains that I talked about. Most of these trials that have gone into phase 3 trials are deemed quite safe based on the early data, but again, we don’t have large-scale data. For the most part, the volunteers that they’re looking at, they generally want to be quite healthy, and so I don’t think that they would necessarily enroll somebody who was on dialysis, for example, or somebody who had cardiovascular disease, COPD as we earlier heard. So, you know, and that’s going to be  important in terms of enrollment, but also important in terms of whether the results from these trials will be generalizable later on.

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

Jean Setzfand: Our next caller is Roberta from Georgia.

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

Roberta: Yes, my sister recently tested positive for the virus. She caught it from her son who quarantined and came out okay. She was asymptomatic and continues to be asymptomatic after she quarantined. My question is, can she still pass it on to others? And does she need to continue to get tested, and will she always keep coming out positive even though she’s asymptomatic? And it’s been a month.

Bill Walsh: A month. A month since she tested positive.

Roberta: Right, the first time, right, the second time, then she quarantined.

Bill Walsh: And she’s been quarantining for the past month.

Roberta: No, she quarantined for 14 days after she initially tested positive. And then she had another test, she was still positive, but still asymptomatic the whole time.

Bill Walsh: Okay. And so the question is, is it safe for her to go out? Is it safe for others to interact with her? Right?

Roberta: Right. Can she spread the virus to others?

Bill Walsh: All right, Roberta. Let’s see what, Dr. Young, do you want to take a crack at that question?

Sheila Marie Young: I could, but since we have an infectious disease expert on the line, I think I’ll let Dr. Walensky go ahead and take that one.

Bill Walsh: Sure. Okay.

Rochelle Walensky: So, I’d be happy to. So this is what we know. We know that our PCR tests can remain positive for up to 12 weeks after people are initially positive. And so it doesn’t concern me. If you actually have the date of the initial positive test that that person quarantined for 14 days, they were asymptomatic, then I would say, you’re good to go. The CDC no longer requires that you take, get a repeat test, and you should no longer be infectious. And if you get symptoms again within the first three months, I don’t believe they would suggest you even get a retest. And then, you know, then we would start again after three months. So I would say you are, you should be, I would continue to mask because you want to, you know, I wouldn’t consider yourself necessarily protected unless...

Bill Walsh: Okay, Dr. Walensky, you seem to be cutting out a little bit.

Rochelle Walensky: Oh, I’m sorry. There’s still a lot to learn.

Bill Walsh: Okay, thank you for that, Dr. Walensky. It seems you’re—

Rochelle Walensky: Hello?

Bill Walsh: Okay. It seems you’re cutting out a little bit. Let’s go to our next caller. Jean, who is next on the line?

Jean Setzfand: We have a question coming in from Facebook and this one’s coming from Monica who lives in Phoenix, Arizona. And she’s wondering, “Will I be able to host Thanksgiving for my son and his girlfriend who live in Tempe, Arizona? They’re fit, healthy, they’re 35, 43 and healthy. What would you recommend?”

Bill Walsh: All right, Dr. Young, do you want to tackle that question?

Sheila Marie Young: Sure. And you know, Bill, I’ll just be honest that we know that families are getting together. We know that parties are happening. And I think that it’s always important to think about how to keep everyone safe. We know that folks are not socially distancing 6 feet, and so I would say the best strategy, because let’s come to this from a perspective of that it’s going to happen, okay? So do your activities outdoors. Make sure that there is adequate ventilation in the house. Make sure all the windows are open, fans are going, that you have a fan that is pulling air out from the house, so it’s facing the opposite direction, to ensure that there’s good air flow. Folks can also install a 1900 level or higher HEPA filter in their home if they’re in such a hot place that it can’t, they can’t open the doors to have that air flow through. Also consider having the events in the later evening where it’s still warm outside and you can have your doors and windows open, especially being in Arizona. So, that’s what I would say would be the safest way to have a Thanksgiving dinner or other events that folks are having.

Now, if you have someone who’s coming over, who is a grandparent and, again, I’m just going to say, I know it’s going to happen. I’ve already seen it happen. So try to ensure that they’re always outside, try to ensure that they’re going to wear a mask. One of the things that we’re especially seeing here in Southern California is that we have a large, our Latino population, and it’s one of the highest rates right now of COVID-19. And honestly, it’s because there there’s a family dynamic that is so critical to the population and to our friends and family. And so we’ve got to be able to adjust to that as health care providers and provide information that will be specific for activities that we know that the community is going to take part in. It’s, for example, one of the reasons that we have a new medication for HIV called Prep. And that is something that just, we know that the activity is going to happen, but we’re going to prevent it by education and getting folks to do something that can protect them. And so at the same time, looking at what folks will do for Thanksgiving or Halloween or even Christmastime or Hanukkah or the other holidays, you know, really do your activities outdoors, make sure there’s good air flow. It should not be enclosed, and make sure that you guys keep your immune systems healthy. Make sure you’re getting sun. Make sure that you’re resting. Resting during this time is critical.

I think that one of the things that we also have to realize as a society is that right now is not business as normal. We just can’t, we can’t carry on with business as normal. We have to take into consideration the multiple factors or issues that people are facing during this time. And so, yes, we can again have our, or we know that people will have events with their family members. And so again, thinking of ways to make it the most safe is critical. So doing those things, again, having your events outdoors: I’m not recommending this, I’m just saying that if you’re going to do it, do it this way. Have them outdoors. For those who are older, allow them to wear a mask during the event; encourage them to. I know some people won’t, but nevertheless, if they won’t wear a mask, keep them outdoors for their events. And then again, you can also do things to make sure that people are healthy. You can have folks take a COVID-19 test before coming over. You can also check them for symptoms by having your own thermometer, and for your family members who may not have symptoms, again, that test could be critical. And I know I’ve seen on YouTube and other places that folks are having these parties and having folks get COVID-19 tests beforehand. But then you have to consider everyone. And again, Dr. Walensky, this is so hard to say because we know what’s the best thing to do; however, we know that as humans, as we mentioned with the previous caller, it’s hard to not be connected and physically it’s hard not to, to have our traditions as we’ve had before. And so again, thinking of ways that are safe, safer. Thinking of ways that we can maintain that connection are really important. And so, yeah, I just want to encourage you to consider those things going forward.

Bill Walsh: All right. Well, let’s connect with some more of our listeners. Jean, who else do you have on the line?

Jean Setzfand:  We have a YouTube question coming from Don. Don’s saying that he was told that an NYU physician, that the COVID viruses morphed into a weaker version. How true was this? And from an epidemiologist standpoint, you mentioned mortality. Is that just outside of New York State?

Bill Walsh: Hmm, that sounds like a good question for you, Dr. Walensky. Do you want to try to tackle that?

Rochelle Walensky: Yeah, sure. Let me make sure I understand it correctly. So for the most part, we haven’t seen a lot of mutation of this virus. So, you know, in terms of a weaker version, I don’t see that much of a weaker version circulating, suggest a weaker version might suggest that future generations of people who get infected get less severely ill than prior generations. I don’t believe that we’re seeing that. What I want to convey, though, is that’s probably good news from a vaccine standpoint. The more stable this virus is, the more likely we are to be able to have one vaccine that can work against it.

Bill Walsh: Hmm. Okay. Jean, who is next in the question queue?

Jean Setzfand: We have Stella from Missouri.

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

Stella: I’m a 73-year-old female with CAD, scheduled for surgery at a surgery center with an overnight stay at a hospital. What questions should I ask, and is there a website for the hospital cases of COVID that I could check?

Bill Walsh: Do you want to say what hospital it is? That might help us track down the website.

Stella: Oh, in St. Louis.

Bill Walsh: In St. Louis. Well, I’m sure that, yeah, well, Dr. Walensky, do you want to chime in on that? It sounds like she has some concerns about her upcoming surgery.

Rochelle Walensky: Yeah. So first of all, wishing you the absolute best as you head into that. I will say our hospitals are really safe. We’ve been doing this for a while now. We’ve been masking, we understand the protocols, we have protocols in place. I would look to your hospital website to see if they have data. Most hospitals now have a morass of data, quite honestly, of what they’re doing and what their protocols are. So I would definitely go to that hospital website and understand the protocols. I’d be quite surprised if your hospital doesn’t reach out to you, your surgi-center doesn’t reach out to you to sort of say, this is what we’re doing, and this is how we’re going to handle it because there’s so many new protocols right now that patients are confused. You’re certainly not alone. I might also suggest that your state may have hospital, or city may have hospital-level data if you wanted to look there if it wasn’t that obvious on your hospital website. The other thing you may want to just ask is, what kind of mask can I wear? What should I expect? But also importantly, what level of support am I allowed to bring? How many visitors are allowed? Who is, what are the new visiting hours? Because we do want to make sure that our patients have the support that they need and many institutions have had limited visitors.

Bill Walsh: Okay, thank you for that. Jean, let’s take one other question.

Jean Setzfand: All right. This is Kathy from Indiana.

Bill Walsh: All right. Hey, Kathy, let’s go ahead with your question.

Kathy: My question is, I have an 11-year-old niece and a 13-year-old nephew that live in my home. And I’m 71, and I had a heart attack last year, and their grandfather also lives here who is in his 60s and has had a heart attack previously and he has diabetes and high blood pressure. And I was wondering since they’re back in school, is there any extra precautions that we may need to take when they come home from school?

Bill Walsh: Okay, Dr. Young, do you want to want to assess that situation?

Sheila Marie Young: Sure, yes. I just want to say that, you know, I’m sorry that you had the heart attacks in the past, but happy to hear and, you know, that you guys are doing well now. Again, this is another hard question because it is one that looks at how the virus could possibly spread. And I know that there was a number of studies that have shown that younger people are actually able to spread the virus and so I think it’s again important to make sure that you guys stay as healthy as possible. And since they live with you, I know it’s hard to, you know, ask them to wear a mask when they’re home, but also looking at what are they doing at school, you know? So what are the precautions that they’re taking? Are they having students wear a mask in the classroom? I know that some schools are having students wear either face shields and masks or just face shields. So those are the things to look at.

And then, another thing to also consider is whether it’s possible to have them work, or do their schoolwork online from home, if that would even be feasible. I know that here in California, we are only doing online education for all of our students because of the rate of community spread for COVID-19. And so that would be another thing to look at is how, what is the rate of spread in the community? And I don’t have the specific data for St. Louis right in front of me, but it is something that we can look up and that is available for everyone. Again, speak with the school administration, make sure that precautions are being taken to keep the children safe. And again, if there’s at any time that they do come down with something, it’s important to get them tested. And other things you can do also at home is again, try to keep those windows and doors open as much as you can. Install a 1900 level or higher HEPA filter in your air intake vent. And, again, keep the family well fed, well rested, healthy. Make sure that you keep your doctor’s appointments as well. And then you can also, you know, get tested again, if the school alerts you, that someone in the school came down with COVID-19.

Bill Walsh: All right. And Dr. Young, we’re wrapping up here, but can you just repeat for our listeners what mask you think is the most effective.

Sheila Marie Young: Well, the most effective mask overall is a fit-tested N95 mask.

Bill Walsh: A fit-tested.

Sheila Marie Young: And that type of mask is available primarily to health care workers. And those who are working with patients who have COVID-19 in the hospital, they are utilizing a surgical mask, and we found that surgical masks are effective; however, they’re not as effective as an N95 mask. What community members can do, again, is to wear their cloth mask with a filter. I think that that is one of the best ways to prevent the spread of COVID-19 right now with the resources that are available to the general population.

Bill Walsh: Okay. Thank you for that, Dr. Young. And Dr. Young and Dr. Walensky, any closing thoughts or recommendations for AARP members? Dr. Young, do you want to go first since you were just talking?

Sheila Marie Young: Sure. One of the things that we’ve been seeing,  and it’s especially on the community side and one of the things that’s been quite difficult to see even with our testing is that someone comes, they look healthy and in a day or two we get a phone call that they’ve tested positive and then they’ve passed away. And this is someone who either was driving to our site or who walked in to our site. So how does this happen? Well, it’s really the function of the virus attacking the lungs and, as Dr. Walensky mentioned as well, the immune system doing what it’s supposed to do, but doing it too well. And so one of the things that I would recommend, and a number of our clinics are doing this in Southern California, they’re sending home pulse oximeter machines with folks who test positive for COVID-19. So if someone has a pulse ox that is less than 90, they should present to their emergency room and request treatment. One of the things that we know is that some individuals especially from Black and brown populations, are not necessarily admitted to the hospital when they need to be. So having a pulse ox will actually help them know when to go to the hospital or if they’re sent home, when to go back to the hospital.

Bill Walsh: Okay, Dr. Young, thank you so much for that. Dr. Walensky, any closing thoughts or recommendations?

Rochelle Walensky: Yeah, I just want to, first of all, thank you and Dr. Young for this terrific forum. I want to say we’re in this for a little while, my dear friends, and so we need to protect ourselves and one another. And also to try and do those things that make us happy when we can, things that get us outside, things that get us to see loved ones even if masked and outside. Please protect vulnerable populations: As Dr. Young said, it is the Black and brown communities who are suffering the morbidity and mortality of this disease more than the white communities. Go and get your routine medical care; it’s very safe to do so and what we really don’t want is casualties of COVID-19 of people who are afraid to go to the hospital. And we have certainly seen that, so please get your routine medical care, your routine vaccinations, your routine screening, and then go ahead and get a flu vaccine for the year ahead. We want to just make sure that we can be as safe as possible for all of the things that might be circulating in the fall.

Bill Walsh: All right. Well, thanks to both of you for answering all of our questions. This has been a really informative discussion and thank you, our AARP members, volunteers and listeners for participating. AARP is a nonprofit, nonpartisan member organization. We have been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we’re providing information 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 and A event can be founded at aarp.org/coronavirus starting tomorrow, August 21st. Again, that web address is aarp.org/coronavirus. Go there if your question was not answered 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 today. Please be sure to tune in on Thursday, September 3rd, at 1 p.m. Eastern Time for another session to address your questions on the coronavirus pandemic. 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. Since the early days of the pandemic in March, we all know that our lives are drastically different. Throughout this trying time we’ve all looked for guidance on how to stay safe and protected and how to separate fact from fiction when it comes to news around vaccines and treatments. Today, we’ll talk with experts who will be answering some of your questions on these important topics.

[00:00:49] If you’ve participated in one of our tele-town halls, you know this is similar to a radio talk show and you have the opportunity to ask your questions live. For those of you joining us on the phone, if you’d like to ask and a question, 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 a queue to ask that question live. If you’re joining on Facebook or YouTube, you can post your question in the comments section.

[00:01:19] Hello. If you’re just joining, I am Bill Walsh with AARP and I want to welcome you to this important coronavirus discussion on how to stay safe and protected, and how to separate fact from fiction around vaccines and treatments. We are talking with leading experts and taking your questions live. To ask your question, please press *3. And if you’re joining on Facebook or YouTube, you can post your question in the comments. Joining us today are Sheila Marie Young, M.D., assistant professor of medicine and science at the Charles R. Drew University in Los Angeles, California. Also joining us is Rochelle Walensky, M.D., chief of the Division of Infectious Diseases at Massachusetts General Hospital and professor of medicine at Harvard Medical School. Later, we’ll bring in Margaret Wallace Brown, director of the City of Houston’s Planning and Development Department. We’ll also be joined by my AARP colleague Jean Setzfand, who will help us facilitate your calls today.

[00:02:21] AARP is convening this Tele-Town Hall to help you access information about the coronavirus. While we see an important role for AARP in providing information and advocacy related to the virus, you should be aware that the best source of health and medical information is the Centers for Disease Control and Prevention. It can be reached at cdc.gov/coronavirus. This event is being recorded and you can access the recording at aarp.org/coronavirus 24 hours after we wrap up. Again, to ask your question, please press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you’re joining on Facebook or YouTube, place your question in the comments.

[00:03:10] Now I’d like to welcome our first guests. Sheila Marie Young, M.D., is an assistant professor at the Charles R. Drew University of Medicine and Science in Los Angeles, where she also runs a COVID-19 mobile testing site. Welcome, Dr. Young.

[00:03:25]Sheila Marie Young:  Hi, Bill. Thank you so much for inviting me on the show today.

[00:03:28]Bill Walsh:  All right, well, thanks for being with us, Dr. Rochelle Walensky, M.D., is a professor of medicine at Harvard Medical School. She is also chief of the Division of Infectious Diseases at Massachusetts General Hospital, where she has been nationally recognized for driving health policy, both in the U.S. and abroad, toward the promotion of HIV treatment. Welcome, Dr. Walensky.

[00:03:51]Rochelle Walensky:  Thanks so much for having me, Bill. I’m looking forward to talking.

[00:03:54]Bill Walsh:  All right. So are we. Let’s get started with the discussion. And just a reminder to our listeners, to ask your question, press *3 on your telephone keypad, or you can drop it in the comments section on Facebook or YouTube.

[00:04:06] Dr. Young, let’s start with you. If you’ve not been tested, what should people expect? Will you need to go to a doctor’s office or are there drive-up locations? And how long does it take and how quickly can you expect results?

[00:04:20]Sheila Marie Young:  Sure, Bill. Well, actually every state has a different process for testing, and so it’s really important to see what your local community has. Oftentimes folks can call their doctor’s office, who will be able to set up an appointment for them at a local laboratory. Otherwise, there are state-run or county-run testing sites that either offer walk-up testing, where someone can walk in, or places where folks can drive up to get tested. Oftentimes, you’ll need to make an appointment beforehand. And right now, because we’re progressing in the amount of testing that we’re doing, we’re asking folks to bring their insurance card so that we can ensure that we have funding for enough tests for everyone.

[00:05:10]Bill Walsh:  And how long does it usually take to get the results of those tests?

[00:05:15]Sheila Marie Young:  Well, it depends. Because this is a new pandemic, or because this is a new virus, because we’ve never run these types of tests before, there are times when we have lots of supplies and times when we’re running low. And so for some laboratories, we’ll be able to get results out in 18 to 72 hours, and sometimes it takes longer. Sometimes there can be a backup, but I want to encourage people that even if their test result doesn’t come back right away, it’s always important to remember to do what you should do to prevent the spread of coronavirus or SARS-CoV-2, which is always wear a mask when you’re outside of your home, or if someone is sick in your home with coronavirus, take the measures that are recommended to protect yourself and your family.

[00:06:08]Bill Walsh:  Right. Okay. Well, very, very good. Thank you for that. Dr. Walensky, we continue to hear encouraging news about a vaccine. Can you fill us in on the latest? When might a vaccine be widely available to the public?

[00:06:22]Rochelle Walensky:  Wow, isn’t that the million-dollar question. Thank you, Bill. I wanted to say that we’re in unprecedented times. The fastest vaccine we’ve ever had before for a communicable disease has been four years. So whatever it is that’s happening right now is truly unprecedented. Let me tell you a little bit about where we are. There are more than a hundred vaccine candidates that we have, and at least three, if not four, of them soon will be in the large scale, what we call phase 3, clinical trials. Those clinical trials will enroll about 30,000 people each, and ultimately the outcome is, did you get infected or did you not, given that you received the vaccine or that you might’ve received the placebo in these randomized clinical trials. I want to mention that several of these vaccine candidates have some side effects. They’re not terrible side effects, but people should expect that they may have low-grade muscle aches, low-grade fevers, headaches. So there are some side effects associated with these.

[00:07:26] In terms of the timeline, the first clinical trials, the first large-scale clinical trials, two of them actually started enrollment on July 27th. So far, they’ve enrolled a little under a third of the people that they are hoping to enroll. And several of these clinical trials require two vaccine shots, two immunizations, before we expect any full efficacy. So I’m thinking that by the time they enroll all these folks, get two vaccines into them and then start looking at the outcomes that we might be able to see signal late this year, early next year. And that is signal of whether these vaccines have worked. And that is assuming they are working and working well. So that’s an, again, an unprecedented timeline, but I don’t necessarily think before the end of this year or early next year we will see any results. There are a couple of caveats to that, and one is that not all of these vaccine candidates are enrolling the spectrum of population. So many of them are not enrolling patients under 18; in fact, I’m not sure any of them are. And not all of them are, in fact, enrolling in people over 65. So we will have some efficacy data, some really important data to move forward on, but I want to manage expectations in terms of how much data we’ll have for all populations.

[00:08:56]Bill Walsh:  That seems to be a chronic problem when it comes to efficacy testing, particularly with older adults, right, getting them into clinical trials and seeing the results. Let me just follow up on that. What is the latest update on how physicians are treating COVID-19?

[00:09:12]Rochelle Walensky:  Yeah, that’s a really great question because there’s been so much in the lay press and it’s getting so confusing. The first thing I want to just mention is, again, unprecedented times. So much of the science that we’re reading is prepublished science. And so things that come out on prepublished literature is not necessarily vetted through peer review. And we get a lot of news through that, but then once it goes through peer review, things might change. And so what gets published may be a little bit different from what got reported in lay press.

[00:09:44] What we’re doing right now, we have two clinical trials that demonstrate that there are two effective things. One is the drug remdesivir. This is an antiviral drug. We use it during the time of high viral replication, when people are getting sick, getting short of breath. It’s indicated for people who are hospitalized, who have an oxygen requirement. It is an IV drug, so it’s not something we can use as an outpatient. And the drug has shown a benefit in decreasing duration of disease, from 15 days to 11 days. That’s important because we, again, have to manage our expectations of what we’re going to get out of it. So far, there has not been a mortality signal in using remdesivir versus not. This signal is in the duration of disease. So that’s one proven treatment. The second is, as people progress with this disease, if they progress to get sicker and sicker, they tend to go into an immune phase. So at first the virus sort of attacks the lungs but then, secondly, the person’s immune system will kick in. And part of that immune response actually can also be damaging to the lungs. So the second treatment that we use is when you are in that sort of period of time when the immune system starts creating part of the problem; that’s when we used dexamethasone or steroids. So it’s again used in people who are quite sick, who have an oxygen requirement, who are progressing even further into their stages of disease, and that drug, dexamethasone, has demonstrated a mortality benefit of about 30 percent. So right now that’s all we have that’s been proven in large-scale clinical trials.

[00:11:35] We have a lot of clinical trials that are up and running. There’s been some data on convalescent plasma; again, not in the clinical trial realm so far. And so one of the things I would say is, given what has happened in the early phases of this when we started using drugs that didn’t have clinical trial data and how confusing that picture got, right now the NIH guidelines on the treatment of COVID only recommend the use of remdesivir or dexamethasone in the treatment of patients with COVID-19, and they recommend that if you have an experimental therapy, yes, please enroll patients in clinical trials to use that therapy, but don’t use it without the context of a clinical trial.

[00:12:16]Bill Walsh:  Oh, thank you for that. Well, Dr. Young, back to you. Let me ask you a similar question from the consumer’s point of view. As Dr. Walensky was just saying, that our knowledge of how COVID-19 spreads among people continues to grow and evolve, frankly, our knowledge overall about this disease continues to grow and evolve. What are examples of high-risk activities, and what activities may not seem risky, but actually are for people?

[00:12:44]Sheila Marie Young:  Sure. I mean, there is a number of activities, but what I’d really like us to do is just take a step back and consider those who are most at risk for serious or critical illness from COVID-19. I think one of the issues that we’re having in addressing this pandemic is that there’s a large majority of folks who are not getting very, very sick, or if they get sick, then they recover, and they think it’s fine. However, my view is that we must protect those who are at high risk of severe or critical illness. Now, who are those individuals? They’re individuals who have a suppressed immune system due to a variety of reasons. One of the great things that we have in our country is advanced technology, advanced medical care, where we’re able to provide immunosuppressive medications to people who need them, such as those who’ve had transplants. And there’s still some data coming out on some of the drugs and who is at risk, but essentially what we know is that they suppress a portion of the immune system that is necessary to fight viruses. And so, those who have autoimmune diseases, so they’re inherently immunosuppressed because of the medication that they’re taking. Also, we have to look at those who have comorbid conditions or conditions that can lead to or are a result of immunosuppression, or that could result in immunosuppression. And, you know, the thing with medicine is that things are constantly changing, and our knowledge is constantly growing. We know, for example, that individuals who have a high level of stress, that that cortisol that’s released with stress actually suppresses the function of the immune system. Those who are depressed, as well, that decreases the function of the immune system. So it’s not as simple as they have diabetes, they have a high, they have cardiovascular disease. It’s not as simple as that. So when we’re seeing folks in different age groups who’ve succumbed to COVID-19, we have to be able to take those things in consideration.

[00:15:14] So, in essence, my point is that it is our responsibility as Americans and as citizens of this world to do everything we can to protect everyone who may be at risk for serious or critical illness. So how do we do that? We assume everyone is infected and we protect ourselves and we protect our loved ones. I don’t think it’s all right, the mentality that’s been proposed, or sort of this idea that certain people are dispensable. That’s, you know, it’s only, it’s only the older adults who are passing away. That is so cryptic. And my mother, who is 63, she’s at risk. And so are we saying that I don’t want, you know, my mother to be able to see her great-grandchildren? No, that’s horrible. And so, again, we must do everything that we can to protect everyone who may be at risk. And we do that by doing everything we can to prevent the spread of COVID-19. So, it is so important to wear a mask at all times, and I keep going back to wearing a mask because we know that that, already, that that slows the spread, and Dr. Walensky, if you’d like to jump in on this as well, I know that you’ve done some research on the effectiveness of different masks. Would you like to talk about what you found?

[00:16:59]Rochelle Walensky:  Sure. So you know a lot of what we were looking at is really the mask efficacy is very much related to how well people are using that mask, how adherent they are to masking, essentially. So, certainly, we can look at all different levels of masks from a cloth mask to a surgical mask to an N95, but really among the most important things is whether the person was able to durably wear the mask or not.

[00:17:27]Bill Walsh:  Right. Okay. Well, thank you both for that. And as a reminder to our listeners, please press *3 on your telephone keypad to be connected with an AARP staff member and get into the queue to ask your question of these experts. And we’re going to get to those live questions shortly, but before we do, I want to take a moment to update you on a critical topic—the U.S. Postal Service.

[00:17:52] The Postal Service is a lifeline for millions of Americans. It’s how older adults receive medicine and health and financial information and absentee ballots. But AARP has become increasingly concerned that recent changes could compromise the health and safety of millions of older Americans and restrict their ability to safely participate in upcoming elections. So AARP members made their voices heard and the U.S. Postal Service responded. They announced this week that any changes to operations would not be made until after the election. This is a good first step and it’s especially important to voters 50-plus. Americans 50 and older vote by absentee more than any other age group, and changes to our mail system at this time could have impacted the ability of many Americans to vote. AARP is helping older adults vote safely, whether they choose to vote from home or in person. And we won’t stop fighting to make sure their vote is counted. While this is an important victory for voting rights, we need to stay vigilant to protect the needs of people 50 and older. Americans stand firm against any changes that will disrupt postal operations, and we will keep fighting to protect Americans 50-plus who count on the post office for lifesaving medicines and health and financial information. We also remain vigilant to protect the people in rural communities as the USPS is often the only service that will even fulfill deliveries there. In addition, AARP will keep watching Washington to make sure that the USPS can continue to operate effectively and efficiently, including timely delivery of medicine, food and election-related material. Many thanks to all of our AARP members, activists and volunteers who made their voice heard on this important issue.

[00:19:46] It’s now time to address your questions about the coronavirus with Dr. Sheila Young and Dr. Rochelle Walensky. Please press *3 at any time on your telephone keypad to be connected with an AARP staff member to share your question. I’d now like to bring in my AARP colleague Jean Setzfand to help facilitate your calls. Welcome, Jean.

[00:20:09]Jean Setzfand:  Thanks, Bill, delighted to be here.

[00:20:11]Bill Walsh:  All right, who is our first questioner?

[00:20:14]Jean Setzfand:  Our first question is coming from Nancy of Ohio.

[00:20:18]Bill Walsh:  Hi, Nancy, go ahead with your question.

[00:20:23]Jean Setzfand:  One second, we have a little technical difficulty.

[00:20:30]Nancy:  Okay. Can you hear me now?

[00:20:32]Bill Walsh:  Hi. Is that Nancy from Ohio?

[00:20:35]Nancy:  Yes, it is.

[00:20:36]Bill Walsh:  All right. Welcome to the show. We’re delighted to have you. What’s your question for our two experts?

[00:20:41]Nancy:  Thank you. Maybe this sounds a little simple, but I do get confused about how often I can wash my cloth mask. How often should I wash it? Or if I do happen to have a surgical mask, do I just throw it away every time I’ve used it no matter how brief that time has been? So in other words, how do I deal with both the surgical and the cloth mask?

[00:21:02]Bill Walsh:  Right. So, thank you for that question. Dr. Young, do you want to take a crack at that? Nancy was asking, of course, about how to protect her mask, how to get the most use out of it.

[00:21:15]Sheila Marie Young:  Sure. Yes. You should actually wash your mask after it’s used. So if you were wearing one cloth mask all day, then wash it afterwards, throw it in the washer, throw it in your hamper to be washed with your other clothing. One of the things that I do like to inform people of is that there was a study that was released about a month or two ago that demonstrated that, it was simulated UV light. UVB light actually has an effect to kill the virus. And so, it is possible to put your surgical mask out in the sun to—and it depends on the cloud covering, so if there’s a lot of cloud covering, it takes about 20 minutes. If there’s not a lot of cloud covering, it takes about 5 or 10 minutes. And then the mask can be reused. Of course, if there are tears in the mask, if there are, if the mask is soiled, of course you don’t want to use that. You want to make sure that essentially you have the protection that you need and the protection for everybody else as well. For cloth masks, I do recommend that you get a mask that you can put a filter in. So one of the things that a lot of our staff and our volunteers have done is they’ve taken a surgical mask and placed it inside of a cloth mask. And that actually provides really good protection against acquiring or infecting others with COVID-19.

[00:22:54]Bill Walsh:  Interesting. Okay. Well thank you for, yeah, thank you for that, Dr. Young. Jean, who is our next caller?

[00:23:02]Jean Setzfand:  We actually have quite a few questions coming in from YouTube. So this is coming from YouTube, from Mark, and he’s asking, “I see people on Facebook having success with hydroxychloroquine and symptoms within days. So why is it not being recommended as a treatment?”

[00:23:18]Bill Walsh:  Okay, Dr. Walensky, do you want to tackle that question?

[00:23:23]Rochelle Walensky:  I would be happy to. Thank you, Mark. This is one of the drugs that has been extraordinarily confusing because I feel like every day we wake up and there’s new news about hydroxychloroquine, some good, some bad. Let me tell you what I know. There have been numerous cohort studies early on that had some suggestion that people who’ve used hydroxychloroquine might be getting better or might have less virus. Ultimately what happened, and this is really where we need these randomized clinical trials, is hydroxychloroquine was put to the test in several randomized clinical trials, and all of them that have been randomized demonstrated either no effect or a negative effect in terms of increased toxicity for people who received hydroxychloroquine. So when compared head to head to not receiving hydroxychloroquine, it was very clear that, if anything, perhaps harm might be done by people who, for people who received it. That is when the FDA removed the emergency use authorization for hydroxychloroquine, and it has been removed from the NIH guidelines for the treatment of how to care for people with COVID-19. Soon thereafter, there was a large cohort study out of Detroit that demonstrated in a cohort, not a clinical trial, that people with hydroxychloroquine might have had some improvement, yet again opening the book as to whether we should use it or not. Importantly, for the most part, the people who received hydroxychloroquine in that cohort study also received dexamethasone—I think 70 percent overlap. So in fact, the benefit of hydroxychloroquine was likely the benefit of dexamethasone, which has been proven to improve mortality. So overall, hydroxychloroquine has not been demonstrated in clinical trials to show a benefit. If anything, it has shown a toxicity, a signal, and the NIH guidelines do not recommend it, and the FDA emergency use authorization to use it for this disease has been withdrawn.

[00:25:33]Bill Walsh:  Thank you very much, Dr. Walensky for that clear answer. It’s refreshing to hear people speak so definitively one way or the other on some of these issues, because there is so much confusion out there, as you can tell from the questioner. Jean, who do we have next in the queue?

[00:25:51]Jean Setzfand:  Our next caller is Thomas from Maryland.

[00:25:54]Bill Walsh:  Hey, Thomas, go ahead with your question.

[00:25:57]Thomas:  Hello. Sure, thank you. What are the latest findings on whether being a COVID-19 survivor grants immunity, temporary or long-term, or at all?

[00:26:11]Bill Walsh:  Hmm. Okay. Dr. Walensky, did you hear that one about—

[00:26:16]Rochelle Walensky:  Yeah, I sure did.

[00:26:16]Bill Walsh:  I wonder if you can address that?

[00:26:19]Rochelle Walensky:  You know, I’ve gotten two million-dollar questions now. I’d be so rich. So the other big thing we really need to understand is immunity. There was a paper, a preprint paper, published today and—actually posted today and reported in today’s New York Times about this, a really interesting study of a ship vessel out of the coast of Seattle. Three people, they looked—I think it was something like 147 people who went on this ship, and they all had viral testing and serology testing, antibody testing, done before they left. They all were negative in theory for disease when they left, but three had antibody. When they came back, I think 103 of them had disease, and several of the people who, the people who didn’t all were the ones who didn’t have antibody. Sorry, all were the ones who had antibody. So it was a very interesting suggestion that the people who left with antibody were somehow immune. Now, that is really promising information to suggest that maybe it’s that antibody that has protected them. Another paper that was just released today in JAMA looked at antibody responses from about 150 people and demonstrated that people were more likely to have antibody if they were older, if they were men, if they had potentially had more severe disease. And the issue is how much, and 10 people actually who had had disease didn’t get antibody at all.

[00:27:54] So this is, unlike the clarity of the first answer I gave with regard to hydroxychloroquine, this picture’s really muddy. What we’re really starting to see is there have been some cases now where people have had demonstrated protective immunity when reexposed, we believe. And we’re trying to understand the levels of neutralizing antibody that have been demonstrated in people with disease, and whether that in the long term protects them from disease in the future. I’ll remind you that we’ve had seven months of history with this disease, so we really don’t know a lot about whether when you had it in January, whether you’ll get it again in November. We have not been living with this disease for that long. We also don’t know whether, how long, if you did have some protection, how long it might last. And then a final thing that we really don’t know is whether some of the conflicting, confusing data in children is a result of the fact that there are many other coronaviruses out there, and whether some of those might deliver some cross-protection to SARS-CoV-2.

[00:29:02]Bill Walsh:  Hmm, it sounds like the bottom line then is for everyone to continue taking the precautions that you discussed at the, that you both discussed at the outset.

[00:29:12]Rochelle Walensky:  Absolutely.

[00:29:13]Bill Walsh:  Yeah, okay. Jean, who is our next caller?

[00:29:17]Jean Setzfand:  Our next caller is Marlene from New York City.

[00:29:20]Bill Walsh:  Hey, Marlene, go ahead with your question.

[00:29:22]Marlene:  Thank you. I’m concerned, I’m going to become a great-grandmother in about 10 weeks; however, I live in New York and my granddaughter lives in Chicago. One, is it safe for me to fly? I’m 88 years old. And once I get to Chicago, will I be able to see the baby, hold the baby? My granddaughter is a type 1 diabetic. I don’t know if I’ll be able to see her. How awful if I go out there and then they don’t let me see them. Please help.

[00:29:59]Bill Walsh:  Yeah, well, first of all, Marlene, congratulations on about to become a great-grandmother.

[00:30:04]Marlene:  Thank you.

[00:30:04]Bill Walsh:  Let’s see if we can get some guidance for you. Dr. Young, do you want to address Marlene’s question?

[00:30:11]Sheila Marie Young:  Sure. Marlene, I completely understand wanting to be there with family, especially at such an important time in your granddaughter’s life and, again, congratulations on the birth of your grandchild. So I do want to say that, again, that certain activities are more risky, such as being on a plane with a number of individuals who may or may not be showing signs of active infection with COVID-19 or the SARS-CoV-2 virus. And so at this point in time because the rates of COVID-19 are continuing to rise, because we’re still seeing an increase in the mortality from COVID-19, I would actually recommend that you can find a way to connect with her via your Facebook or FaceTime, Facebook Live, the other mechanisms that we have. And one of the things that I’ve actually found that I think we should really be encouraged about during this time is that we are more connected at this point in time in our history than we’ve ever been before. We have these technologies that allow us to work from home, allow us to see our family members, allow us to be part of events. I remember just being a part of events that my family participated in, in other countries previous to COVID-19, and how I felt a part of that. And so as we’re going through this pandemic, I’d really like to encourage us to find ways to safely be together. If it were a different circumstance, I could possibly suggest otherwise, but we’re looking at multiple risk factors. And I would, again, just encourage you to find a way to connect with your granddaughter and your grandchild and her family through other ways and, again, just know that even if we can’t be there in person that we can still be connected. I know that many of us have attended funerals or weddings and also parties via this method. Or we’ve taught our classes, and we’re still able to make that connection, that connection as family and friends and professors and students. And so I would encourage you to do that during this time.

[00:33:03]Bill Walsh:  Okay, thank you for that, Dr. Young. Jean, who is our next caller?

[00:33:08]Jean Setzfand:  Our next caller is Carolyn from Arkansas.

[00:33:13]Bill Walsh:  Hey, Caroline. Go ahead and ask your question.

[00:33:16]Caroline:  Sure. I have a comorbidity, I have COPD, and I was wondering if even after a vaccine, an effective vaccine is found, will it be advisable to still wear a mask for people like me? I am also 65 as well and out in public and stores and you know, things like that.

[00:33:43]Bill Walsh:  Sure, Caroline, thank you for the question. Dr. Walensky, do you want to try to address that? She’s thinking about steps to take after a vaccine emerges.

[00:33:54]Rochelle Walensky:  Thank you, Caroline. I want to be very clear about what we can expect in the weeks, months and years ahead. The FDA is probably going to approve a vaccine if it’s just even got 50 to 60 percent efficacy. So we may have a vaccine, and it may not be perfect but it’ll be a great incremental step forward. After that we can expect that not everybody who is going to be eligible for the vaccine is going to want it. We know year after year, in a very well tested and long history—flu vaccine—only about 50 percent, 45 percent of Americans choose to get a flu vaccine every year. So if you kind of do that math, we can perhaps expect that, you know with 50 percent efficacy and 50 percent of people getting it, only about a quarter of Americans might have protection against SARS-CoV-2. So I guess that’s a long-winded way of saying that I think we’re going to have to learn how to coexist with this virus for the, at least for the medium term. And by coexisting, I think that that does mean that taking someone like yourself, Caroline, with COPD and some increased risk by age, that masks are going to be part of our future for the medium term.

[00:35:09]Bill Walsh:  Let me just follow up on that, Dr. Walensky. Once, let’s fast-forward and imagine that FDA has in fact approved a vaccine at some point. What would you then say to people who are concerned about the safety of the treatment?

[00:35:26]Rochelle Walensky:  So I think—first of all, maybe let’s rewind, and say everybody should get a flu vaccine. This is going to be really—the flu vaccine is tried and true. We know it’s not always a hundred percent efficacious every year. We do know that going into flu season it’s going to be really hard to disentangle the symptoms of flu and the symptoms of COVID-19, and we know it’s likely the case that some people will be able to be infected with both at the same time. If it’s possible to take one of them off the table, that is, influenza, we should be doing so, and everybody who is eligible for a flu vaccine, in my mind, should get it. We know it’s got an amazing safety profile and that it can really prevent severe disease. So if we sort of say, let’s see if everybody, if we can get as many people vaccinated with influenza as possible.

[00:36:13] Now let’s turn to the COVID-19 vaccine. I am really hopeful that we will be able to rely on our colleagues at the NIH who are in charge of all of these vaccine trials through the COVID Prevention Trials Network to give us and put forward something with true vaccine efficacy, with its caveats of, these are the risk factors, these are the groups that it showed most benefit to, and these are the potential side effects. And we’ll have to see those data as they emerge. And then we’ll have to use the vaccine gingerly in the populations that demonstrated the most efficacy and limited amount of toxicity. That’s a really, a hard step for the vaccine trials. One of the big challenges associated with the vaccine trials is enrolling underrepresented and vulnerable populations. For example, we know that 2½, the mortality of COVID-19 has been 2½ times-fold for Black Americans than for white Americans. However, we’re not overenrolling for some challenges in the vaccine trials, Black Americans versus white Americans. And this again relates to that issue of trust: Who is going to trust the vaccine, who is going to take the vaccine. And that’s on us, we scientists, we in the community to work together, to enroll, to ensure that when we have a vaccine that is deemed safe by the NIH and by the FDA, that not only are there enough data to make sure that it’s generalizable to the population, but then that people trust it so that we can get as many people vaccinated at risk as possible.

[00:37:57]Bill Walsh:  Okay, thank you for that. Jean, who is our next caller?

[00:38:02]Jean Setzfand:  We have another question coming from YouTube and this one’s coming from Dr. Baker who’s asking, “Are tests with fast results as accurate as those that take a few days to get results?”

[00:38:14]Bill Walsh:  Hmm. That’s an interesting question. Dr. Young, do you want to try to tackle that?

[00:38:18]Sheila Marie Young:  Sure, thank you so much. So for tests that take a few hours, it really just depends on the lab, to be honest, and what type of test they’re running. So we have to understand that there are what we call RT-PCR tests. That’s when we’re actually looking at the viral RNA and verifying that the correct sequence is there that identifies this particular strain of a virus, which is SARS-CoV-2. The other issue is that there are rapid tests, and so those are different tests. Those are antigen tests. So those tests look for what we call sort of pieces of the virus that would generate immunity, and that’s an antigen. And one of the issues that we’re seeing right now with the rapid test is that there are, at times, false negative or false positive rates. And so again, I would like to see the rapid tests used in a similar way that we do HIV screening, and we are very fortunate at CDU to have an expert who’s worked in the field with vulnerable populations, Professor Cynthia Davis, who was at the forefront of the HIV pandemic here in Southern California. And so she described her process that we currently use and that they initiated when HIV initially came into our populations. And so once they had a rapid test, if someone was positive, they then confirmed. Now, will we be able to do that with everyone? Possibly not, but should we do it with those who are high risk? Yes, we should.

[00:40:15]Bill Walsh:  And Dr. Young, let me just ...

[00:40:16]Sheila Marie Young:  And so when we have rapid tests available, we, as physicians, should look at each patient and, you know, their comorbidities or their underlying diseases, their age, their other risk factors and determine who should receive that follow-up test.

[00:40:37]Bill Walsh:  Thanks, Dr. Young. Let me just follow up on that, ’cause you threw around a fair amount of terminology that I certainly didn’t understand.

[00:40:44]Sheila Marie Young:  Sorry about that.

[00:40:44]Bill Walsh:  But I’m wondering from a consumer’s point of view, from a consumer’s point of view, if they’re interested in getting tested, should they be asking for a particular type of test or will they simply be administered a test that the lab or the doctor decides.

[00:41:00]Sheila Marie Young:  It can actually be both. And so again, a rapid test is a test that you can get results back sometimes between 5 and 15 minutes. There are a number of those rapid tests that are available and that’s different again, than what we call a PCR test. And what we need to realize as well is that it’s not the way that you collect the test. It’s not whether it’s a nasal sample or an oral sample or a saliva sample, it’s really the test processing that’s different. And so if you hear a test is, it takes a day or two, does that mean that it’s better than a test that takes a few minutes? Again, you can ask, is this what we call an antigen test? And so I’m going to give you that terminology. So antigen and an antigen test, those are the tests that take 5 to 15 minutes to get a result back right there on the spot. The other tests are the PCR tests and those tests you’ll have to receive results through your health care provider. If you’re using a system such as Healthvana, you will get—that we are using here in Southern California—you’ll receive a text message or an email indicating what your results are. For us, if you’re positive, you will also get a call back, and we check in on you and make sure that you have the resources necessary to manage the illness.

[00:42:41]Bill Walsh:  Okay. Let’s leave it there. Thank you, Dr. Young for that. And thanks for all of these questions. We’ll take more questions later. And just a reminder to our listeners to press *3 on your telephone keypad to be connected.

[00:42:54] And before we get to our next guest, I want to take a moment to share how AARP is supporting cities, towns and villages around the country as they work to become places where people can thrive no matter their age. In support of this vision, I’m pleased to share that AARP is investing $2.4 million in grants to 184 organizations throughout—I’m sorry, through our AARP Community Challenge program. Grants will make tangible improvements in all 50 states, the District of Columbia, Puerto Rico and the Virgin Islands. These investments are important every year, but 2020 is a year that has challenged us in some distinct ways, with the coronavirus upending our norms and shining a light on the injustices in our country. In the face of these challenges and the unprecedented local needs, the program was expanded this year with a heightened focus on diversity and inclusion and helping local governments and organizations as they respond to the pandemic. Let me just give you a couple of examples. In Tulsa, Oklahoma, where a pilot program will help deliver groceries to older adults and people with disabilities. In Atlanta, another project will help build accessible garden beds and little free pantries to help older adults experiencing food insecurity in refugee and marginalized communities. To learn more and see a list of all the grantees in your state, visit aarp.org/livable.

[00:44:33] Now I’m pleased to introduce our next guest, Margaret Wallace Brown. She is the director of the City of Houston’s Planning and Development Department, where she is Houston’s top planning and development official. She leads much of Houston’s transportation and community planning efforts, including the mayor’s signature Complete Communities Initiative. Welcome, Margaret.

[00:44:56]Margaret Wallace Brown:  Thank you. Thank you for having me today. I am pleased to be with you.

[00:45:00]Bill Walsh:  All right. We’re pleased to have you, and I know we have you only briefly. So let’s get to it. I understand that Houston just received an AARP Community Challenge grant. Can you share how this project will improve the city for people of all ages?

[00:45:17]Margaret Wallace Brown:  Absolutely. So we are very pleased to have received a $2,100 grant from the Challenge, from AARP Challenge grant system to create a demonstration project, a demonstration tool kit per se for creating bike lanes in Houston. As many of you know, Houston’s a car-centric Sun Belt city and so it is difficult to go back and retrofit safe and affordable transportation systems for pedestrians and bicyclists in a city that’s really kind of built around the car. And we applied for and received a grant that will help us conduct demonstrations and create a tool kit that is, that can carry us into several neighborhoods time after time after time. The first bike lane demonstration project will take place in Gulfton neighborhood.

[00:46:14] So the mayor’s Complete Communities effort is an ongoing process. It’s a signature initiative to look at neighborhoods that have been underserved for decades, and to try to work with the community and develop plans and to develop relationships with both the neighborhoods and the business entities and create better resources for these neighborhoods. And the Gulfton area is unique in Houston in that it is one of our most dense communities, it is almost entirely apartment complexes, and it is primarily Houston immigrants. You know, three-fourths of all Houstonians were born outside of the state of Texas, but this area is primarily first-generation immigrants. And it’s kind of a landing spot, it’s Houston’s Ellis Island, it’s been called that for a number of times, and it has a population that is both old and young, I mean old and very young and very, very diverse. And so we will be able to do some demonstration projects for bike lanes in this community. Many of the people who live in the Gulfton area do not own cars. It is one of our highest areas of, or one of our lowest areas of car ownership in Houston. So these bike lanes will be really transformational for the people who live here in providing safe passage for them to get to transit or to their jobs or to the grocery stores without worrying about cars and accidents and risking their lives. So we’re thrilled about this.

[00:47:52]Bill Walsh:  Fantastic. Well, I wonder how the coronavirus has changed your plans for the project, if at all.

[00:47:57]Margaret Wallace Brown:  It’s actually, well, it has actually accelerated them. We have, because most cities have also, you know, slowed down and the traffic has waned a little bit, and we now have a little bit better access to our roads and to our sidewalks than we had back in February, we’ve been able to accelerate projects. And bike lanes have been one of those that we’ve really been able to accelerate, even created a few open-space roads where we have given them road diets, so to speak, choked back the traffic and opened up for pedestrians, and so having this virus has really illustrated to Houstonians, more than just policymakers like me, but has really illustrated to our residents how important safe passage for all ages and abilities is. And so we have really taken this opportunity to ramp up our effort to create safe and safe passage for both bicyclists and pedestrians of all ages across Houston.

[00:48:56]Bill Walsh:  Well, and it’s great that it’s providing more outdoor space that’s usable at this time. That’s so important if people choose to get out of the house, that they can do it in a safe way. Thanks so much, Margaret. Before you leave, do you want to provide any closing comments for our audience?

[00:49:13]Margaret Wallace Brown:  No, other than we have just had a wonderful relationship with the Houston area AARP offices for years. And this is just one more step in the right direction for our collaborations. And it’s been such a blessing to Houstonians to be able to collaborate with the team here in Houston, and we look forward to many more years of it.

[00:49:35]Bill Walsh:  Okay, as do we. Well, thanks again, I know you have to drop off. We appreciate your being here.

[00:49:41]Margaret Wallace Brown:  Thank you.

[00:49:42]Bill Walsh:  All right. Dr. Walensky and Dr. Young, I’d like to bring you back into the discussion. Dr. Walensky, September’s right around the corner and fall isn’t far behind. Do we anticipate any changes because of the cooler weather as it relates to the virus. Is COVID-19 more potent in colder weather, or is there a greater risk when more of our socializations are occurring inside?

[00:50:10]Rochelle Walensky:  Yeah, that’s a great question, Bill, and it’s actually one the opposite of which I got in May last year. Can we hope that this is all going to go away over the summer? Right? So there are several reasons why we think that weather matters. First of all, generally respiratory viruses thrive more in the winter than they do in the summer. Almost all respiratory viruses are circulating much at higher levels in the winter, including influenza, than they do in the summer. One of the reasons for that is related to the fact that the virus actually does better. There’s more humidity in the summer. And so, because of that humidity, the viral particles don’t last in the air for as long and they drop after shorter distances. So the humidity actually helps you out in the summer, the dry air in the heat of the winter doesn’t do us a service there. Some people would argue that people’s immunity is a little bit worse in the winter than it is in the summer. And then, of course, there’s the issue of close quarters. People being, you know, we know that the best thing to do with this virus is be outside. If you can do all of your activities outside, you’re in much better shape than if you do them all inside with regard to this virus and in greeting one another. So what we know in the winter is that there will be many more people inside. We need to then worry about the ventilation, circulation and filtration of air in these places. And it will be then all that much more important that people are wearing masks.

[00:51:37]Bill Walsh:  Thank you for that. And Dr. Young, let’s pick up on the discussion about masks. The effectiveness of masks has been in the news again, in part driven by recent tests conducted at Duke University. What masks work better than others and are masks needed in all situations or are they sometimes unnecessary?

[00:51:56]Sheila Marie Young:  Very good question. So one of the things I’ll say is that we know that the N95 masks that are fitted, where you have a fit test, this is a technique that they teach us in medical school where we put a bag over our head, they spray some really bitter material. And if your mask is on correctly, you won’t be able to smell or taste that bitter material. If it’s on incorrectly, you will. And so that is a process for fit-testing a mask. So fit-tested N95 masks by far are the best protection for preventing infection with COVID-19 or the SARS-CoV-2 virus. Of course, not everyone has access to that type of technology or those techniques, and it’s not necessarily what we’re calling everyone to do right now, but you asked what’s the best. And so that’s the best. So what can we do next? For people in the general community, again, it is important and, Dr. Walensky, we’ve discussed this prior to the call, it’s important that you wear a mask in general. The most effective masks after the N95 mask or the KN95 mask are surgical masks. There’s also different, better, widely available in our communities. There are other masks available such as KN95 masks that are from, being shipped over from China. So if it’s a K in front of it, that means it’s usually being shipped from another location. However, they have a certification and to make sure that you’re getting the correct mask, it’s a certification that should be on the bottom of the mask, And it’s called N-I-O-S-H, a NIOSH certification, that it’s either an N95 or a KN95 mask. If it doesn’t have that certification, and you’re going into an area that’s higher risk, say that you’re working in an environment where there is a lot of people, you’re working at the airports or there’s a high risk of exposure, you really should be wearing a higher level mask, especially if you are in contact with the public on a regular basis. And then for those who are going into places, really, having a mask that has multiple layers and cloth and then a non-cloth material in the mask will also make it a better mask. A lot of folks are making masks from home. If you can make a mask that has a place for a filter, you can put a surgical mask inside, and I think that that’s what we, that’s one of the best things that we can do right now to prevent the spread of the SARS-CoV-2 virus.

[00:55:01]Bill Walsh:  Let me just follow up on a couple of things you said there, Dr. Young. So if I’m wearing the KN95 mask, will it protect me if others are not wearing a mask?

[00:55:12]Sheila Marie Young:  It can protect you as long as you have it on properly. So the mask should cover your nose and your mouth, so, of course, we see folks who have their masks around their chin. They sort of wear it as a beard; that doesn’t help. It should fit properly. So sometimes the masks with the ear loops, they’re not as tightly fitted as masks that go around your head. And so again, I would encourage you if you’re going to be in a place that is indoors where the AC is running, make sure that you have a mask that fits tightly. And this also applies to office buildings. Just because you’re in your office, it doesn’t mean that the virus couldn’t per se go through the ventilation system. And there was a nice study that was done out of MIT demonstrating that. There’s a nice YouTube video, it’s 5.4 or five minutes four seconds, and it’s called Nothing to Sneeze At. And that shows you another instance of how viruses can travel.

[00:56:16]Bill Walsh:  Okay, let me just ask one other follow-up. You had mentioned a certification on masks, the NIOSH. Now, a lot of the cloth masks that people may be buying presumably don’t have that certification. What are your views on people wearing cloth masks?

[00:56:35]Sheila Marie Young:  I think again that the cloth mask has to be multiple-layered and that it should have a filter in it. And this is particularly important, I believe for those who are in areas where they have high contact with the public. This includes a lot of our essential workers, those who are working at grocery stores. We’ve actually been distributing higher level masks that have been donated to us to our essential workers in the South Los Angeles community, and we know that we have high rates of COVID-19 here and we also know that we have high morbidity and mortality rates from COVID-19. So it is our passion to protect those who are most at risk. And we also have to realize even if that person doesn’t succumb to critical or serious illness, it’s possible for them to pass on the virus to others. And so one of the things that we know in our community is that, and especially because of the rents are so high in Southern California, folks live in multigenerational households, they live with multiple families in one home, they live with, in places where they can’t self-isolate if needed or they can’t use their own restroom. And so again, we have to ensure again that everyone wears a mask so that those who are at risk can be protected.

[00:58:10]Bill Walsh:  Okay. Very good. Thank you very much, Dr. Young. Now it’s time to address more of your questions with Dr. Young and Dr. Walensky. And as a reminder, press *3 on your telephone keypad at any time to be connected with AARP staff. Jean, who is our next caller?

[00:58:28]Jean Setzfand:  Our next caller is Tim from Connecticut.

[00:58:31]Bill Walsh:  Hey, Tim, go ahead with your question.

[00:58:35]Tim:  Yeah, I’m 64 with A-fib and some well-controlled heart failure but I don’t have diabetes. My family has been super protective, so I’ve gone nowhere in six months; store visits, doctor’s appointments, et cetera, have been continually pushed out. Is it, my first part of my question is, is it still too risky for me to venture out here in Connecticut even if I wear a mask, wash my hands and socially distance? And then the second part of my question is, my 33-year-old son was intensely ill back in December with what he thought was the worst flu he’d ever had. Is it, are the antibody, is the antibody testing developed enough, reliable enough now where he should go get a test to see if he indeed did have COVID or has the antibodies now?

[00:59:22]Bill Walsh:  Okay, Tim. All right, well, thanks very much for that. Let’s turn to Dr. Walensky. So his first question was, is it too risky for him to go out given that he’s 64, has A-fib and really hasn’t left the house much, if at all, in the last few months?

[00:59:40]Rochelle Walensky:  Great. It’s a great question, an important question. And thank you for that, Tim. A couple things to note. Connecticut is doing beautifully well. You can look at the map of the United States on, my favorite site is the New York Times website to see how many cases there are per hundred thousand in your state. Connecticut is at 1.8 per hundred thousand, among the lowest in the country. There’s very little disease circulating there. That doesn’t mean we don’t need to be cautious, it’s just to say that there’s not a lot of community spread all over. And if that’s the case, it’s the time when we should think about what is it that we can and cannot do. I would encourage you, urge you in fact, to go see your doctor. Our hospitals are really quite safe. And one of the things that we’re really starting to see in the hospital is the manifestations of people who have deferred their essential care because they didn’t get it because they were worried about their safety in the hospital. So I do think that you should, I presume you might be doing some video visits, but you should resume getting your routine medical care because hospitals are safe. They know how to handle this. We know how to, our infection-control policies are such that you can keep safe.

[01:00:49] I would say now is the time to start thinking about who you might interact with either outside wearing a mask or even, and staying perhaps 6 feet apart, but could you, might you now socialize with people outside for a little while to just sort of try and get your life closer to a new normal than where you were. Because, you know, we’re about to head back indoors till the spring, like the, to the fall like the first question, the prior question commented. And, you know, you really want to see if you can do something to boost your morale a little bit. Being in the house for six months is really quite hard, but you can do that in Connecticut. I’m not sure I would do that right now in Atlanta.

[01:01:34]Bill Walsh:  Let me just ask a follow-up to that. A number of folks were asking about visiting their dentist. They’ve put off dentist visits and I wonder how you, what advice you would have for people thinking about going back to the dentist.

[01:01:47]Rochelle Walensky:  I think it’s a really important call to make. I would call your dentist and start thinking about what are the strategies that they’ve imposed to make sure that their patients are safe. I personally have been to the dentist; my entire family has been back to the dentist. But I know my dentist, and I was, felt incredibly safe when I saw the strategies that they have put in place. Not all of them are going to be the same, but I think if you’re in a low community, in a low case per hundred thousand setting, and you can call your dentist and understand exactly what it is that they’re doing to keep their patients safe, that that is definitely a place you could go.

[01:02:29]Bill Walsh:  Okay, and Dr. Walensky, Tim from Connecticut had also asked about his 33-year-old son who was ill some time ago. And he was asking about the accuracy of the antibody tests. What would you say to that, say to him about that?

[01:02:42]Rochelle Walensky:  I would say, you know, many people are curious as to whether the sniffles or the flu that they might’ve had earlier on might’ve been COVID. It would certainly be an appropriate test to get. I don’t know that I would necessarily pay the hundred bucks if you had to pay for it, to get it. The serology tests tend to be less expensive than that. So if somebody is asking you to pay a hundred bucks, I wouldn’t necessarily pay it. But yeah, I think that’s a very appropriate use for the antibody test. What I would say is, people are more often disappointed that they didn’t have it, than they did, and that what you need to be cautious about what you assume from the results. So for example, if your 33-year-old son were to have antibody, that doesn’t necessarily mean that he is not, does not have the potential to future shed virus. He doesn’t have the potential to get it again. We still don’t have data on that. And I would certainly recommend if you don’t live with each other that even if he does have antibody, you mask when you’re together.

[01:03:37]Bill Walsh:  Okay, thank you for that. Jean, who is our next caller?

[01:03:42]Jean Setzfand:  Our next caller is Paul from Virginia.

[01:03:45]Bill Walsh:  Hey, Paul, go ahead with your question.

[01:03:48]Paul:  Yes. Good afternoon. Thanks for hosting this session. I have just what I hope to be a quick question regarding my brother who tested positive for the COVID-19 virus. And about four weeks till he got retested, he’s negative, but he continues to have a persistent cough. And I wonder if one of the doctors could maybe shed some light on what that’s all about.

[01:04:10]Bill Walsh:  Hmm. Okay. Dr. Young, do you want to take that? Brother tested positive but continues to have persistent cough. What do you make of that?

[01:04:19]Sheila Marie Young:  Yes, so he tested positive and then negative. And so I would, again, I wouldn’t say that he’s completely clear and out of the woods. We know that not every laboratory test is a hundred percent accurate. I’m not saying that his was not. And then also realize that there are other viruses as well that could be causing his symptoms. Is it the same type of cough? Is it the, is it the same symptoms, the same virus? At this point we wouldn’t know unless he, unless we had more data for that. But again, overall, the most important thing to know is that we still have to make sure that he protects himself and that he protects others. And I understand that I keep saying that on this call; however, it is the thing that we can do, regardless of the details. And that’s sort of what I want to bring us, bring our focus to, is let’s get out of the details and let’s get into the overall strategy to prevent this virus from continuing to spread. Whether we have antibodies or not, whether we have, we tested positive and then negative and then positive again. There are many things that we don’t know. We’re not out of the woods, and so taking a national stance of protection for everyone is key. And so, let’s try to approach this virus this way to help decrease the spread, stop the transmission as much as possible, and stop our mortality and morbidity from COVID-19.

[01:06:10]Bill Walsh:  You know, it’s interesting. I was just going to, as I was listening to you talk, I mean, I wonder if people were kind of growing a little bit immune to that advice. You said you’ve repeated it a number of times; we’ve all heard it. Wash your hands, wear a mask, socially distance, and yet really, it’s the most important thing people can be doing. It might maybe lose its effect on people cause they’ve heard it so much, but it sounds like it continues to be the best piece of advice.

[01:06:38]Rochelle Walensky:  And, Bill, may I just time in for one minute about, for Paul and just say, of all our respiratory, when we have respiratory viruses, the last symptom to go away is the cough. It is the one that lingers the longest. So that wouldn’t necessarily surprise me even under normal circumstances, and especially under COVID-19. What we also know is that there are now numerous cases of patients who have been weeks, even months out of their primary illness who still have the nausea, I can’t smell, neurologic manifestations, cardiac manifestations. And so we are just starting to learn about this long-term survivor cohort of people who have persistent symptoms long after. There are some of those survivor cohorts in many medical centers throughout the country. So if the cough does persist, then I would say, perhaps pursue one of those, one of those centers as well.

[01:07:29]Bill Walsh:  Okay, thank you very much for that. Now let’s take more of your questions. And as a reminder, please press *3 at any time on your telephone keypad to be connected with an AARP staff member to share your question. Jean, who is next on the line?

[01:07:45]Jean Setzfand:  Oh, we have Jeanie from California.

[01:07:48]Bill Walsh:  Okay. Hey, Jeanie, go ahead with your question.

[01:07:51]Jeanie:  Yes. I was calling to see about, I hear about volunteers are needed and I wanted to know if they’re still needed, seniors, who should not do it, or who should do it, to give us some guidance. What’s the risk? Do you recommend it? And if so, where’s the best place to do it? I don’t, there’s different places that I’ve heard.

[01:08:13]Bill Walsh:  Jeanie, do you mean volunteers for clinical trials?

[01:08:17]Jeanie:  Yes. Volunteers for trials for the vaccine.

[01:08:24]Bill Walsh:  Got it. Dr. Walensky, maybe you can address that question.

[01:08:27]Rochelle Walensky:  Oh, that’s a really good question. I’d love to give you a resource, a centralized resource. The most important thing, Jeanie, and thank you so much for being among those to consider volunteering. The most important thing is to see whether there’s a site near you that is enrolling in a vaccine trial, because you likely don’t want to travel far and wide to enroll. So, I would look at your largest academic medical centers. Most of that is where these trials, these vaccine trials are enrolling and to see you can even call them and ask them if they are enrolling in vaccine trials, if they are enrolling in any one of the three, I believe, enrolling vaccine trials. A fourth one is going to be up and running in September. So I can tell you here, you’re in California, but here in Boston, there would be one, you know, there’d be several different sites of different vaccine trials, and then you might ask them for their eligibility, and then you could see if you’re eligible and then you could further pursue.

[01:09:25]Bill Walsh:  Dr. Walensky, Jeanie had also asked about the risks associated with volunteering for a clinical trial. Could you talk a little bit about that?

[01:09:33]Rochelle Walensky:  Yeah, I think they’re going to lay them out for you when you get there, and it will be trial specific. They’re, you know, we have data on the hundreds along these lines of these vaccines, not along the thousands. So there will be risks of side effects that we know of, the fever, the headaches, the myalgias that I talked about, the muscle pains that I talked about. Most of these trials that have gone into phase 3 trials are deemed quite safe based on the early data, but again, we don’t have large-scale data. For the most part, the volunteers that they’re looking at, they generally want to be quite healthy, and so I don’t think that they would necessarily enroll somebody who was on dialysis, for example, or somebody who had cardiovascular disease, COPD as we earlier heard. So, you know, and that’s going to be important in terms of enrollment, but also important in terms of whether the results from these trials will be generalizable later on.

[01:10:30]Bill Walsh:  Okay, thank you very much for that. Jean, who is our next caller?

[01:10:35]Jean Setzfand:  Our next caller is Roberta from Georgia.

[01:10:38]Bill Walsh:  Hey, Roberta, go ahead with your question.

[01:10:42]Roberta:  Yes, my sister recently tested positive for the virus. She caught it from her son who quarantined and came out okay. She was asymptomatic and continues to be asymptomatic after she quarantined. My question is, can she still pass it on to others? And does she need to continue to get tested, and will she always keep coming out positive even though she’s asymptomatic? And it’s been a month.

[01:11:08]Bill Walsh:  A month. A month since she tested positive.

[01:11:15]Roberta:  Right, the first time, right, the second time, then she quarantined.

[01:11:18]Bill Walsh:  And she’s been quarantining for the past month.

[01:11:22]Roberta:  No, she quarantined for 14 days after she initially tested positive. And then she had another test, she was still positive, but still asymptomatic the whole time.

[01:11:34]Bill Walsh:  Okay. And so the question is, is it safe for her to go out? Is it safe for others to interact with her? Right?

[01:11:42]Roberta:  Right. Can she spread the virus to others?

[01:11:47]Bill Walsh:  All right, Roberta. Let’s see what, Dr. Young, do you want to take a crack at that question?

[01:11:52]Sheila Marie Young:  I could, but since we have an infectious disease expert on the line, I think I’ll let Dr. Walensky go ahead and take that one.

[01:11:58]Bill Walsh:  Sure. Okay.

[01:11:59]Rochelle Walensky:  So, I’d be happy to. So this is what we know. We know that our PCR tests can remain positive for up to 12 weeks after people are initially positive. And so it doesn’t concern me. If you actually have the date of the initial positive test that that person quarantined for 14 days, they were asymptomatic, then I would say, you’re good to go. The CDC no longer requires that you take, get a repeat test, and you should no longer be infectious. And if you get symptoms again within the first three months, I don’t believe they would suggest you even get a retest. And then, you know, then we would start again after three months. So I would say you are, you should be, I would continue to mask because you want to, you know, I wouldn’t consider yourself necessarily protected unless...

[01:12:48]Bill Walsh:  Okay, Dr. Walensky, you seem to be cutting out a little bit.

[01:12:51]Rochelle Walensky:  Oh, I’m sorry. There’s still a lot to learn.

[01:12:53]Bill Walsh:  Okay, thank you for that, Dr. Walensky. It seems you’re—

[01:12:57]Rochelle Walensky:  Hello?

[01:12:57]Bill Walsh:  Okay. It seems you’re cutting out a little bit. Let’s go to our next caller. Jean, who is next on the line?

[01:13:04]Jean Setzfand:  We have a question coming in from Facebook and this one’s coming from Monica who lives in Phoenix, Arizona. And she’s wondering, “Will I be able to host Thanksgiving for my son and his girlfriend who live in Tempe, Arizona? They’re fit, healthy, they’re 35, 43 and healthy. What would you recommend?”

[01:13:22]Bill Walsh:  All right, Dr. Young, do you want to tackle that question?

[01:13:25]Sheila Marie Young:  Sure. And you know, Bill, I’ll just be honest that we know that families are getting together. We know that parties are happening. And I think that it’s always important to think about how to keep everyone safe. We know that folks are not socially distancing 6 feet, and so I would say the best strategy, because let’s come to this from a perspective of that it’s going to happen, okay? So do your activities outdoors. Make sure that there is adequate ventilation in the house. Make sure all the windows are open, fans are going, that you have a fan that is pulling air out from the house, so it’s facing the opposite direction, to ensure that there’s good air flow. Folks can also install a 1900 level or higher HEPA filter in their home if they’re in such a hot place that it can’t, they can’t open the doors to have that air flow through. Also consider having the events in the later evening where it’s still warm outside and you can have your doors and windows open, especially being in Arizona. So, that’s what I would say would be the safest way to have a Thanksgiving dinner or other events that folks are having.

[01:14:53] Now, if you have someone who’s coming over, who is a grandparent and, again, I’m just going to say, I know it’s going to happen. I’ve already seen it happen. So try to ensure that they’re always outside, try to ensure that they’re going to wear a mask. One of the things that we’re especially seeing here in Southern California is that we have a large, our Latino population, and it’s one of the highest rates right now of COVID-19. And honestly, it’s because there there’s a family dynamic that is so critical to the population and to our friends and family. And so we’ve got to be able to adjust to that as health care providers and provide information that will be specific for activities that we know that the community is going to take part in. It’s, for example, one of the reasons that we have a new medication for HIV called Prep. And that is something that just, we know that the activity is going to happen, but we’re going to prevent it by education and getting folks to do something that can protect them. And so at the same time, looking at what folks will do for Thanksgiving or Halloween or even Christmastime or Hanukkah or the other holidays, you know, really do your activities outdoors, make sure there’s good air flow. It should not be enclosed, and make sure that you guys keep your immune systems healthy. Make sure you’re getting sun. Make sure that you’re resting. Resting during this time is critical.

[01:16:42] I think that one of the things that we also have to realize as a society is that right now is not business as normal. We just can’t, we can’t carry on with business as normal. We have to take into consideration the multiple factors or issues that people are facing during this time. And so, yes, we can again have our, or we know that people will have events with their family members. And so again, thinking of ways to make it the most safe is critical. So doing those things, again, having your events outdoors: I’m not recommending this, I’m just saying that if you’re going to do it, do it this way. Have them outdoors. For those who are older, allow them to wear a mask during the event; encourage them to. I know some people won’t, but nevertheless, if they won’t wear a mask, keep them outdoors for their events. And then again, you can also do things to make sure that people are healthy. You can have folks take a COVID-19 test before coming over. You can also check them for symptoms by having your own thermometer, and for your family members who may not have symptoms, again, that test could be critical. And I know I’ve seen on YouTube and other places that folks are having these parties and having folks get COVID-19 tests beforehand. But then you have to consider everyone. And again, Dr. Walensky, this is so hard to say because we know what’s the best thing to do; however, we know that as humans, as we mentioned with the previous caller, it’s hard to not be connected and physically it’s hard not to, to have our traditions as we’ve had before. And so again, thinking of ways that are safe, safer. Thinking of ways that we can maintain that connection are really important. And so, yeah, I just want to encourage you to consider those things going forward.

[01:19:14]Bill Walsh:  All right. Well, let’s connect with some more of our listeners. Jean, who else do you have on the line?

[01:19:19]Jean Setzfand:  We have a YouTube question coming from Don. Don’s saying that he was told that an NYU physician, that the COVID viruses morphed into a weaker version. How true was this? And from an epidemiologist standpoint, you mentioned mortality. Is that just outside of New York State?

[01:19:38]Bill Walsh:  Hmm, that sounds like a good question for you, Dr. Walensky. Do you want to try to tackle that?

[01:19:43]Rochelle Walensky:  Yeah, sure. Let me make sure I understand it correctly. So for the most part, we haven’t seen a lot of mutation of this virus. So, you know, in terms of a weaker version, I don’t see that much of a weaker version circulating, suggest a weaker version might suggest that future generations of people who get infected get less severely ill than prior generations. I don’t believe that we’re seeing that. What I want to convey, though, is that’s probably good news from a vaccine standpoint. The more stable this virus is, the more likely we are to be able to have one vaccine that can work against it.

[01:20:21]Bill Walsh:  Hmm. Okay. Jean, who is next in the question queue?

[01:20:27]Jean Setzfand:  We have Stella from Missouri.

[01:20:30]Bill Walsh:  Hey, Stella, go ahead with your question.

[01:20:32]Stella:  I’m a 73-year-old female with CAD, scheduled for surgery at a surgery center with an overnight stay at a hospital. What questions should I ask, and is there a website for the hospital cases of COVID that I could check?

[01:20:51]Bill Walsh:  Do you want to say what hospital it is? That might help us track down the website.

[01:20:57]Stella:  Oh, in St. Louis.

[01:21:00]Bill Walsh:  In St. Louis. Well, I’m sure that, yeah, well, Dr. Walensky, do you want to chime in on that? It sounds like she has some concerns about her upcoming surgery.

[01:21:14]Rochelle Walensky:  Yeah. So first of all, wishing you the absolute best as you head into that. I will say our hospitals are really safe. We’ve been doing this for a while now. We’ve been masking, we understand the protocols, we have protocols in place. I would look to your hospital website to see if they have data. Most hospitals now have a morass of data, quite honestly, of what they’re doing and what their protocols are. So I would definitely go to that hospital website and understand the protocols. I’d be quite surprised if your hospital doesn’t reach out to you, your surgi-center doesn’t reach out to you to sort of say, this is what we’re doing, and this is how we’re going to handle it because there’s so many new protocols right now that patients are confused. You’re certainly not alone. I might also suggest that your state may have hospital, or city may have hospital-level data if you wanted to look there if it wasn’t that obvious on your hospital website. The other thing you may want to just ask is, what kind of mask can I wear? What should I expect? But also importantly, what level of support am I allowed to bring? How many visitors are allowed? Who is, what are the new visiting hours? Because we do want to make sure that our patients have the support that they need and many institutions have had limited visitors.

[01:22:33]Bill Walsh:  Okay, thank you for that. Jean, let’s take one other question.

[01:22:38]Jean Setzfand:  All right. This is Kathy from Indiana.

[01:22:41]Bill Walsh:  All right. Hey, Kathy, let’s go ahead with your question.

[01:22:45]Kathy:  My question is, I have an 11-year-old niece and a 13-year-old nephew that live in my home. And I’m 71, and I had a heart attack last year, and their grandfather also lives here who is in his 60s and has had a heart attack previously and he has diabetes and high blood pressure. And I was wondering since they’re back in school, is there any extra precautions that we may need to take when they come home from school?

[01:23:16]Bill Walsh:  Okay, Dr. Young, do you want to want to assess that situation?

[01:23:21]Sheila Marie Young:  Sure, yes. I just want to say that, you know, I’m sorry that you had the heart attacks in the past, but happy to hear and, you know, that you guys are doing well now. Again, this is another hard question because it is one that looks at how the virus could possibly spread. And I know that there was a number of studies that have shown that younger people are actually able to spread the virus and so I think it’s again important to make sure that you guys stay as healthy as possible. And since they live with you, I know it’s hard to, you know, ask them to wear a mask when they’re home, but also looking at what are they doing at school, you know? So what are the precautions that they’re taking? Are they having students wear a mask in the classroom? I know that some schools are having students wear either face shields and masks or just face shields. So those are the things to look at.

[01:24:36] And then, another thing to also consider is whether it’s possible to have them work, or do their schoolwork online from home, if that would even be feasible. I know that here in California, we are only doing online education for all of our students because of the rate of community spread for COVID-19. And so that would be another thing to look at is how, what is the rate of spread in the community? And I don’t have the specific data for St. Louis right in front of me, but it is something that we can look up and that is available for everyone. Again, speak with the school administration, make sure that precautions are being taken to keep the children safe. And again, if there’s at any time that they do come down with something, it’s important to get them tested. And other things you can do also at home is again, try to keep those windows and doors open as much as you can. Install a 1900 level or higher HEPA filter in your air intake vent. And, again, keep the family well fed, well rested, healthy. Make sure that you keep your doctor’s appointments as well. And then you can also, you know, get tested again, if the school alerts you, that someone in the school came down with COVID-19.

[01:26:15]Bill Walsh:  All right. And Dr. Young, we’re wrapping up here, but can you just repeat for our listeners what mask you think is the most effective.

[01:26:25]Sheila Marie Young:  Well, the most effective mask overall is a fit-tested N95 mask.

[01:26:31]Bill Walsh:  A fit-tested.

[01:26:31]Sheila Marie Young:  And that type of mask is available primarily to health care workers. And those who are working with patients who have COVID-19 in the hospital, they are utilizing a surgical mask, and we found that surgical masks are effective; however, they’re not as effective as an N95 mask. What community members can do, again, is to wear their cloth mask with a filter. I think that that is one of the best ways to prevent the spread of COVID-19 right now with the resources that are available to the general population.

[01:27:14]Bill Walsh:  Okay. Thank you for that, Dr. Young. And Dr. Young and Dr. Walensky, any closing thoughts or recommendations for AARP members? Dr. Young, do you want to go first since you were just talking?

[01:27:25]Sheila Marie Young:  Sure. One of the things that we’ve been seeing, and it’s especially on the community side and one of the things that’s been quite difficult to see even with our testing is that someone comes, they look healthy and in a day or two we get a phone call that they’ve tested positive and then they’ve passed away. And this is someone who either was driving to our site or who walked in to our site. So how does this happen? Well, it’s really the function of the virus attacking the lungs and, as Dr. Walensky mentioned as well, the immune system doing what it’s supposed to do, but doing it too well. And so one of the things that I would recommend, and a number of our clinics are doing this in Southern California, they’re sending home pulse oximeter machines with folks who test positive for COVID-19. So if someone has a pulse ox that is less than 90, they should present to their emergency room and request treatment. One of the things that we know is that some individuals especially from Black and brown populations, are not necessarily admitted to the hospital when they need to be. So having a pulse ox will actually help them know when to go to the hospital or if they’re sent home, when to go back to the hospital.

[01:28:51]Bill Walsh:  Okay, Dr. Young, thank you so much for that. Dr. Walensky, any closing thoughts or recommendations?

[01:28:58]Rochelle Walensky:  Yeah, I just want to, first of all, thank you and Dr. Young for this terrific forum. I want to say we’re in this for a little while, my dear friends, and so we need to protect ourselves and one another. And also to try and do those things that make us happy when we can, things that get us outside, things that get us to see loved ones even if masked and outside. Please protect vulnerable populations: As Dr. Young said, it is the Black and brown communities who are suffering the morbidity and mortality of this disease more than the white communities. Go and get your routine medical care; it’s very safe to do so and what we really don’t want is casualties of COVID-19 of people who are afraid to go to the hospital. And we have certainly seen that, so please get your routine medical care, your routine vaccinations, your routine screening, and then go ahead and get a flu vaccine for the year ahead. We want to just make sure that we can be as safe as possible for all of the things that might be circulating in the fall.

[01:29:54]Bill Walsh:  All right. Well, thanks to both of you for answering all of our questions. This has been a really informative discussion and thank you, our AARP members, volunteers and listeners for participating. AARP is a nonprofit, nonpartisan member organization. We have been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we’re providing information 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 and A event can be founded at aarp.org/coronavirus starting tomorrow, August 21st. Again, that web address is aarp.org/coronavirus. Go there if your question was not answered 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 today. Please be sure to tune in on Thursday, September 3rd, at 1 p.m. Eastern Time for another session to address your questions on the coronavirus pandemic. Thank you and have a good day. This concludes our call.

[01:31:16]

Bill Walsh: Hola, soy Bill Walsh, vicepresidente de AARP, y quiero darles la bienvenida a esta importante discusión sobre el coronavirus. AARP, una organización de membresía sin fines de lucro y sin afiliación política, ha estado trabajando para promover la salud y el bienestar de los adultos mayores del país durante más de 60 años. Frente a la pandemia mundial de coronavirus, AARP brinda información y recursos para ayudar a los adultos mayores y a quienes los cuidan.

Desde los primeros días de la pandemia en marzo, todos sabemos que nuestras vidas son drásticamente diferentes. A lo largo de estos tiempos difíciles, todos hemos buscado orientación sobre cómo mantenernos seguros y protegidos y cómo separar los hechos de la ficción, cuando se trata de noticias sobre vacunas y tratamientos. Hoy hablaremos con expertos que responderán algunas de sus preguntas sobre estos importantes temas.

Si ya has participado en alguna de nuestras teleasambleas, sabes que esto es similar a un programa de radio y tienes la oportunidad de hacer preguntas en vivo. Para aquellos de ustedes que se unen a nosotros por teléfono, si deseas hacer una pregunta, presiona * 3 en el teclado de tu teléfono para conectarte con un miembro del personal de AARP que anotará tu nombre y pregunta, y te colocará en una lista para hacer esa pregunta en vivo. Si te unes a través de Facebook o Youtube, puedes publicar tu pregunta en la sección de comentarios.

Hola, si acabas de unirte, soy Bill Walsh de AARP y quiero darte la bienvenida a esta importante discusión sobre el coronavirus sobre cómo mantenerse seguro y protegido y cómo separar la realidad de la ficción en torno a las vacunas y los tratamientos. Estaremos hablando con los principales expertos y respondiendo sus preguntas en vivo. Para hacer una pregunta, presiona * 3 y si te unes a través de Facebook o Youtube, puedes publicar tu pregunta en los comentarios.

Hoy se une a nosotros la doctora Sheila Marie Young, profesora adjunta de Medicina y Ciencia en Charles R. Drew University de Los Ángeles, California. También nos acompañan La doctora Rochelle Walensky, directora de la División de Enfermedades Infecciosas en el Mass General Hospital, y profesora de Medicina en la Escuela de Medicina de Harvard University. Más tarde, traeremos a Margaret Wallace Brown, Directora del Departamento de Planificación y Desarrollo de la Ciudad de Houston. También nos acompañará mi colega de AARP, Jean Setzfand, quien nos ayudará a facilitar sus llamadas hoy.

AARP está convocando esta teleasamblea para ayudarte a acceder a información sobre el coronavirus. Si bien consideramos que AARP cumple un papel importante en la provisión de información y promoción relacionada con el virus, debes saber que la mejor fuente de información médica y de salud son los Centros para el Control y la Prevención de Enfermedades. Se puede encontrar en cdc.gov/coronavirus.

Este evento está siendo grabado y puedes acceder a la grabación en aarp.org/coronavirus, 24 horas después de que terminemos. Nuevamente, para hacer una pregunta, presiona * 3 en cualquier momento en el teclado de tu teléfono para conectarte con un miembro del personal de AARP, o si te unes a través de Facebook o Youtube, coloca tu pregunta en los comentarios.

Ahora, me gustaría darles la bienvenida a nuestras primeras invitadas. La doctora Sheila Marie Young es profesora adjunta en la Charles R. Drew University de Los Ángeles, donde también dirige un centro de pruebas móvil para COVID-19. Bienvenida, Dra. Young.

Dra. Young: Hola, Bill. Muchas gracias por invitarme al programa de hoy.

Bill Walsh: Bueno, gracias por estar con nosotros. La Dra. Rochelle Walensky, es profesora de Medicina en la Escuela de Medicina de Harvard University. También es directora de la División de Enfermedades Infecciosas en Mass General Hospital, donde ha sido reconocida a nivel nacional por impulsar las políticas de salud, tanto en EE.UU. como en el extranjero, hacia la promoción del tratamiento del VIH. Bienvenida, Dra. Walensky.

Dra. Walensky: Muchas gracias por invitarme, Bill. Tengo muchos deseos de hablar.

Bill Walsh: Muy bien, nosotros también. Comencemos con la discusión y solo un recordatorio para nuestros oyentes, para hacer una pregunta, presiona * 3 en el teclado de tu teléfono o puedes dejarla en la sección de comentarios en Facebook o Youtube. Dra. Young, comencemos por usted. Si uno no ha sido examinado, ¿qué debe esperar la gente? ¿Deberían ir al consultorio de un médico? ¿O hay sitios donde puedan acudir, y cuánto tiempo Lleva, y qué tan rápido puede esperar uno los resultados?

Dra. Young: Claro, Bill. Bueno, en realidad, cada estado tiene un proceso diferente para realizar pruebas, por lo que es muy importante ver qué tiene tu comunidad local. A menudo, las personas pueden llamar al consultorio de su médico, quien podrá programar una cita para ellos en un laboratorio local. De lo contrario, hay sitios de pruebas administrados por el estado o el condado que ofrecen pruebas sin cita previa o alguien puede ingresar, o lugares donde la gente puede conducir para hacerse la prueba.

A menudo, deberás programar una cita con anticipación y ahora mismo, debido a que estamos progresando en la cantidad de pruebas que estamos haciendo, les pedimos a las personas que traigan su tarjeta de seguro para asegurarnos de que tenemos financiación para suficientes pruebas para todos.

Bill Walsh: ¿Y cuánto tiempo se tarda normalmente en obtener los resultados de esas pruebas?

Dr. Young: Bueno, depende, porque se trata de una nueva pandemia, o porque es un virus nuevo, porque nunca hemos realizado este tipo de pruebas antes, hay momentos en los que tenemos muchos suministros y momentos en los que no contamos con tantos. Entonces, para algunos laboratorios, podremos obtener resultados en 18-72 horas y, a veces, lleva más tiempo.

A veces puede haber una de reserva, pero quiero alentar a las personas a que, incluso si los resultados de la prueba no se obtienen de inmediato, siempre es importante recordar hacer lo que deben hacer para prevenir la propagación del coronavirus o SARS-COV-2, que es siempre usar una mascarilla cuando estén fuera de su casa, o si alguien está enfermo en tu casa con coronavirus, tomes las medidas que se recomiendan para protegerse uno y la familia.

Bill Walsh: Está bien. Bueno, muy bien. Gracias por eso. Dra. Walensky, seguimos escuchando noticias alentadoras sobre una vacuna. ¿Puede informarnos sobre las últimas novedades? ¿Cuándo podría una vacuna estar ampliamente disponible para el público?

Dra. Walensky: Bueno, ¿no es esa la pregunta del millón de dólares? Gracias, Bill. Quería decir que estamos en una época sin precedentes. La vacuna más rápida que hemos logrado hasta ahora para una enfermedad contagiosa ha sido de cuatro años. Entonces, sea lo que sea que esté sucediendo en este momento, realmente no tiene precedentes. Déjame contarte un poco sobre dónde estamos parados.

Tenemos más de 100 candidatas a vacunas y al menos tres, si no cuatro de ellas pronto estarán a gran escala, lo que llamamos "Ensayos Clínicos de Fase 3". Esos ensayos clínicos inscribirán a unas 30,000 personas cada uno y, en última instancia, el resultado es: "¿Se infectó o no?". Ya sea que recibió la vacuna o que podría haber recibido el placebo en estos ensayos clínicos aleatorizados.

Quiero mencionar que varios de estos candidatos a vacunas tienen algunos efectos secundarios, no son efectos secundarios terribles, pero las personas deben esperar que pueden tener dolores musculares leves, fiebres leves, dolores de cabeza. Entonces, hay algunos efectos secundarios asociados con estas.

En términos de un cronograma, el primer ensayo clínico, el primer ensayo clínico a gran escala, dos de ellos comenzaron con la inscripción del 3 al 27 de julio. Hasta ahora, han inscrito un poco menos de 1/3 de las personas que esperan inscribir y varios de estos ensayos clínicos requieren dos inyecciones de vacunas, dos inmunizaciones, para poder esperar la eficacia total. Entonces, estoy pensando que para cuando inscriban a todas estas personas, les pongan dos vacunas y luego comiencen a ver los resultados, podríamos dar señales a fines de este año, principios del próximo. Y esa es una señal de si estas vacunas han funcionado, y eso es asumiendo que están funcionando y funcionando bien. Así que, de nuevo, es una línea de tiempo sin precedentes, pero no creo necesariamente que antes de que finalice este año, a principios del próximo, veremos algún resultado. Hay un par de advertencias al respecto.

Una es que no todas estas vacunas candidatas se están inscribiendo en el espectro poblacional. Entonces, muchas de ellas no están inscribiendo pacientes menores de 18 años, de hecho, no estoy segura de que alguna de ellas lo haga. Y no todas, de hecho, inscriben personas mayores de 65 años. Por lo tanto, tendremos algunos datos de eficacia, algunos datos realmente importantes para avanzar, pero quiero administrar las expectativas en términos de cuántos datos tendremos para todas las poblaciones.

Bill Walsh: Eso parece ser un problema crónico cuando se trata de pruebas de eficacia, especialmente con adultos mayores, ¿verdad?

Dra. Walensky: Efectivamente.

Bill Walsh: Obtener los ensayos clínicos y ver los resultados. Permítanme seguir con eso, ¿cuál es la última actualización sobre cómo los médicos están tratando la COVID-19?

Dra. Walensky: Sí, esa es una buena pregunta porque ha habido mucho en la prensa últimamente y se está volviendo muy confuso. Lo primero que quiero mencionar es, nuevamente, épocas sin precedentes, gran parte de la ciencia que estamos leyendo es ciencia publicada previamente. Por lo tanto, las cosas que surgen de la literatura prepublicada no necesariamente se someten a revisión por pares, y recibimos muchas noticias a través de eso y luego, una vez que pasa por la revisión por pares, las cosas pueden cambiar. Entonces, lo que se publica puede ser un poco diferente de lo que se informa en la prensa.

Lo que estamos haciendo ahora mismo, tenemos dos ensayos clínicos que demuestran que hay dos cosas efectivas. Uno es el medicamento Remdesivir. Este es un medicamento antiviral que usamos durante el período de alta replicación viral cuando las personas se enferman y les falta el aire. Está indicado para las personas que están hospitalizadas, que tienen un requerimiento de oxígeno, es un medicamento intravenoso, por lo que no es algo que podamos usar en un paciente ambulatorio y el medicamento ha demostrado un beneficio para disminuir la duración de la enfermedad. De 15 días a 11 días. Eso es importante porque, de nuevo, tenemos que gestionar nuestras expectativas de lo que vamos a sacar de ello. Hasta ahora, no ha habido una señal de mortalidad al usar Remdisivir versus no, la señal está en la duración de la enfermedad.

Bill Walsh: Ya veo.

Dra. Walensky: Ese es un tratamiento probado. La segunda es que a medida que las personas progresan con esta enfermedad, si progresan y se enferman cada vez más, tienden a entrar en una fase inmunológica. Entonces, al principio, el virus ataca los pulmones, pero luego, en segundo lugar, el sistema inmunológico de la persona se activará y parte de esa respuesta inmunológica en realidad también puede dañar los pulmones.

Entonces, el segundo tratamiento que usamos es cuando estás en esa especie de período de tiempo en el que el sistema inmunológico comienza a crear parte del problema, ahí es cuando usamos Dexametasona o esteroides. Por lo tanto, se usa en personas que están bastante enfermas, que necesitan oxígeno, que están progresando aún más en sus etapas de la enfermedad y ese medicamento, la dexametasona, ha demostrado un beneficio en la mortalidad de aproximadamente un 30%.

Entonces, en este momento, eso es todo lo que tenemos, que haya sido probado en ensayos clínicos a gran escala. Tenemos muchos ensayos clínicos en marcha. Ha habido algunos datos sobre el plasma convaleciente, nuevamente, no en el ámbito de los ensayos clínicos hasta ahora. Entonces, una de las cosas que diría es, dado lo sucedido en las primeras fases de esto, cuando comenzamos a usar medicamentos que no tenían datos de ensayos clínicos y lo confuso que se volvió esa imagen, en este momento, las pautas de los NIH sobre el tratamiento para la COVID-19 solo recomiendan el uso de Remdesivir o Dexametasona en el tratamiento de pacientes con COVID-19, y recomiendan que si tienes una terapia experimental, sí, inscribe a pacientes en ensayos clínicos para usar esa terapia, pero no la uses sin el contexto de un ensayo clínico.

Bill Walsh: Gracias por eso. Dra. Young, volviendo a usted, permítame hacerle una pregunta similar desde el punto de vista del consumidor. Como acababa de decir la Dra. Walensky, nuestro conocimiento de cómo se propaga la COVID-19 entre las personas continúa creciendo y evolucionando, francamente, nuestro conocimiento general sobre esta enfermedad continúa creciendo y evolucionando. ¿Cuáles son ejemplos de actividades de alto riesgo? ¿Y qué actividades pueden no parecer riesgosas pero en realidad lo son para las personas?

Dra. Young: Claro, hay una serie de actividades, pero lo que realmente me gustaría que hiciéramos es dar un paso y considerar a aquellos que están en mayor riesgo de contraer una enfermedad grave o crítica por COVID-19. Creo que uno de los problemas que estamos teniendo al abordar esta pandemia es que hay una gran mayoría de personas que no se enferman mucho o que si se enferman, se recuperan y piensan que está todo bien.

Sin embargo, mi opinión es que debemos proteger a quienes corren un alto riesgo de sufrir una enfermedad grave o crítica. Ahora, ¿quiénes son esos individuos? Son personas que tienen un sistema inmunológico debilitado, debido a una variedad de razones. Una de las grandes cosas que tenemos en nuestro país es tecnología avanzada, atención médica avanzada donde podemos brindar medicamentos inmunosupresores a las personas que los necesitan. Como aquellos que se han sometido a trasplantes, y todavía hay algunos datos sobre algunos de los medicamentos y quién está en riesgo, pero esencialmente lo que sabemos es que suprimen una parte del sistema inmunológico que es necesaria para combatir los virus. Y entonces, aquellos que tienen enfermedades autoinmunes, por lo que están inherentemente inmunosuprimidos debido a la medicación que están tomando.

Además, tenemos que mirar a aquellos que tienen condiciones comórbidas o condiciones que pueden conducir a un resultado de inmunosupresión, o que pueden resultar en inmunosupresión y, ya sabes, lo que pasa con la medicina es que las cosas cambian constantemente y nuestro conocimiento crece constantemente.

Sabemos, por ejemplo, que las personas que tienen un alto nivel de estrés, que el cortisol que se libera con el estrés, de hecho suprime la función del sistema inmunológico. Aquellos que están deprimidos, también, disminuye la función del sistema inmunológico. Entonces, no es tan simple como "tienen diabetes, tienen un aumento, tienen enfermedades cardiovasculares". No es tan simple como eso. Entonces, cuando vemos personas de diferentes grupos de edad que han sucumbido ante la COVID-19, debemos poder tomar esas cosas en consideración. Entonces, en esencia, mi punto es que es nuestra responsabilidad como estadounidenses y como ciudadanos de este mundo hacer todo lo posible para proteger a todos los que puedan estar en riesgo de sufrir una enfermedad grave o crítica.

¿Entonces, cómo hacemos eso? Asumimos que todos están infectados, nos protegemos y protegemos a nuestros seres queridos. No creo que esté bien, la mentalidad que se ha propuesto o una especie de idea de que ciertas personas son prescindibles. Ya sabes, que son solo los adultos mayores los que están falleciendo. Eso es tan críptico, y mi madre, que tiene 63 años, está en riesgo, y entonces ¿estamos diciendo que no quiero que mi madre pueda ver a sus bisnietos? No, eso es horrible y, de nuevo, debemos hacer todo lo posible para proteger a todos los que puedan estar en riesgo, y lo hacemos haciendo todo lo posible para prevenir la propagación de COVID-19. Entonces, es muy importante usar una mascarilla en todo momento y sigo volviendo a usar una mascarilla, porque ya sabemos que ralentiza la propagación y Dra. Walensky, si desea participar en esto, sé que ha investigado un poco la eficacia de diferentes mascarillas. ¿Le gustaría hablar sobre lo que encontró?

Dra. Walensky: Claro. Bueno, ya sabes, mucho de lo que estábamos viendo es que la eficacia de las mascarillas está muy relacionada con qué tan bien las personas usan esas mascarillas. Cuánto se adhieren al uso de las mascarillas, esencialmente. Entonces, ciertamente, podemos ver todos los diferentes niveles de mascarillas, desde una de tela hasta una quirúrgica, hasta una N-95, pero en realidad, entre las cosas más importantes está si la persona pudo usar la mascarilla de forma constante o no.

Bill Walsh: Bien, está bien. Bueno, gracias a ambos por eso. Y como recordatorio para nuestros oyentes, por favor presiona * 3 en el teclado de tu teléfono para conectarte con un miembro del personal de AARP y entrar en la lista para hacer tu pregunta a estas expertas. Y vamos a llegar a esas preguntas en vivo en breve, pero antes de hacerlo, quiero tomarme un momento para actualizarlos sobre un tema crítico. El Servicio Postal de Estados Unidos.

El Servicio Postal es un salvavidas para millones de personas en el país. Es la forma en que los adultos mayores reciben medicamentos e información financiera y de salud, y las papeletas de voto en ausencia, pero AARP se ha preocupado cada vez más de que los cambios recientes podrían comprometer la salud y la seguridad de millones de adultos mayores en el país y restringir su capacidad de participar de manera segura en las próximas elecciones. Entonces, los socios de AARP hicieron oír su voz y el Servicio Postal de EE.UU. respondió.

Anunciaron esta semana que ningún cambio en las operaciones se realizaría hasta después de las elecciones. Este es un buen primer paso y es especialmente importante para los votantes mayores de 50 años. Los adultos mayores de 50 años votan por ausencia más que cualquier otro grupo de edad y los cambios en nuestro sistema de correo en este momento podrían haber afectado la capacidad de voto de muchos en el país. AARP está ayudando a los adultos mayores a votar de manera segura, ya sea que elijan hacerlo desde casa o en persona, y no dejaremos de luchar para asegurarnos de que su voto sea contado.

Si bien esta es una victoria importante para los derechos de voto, debemos estar atentos para proteger las necesidades de las personas de 50 años o más. Las personas en Estados Unidos se mantienen firmes ante cualquier cambio que interrumpa las operaciones postales, y seguiremos luchando para proteger a los adultos mayores de 50 años que cuentan con la oficina de correos para obtener medicamentos que salvan vidas e información financiera y de salud.

También permanecemos atentos para proteger a las personas en las comunidades rurales, ya que el USPS es a menudo el único servicio que si quiera cumple con las entregas allí. Además, AARP seguirá vigilando a Washington para asegurarse de que el USPS pueda continuar operando de manera eficaz y eficiente, incluida la entrega oportuna de medicamentos, alimentos y material relacionado con las elecciones. Muchas gracias a todos nuestros socios, activistas y voluntarios de AARP que hicieron oír su voz sobre este importante tema.

Ahora es el momento de abordar sus preguntas sobre el coronavirus con la Dra. Sheila Young y la Dra. Rochelle Walensky. Presiona * 3 en cualquier momento en el teclado de tu teléfono para comunicarte con un miembro del personal de AARP y compartir tu pregunta. Ahora me gustaría traer a mi colega de AARP, Jean Setzfand, para ayudar a facilitar sus llamadas. Bienvenida, Jean.

Jean Setzfand: Gracias, Bill. Encantada de estar aquí.

Bill Walsh: Muy bien, ¿cuál es nuestra primera pregunta?

Jean Setzfand: Nuestra primera pregunta viene de Nancy de Ohio.

Bill Walsh: Hola, Nancy. Continúa con tu pregunta.

Jean Setzfand: Un segundo, tenemos una pequeña dificultad técnica.

Bill Walsh: Está bien.

Nancy: Está bien. ¿Pueden escucharme ahora?

Bill Walsh: Hola, ¿eres Nancy de Ohio?

Nancy: Sí.

Bill Walsh: Muy bien, bienvenida al programa. Estamos encantados de tenerte, ¿cuál es tu pregunta para nuestras dos expertas?

Nancy: Gracias. Tal vez esto suene un poco simple, pero me confunde la frecuencia con la que puedo lavar mi mascarilla de tela. ¿Con qué frecuencia debo lavarla? O si tengo una mascarilla quirúrgica, ¿la tiro cada vez que la uso? No importa lo breve que haya sido ese tiempo. Entonces, en otras palabras, ¿cómo manejo esto? La mascarilla quirúrgica y de tela.

Bill Walsh: Claro. Gracias por esa pregunta. Dra. Young, ¿quiere intentar responder? Nancy preguntaba, por supuesto, cómo proteger su mascarilla. Cómo sacarle el máximo provecho.

Dr. Young: Claro. Sí, debería lavarse la mascarilla después de usarla. Entonces, si usas una mascarilla de tela todo el día, lávala después. Métela en la lavadora, en tu cesto para lavarlo con tu otra ropa. Una de las cosas de las que me gusta informar a la gente es que hubo un estudio que se publicó hace aproximadamente un mes o dos, que demostró que... Eran luces UV simuladas, luces ultravioletas, que en realidad tienen un efecto para matar el virus y así, es posible poner la mascarilla quirúrgica al sol y depende de la cobertura de nubes. Entonces, si hay mucha cobertura de nubes, se necesitan unos 20 minutos. Si no hay mucha nubosidad, se necesitan entre 5 y 10 minutos y luego se puede reutilizar la mascarilla. Por supuesto, si hay rasgaduras en la mascarilla, si las hay, si la mascarilla está sucia, por supuesto, no debes usarla.

Debes asegurarte de que, esencialmente, tiene la protección que necesitas y la protección para todos los demás también. Para las mascarillas de tela, te recomiendo que consigas una mascarilla en la que puedas poner un filtro, por lo que una de las cosas que han hecho muchos de nuestro personal y nuestros voluntarios es tomar una mascarilla quirúrgica y colocarla dentro de una mascarilla de tela y eso en realidad proporciona una muy buena protección contra el contagio o infección de otros con COVID-19.

Bill Walsh: Interesante, está bien, gracias. Sí, gracias por eso, Dra. Young. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: De hecho, tenemos bastantes preguntas provenientes de YouTube. Esta proviene de YouTube, de Mark, y él pregunta "Veo a personas en Facebook que tienen éxito con la hidroxicloroquina y los síntomas en días. Entonces, ¿por qué no se recomienda como tratamiento?"

Bill Walsh: Está bien. Dra. Walensky, ¿quiere abordar esa pregunta?

Dra. Walensky: Con gusto Gracias, Mark. Esta es una de las drogas que ha sido extraordinariamente confusa porque siento que todos los días nos despertamos y hay nuevas noticias sobre la hidroxicloroquina. Algunas buenas, otras malas. Déjame decirte lo que sé. Ha habido numerosos estudios de cohortes al principio que sugirieron que las personas que han usado hidroxicloroquina podrían estar mejorando, podrían tener menos virus.

En última instancia, lo que sucedió y aquí es realmente donde necesitamos estos ensayos clínicos aleatorizados es que la hidroxicloroquina se puso a prueba en varios ensayos clínicos aleatorizados y todos ellos, que han sido aleatorizados, no demostraron ningún efecto o un efecto negativo en términos de aumento de la toxicidad para las personas que recibieron hidroxicloroquina. Entonces, cuando se comparó cara a cara, sin recibir hidroxicloroquina, estaba muy claro que, en todo caso, tal vez podría hacerle daño a las personas que la recibieron.

Fue entonces cuando la FDA eliminó la autorización de uso de emergencia para la hidroxicloroquina y se eliminó de las pautas de los NIH para el tratamiento de cómo cuidar a las personas con COVID-19. Poco después, hubo un gran estudio de cohorte en Detroit que demostró en una cohorte, no en un ensayo clínico, que las personas con hidroxicloroquina podrían haber tenido alguna mejoría.

Una vez más, abriendo el libro sobre si deberíamos usarlo o no. Es importante destacar que, en su mayor parte, las personas que recibieron hidroxicloroquina en ese estudio de cohorte también recibieron dexametasona. Creo que el 70% se superpone. Entonces, de hecho, el beneficio de la hidroxicloroquina fue probablemente el beneficio de la dexametasona, que se ha demostrado que mejora la mortalidad.

Por lo tanto, en general, no se ha demostrado en ensayos clínicos que la hidroxicloroquina muestre un beneficio, en todo caso, ha mostrado una señal de toxicidad y las pautas de los NIH no la recomiendan y se ha retirado la autorización de uso de emergencia de la FDA para usarla para esta enfermedad.

Bill Walsh: Muchas gracias, Dra. Walensky, por esa clara respuesta. Es reconfortante escuchar a la gente hablar tan segura de una forma u otra sobre algunos de estos temas porque hay mucha confusión, como se puede ver por el interlocutor. Jean, ¿a quién tenemos a continuación en la lista?

Jean Setzfand: Nuestro próximo interlocutor es Thomas de Maryland.

Bill Walsh: Hola, Thomas, sigue adelante con tu pregunta.

Thomas: Hola. Claro, gracias. ¿Cuáles son los últimos hallazgos sobre si ser COVID-19 positivo otorga inmunidad, temporal o a largo plazo, o en absoluto?

Bill Walsh: De acuerdo. Dra. Walensky, ¿escuchó?

Dr. Walensky: Sí, claro que sí, Thomas.

Bill Walsh: Me pregunto si puede abordar eso. ¿Si?

Dr. Walensky: Sabes, he recibido dos preguntas del millón de dólares ya, ¡sería tan rica! Bien, la otra gran cosa que realmente necesitamos entender es la inmunidad. Hubo un artículo, un artículo preimpreso publicado hoy y reportado hoy en el New York Times sobre esto. Un estudio realmente interesante de un barco en la costa de Seattle. Tres personas, estudiaron, creo que fueron algo así a como 147 personas, que fueron en este barco, y todas se sometieron a pruebas virales y serológicas, pruebas de anticuerpos antes de irse.

Todos eran negativos en teoría, de la enfermedad cuando se fueron, pero tres tenían anticuerpos. Cuando regresaron, creo que 103 de ellos tenían enfermedades y varias de las personas, las personas que no, todas eran las que no tenían anticuerpos, lo siento, todas eran las que tenían anticuerpos. Entonces, fue una sugerencia muy interesante que las personas que se fueron con anticuerpos fueran de alguna manera inmune.

Ahora, esa es información realmente prometedora para sugerir que tal vez sea ese anticuerpo el que los ha protegido. Otro artículo que se acaba de publicar hoy en la revista JAMA, analizó las respuestas de anticuerpos de aproximadamente 150 personas y demostró que las personas tenían más probabilidades de tener anticuerpos si eran mayores, si eran hombres, si habían tenido una enfermedad potencialmente más grave y el problema es cuántas de cada 10 personas que han tenido la enfermedad, no obtuvieron anticuerpos en absoluto. Así que esto es, a diferencia de la claridad de la primera respuesta que di con hidroxicloroquina, esta imagen es realmente turbia.

Lo que realmente estamos empezando a ver es que ha habido algunos casos en los que las personas han demostrado inmunidad protectora al volver a exponerse, creemos, y estamos tratando de comprender los niveles de anticuerpos neutralizantes que se han demostrado en personas enfermas y si eso a largo plazo los protege de enfermarse en el futuro. Les recordaré que hemos tenido siete meses de historia con esta enfermedad, por lo que realmente no sabemos mucho sobre si lo tuvo en enero, si lo volverá a tener en noviembre. No llevamos tanto tiempo viviendo con esta enfermedad. Tampoco sabemos cuánto tiempo, si tuvieras alguna protección, cuánto podría durar. Y luego, una última cosa que realmente no sabemos es si algunos de los datos contradictorios y confusos en los niños son el resultado del hecho de que hay muchos otros coronavirus por ahí, y si algunos de ellos podrían brindar alguna protección cruzada a SARS-COV-2.

Bill Walsh: Parece que el resultado final es que todos sigan tomando las precauciones que ambas mencionaron al principio.

Dra. Walensky: Absolutamente.

Bill Walsh: Sí, de acuerdo. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: Nuestra próxima llamada es de Marleen de la ciudad de Nueva York.

Bill Walsh: Hola Marleen. Adelante con tu pregunta.

Marleen: Hola. Gracias. Estoy preocupada. Me convertiré en bisabuela en unas 10 semanas, sin embargo, vivo en Nueva York y mi nieta vive en Chicago. Uno, ¿es seguro para mí volar? Tengo 88 años. Y una vez que llegue a Chicago, ¿podré ver al bebé? ¿Sostener al bebé? Mi nieta es diabética tipo 1, no sé si podré verla. Qué espanto si voy y luego no me dejan verlos. Por favor, ayuda.

Bill Walsh: Sí, bueno, en primer lugar, Marleen, felicitaciones por estar a punto de convertirse en bisabuela.

Marleen: Gracias.

Bill Walsh: Veamos si podemos ofrecerle alguna orientación. Dra. Young, ¿quiere responder a la pregunta de Marleen?

Dra. Young: Claro. Marleen, entiendo completamente el deseo de estar allí con la familia, especialmente en un momento tan importante en la vida de su nieta y nuevamente, felicitaciones por el nacimiento de su nieto. Entonces, quiero decir nuevamente que ciertas actividades son más riesgosas, como estar en un avión con varias personas que pueden o no mostrar signos de infección activa con COVID-19 o el virus SARS-COVID-2, y entonces, en este momento, debido a que las tasas de COVID-19 continúan aumentando, porque todavía estamos viendo un aumento en la mortalidad por COVID-19, recomendaría que pueda encontrar un manera de conectarse con ella a través de Facebook o FaceTime, Facebook Live.

Los otros mecanismos que tenemos, y una de las cosas que realmente he encontrado, que creo que realmente debería animarnos durante este tiempo es que estamos más conectados en este momento que nunca antes en la historia. Contamos con estas tecnologías que nos permiten trabajar desde casa, nos permiten ver a nuestros familiares, nos permiten ser parte de eventos. Recuerdo ser parte de eventos en los que participó mi familia, en otros países, pero antes de la COVID-19 y cómo me sentí parte de eso. Y mientras atravesamos esta pandemia, realmente me gustaría animarnos a encontrar formas de estar juntos de manera segura. Si fuera una circunstancia diferente, yo posiblemente podría sugerir lo contrario, pero estamos ante múltiples factores de riesgo y yo, nuevamente, la animaría a encontrar una manera de conectarse con su nieta, y su nieto, y su familia a través de otras maneras y nuevamente, solo sepa que incluso si no podemos estar allí en persona, aún podemos estar conectados. Sé que muchos de nosotros hemos asistido a funerales o bodas, y también a fiestas a través de este método. O hemos enseñado nuestras clases, y todavía podemos hacer esa conexión, como familia y amigos, profesores y estudiantes. Así que te animo a que lo haga durante este tiempo.

Bill Walsh: Está bien. Gracias por eso, Dra. Young. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: Nuestra próxima llamada es Caroline de Arkansas.

Bill Walsh: Hola, Caroline. Adelante, haz tu pregunta.

Caroline: Claro. Tengo una comorbilidad, tengo EPOC y me preguntaba si incluso después de que se encuentre una vacuna eficaz, ¿sería aconsejable seguir usando una mascarilla para personas como yo? También tengo 65 años, y estoy en público en las tiendas, y ya sabes, cosas así.

Bill Walsh: Claro. Seguro, Caroline, gracias por esa pregunta. Dra. Walensky, ¿quiere intentar responder?

Dra. Walensky: Claro, sí.

Bill Walsh: Está pensando en los pasos a seguir después de que surja una vacuna.

Dra. Walensky: Gracias, Caroline. Quiero dejar muy claro lo que podemos esperar en las próximas semanas, meses y años. La FDA probablemente aprobará una vacuna, aunque solo tenga una eficacia del 50 al 60%. Entonces, puede que tengamos una vacuna y puede que no sea perfecta, pero será un gran paso instrumental hacia adelante. Después de eso, podemos esperar que no todos los que serán elegibles para la vacuna la deseen.

Sabemos que año tras año, en una vacuna contra la influenza muy bien probada y con una larga historia, solo entre el 50 y el 45% de las personas en el país optan por vacunarse contra la influenza cada año. Entonces, si haces las cuentas, quizás podamos esperar que, ya sabes, con el 50% de eficacia y el 50% de las personas vacunándose solo alrededor de 1/4 de las personas en EE.UU. podrían tener protección contra SARS-COVID-2. Entonces, supongo que es una forma larga de decir que, creo que vamos a tener que aprender a coexistir con este virus durante, al menos a medio plazo y coexistir, creo que esto significa que para alguien como tú, Caroline, con EPOC y algunos riesgos incrementados por edad, ya sabes, las mascarillas serán parte de nuestro futuro a mediano plazo.

Bill Walsh: Permítame seguir con eso, Dra. Walensky, avancemos rápidamente e imaginemos que la FDA de hecho aprueba una vacuna en algún momento, ¿qué le diría entonces a las personas que están preocupadas por la seguridad del tratamiento?

Dr. Walensky: Bueno, creo que, en primer lugar, tal vez retrocedamos y digamos: "Todos deberían vacunarse contra la gripe". La vacuna contra la gripe está probada y es cierta, sabemos que no siempre es 100% eficaz todos los años. Sabemos que entrar en la temporada de gripe va a ser muy difícil para desenredar los síntomas de la gripe y los síntomas de COVID-19, y sabemos que es probable que algunas personas puedan infectarse con ambos al mismo tiempo Si es posible quitar uno de ellos de la mesa, eso es influenza, deberíamos hacerlo. Y todos los que son elegibles para una vacuna contra la gripe, en mi opinión, deberían recibirla.

Sabemos que tiene un perfil de seguridad asombroso y que realmente puede prevenir enfermedades graves. Entonces, si decimos: "Veamos si podemos vacunar a la mayor cantidad posible de personas contra la influenza". Ahora, pasemos a la vacuna COVID-19. Tengo muchas esperanzas de que podamos confiar en nuestros colegas de los NIH que están a cargo de todos estos ensayos de vacunas a través de la COVID Vaccine Prevention Network para que nos brinden y presenten algo con verdadera eficacia de vacuna con sus advertencias de: "Estos son tres factores de riesgo, estos son los factores de riesgo, estos son los grupos que demostraron mayor beneficio, y estos son los posibles efectos secundarios. Y tendremos que ver esos datos a medida que surjan y tendremos que usar la vacuna con cautela en las poblaciones que demostraron la mayor eficacia y la cantidad limitada de toxicidad. Ese es un paso realmente difícil para los ensayos de vacunas.

Uno de los grandes desafíos asociados con los ensayos de vacunas es inscribir una población vulnerable y subrepresentada. Por ejemplo, sabemos que la mortalidad de COVID-19 ha sido 2.5 veces más común entre las personas de raza negra que entre las personas de raza blanca. Sin embargo, debido a los desafíos de los ensayos de las vacunas, no estamos inscribiendo a más personas negras que a personas blancas. Y esto nuevamente se relaciona con el tema de la confianza.

¿Quién va a confiar en la vacuna, quién se va a poner la vacuna? Y eso depende de nosotros. Nosotros, los científicos, nosotros en la comunidad, trabajamos juntos para estar informados, para asegurarnos de que cuando tengamos una vacuna que los NIH y la FDA consideren segura, no solo haya suficientes datos para asegurarnos de que sea generalizable a la población, pero que la gente confíe en ella, para que podamos vacunar a la mayor cantidad posible de personas en riesgo.

Bill Walsh: Está bien. Gracias por eso. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: Tenemos otra pregunta proveniente de YouTube y esta proviene del Dr. Baker, quien pregunta: "¿Las pruebas con resultados rápidos son tan precisas como las que tardan unos días en obtener resultados?"

Bill Walsh: Esa es una pregunta interesante, Dra. Young, ¿quiere intentar abordar eso?

Dr. Young: Seguro, muchas gracias. Entonces, para las pruebas que toman algunas horas, en realidad solo depende del laboratorio, para ser honesta, y del tipo de prueba que estén realizando. Entonces, tenemos que entender que existen lo que llamamos pruebas de RT PCR. Ahí es cuando realmente estamos mirando el ARN viral y verificamos que la secuencia correcta esté allí, que identifica esta cepa particular de virus, que es SARS-COV2. El otro problema es que hay pruebas rápidas y, por lo tanto, son pruebas diferentes. Esas son pruebas de antígenos.

Entonces, esas pruebas buscan lo que llamamos una especie de partes del virus que generarían inmunidad, y eso es un antígeno. Y uno de los problemas que estamos viendo en este momento con la prueba rápida es que a veces hay falsos negativos o falsos positivos. Y entonces, me gustaría ver que las pruebas rápidas se usen de manera similar a como hacemos la detección del VIH, y somos muy afortunados en la CDU de tener una experta que ha trabajado en el campo, con poblaciones vulnerables, la profesora Cynthia Davis, que está al frente de la pandemia del VIH aquí en el sur de California. Entonces, ella describió el proceso que usamos actualmente, que iniciaron cuando el VIH inicialmente entró en nuestra población y así, una vez que se hicieron una prueba rápida, si alguien dio positivo, lo confirmaban. Ahora, ¿seremos capaces de hacer eso con todos? Posiblemente no, pero ¿deberíamos hacerlo con los de alto riesgo? Sí, deberíamos.

Bill Walsh: Dra. Young, permítame...

Dr. Young: Nosotros, como médicos, deberíamos observar a cada paciente y sus comorbilidades o sus enfermedades subyacentes, su edad, sus otros factores de riesgo y determinar quién debe recibir esa prueba de seguimiento.

Bill Walsh: Gracias, Dra. Young. Permítanme continuar con eso porque nombró una buena cantidad de terminología que ciertamente no entendí, pero...

Dra. Young: Lo siento.

Bill Walsh: Me pregunto si desde el punto de vista del consumidor, desde el punto de vista del consumidor, si uno está interesado en hacerse la prueba, ¿debería estar pidiendo un tipo particular de prueba o simplemente se le administrará la prueba que decida el laboratorio o el doctor?

Dr. Young: De hecho, pueden ser ambas cosas, y de nuevo, una prueba rápida, es una prueba que puede obtener resultados a veces entre 5 y 15 minutos. Hay varias de esas pruebas rápidas que están disponibles y eso es diferente, nuevamente, a lo que llamamos una prueba de PCR. Y lo que también debemos darnos cuenta es que no es la forma en que se recoge la muestra.

No se trata de si es una muestra nasal, una muestra oral o una muestra de saliva, es realmente el procesamiento de la prueba lo que es diferente. Entonces, si escuchas que una prueba toma uno o dos días, ¿significa eso que es mejor que una prueba que toma unos minutos? De nuevo, puede preguntar: "¿Es esto lo que llamamos una prueba de antigenomas?" Y entonces les voy a dar esa terminología. Antígeno y una prueba de antígeno. Esas son las pruebas que tardan entre 5 y 15 minutos en obtener un resultado, allí mismo en el acto.

Bill Walsh: De acuerdo.

Dr. Young: Las otras pruebas son las pruebas de PCR y esas pruebas, tendrá que recibir los resultados a través de su proveedor de atención médica, si está utilizando un sistema como Healthvana, que estamos usando aquí en el sur de California, recibirá un mensaje de texto o un correo electrónico indicando cuáles son sus resultados. Para nosotros, si das positivo, también te devolveremos la llamada, lo revisaremos y nos aseguraremos de que tenga los recursos necesarios para manejar la enfermedad.

Bill Walsh: Bien, dejémoslo ahí. Gracias, Dra. Young, por eso y gracias por todas estas preguntas. Responderemos más preguntas más tarde. Y solo un recordatorio para nuestros oyentes, que deben presionar * 3 en el teclado de su teléfono para conectarse. Antes de hablar con nuestra próxima invitada, quiero tomarme un momento para compartir cómo AARP está apoyando a las ciudades, pueblos y aldeas de todo el país mientras trabajan para convertirse en lugares donde las personas puedan prosperar, sin importar su edad.

En apoyo de esta visión, me complace compartir que AARP está invirtiendo $2.4 millones en subvenciones para 100 organizaciones necesitadas, a través del AARP Community Challenge, o programa de Desafío Comunitario de AARP. Las subvenciones harán mejoras tangibles en los 50 estados, el Distrito de Columbia, Puerto Rico y las Islas Vírgenes. Estas importaciones, estas inversiones, más bien, son importantes todos los años, pero 2020 es un año que nos ha desafiado de diferentes maneras con el coronavirus que trastorna nuestras normas y saca a la luz las injusticias en nuestro país.

Ante estos desafíos y las necesidades locales sin precedentes, el programa se amplió este año con un mayor enfoque en la diversidad y la inclusión, y en ayudar a los Gobiernos y organizaciones locales, como respuesta a la pandemia. Permítanme darles un par de ejemplos, en Tulsa, Oklahoma, donde un programa piloto ayudará a entregar comestibles a adultos mayores y personas con discapacidades. En Atlanta, otro proyecto ayudará a construir huertos accesibles y pequeñas despensas gratuitas para ayudar a los adultos mayores que experimentan inseguridad alimentaria en comunidades de refugiados y marginadas. Para obtener más información y ver una lista de todos los beneficiarios de tu estado, visita aarp.org/liveable.

Ahora, me complace presentar a nuestra próxima invitada, Margaret Wallace Brown. Ella es la directora del Departamento de Planificación y Desarrollo de la ciudad de Houston, donde es la principal funcionaria de planificación y desarrollo de Houston. Dirige gran parte de los esfuerzos de planificación comunitaria y de transporte de Houston. Incluyendo el proyecto del alcalde de Iniciativa de Comunidades Completas. Bienvenida, Margaret.

Margaret Wallace: ¡Gracias! Gracias por invitarme hoy, es un placer estar con ustedes.

Bill Walsh: Bien. Estamos encantados de tenerte. Y sé que solo te tenemos brevemente. Entremos en la conversación. Entiendo que Houston acaba de recibir una subvención del AARP Community Challenge Grant, ¿puedes compartir cómo este proyecto mejorará la ciudad para personas de todas las edades?

Margaret Wallace: ¡Por supuesto! Estamos muy contentos de haber recibido una subvención de $2100 del AARP Community Challenge Grant para crear un proyecto de demostración, un conjunto de herramientas de demostración, por ejemplo, para crear carriles para bicicletas en Houston. Como muchos saben, Houston es una ciudad centrada en los automóviles por lo que es difícil volver atrás y modernizar los sistemas de transporte y hacerlos seguros y asequibles para peatones y ciclistas en una ciudad que fue realmente construida alrededor de los autos. Y solicitamos y recibimos una subvención que nos ayudará a realizar demostraciones y crear un conjunto de herramientas que puede llevarnos a varios vecindarios una y otra vez.

El primer proyecto de demostración de carriles para bicicletas se llevará a cabo en el vecindario de Gulfton. Entonces, el esfuerzo de Comunidades Completas del alcalde es un proceso continuo. Es su iniciativa emblemática fijarse en los vecindarios que han estado desatendidos durante décadas y tratar de trabajar con la comunidad para desarrollar planes y desarrollar relaciones con ellos, los vecindarios y las entidades comerciales, y crear mejores recursos para estos vecindarios.

Y el área de Gulfton es única en Houston, ya que es una de nuestras comunidades más densas. Se trata casi en su totalidad de complejos de apartamentos y son principalmente residentes de Houston que eran inmigrantes. Sabes, 3/4 de todos los habitantes de Houston nacieron fuera del estado de Texas, pero esta área es principalmente de inmigrantes de primera generación, y es una especie de lugar de aterrizaje. Es la isla Ellis de Houston, se la ha llamado así varias veces y tiene una población que es tanto adultos mayores como jóvenes. Quiero decir, mayores y muy jóvenes, y muy... muy diversos.

Y así, podremos hacer algunos proyectos de demostración para carriles para bicicletas en esta comunidad. Muchas de las personas que viven en el área de Gulfton no poseen automóviles. Es una de nuestras áreas más altas, o mejor dicho, de nuestras áreas más bajas de propietarios de automóviles en Houston. Por lo tanto, estos carriles para bicicletas serán realmente transformadores para las personas que viven aquí al brindarles un paso seguro para que puedan transitar, o ir a sus trabajos o a las tiendas de comestibles sin preocuparse por los automóviles y los accidentes, y arriesgar sus vidas.

Bill Walsh: Muy bien, fantástico. Bueno, me pregunto si el coronavirus ha cambiado sus planes para el proyecto, en alguna manera.

Margaret Wallace: En realidad, bueno, en realidad los aceleró. Como la mayoría de las ciudades también han disminuido la velocidad y el tráfico se ha reducido un poco, y ahora tenemos un mejor acceso a nuestras carreteras y aceras que en febrero. Hemos podido acelerar proyectos y los carriles de bicicleta ha sido uno de los que realmente hemos podido acelerar. Hemos creado algunas carreteras de espacios abiertos donde les hemos dado una “dieta” a las carreteras, por así decirlo, ahogamos el tráfico y lo hemos abierto para los peatones.

Entonces, tener este virus realmente ha demostrado a los residentes de la ciudad, no solo a los legisladores como yo, sino que realmente ha demostrado a nuestros residentes lo importante que es el paso seguro para todas las edades y habilidades. Por eso, realmente hemos aprovechado esta oportunidad para intensificar nuestro esfuerzo para crear un paso seguro tanto para ciclistas como para peatones de todas las edades en Houston.

Bill Walsh: Bueno, y es genial que esté proporcionando más espacio al aire libre que se puede usar en este momento, eso es tan importante si las personas eligen salir de la casa, que pueden hacerlo de una manera segura. Muchas gracias, Margaret. Antes de irte, ¿deseas brindar algún comentario final para nuestra audiencia?

Margaret Wallace: No, más que decir que hemos tenido una relación maravillosa con las oficinas de AARP del área de Houston durante años, y este es solo un paso más en la dirección correcta para nuestras colaboraciones y ha sido una gran bendición para los habitantes de Houston poder colaborar con el equipo aquí en Houston, y esperamos sean muchos años más.

Bill Walsh: Está bien, también nosotros. Bueno, gracias de nuevo. Sé que tienes que tienes que irte. Agradecemos que estés aquí.

Margaret Wallace: Gracias.

Bill Walsh: Bueno. Dra. Walensky y Dra. Young, me gustaría traerlas nuevamente a la discusión. Dra. Walensky, septiembre está a la vuelta de la esquina, y el otoño no está muy lejos, ¿anticipamos algún cambio debido al clima más fresco, en lo que respecta al virus? ¿La COVID-19 es más potente en climas más fríos o existe un mayor riesgo cuando más de nuestra socialización ocurre en el interior?

Dra. Walensky: Sí, esa es una buena pregunta, Bill. Y en realidad es una opuesta a la que me hicieron en mayo del año pasado. "¿Podemos esperar que todo esto desaparezca durante el verano?" ¿Cierto? Entonces, hay varias razones por las que pensamos que el clima es importante. En primer lugar, en general, los virus respiratorios prosperan más en el invierno que en el verano. Casi todos los virus respiratorios circulan mucho, a niveles más altos en el invierno, incluida la influenza, que en el verano.

Una de las razones está relacionada con el hecho de que el virus funciona mejor. Hay más humedad en el verano y, debido a esa humedad, las partículas virales no duran tanto en el aire y caen después de una distancia más corta. Así que la humedad realmente te ayuda en el verano, el aire seco y el calor del invierno no nos hace ningún favor. Algunas personas dirían que la inmunidad de las personas es un poco peor en el invierno que en el verano, y luego, por supuesto, está el problema de los espacios reducidos. Sabemos que lo mejor que se puede hacer con este virus es estar afuera. Si puedes hacer todas tus actividades al aire libre, estarás mucho mejor que si las hicieras todas adentro, con respecto a este virus y saludándose unos a otros. Entonces, lo que sabemos en el invierno es que habrá mucha más gente adentro. Entonces, debemos preocuparnos por la ventilación, la circulación y la filtración del aire en estos lugares, y entonces será mucho más importante que las personas usen mascarillas.

Bill Walsh: Gracias por eso. Y Dra. Young, retomemos la discusión sobre las mascarillas, su efectividad ha estado nuevamente en las noticias, en parte debido a las pruebas recientes realizadas en Duke University. ¿Qué hace que funcione mejor que otras? ¿Se necesitan mascarillas en todas las situaciones? ¿O son a veces innecesarias?

Dra. Young: Muy buena pregunta. Una de las cosas que diré es que sabemos que las mascarillas N-95 que se fijan en la colocación, tienes una prueba de colocación, es una técnica que nos enseñan en la facultad de medicina. Nos tapamos la cabeza con una bolsa, nos rocían un material realmente amargo y si tu mascarilla está puesta correctamente no podrás oler ni saborear ese material amargo. Si está puesto incorrectamente, lo sentirás. Y ese es el proceso para probar la colocación de una mascarilla. Por lo tanto, una mascarilla N-95 probada, por lejos, es la mejor protección para prevenir la infección con COVID-19 o el virus SARS-COVID-2.

Por supuesto, no todos tienen acceso a ese tipo de tecnología o esas técnicas, y no es necesariamente lo que estamos pidiendo a todos que hagan en este momento, pero me preguntaste qué es lo mejor y eso es lo mejor. Entonces, ¿qué podemos hacer a continuación? Para las personas de la comunidad en general, nuevamente, es importante y con la Dra. Walensky lo discutimos antes de la llamada, es importante que usen una mascarilla, en general.

La mascarilla más eficaz después de la mascarilla N-95 o la mascarilla KN-95 son las mascarillas quirúrgicas. También hay unas diferentes que están ampliamente disponibles en nuestras comunidades. Hay otras mascarillas disponibles, como las KN-90 que se envían desde China, por lo que si tiene una K delante, eso significa que normalmente se envían desde otra ubicación. Sin embargo, tienen una certificación para asegurarse de que recibes la mascarilla correcta. Es una certificación que debe estar en la parte inferior de la mascarilla y se llama NIOSH, una certificación de NIOSH que se encuentra en una mascarilla N-95 o KN-95. Si no tiene esa certificación y vas a un área de mayor riesgo, digamos que estás trabajando en un entorno donde hay mucha gente, estás trabajando en el aeropuerto o hay un alto riesgo de exposición, realmente deberías usar una mascarilla de nivel superior.

Especialmente si estás en contacto con el público de forma regular. Y luego, para aquellos que van a lugares, tener realmente una mascarilla que tiene múltiples capas y tela, y luego un material que no sea de tela en la mascarilla también la convertirá en una mejor mascarilla. Mucha gente hace mascarillas en la casa. Si puedes hacer una mascarilla que tenga un lugar para un filtro, puedes poner una mascarilla quirúrgica dentro, y creo que esa es, una de las mejores cosas que podemos hacer ahora mismo para prevenir la propagación del virus SARS-COV-2.

Bill Walsh: Permítame seguir con un par de cosas que dijo, Dra. Young. Entonces, si llevo una mascarilla KN-95, ¿me protegerá si otros no usan una mascarilla?

Dra. Young: Puede protegerte, siempre que la uses correctamente. Entonces la mascarilla para cubrir tu nariz y tu boca. Entonces, por supuesto, vemos personas que tienen su mascarilla alrededor de la barbilla. Lo usan como barba, eso no ayuda. Debería encajar correctamente. Entonces, a veces, la mascarilla que se agarran de las orejeras no están tan ajustadas como las mascarillas que van alrededor de tu cabeza. Y así, de nuevo, les animo a que si van a estar en un lugar que está en el interior, donde el aire acondicionado está funcionando, asegúrense de tener una mascarilla que le quede bien ajustada, y esto también se aplica a los edificios de oficinas.

El hecho de que estés en tu oficina no significa que el virus no pueda pasar por el sistema de ventilación. Y hubo un buen estudio realizado por MIT que lo demostró. Hay un buen video de YouTube. Son 5,4 o 5 minutos, cuatro segundos, y se llama "Nothing to Sneeze At" y te muestra otra instancia de cómo pueden viajar los virus.

Bill Walsh: Está bien, permítame hacer otra pregunta de seguimiento. Habías mencionado una certificación de mascarillas, NIOSH. Ahora, muchas de las mascarillas de tela que la gente puede estar comprando, no tienen esa certificación, ¿qué opina de las personas que usan mascarillas de tela?

Dra. Young: Pienso, nuevamente, que la mascarilla de tela tiene que ser de múltiples capas y que debe tener un filtro. Y esto es particularmente importante, creo, para aquellos que se encuentran en áreas donde tienen un alto contacto con el público. Esto incluye a muchos de nuestros trabajadores esenciales, aquellos que trabajan en las tiendas de comestibles. De hecho, hemos estado distribuyendo mascarillas de nivel superior, que nos han sido donadas, a nuestros trabajadores esenciales en la comunidad del sur de Los Ángeles, y sabemos que tenemos altas tasas de COVID-19 aquí, y también sabemos que tenemos altas tasas de morbilidad y mortalidad de COVID-19. Por lo tanto, nuestra pasión es proteger a quienes están en mayor riesgo, y también tenemos que darnos cuenta de que, incluso si esa persona no sucumbe a una enfermedad crítica o grave, es posible que transmita el virus a otras personas.

Entonces, una de las cosas que sabemos en nuestra comunidad es que, y especialmente porque los riesgos son tan altos en el sur de California, la gente vive en hogares multigeneracionales. Viven con varias familias en una casa. Viven en lugares donde no pueden aislarse voluntariamente si es necesario, o no pueden usar su propio baño, por lo que, nuevamente, tenemos que asegurarnos, nuevamente, de que todos usen una mascarilla, para que quienes estén en riesgo puedan estar protegidos.

Bill Walsh: Bueno, muy bien. Muchas gracias, Dra. Young. Ahora es el momento de abordar más preguntas con la Dra. Young y la Dra. Walensky y, como recordatorio, presiona * 3 en el teclado de tu teléfono en cualquier momento para comunicarte con el personal de AARP. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: Nuestra próxima llamada es de Tim de Connecticut.

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

Tim: Um, sí. Tengo 64 años con fibrilación atrial y algo de insuficiencia cardíaca bien controlada, pero no tengo diabetes. Mi familia ha sido sobreprotectora, así que no he ido a ninguna parte en seis meses. Visitas a la tienda, citas con el médico, etcétera... han sido continuamente aplazadas. Mi primera parte de la pregunta es, ¿sigue siendo demasiado arriesgado para mí aventurarme aquí en Connecticut? ¿Incluso si uso una mascarilla, me lavo las manos y mantengo distancia social? Y luego, la segunda parte de mi pregunta es, mi hijo de 33 años estuvo muy enfermo en diciembre con lo que él pensó que era la peor gripe que había tenido. ¿La prueba de anticuerpos está suficientemente desarrollada? ¿Lo suficientemente confiable ahora? Adónde debería ir para hacerse una prueba para ver si realmente tenía COVID-19 o tiene los anticuerpos ahora.

Bill Walsh: Sí, de acuerdo, Tim. Muy bien, muchas gracias por eso. Recurramos a la Dra. Walensky. Entonces, su primera pregunta fue, ¿es arriesgado para él salir? Dado que tiene 64 años, tiene fibrilación atrial y realmente no ha salido mucho de casa, o no ha salido directamente, en los últimos meses.

Dr. Walensky: Genial, es una buena pregunta, una pregunta importante y gracias por eso, Tim. Un par de cosas a tener en cuenta, a Connecticut le está yendo maravillosamente bien. Puedes mirar el mapa de Estados Unidos en mi sitio web favorito, el New York Times, para ver cuántos casos hay por cada 100,000 en tu estado. Connecticut está en 1.8 por 100,000, entre los más bajos del país. Hay muy poca enfermedad circulando allí. Eso no significa que no debamos ser cautelosos, es solo para decir que no hay mucho contagio comunitario por todas partes y si ese es el caso. Es el momento en que debemos pensar: "¿Qué es lo que podemos y no podemos hacer?" Le animo, le insto, de hecho, a que vaya a ver a su médico.

Nuestros hospitales son realmente bastante seguros, y una de las cosas que estamos comenzando a ver en el hospital, las manifestaciones de personas que han diferido sus cuidados esenciales porque no los recibieron, porque estaban preocupados por su seguridad en el hospital. Así que creo que debería... Supongo que quizás está haciendo algunas visitas por video, pero debería volver a recibir su atención médica de rutina porque los hospitales son seguros. Ellos saben cómo manejar esto, nosotros sabemos cómo hacerlo, nuestras políticas de control de infecciones es tal, que puede mantenerte a salvo.

Yo diría que ahora es el momento de comenzar a pensar con quién podrías interactuar, ya sea en el exterior con una mascarilla y permaneciendo, tal vez, a seis pies de distancia, pero podrías socializar con la gente afuera por un rato para tratar de hacer que tu vida se acerque más a una nueva normalidad de lo que era porque ya sabes, estamos a punto de regresar puertas adentro al otoño, como la primera pregunta, la pregunta comentada anteriormente. Y sabes, realmente debes ver si puedes hacer algo para levantar un poco tu ánimo. Estar en la casa durante seis meses es realmente bastante difícil.

Bill Walsh: ¡Claro! ¡Es cierto!

Dra. Walensky: Pero puedes hacer eso en Connecticut, no estoy segura de que lo haría ahora mismo en Atlanta.

Bill Walsh: Permítanme hacer un seguimiento de eso, varias personas están preguntando acerca de visitar a su dentista. Han pospuesto las visitas al dentista y, me pregunto cómo, qué consejo le daría a la gente que está pensando en volver al dentista.

Dr. Walensky: Creo que es una decisión muy importante. Llamaría a su dentista y empezaría a pensar en las estrategias que le han impuesto, para asegurarse de que sus pacientes estén a salvo. Yo, personalmente, he ido al dentista, toda mi familia ha vuelto al dentista, pero conozco a mi dentista y me sentí increíblemente segura cuando vi las estrategias que habían puesto en práctica. No todos van a ser iguales, pero creo que si estás en un lugar con baja transmisión por cada 100,000, puedes llamar a tu dentista y comprender exactamente qué es lo que que está haciendo para mantener a salvo a sus pacientes, que es definitivamente un lugar al que puedes ir.

Bill Walsh: De acuerdo, y Dra. Walensky, Tim de Connecticut también había preguntado por su hijo de 33 años. Quien estuvo enfermo hace un tiempo y preguntaba sobre la precisión de la prueba de anticuerpos. ¿Qué le diría a él?

Dra. Walensky: Yo diría que muchas personas sienten curiosidad por saber si el resfriado o la gripe que tuvieron antes, podría haber sido COVID-19. Sin duda, sería una prueba adecuada. No sé si pagaría necesariamente los $100 si tuvieras que pagarlos para hacerla. Aunque la prueba serológica tiende a ser menos costosa que eso, si alguien le pide que pague $100, yo no lo pagaría. Pero sí, creo que es un uso muy apropiado para la prueba de anticuerpos. Lo que yo diría es que la gente a menudo se siente más decepcionada por no tenerlos que por tenerlos, ¿y eso qué? Debes tener cuidado con lo que asumes de los resultados.

Por ejemplo, si tu hijo de 30 años tuviera anticuerpos, eso no significa necesariamente que no tiene el potencial de propagar el virus en el futuro, o que no pueda contraerlo nuevamente. Todavía no tenemos datos sobre eso, y ciertamente recomendaría, si no viven juntos, incluso si él tiene anticuerpos, que usen tapabocas cuando están juntos.

Bill Walsh: Bien, gracias por eso. Jean, ¿quién es nuestro próximo oyente?

Jean Setzfand: Nuestra siguiente llamada es de Paul de Virginia.

Bill Walsh: ¡Hola, Paul! Continúa con tu pregunta.

Paul: Sí, buenas tardes, gracias por organizar esta sesión. Tengo, algunas preguntas con respecto a mi hermano, que dio positivo por el virus de la COVID-19 y hace unas cuatro semanas, se le volvió a hacer la prueba. Es negativo, pero sigue teniendo tos persistente. Y me preguntaba si una de las doctoras tal vez podría aclarar de qué se trata.

Bill Walsh: De acuerdo. Dra. Young, ¿quiere responder? El hermano dio positivo pero sigue teniendo tos persistente, ¿qué opina de eso?

Dra. Young: Sí, dio positivo y luego negativo. Y entonces, no diría que está completamente a salvo. Sabemos que no todas las pruebas de laboratorio son 100% precisas. No digo que la suya no lo fuera. Y luego también darse cuenta de que hay otros virus que podrían estar causando sus síntomas. ¿Es el mismo tipo de tos? ¿Son los mismos síntomas, el mismo virus? En este punto, no lo sabríamos a menos que tuviéramos más datos. Pero, de nuevo, en general, lo más importante que hay que saber es que todavía tenemos que asegurarnos de que él se protege a sí mismo y a los demás. Y entiendo que yo sigo diciendo lo mismo en esta llamada, sin embargo, es lo que podemos hacer sin importar los detalles, y eso es en lo que quiero que nos enfoquemos.

Salgamos de los detalles y entremos en la estrategia general para evitar que este virus continúe propagándose. Ya sea que tengamos anticuerpos o no, ya sea que obtuvimos un resultado positivo, luego negativo y el positivo nuevamente. Hay muchas cosas que no sabemos. No estamos fuera de peligro, por lo que es clave adoptar una postura nacional de protección para todos. Entonces, intentemos abordar este virus de esta manera, para ayudar a disminuir la propagación, detener la transmisión tanto como sea posible y detener nuestra mortalidad y morbilidad por COVID-19.

Bill Walsh: Saben, es interesante, mientras la escuchaba hablar, me pregunto si la gente se está volviendo un poco inmune a ese consejo. Mencionó que lo había repetido varias veces, todos lo hemos escuchado. "Lávate las manos, usa una mascarilla, mantén distancia social" y, sin embargo, realmente es lo más importante que la gente puede estar haciendo, y podría perder su efecto en las personas porque lo han escuchado tanto, pero parece que sigue siendo el mejor consejo.

Dra. Walensky: Y Bill, ¿puedo intervenir un minuto para Paul y decir, cuando tenemos virus respiratorios, el último síntoma que desaparece es la tos. Es el que dura más tiempo, por lo que no me sorprendería incluso en circunstancias normales, y especialmente bajo COVID-19. Lo que también sabemos es que ahora hay numerosos casos de pacientes que han estado semanas, incluso meses fuera de su enfermedad primaria, que todavía tienen el enigma, "no puedo oler", manifestaciones neurológicas. Manifestaciones cardíacas, por lo que apenas estamos comenzando a aprender sobre esta cohorte de personas sobrevivientes a largo plazo que tienen síntomas persistentes mucho tiempo después. Hay algunas de esas cohortes de sobrevivientes y muchos centros médicos en todo el país. Entonces, si la tos persiste, entonces diría, tal vez, que visite uno de esos, uno de esos centros también.

Bill Walsh: Bien, muchas gracias por eso. Ahora, abordemos más preguntas y, como recordatorio, presiona * 3 en cualquier momento en el teclado de tu teléfono para comunicarte con un miembro del personal de AARP y compartir tu pregunta. Jean, ¿quién es el siguiente en la línea?

Jean Setzfand: Tenemos a Jeanny de California.

Bill Walsh: De acuerdo, hola Jeanny, adelante con tu pregunta.

Jeanny: Sí, llamé porque escuché que se necesitan voluntarios y quería saber si todavía se necesitan, personas mayores, quién no debería hacerlo o quién debería hacerlo. Para darnos alguna orientación, ¿cuál es el riesgo? ¿Lo recomiendan? Y si es así, ¿cuál es el mejor lugar para hacerlo? He escuchado de diferentes lugares.

Bill Walsh: Jeanny, ¿te refieres a voluntarios para ensayos clínicos?

Jeanny: Sí, voluntarios para los ensayos de la vacuna.

Bill Walsh: Entendido. Dra. Walensky, tal vez pueda abordar esa pregunta.

Dra. Walensky: ¡Oh, esa es una muy buena pregunta! Me encantaría brindarle un recurso centralizado. Lo más importante, Jeanny, y muchas gracias por estar entre los que consideran el voluntariado. Lo más importante es ver si hay un sitio cerca de usted que esté realizando inscripciones en un ensayo de vacunas porque probablemente no querrás viajar muy lejos para inscribirse. Así que me fijaría en los centros médicos académicos más grandes.

En su mayoría es en donde están inscribiendo para estos ensayos de vacunas y, fíjese, incluso puede llamarlos y preguntarles si están inscribiendo para cualquiera de los tres, creo que son, ensayos de vacunas. El cuarto estará en funcionamiento en septiembre. Entonces, puedo decirle que aquí, usted está en California, pero aquí en Boston, habrá varios sitios diferentes de diferentes ensayos de vacunas y podría preguntarles su elegibilidad, y luego puede ver si es elegible, y luego podría seguir adelante.

Bill Walsh: Dra. Walensky, Jeanny también había preguntado sobre los riesgos asociados con el voluntariado para un ensayo clínico. ¿Podrías hablar un poco sobre eso?

Dra. Walensky: Sí, creo que lo explicarán cuando estés ahí y será específico a la prueba. Tenemos datos sobre los cientos a lo largo de estas líneas con estas vacunas, no sobre los miles, por lo que habrá riesgos y efectos secundarios que conocemos. La fiebre, los dolores de cabeza, la mialgia, de la que hablé. Hablé de los dolores musculares.

La mayoría de estos ensayos que han entrado en ensayos de fase tres se consideran bastante seguros, según los datos iniciales, pero nuevamente, no tenemos datos a gran escala. En su mayor parte, los voluntarios que están viendo, generalmente quieren que sean bastante saludables, por lo que no creo que necesariamente inscriban a alguien que esté en diálisis, por ejemplo. O alguien que tenía una enfermedad cardiovascular, EPOC, como escuchamos anteriormente. Entonces, ya sabes, y eso será importante en términos de inscripción, pero también importante en términos de si los resultados de estos ensayos serán generalizables más adelante.

Bill Walsh: Bien, muchas gracias por eso. Jean, ¿de quién es nuestra próxima llamada?

Jean Setzfand: Nuestra próxima llamada es de Roberta de Georgia.

Bill Walsh: Hola, Roberta. Continúa con tu pregunta.

Roberta: Sí, mi hermana, recientemente dio positivo por el virus, se lo contagió su hijo, quien se puso en cuarentena y salió bien. Ella estaba asintomática y sigue estando asintomática después de su cuarentena. Mi pregunta es, ¿todavía puede transmitirlo a otras personas? ¿Necesita seguir haciéndose la prueba y siempre seguirá dando positivo? Aunque ha estado asintomática y ha pasado un mes.

Bill Walsh: Todo un mes, de acuerdo. ¿Un mes desde que dio positivo?

Roberta: Correcto. La primera vez.

Bill Walsh: De acuerdo.

Roberta: La segunda vez, luego la cuarentena.

Bill Walsh: ¿Y ha estado en cuarentena durante el último mes?

Roberta: Se puso en cuarentena durante 14 días después de que inicialmente dio positivo, y luego se hizo otra prueba, y todavía era positiva y seguía asintomática todo el tiempo.

Bill Walsh: Está bien y la pregunta es, ¿es seguro para ella salir? ¿Es seguro que otros interactúen con ella, verdad?

Roberta: Correcto, ¿puede transmitir el virus a otras personas?

Bill Walsh: Bueno, está bien Roberta, veamos, Dra. Young ¿quiere responder a esa pregunta?

Dra. Young: Podría, pero dado que tenemos una experta en enfermedades infecciosas en la línea, creo que dejaré que la Dra. Walensky responda.

Bill Walsh: De acuerdo.

Dr. Walensky: Claro, sería un placer. Bueno, esto es lo que sabemos: sabemos que nuestra prueba de PCR puede seguir dando positivo hasta 12 semanas después de que las personas sean inicialmente positivas, por lo que no me preocupa. Si realmente tiene los datos, la prueba inicial positiva, que la persona se puso en cuarentena durante 14 días, eran asintomáticos, entonces diría que está todo en orden. Los CDC ya no requieren que se repita la prueba, y ya no deberías ser contagioso y si vuelves a tener síntomas, dentro de los primeros tres meses, no creo que sugieran que se haga una nueva prueba y luego, volveríamos a empezar después de cuatro, después de tres meses. Entonces, yo seguiría usando la mascarilla porque no me consideraría necesariamente protegida.

Bill Walsh: De acuerdo. Dra. Walensky, parece que se está cortando un poco.

Dr. Walensky: Oh, lo siento. Aún queda mucho por aprender.

Bill Walsh: Bien, gracias por eso, Dra. Walensky. Parece.

Dra. Walensky: ¿Hola?

Bill Walsh: Parece que se le está cortando un poco. Vayamos a nuestra próxima llamada. Jean, ¿quién es el siguiente?

Jean Setzfand: Tenemos una pregunta procedente de Facebook, y esta viene de Monica, que vive en Phoenix, Arizona, y se pregunta: "¿Podré organizar el Día de Acción de Gracias para mi hijo y su novia que viven en Tempe, Arizona? Están sanos, tienen 35, 43 años y están sanos. ¿Qué recomendarían?"

Bill Walsh: Muy bien, Dra. Young, ¿quiere abordar esa pregunta?

Dra. Young: Claro. Y sabes, Bill, seré honesta en que sabemos que las familias se están juntando, sabemos que se están celebrando fiestas y creo que siempre es importante pensar en cómo mantener a todos a salvo. Sabemos que la gente no se está distanciando socialmente 6 pies, por lo que yo diría que es la mejor estrategia porque, veamos esto desde una perspectiva de que va a suceder, ¿de acuerdo? Entonces, haz tus actividades al aire libre. Asegúrate de que haya una ventilación adecuada en la casa, asegúrate de que todas las ventanas estén abiertas, los ventiladores estén funcionando. Que tienes un ventilador que extrae aire de la casa.

Por lo tanto, está en la dirección opuesta, para garantizar que haya un buen flujo de aire. Las personas también pueden instalar un filtro HEPA de nivel 1900 o superior en su hogar. Si están en un lugar tan caluroso que no pueden abrir las puertas para que fluya el aire, también considera tener los eventos por la tarde o por la noche. Donde todavía hace calor afuera y puedes tener las puertas y ventanas abiertas, especialmente en Arizona. Entonces, eso es lo que haría: sería la forma más segura de tener una cena de Acción de Gracias u otros eventos que la gente esté teniendo. Ahora, si tienes a alguien que va a venir y que es un abuelo, y nuevamente, solo voy a decir, sé que va a suceder.

Ya lo he visto suceder, así que trata de asegurarte de que siempre estén afuera, trata de asegurarte de que vayan a usar una mascarilla. Una de las cosas que estábamos viendo especialmente aquí en el sur de California es que tenemos una gran población latina, y es una de las tasas más altas en este momento de COVID-19, y honestamente, es porque hay una dinámica familiar que es muy crítica para la población y nuestros amigos y familiares. Por lo tanto, tenemos que ser capaces de adaptarnos a eso como proveedores de atención médica y proporcionar información que será específica para las actividades en las que sabemos que la comunidad va a participar.

Es, por ejemplo, una de las razones por las que tenemos un nuevo medicamento para el VIH, llamado Prep, y eso es algo que simplemente, sabemos que la actividad se llevará a cabo, pero lo vamos a prevenir mediante la educación y haciendo que la gente haga algo que pueda protegerlos. Y así, al mismo tiempo, fijarse en qué hará la gente para el Día de Acción de Gracias o Halloween, o incluso la época de Navidad, o Hanukkah, o los otros días festivos, ya sabes, realmente haz tus actividades al aire libre, asegúrate de que haya un buen flujo de aire, no deberían estar encerrados y asegúrense de mantener saludable su sistema inmunológico. Asegúrate de estar tomando el sol, asegúrate de estar descansando.

Descansar durante este tiempo es fundamental. Creo que una de las cosas que nosotros también tenemos que darnos cuenta como sociedad es que en este momento simplemente no podemos seguir como si nada. Tenemos que tener en cuenta los múltiples factores o problemas a los que se enfrentan las personas durante este tiempo. Y entonces, sí, podemos, nuevamente, tener nuestro... o sabemos que las personas tendrán eventos con sus familiares, por lo que, nuevamente, pensar en formas de hacerlo más seguro es fundamental. Entonces, hacer esas cosas, de nuevo, tener sus eventos al aire libre. No lo recomiendo, Solo digo que si lo vas a hacer, hazlo de esta manera.

Bill Walsh: Sí.

Dra. Young: Hazlos al aire libre para los mayores. Permíteles usar una mascarilla durante el evento. Anímalos a que lo hagan, sé que algunas personas no lo harán, pero sin embargo, si no usan una mascarilla, manténganlos afuera para el evento y, de nuevo, también puedes hacer cosas para asegurarte de que las personas estén saludables. Puedes hacer que las personas se hagan una prueba de COVID-19 antes de venir, también puedes verificar si tienen síntomas con tu propio termómetro, y para los miembros de tu familia que pueden no tener síntomas, nuevamente, esa prueba podría ser crítica.

Y sé que he visto en YouTube y otros lugares que la gente está celebrando estas fiestas y que la gente se hace las pruebas de COVID-19 de antemano, pero hay que tener en cuenta a todos. Y, nuevamente, Dra. Walensky, esto es muy difícil de decir porque sabemos qué es lo mejor que podemos hacer, sin embargo, sabemos que como humanos, como mencionamos con la persona que llamó anteriormente, es difícil no estar conectados físicamente. Es difícil no tener las tradiciones que teníamos antes y entonces pensar en formas que son más seguras. Pensar en las formas en que podemos mantener esa conexión es realmente importante y, por lo tanto, solo quiero alentarlos...

Bill Walsh: Sí.

Dra. Young: a considerar estas cosas en el futuro.

Bill Walsh: Muy bien, conectemos con algunos de nuestros oyentes. Jean, ¿a quién más tienes en la línea?

Jean Setzfand: Tenemos una pregunta de YouTube de Don. Don dice que un médico De New York University le dijo que el coronavirus se había transformado en una versión más débil. ¿Qué tan cierto es esto? Y desde el punto de vista de un epidemiólogo, mencionó la mortalidad. ¿Eso es en las afueras del estado de Nueva York?

Bill Walsh: Parece una buena pregunta para usted, Dra. Walensky. ¿Quiere intentar abordar eso?

Dra. Walensky: Sí, claro. Déjame asegurarme de que lo entiendo correctamente. Entonces, en su mayor parte, no hemos visto muchas mutaciones de este virus. Entonces, ya sabes, en términos de una versión más débil, yo no veo que circule una versión más débil. Una versión más débil podría sugerir que las generaciones futuras de personas infectadas se enfermarán menos gravemente que las generaciones anteriores. No creo que estemos viendo eso. Sin embargo, lo que quiero transmitir es que probablemente esta sea una buena noticia desde el punto de vista de la vacuna. Cuanto más estable sea este virus, es más probable que podamos tener una vacuna que funcione contra él.

Bill Walsh: De acuerdo. Jean, ¿quién sigue en la lista?

Jean Setzfand: Tenemos a Stella de Misuri.

Bill Walsh: Hola Stella, adelante con tu pregunta.

Stella: Soy una mujer de 73 años con CAD, programada para cirugía en un centro quirúrgico con estadía de una noche en un hospital. ¿Qué preguntas debo hacer? ¿Existe un sitio web para los casos hospitalarios de COVID-19 que pueda consultar?

Bill Walsh: ¿Quieres decir qué hospital es? Eso podría ayudarnos a localizar el sitio web.

Stella: En St. Louis.

Bill Walsh: En St. Louis, estoy seguro de que sí. Bueno, Dra. Walensky, ¿quiere intervenir en eso? Parece que tiene algunas preocupaciones sobre su próxima cirugía.

Dra. Walensky: Sí. En primer lugar, le deseo lo mejor mientras se dirige a eso. Diré que nuestros hospitales son realmente seguros. Venimos haciendo esto hace tiempo. Utilizamos mascarillas, entendemos los protocolos, tenemos protocolos activos. Buscaría en el sitio web de su hospital para ver si tienen datos. La mayoría de los hospitales ahora tienen un montón de datos, honestamente sobre lo que están haciendo y cuáles son sus protocolos. Así que definitivamente iría al sitio web del hospital y entendería los protocolos. Me sorprendería bastante si su hospital no se comunicara con usted, su centro quirúrgico, no se comunicara con usted para decirle: "Esto es lo que estamos haciendo y así es como vamos a manejarlo", porque hay tantos protocolos nuevos en este momento que los pacientes están confundidos, usted no está sola.

También podría sugerir que su estado o ciudad, puede tener datos a nivel de hospitales si quisiera buscar allí. Si no fuera tan obvio en el sitio web de su hospital. La otra cosa que puede preguntar es: "¿Qué tipo de mascarilla puedo usar? ¿Qué debo esperar?" Pero también, lo que es más importante, "¿Qué nivel de apoyo puedo traer conmigo? ¿Cuántos visitantes están permitidos? ¿Cuáles son los nuevos horarios de visita?" Porque queremos asegurarnos de que nuestros pacientes tengan el apoyo que necesitan y muchas instituciones tienen visitas limitadas.

Bill Walsh: Bien, gracias por eso. Jean, tomemos otra pregunta.

Jean Setzfand: Muy bien, esta es Kathy de Indiana.

Bill Walsh: Está bien. Hola Kathy, sigamos adelante con tu pregunta.

Kathy: Mi pregunta es, tengo una sobrina de 11 años y un sobrino de 13 que viven en mi casa, y yo tengo 71, y tuve un ataque al corazón el año pasado, y su abuelo también vive aquí, tiene más de 60 años, ha tenido un ataque cardíaco anteriormente y tiene diabetes e hipertensión arterial. Y me preguntaba, ya que están de regreso en la escuela, ¿hay alguna precaución adicional que podamos necesitar tomar cuando regresen a casa de la escuela?

Bill Walsh: De acuerdo. Dra. Young, ¿quiere evaluar esa situación?

Dra. Young: Claro, sí. Es solo quiero decir que, ya saben, lamento que hayan tenido los ataques cardíacos, pero me alegra saber, que ahora están bien. Una vez más, esta es otra pregunta difícil porque analiza cómo podría propagarse el virus. Y sé que hay una serie de estudios que han demostrado que las personas más jóvenes en realidad pueden transmitir el virus, por lo que, nuevamente, creo que es importante asegurarse de que ustedes se mantengan lo más saludables posible, y ya que viven con ustedes, sé que es difícil, pedirles que usen una mascarilla cuando están en casa, pero también fijarse en, "¿Qué están haciendo en la escuela?" Ya sabes, entonces, ¿cuáles son las precauciones que están tomando? ¿Están haciendo que los estudiantes usen una mascarilla en el aula?

Sé que algunas escuelas están haciendo que los estudiantes usen protectores faciales y mascarillas, o simplemente protectores faciales. Y esas son las cosas a tener en cuenta, y luego otra cosa a considerar es si es posible que trabajen o hagan sus tareas escolares en línea, desde casa, si eso fuera posible. Sé que aquí en California, solo estamos haciendo educación en línea para todos nuestros estudiantes debido a las tasas de propagación comunitaria de COVID-19. Entonces, eso sería otra cosa a tener en cuenta. ¿Cómo? ¿Cuál es la tasa de propagación en la comunidad? Y no tengo los datos específicos de St. Louis justo frente a mí, pero es algo que podemos buscar y que está disponible para todos.

Habla con la administración de la escuela, asegúrate de que se tomen las precauciones necesarias para mantener a los niños seguros y, de nuevo, si en algún momento se enferman, es importante que les hagan la prueba. Y otras cosas que pueden hacer también en casa, es tratar de mantener las ventanas y puertas abiertas, tanto como puedan, instalar un filtro HEPA de nivel 1900 o superior en su ventilación de entrada de aire, y nuevamente, mantener a la familia bien alimentada, bien descansada, sana. Asegúrense de asistir también a las citas con su médico y luego también pueden, hacerse la prueba nuevamente si la escuela les advierte que alguien en la escuela contrajo COVID-19.

Bill Walsh: Muy bien y Dra. Young, estamos terminando, pero ¿puede simplemente repetir para nuestros oyentes qué mascarilla cree que es la más efectiva?

Dra. Young: Bueno, la mascarilla más efectiva, en general, es una mascarilla N-95 probada.

Bill Walsh: Con el ajuste probado, de acuerdo.

Dra. Young: Y ese tipo de mascarilla está disponible principalmente para los trabajadores de la salud. Y aquellos que trabajan con pacientes que tienen COVID-19. En el hospital, están utilizando mascarillas quirúrgicas y descubrimos que las mascarillas quirúrgicas son efectivas, sin embargo, no son tan efectivas como una mascarilla N-95. Lo que los miembros de la comunidad pueden hacer, nuevamente, es usar su mascarilla de tela con un filtro. Creo que es una de las mejores formas de prevenir la propagación de COVID-19, en este momento, con los recursos que están disponibles para la población en general.

Bill Walsh: Muy bien, gracias por eso Dra. Young y Dra. Young y Dra. Walensky, ¿algún comentario final o recomendación para los socios de AARP? Dra. Young, ¿quiere ir primero ya que estaba hablando?

Dra. Young: Claro. Una de las cosas que hemos estado viendo y es especialmente del lado de la comunidad y una de las cosas que ha sido bastante difícil de ver, incluso con nuestras pruebas, es que alguien viene, se ve saludable y en uno o dos días, recibimos una llamada telefónica diciendo que dio positivo, y luego fallecieron. Y se trata de alguien que visitó o entró en nuestro sitio. Entonces, ¿cómo sucede esto?

Bueno, es realmente la función del virus que ataca los pulmones y, como mencionó la Dra. Walensky, también, el sistema inmunológico hace lo que se supone que debe hacer pero lo hace demasiado bien. Entonces, una de las cosas que recomendaría y varias de nuestras clínicas hacen esto en el sur de California, están enviando a casa una máquina de oxímetro de pulso con personas que dan positivo por COVID-19. Entonces, si alguien tiene un pulso oxigenado menor a 90, debe presentarse en su sala de emergencias y solicitar tratamiento.

Una de las cosas que sabemos es que algunas personas, especialmente de las poblaciones de raza negra y morena, no son necesariamente admitidas en el hospital cuando es necesario. Por lo tanto, tener un pulso de oxigeno les ayudará a saber cuándo ir al hospital, o si los envían a casa, cuándo regresar al hospital.

Bill Walsh: De acuerdo. Dra. Young, muchas gracias por eso. Dra. Walensky, ¿alguna idea o recomendación final?

Dra. Walensky: Sí. En primer lugar, quiero agradecerles a usted y a la Dra. Young por este magnífico foro. Quiero decirles que tenemos para rato con esto, mis queridos amigos, y por eso debemos protegernos a nosotros mismos y a los demás. Además, tratemos de hacer aquellas cosas que nos hagan felices, cuando podamos. Cosas que nos hacen salir, cosas que nos hacen ver a nuestros seres queridos, aunque sea enmascarados afuera. Protege a las poblaciones vulnerables. Como dijo la Dra. Young, son las comunidades negras y morenas las que sufren la morbilidad y la mortalidad de esta enfermedad más que las comunidades blancas. Ve y recibe tu atención médica de rutina. Es muy seguro hacerlo, y lo que realmente no queremos son víctimas del COVID-19, de personas que tenían miedo de ir al hospital, y ciertamente lo hemos visto. Por lo tanto, busca tu atención médica de rutina, tus vacunas de rutina, tus exámenes de detección de rutina y ponte la vacuna contra la gripe para el año que viene. Debemos asegurarnos de estar lo más seguros posible para todas las cosas que puedan estar circulando en el otoño.

Bill Walsh: De acuerdo. Bueno, gracias a ambas por responder a todas nuestras preguntas. Esta ha sido una discusión realmente informativa y gracias a nuestros socios, voluntarios y oyentes de AARP por participar. AARP es una organización de membresía sin fines de lucro y no partidista, hemos trabajado para promover la salud y el bienestar de los estadounidenses mayores durante más de 60 años.

Frente a esta crisis, estamos brindando información, recursos para ayudar a los adultos mayores y a quienes los cuidan a protegerse del virus, u prevenir el contagio a otros mientras se cuidan. Todos los recursos a los que se hizo referencia hoy, incluida una grabación del evento de preguntas y respuestas de hoy, se podrán encontrar en aarp.org/coronavirus a partir de mañana, 21 de agosto. De nuevo, esa dirección web es aarp.org/coronavirus. Vaya allí si su pregunta no fue respondida y encontrará las últimas actualizaciones, así como información creada específicamente para adultos mayores y cuidadores familiares.

Esperamos que hayas aprendido algo que pueda ayudarte a ti y a tus seres queridos a mantenerse saludables hoy. Asegúrate de sintonizar el jueves 3 de septiembre a la 1:00 p.m., hora del Este, para otra sesión para abordar sus preguntas sobre la pandemia de Coronavirus. Gracias y que tengan un buen día. Con esto concluye nuestra llamada.

Coronavirus: Your Health & Staying Protected

Listen to a replay of the live event here.

The live event featured a panel of experts to address your questions related to the latest information on the potential treatments and vaccine trials and what you can do to stay safe during the pandemic.

The experts:

Sheila Marie Young, MD
Assistant Professor, Charles R. Drew University of Medicine and Science

Rochelle Walensky, MD, MPH
Chief, Division of Infectious Diseases, Massachusetts General,
Professor of Medicine, Harvard Medical School

Margaret Wallace Brown
Director, Planning & Development
City of Houston, TX

 


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


Replay previous AARP Coronavirus Tele-Town Halls

  • 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
  • June 18 and 20 - Strengthening Relationships Over Time and  LGBTQ Non-Discrimination Protections
  • June 11 – Coronavirus: Personal Resilience in the New Normal
  • 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
  • May 21 – Coronavirus: Caring for Loved Ones in Care Facilities With Special Guests Susan Lucci and Jo Ann Jenkins
  • May 14 –  Coronavirus: Veterans & Staying at Home With Lifestyle Experts
  • May 7 – Coronavirus: Protecting Your Health & Bank Account and Managing Your Career, Business & Income
  • April 30 – Coronavirus: Caring for Parents, Kids & Grandkids
  • April 23 – Coronavirus: Supporting Loved Ones in Care Facilities and Disparate Impact on Communities
  • April 16 – Coronavirus: Telehealth
  • April 9 – Coronavirus: Coping and Maintaining Your Well-Being
  • April 2 – Coronavirus: Managing Your Money and Protecting Your Health
  • March 26 – Coronavirus: Protecting and Caring for Loved Ones
  • March 19  Coronavirus: Protect Your Health, Wealth and Loved Ones
  • March 10 – Coronavirus: Symptoms. How to Protect Yourself, and What It Means for Older Adults and Caregivers