May 6: AARP Coronavirus Tele-Town Hall

Bill Walsh: Hello. I am AARP Vice President Bill Walsh. And I want to welcome you to this important discussion about the coronavirus. Before we begin, if you’d like to hear this telephone town hall in Spanish, press *0 on your telephone keypad now. 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. The good news is that vaccine access is improving across the country, with all people 16 and older now eligible for the vaccine in every state. While over 82 percent of adults 65 and older have received at least one dose, some younger people are resistant to getting the vaccine. Some people are struggling to get doses, and new variants of COVID-19 continue to spread. What’s more after a year in the shadow of the pandemic, many Americans are feeling emotionally wrung out. In fact, new AARP research suggests that large numbers of the 50-plus population feel depressed, anxious, lonely, and as much as they want to return to life as normal, they also have concerns about the future as we emerge from the pandemic.

Today, we’ll hear from an impressive panel of experts about these issues and more. 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 a question about the coronavirus pandemic, press *3 on your telephone keypad to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. If you’d like to listen in Spanish, press *0 on your telephone keypad now, and if you’re joining on Facebook or YouTube, you can put your question in the comments section.

Hello, if you’re just joining, I’m Bill Walsh with AARP, and I want to welcome you to this important discussion on the global coronavirus pandemic. We’re talking with leading experts today 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. We have some outstanding guests joining us today, including health experts from the Division of Infectious Diseases at the University of Maryland, Baltimore, and the University of Colorado Anschutz Medical Campus Multidisciplinary Center on Aging. We’ll also be joined by my AARP colleague, Jean Setzfand, who will help facilitate your calls today. This event is being recorded and you can access the recording at aarp.org/coronavirus 24 hours after we wrap up. 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 guests. Rekha Rapaka, M.D., Ph.D. is an assistant professor of medicine at the Center for Vaccine Development and Global Health at the University of Maryland Medical Center. Welcome back to the program, Dr. Rapaka.

Rehka Rapaka: Thank you so much for having me.

Bill Walsh: All right. And Samantha Farro, Ph.D., is a licensed psychologist at the University of Colorado Anschutz Medical Campus Multidisciplinary Center on Aging. Welcome, Dr. Farro.

Samantha Farro: It’s a pleasure to be here.

Bill Walsh: All right, it’s a pleasure to have you. Let’s, let’s get started with our discussion. Just a reminder, to ask your question, please press *3 on your telephone keypad or drop it in the comments on Facebook or YouTube.

Dr. Rapaka, let’s start with you. The CDC recently released new guidance on mask wearing and traveling for vaccinated people. What should people listening today know about the new guidance?

Rekha Rapaka: Yes, it’s important for everyone listening to know there have been updates to the guidance on mask wearing and traveling for individuals that have been vaccinated. So this specifically applies to people who’ve had at least two weeks after their second Moderna or Pfizer vaccine, or two weeks after the single dose Johnson & Johnson vaccine. So, the new, the new guidance is that individuals that have been meeting these criteria and have been vaccinated can meet indoors with others who are also vaccinated, other adults, without a mask. Secondly, as someone in this group of being vaccinated, you can also visit a single, up to one household of individuals that may not have been vaccinated, unless there is a member of that family with increased risk of severe COVID-19. And I can talk more about that if there are questions. As well, outdoors, it’s considered now, if you’ve been vaccinated, generally to be okay to not need to wear a mask, unless you’re in a crowded situation.

And then there are also some updates related to travel specifically, you know, in the past there was a period of quarantine when traveling between states and, you know, a need for testing. That’s no longer required. It is recommended if you’re doing international travel to be tested afterwards when you return home and, you know, I think there is some examples that I can give you just to kind of clarify what the guidance looks like. So, for example, dining outdoors might be something you could consider as a vaccinated person, small outdoor gatherings; but, you know, in the setting of other situations, like, for example, anytime you’re in public transport you should be wearing a mask even though you’re vaccinated, and in settings like going grocery shopping, going to church, going to the gym, things like that, you should continue to wear a mask. It’s often a point of using your best judgment and kind of taking a look at what’s available, but I would say overall, there’s been some restrictions that have been lifted for those that have been vaccinated. And I think it’s a good sign and a good kind of reward for getting vaccinated, so to speak, getting back to some of these things.

Bill Walsh: Right. And very quickly, I mean, some people I think are wondering why they have to wear a mask at all if they’ve been vaccinated and they’re past that 14-day period. Can you just very quickly explain what the purpose of wearing a mask is if you’ve been vaccinated.

Rekha Rapaka: Yeah, so the purpose is that, you know, we right now don’t know everything about the benefits of the vaccine. And we also, we know there’s a strong benefit, right? The efficacy is excellent but we don’t know— you know there’s still a risk of catching the infection. So you still have that risk. It’s not a hundred percent, right, this vaccine, these vaccines. So it’s important from that perspective. And I think also, you know, there’s a situation where you could also be a carrier of the virus without having any symptoms, and we want to prevent risk of transmission to others as well. So those are part of the calculations. But really crowded settings, situations where you’re near people coughing, talking, laughing, really close type settings are still risky. And so those are situations where at this point, we’re not ready to say, you know, take, stop wearing the mask. We still need that mask going. So.

Bill Walsh: Right. Dr. Rapaka, I mean we’re seeing, the good news is we’re seeing cases generally on a downward trend nationally. But there’s still a few states, and Michigan’s an example, where there’s a surge of new infections, even as people are getting vaccinated. Do we know what’s going on there? What’s driving this?

Rekha Rapaka: Yeah. So this is an interesting, really interesting question. I don’t think we know everything about why, but there’s, there’s some factors I think, to take into account. So Michigan has been surging for the past month with numbers of cases, and it’s just starting to decline. Minnesota and Illinois are also kind of states in this category, you know, where it, rates of like 15 percent of people that are getting tested for COVID are actually COVID positive, which is very high. And I think the factors that go into this are: One, you know the vaccination rate does impact things. Two, the kinds of strains that are circulating are important to take into consideration. And then I think thirdly and probably the most impactful is, you know, the intensity of restrictions and when they were lifted. So, for example, states like Texas and Florida, they’ve had more infections early on in the pandemic. And so those people, too, have some level of immunity; once you’re infected, you have some level of immunity that persists for at least six months. And so they’ve had lower restrictions and that’s kind of continued, and they have about the same vaccination rate as Michigan. So I would contrast Michigan as being a situation where they had a lot more of the quarantine in the beginning, and now that’s being, those factors are being more lifted and there’s been less restrictions. And I think that’s coming in the context of having, you know, the new variants. So I think that combination is what’s the challenge. And as we’re seeing, the numbers are declining now, but I think it’s a testament to probably the vaccine being approached more and more people just having immunity from either having been exposed or being vaccinated.

Bill Walsh: Right, okay, well thanks for that. Let’s turn to you, Dr. Farro, on the topic of mental well-being. I mentioned earlier that AARP has a new poll that we just conducted that showed that 70 percent of older adults feel sad, depressed, anxious, lonely, and they have concerns about the future as a result of the pandemic. So while the pandemic has had a well-documented and devastating toll on physical health, can you talk about some of the impacts on mental well-being and why so many people are feeling this way? I’d also like to hear if there are long-term consequences to this.

Samantha Farro: Absolutely. I really appreciate your attention to this topic because I think there’s been so much focus on, you know, trying to stay safe and trying to stay physically healthy during this pandemic. But we have definitely seen emotional health impacts from the upheaval of the past year. You know, similar to what you’ve said, I would say most commonly I’m hearing about how lonely people have felt having to stay at home or distance, you know, physically distance and isolate from friends and family. I think also really common is that there has been a lot of boredom for folks that are staying home and, you know, they’ve lost some of the normal activities and interests that they used to do. They’re not, you know, at a certain point you’ve read lots of books, you’ve done lots of puzzles, you’ve watched lots of Netflix, and you kind of are trying to figure out what to do. And so boredom has been by far one of the most common things I’ve heard.

And then something else that I don’t think a lot of folks have necessarily talked about, but that has definitely been true, is that the pandemic has really turned our daily routines upside-down. And so something that I’m hearing a lot of folks are doing is that they’re noticing a lot of sleep disruption. So maybe they’re more bored during the daytime. So they’re napping more, then they’re having trouble sleeping at night. And so it just kind of becomes this cumulative effect where we know that sleep disruptions relate to our mental well-being and our emotional health. And so these are some of the things that I think have been, throughout the entire pandemic, very common. Now, for some of these people who have experienced some of those, those things, those difficulties have led to more serious concerns. So, things like increased alcohol and substance use; as you mentioned, anxiety and depression was very common as we faced so much uncertainty and so much was unknown. That was a very common thing that folks were feeling. And then we’re also seeing a lot more as people are staying home and maybe you and your spouse or you and your family are confined to being at home, there’s been a lot more tension and conflict within relationships. So I definitely think the pandemic has been very impactful on mental wellness.

You asked a question about, you know, what are the long-term consequences of this. One of the things that’s really wonderful about older adults, and as we age, we get lots of experience and we have more kind of resiliency. We have more, you know, we faced many challenges in our lifetime, and we’ve overcome that. And so I think something that is actually a real wonderful thing about — you know, I personally work with older adults, and I’m in a geriatrics clinic — one of the things that’s really wonderful is how resilient we are. Having had lots of life experience, we may have already developed coping strategies. So certainly there can be long-term impacts when mental wellness and emotional health are impacted it in the way that they have been for the past year, but I encourage folks to also connect with and remember what are the things that they’ve done previously when they’ve faced challenges that have been helpful to them? I think that that is one way that we can really curtail some of those long-term effects. And so even though the pandemic has definitely been impactful on mental wellness, we all have strengths and resiliency and coping strategies that we can kind of remember and try to rely on.

Bill Walsh: Well, let me dig into that a little bit and look forward a little bit. You know, we’ve been living under this pandemic for over a year and, you know, over 60 percent of older adults are meeting and socializing less with family and friends, which of course only adds to anxiety and depression and sadness. You know, while many people are anxious to get back to normal activities after receiving their vaccine doses, others are really anxious about venturing back into this new normal. I wonder what guidance you’d have for people who are grappling with those conflicted emotions.

Samantha Farro: Absolutely. This is so common that, you know, on the one hand, people are really wanting to go back out into the world and reconnect with loved ones and friends and neighbors that maybe they haven’t seen in many months, but the act of actually doing that can be quite uncomfortable because it is so different from the past 12-plus months. And so I think first and foremost, it’s important for all of us to know that there is going to be a relearning process to making those changes. You know, some of the things that I recommend that can help us as we transition back to some semblance of normalcy is to make a plan that allows you to gradually begin to experience that kind of novelty with new places and being around, you know, people again. This is not something that we’ve done, you know, for almost over a year. And so I don’t recommend that you go from, you know, staying safe at home and not seeing people to going to a super-crowded event. Even if you are vaccinated, that can be a real intense experience for a lot of people. But rather, try to take it slow. You know, how can you do this and be really gentle with yourself? Allow yourself time to get used to being in the world again, and know that the first time you do anything, it’s going to be a little bit uncomfortable and that’s normal. So, taking it slow, giving yourself room to take breaks, even just pausing to take a couple of deep breaths as you get used to being back out. And certainly, you know, that might be enough for a lot of people, but if these anxieties persist or if they become so severe that you feel really stuck and maybe it’s just, you know, terrifying to leave your home, or it’s terrifying the thought of, you know, going back out, then you might want to try to seek out professional help from a therapist. You may not need that long-term, but it can definitely be helpful during the transition of getting back into the world where you have a professional who can give you very specific strategies on how to manage those kinds of more severe symptoms.

Bill Walsh: Yeah. All right. Thanks for that, Dr. Farro. We’re going to be talking more about mental well-being later on in the program. As a reminder to our listeners, to ask your question, please press *3 on your telephone keypad. And we’re going to get to those live questions shortly, but before we do, I wanted to bring in Nancy LeaMond. Nancy is the executive vice president and chief advocacy and engagement officer here at AARP. Welcome, Nancy.

Nancy LeaMond: Hey, Bill. How are you?

Bill Walsh: Very good. There’s been a lot of action on COVID-19 on Capitol Hill over the last few months. What are the big things that our listeners should know about?

Nancy LeaMond: Well, as you say, it’s been a very busy stretch, with AARP really pushing Congress to help 50-plus Americans protect themselves and their families and navigate financially through this pandemic. For example, in March, Congress passed, and President Biden has signed, the American Rescue Plan Act, which included a number of AARP priorities: delivering $1,400 payments to millions of older adults, including Social Security beneficiaries; expanding paid-leave tax credits and the child tax credit; helping more people receive care in their homes and communities; making health insurance more affordable through expanded subsidies under the Affordable Care Act; extending unemployment benefits for people who were pushed out of work during the pandemic; expanding the COVID vaccination efforts, as both of our guests have talked about; and improving infection control in nursing homes.

Now, in addition to this work in the Congress, AARP is also working with governors and state legislators across the country to allocate funding in ways that address the needs of older Americans. For example, AARP West Virginia is urging the governor to prioritize vaccinating homebound residents, and AARP Massachusetts successfully advocated for legislation that provides emergency paid leave for those who need to take time off to get vaccinated, or to take care of someone who has COVID, or to get themselves taken care of if they get COVID themselves. So these are just a couple of the examples of the many things we’re working on across the country.

Bill Walsh: Right. Well, thanks for that. What should we expect moving forward?

Nancy LeaMond: Well, looking ahead, Congress will soon begin working on an infrastructure plan and AARP will continue to fight for the financial and health security of those over 50. We were very heartened to hear President Biden in his recent remarks to Congress address many of the concerns Americans over 50 feel: continuing to increase access to vaccines, especially for folks who are hard to reach or homebound; improving long-term care; providing more support for the 48 million people who are voluntarily caring for loved ones; lowering the skyrocketing price of prescription drugs that continue to cripple family budgets; and improving access to high-speed internet, safe transportation and better housing options across the country. COVID has certainly shined a light on all of these challenges older Americans face. And if it’s taught us anything, it’s that America’s care infrastructure and physical infrastructure are failing, and there is a lot of work that has to be done. It’s a busy time on Capitol Hill and AARP staff and volunteers, and maybe activists like those of you on the line, will continue to work hard to make sure the needs of older adults across this country are a priority, and that your voices are heard, and that we at AARP advocate on issues that matter to you the most.

Bill Walsh: Okay. And finally, as the vaccine distribution process continues, where is AARP focusing its efforts?

Nancy LeaMond: Well, since the beginning of this pandemic, AARP has been fighting for you, calling for big investments in research around treatments and vaccines for this virus. And I’m glad to say those efforts are paying off. Once the vaccines were available, we knew that this was the issue that mattered most to our constituency. And that’s why we worked with the Trump administration and then with the Biden administration and in every single state to make older people a priority. That’s also why we’ve published online guides for every state explaining how to get the vaccine where you live. And you can find those at aarp.org/vaccineinfo. Based on our work, governments prioritize long-term care facilities and older Americans. Cases in nursing homes have, thankfully, finally dropped drastically, although we still have serious concerns in some places. And more than 80 percent of people over 65 have now received at least one dose of a COVID-19 vaccine. This is a monumental accomplishment and means so much to people who can now safely visit with their families and their grandchildren again. There’s a lot of work to do to ensure that everyone who wants a vaccine can get it, and people may still have questions, and we need to help them get them answered in sessions like today. We’re going to be focused on ensuring that older adults, particularly older adults of color and those who are homebound, have access. And as the rollout continues, we’ll keep the pressure on elected leaders and continue to provide critical information to our members.

As I mentioned before, AARP State Offices are hard at work reaching out to older adults across the country. For example, AARP California is reaching out to Latinos about COVID-19 and vaccine information through a targeted Spanish-language Facebook Live series; AARP volunteers in states like Connecticut, Alaska, Indiana and many more are making phone calls to older adults to provide them with the information about vaccines, and in some cases, we’re actually able to help people get registered. And AARP Pennsylvania is a lead partner working with Black Doctors Consortium on a multistate event to focus on vaccine education and hesitancy among Black Americans. We have lots else going on; I won’t go into it now, but to stay up to date on all of these efforts, please take a minute and go to our website, www.aarp.org/coronavirus. And with that, back to you, Bill, and back to our terrific panel.

Bill Walsh: All right, thanks for that update, Nancy. I very much appreciate it. And we’re going to get to our listener questions in just a moment. Before we do, I wanted to address an important issue.

We know that many of you are having challenges registering for vaccines in your states or communities because many places require signups through online forms and if you don’t have access to a computer, this can be a real challenge. AARP wants to help. We’ve established an AARP Vaccine Finder Support Team to try to assist in these cases. So, if you’re listening today and you don’t have a computer and can’t register for a vaccine because of that, please press 1 to be added to a list to receive a phone call from AARP staff to assist you. Again, if you’re listening today, and you do not have access to a computer or the internet, and you can’t register for a vaccine because of that, please press 1 to be added to a list to receive a phone call and we will try to help you out. When you do, when you hit 1, you’ll listen to a brief message and then be returned to this call.

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

Jean Setzfand: Thanks so much, Bill. Delighted to be here for this important conversation.

Bill Walsh: All right, who is our first caller today?

Jean Setzfand: Our first caller is Karen from Pennsylvania.

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

Karen: Okay. Thank you for taking my call. I had my first dose of the Pfizer vaccine. My question is how much leeway do you have to get the second dose? Because I heard that you shouldn’t wait too long to get the second dose of the vaccine.

Bill Walsh: Okay, let’s ask Dr. Rapaka about that. Dr. Rapaka, can you answer Karen’s question?

Rekha Rapaka: Yes, Karen, that’s a really good question. So, you know the way the vaccine was tested was in this situation of a clinical trial. And we typically, you know, in that context, there was a three-week interval between the first and the second dose. That’s sort of the ideal situation, but if it can’t be, you know, if you can’t get the booster vaccine at three weeks, you know, a little bit extra time is okay. And I think not straying too far from that goal is probably for the best, because we have the most information on how effective the vaccine is in that context. But some time, you know, a few weeks or even a little longer should be okay.

Bill Walsh: Okay. And, and that goes for the other vaccines as well.

Rekha Rapaka: Well, so, for the Moderna, which has a booster, that booster’s at four weeks, and that should be basically, again, try to be as close as you can to that point, but if you need to go later, that’s okay.

Bill Walsh: We’re hearing that a fair number of people aren’t getting their second shots. I saw a data point the other day that 8 percent had not done that for various reasons. How much protection do you have with a single dose of Moderna or Pfizer?

Rekha Rapaka: Yeah, that’s a really great question. So actually, the single dose of Moderna and Pfizer from the data that we have as far as protection in that short period of time is pretty, pretty darn good. It’s around, actually almost that same range of 90 percent. I will say that though with a caveat that the immune response is a complicated thing, and the booster, the effect of giving that second booster really strengthens the immune response, not just from the perspective of how good it is, but also how long it might last. And right now we have very little data about duration. So I would advise people to really follow that protocol of the two doses if they can because that’s where we have the most information. And when we, if we end up in a situation where we might need to give boosters and things that, you know, being kind of on that schedule will help. So since, that’s how I’d answer that. With the information we have now, stick to the, if you can, stick to the published time course.

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

Jean Setzfand: Our next caller is Betty from Pennsylvania.

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

Betty: Yes, a little while ago, I don’t remember who it was, they mentioned that if you still have a problem getting out, if you have both your shots, to see a therapist, how do, how do I get to see a therapist when none of them will take my Medicare insurance. The psychiatrist won’t take them, and neither will the psychotherapist. They want cash only.

Bill Walsh: Dr. Farro, yeah. All right. Well, let’s ask Dr. Farro about what she recommends. Dr. Farro?

Samantha Farro: Thank you, Betty. I really appreciate this question because I think that is a huge issue, and it is definitely a barrier to access when we don’t have enough people paneled on our Medicare insurance plans to be able to meet the demand. And I think that’s been a tremendous challenge in the past year. My recommendation— there’s a couple of ways that you can try to find a therapist or a psychiatrist to work with. So the first thought that I have is, one, contact your insurance, whether it’s Medicare or an Advantage plan or whatever your insurance situation is, contacting them, they are required to be able to provide you with a list of providers. And if you go through their paneled, you know, providers on the insurance list, and you’re not able to receive care, they are required to find you a provider. So sometimes insurances can make exceptions and things like that depending on what your insurance coverage is. So that’s one strategy is to reach out to your insurance and to talk with them.

I also would recommend if you have a primary care doctor, which I recommend everybody do have that, because I do work in primary care and I think that it’s a tremendously important, you know, service. If you do have a primary care physician, then talk with them about who they might recommend. A lot of times primary care providers may know of resources that you may not. For example, I work in geriatric primary care at the University of Colorado Hospital, and I am, I serve as an integrated behavioral health provider in our clinic. And so I am kind of a liaison. I act as a consultant to our patients to one, either help them try to resolve if they’re having behavioral health concerns, or two, if it’s something that’s more severe, part of my role is to help connect them to providers in the community for long-term follow-up. And so I think another resource that might be of help is to go through your primary care provider. The last resource I just want to give you is the Substance Abuse Mental Health Services Administration is a federal government agency. They actually have a national hotline that helps folks to try to find providers in their immediate area. And so they have a hotline phone number that is 1-800-662-4357. And I’ll repeat that again in just a minute, but this phone number, this hotline is really meant to try to help folks who are struggling with mental health to be able to connect to providers in their local community. Again, Betty, I think your question is really important, and there is, you know, it represents an issue that I think has been pretty well documented, that Medicare providers are few and far between in some areas of the country. But some of these are some of the resources that might be helpful. And again, that SAMHSA National Hotline is 1-800-662-4357. So hopefully that helps.

Bill Walsh: Thank you very much, Dr. Farro, very helpful. Jean, who is our next caller?

Jean Setzfand: We have several questions coming in from YouTube, and here’s a question from John. John’s asking, “I’d like to know about what I heard from one of the objectors to the vaccine. They said it could cause an immune system to attack the body. Something called a ‘cycloklin storm.’ Is that true?”

Bill Walsh: Hmm, Dr. Rapaka, can you weigh in on that?

Rekha Rapaka: I’m not, yeah, so I’m not totally sure about the phrase that was use, I believe he said he might’ve been referring to something called cytokine storm. So we have not observed cytokine storm, which is a very intense immune response basically, we’ve not observed that with any of the COVID vaccines that have been tested. It’s not an adverse event that we’ve seen. You know, I think perhaps this question, though, drives at the fear of maybe what kind of side effects one might experience with the vaccine and, typically, for most people they are, for the vaccines, the three that are approved and in use in the United States, they’re mild and self-limited. So hopefully that gives some reassurance to John about that.

Bill Walsh: Okay. Jean, let’s take another question.

Jean Setzfand: Next caller is Linda from Colorado.

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

Bill Walsh: Hello. Go ahead with your question.

Linda: Hello?

Bill Walsh: Hi, is this Linda? Go ahead with your question.

Linda: Oh yes. I belong to a faith group that it has been wonderful to be part of during this last year. Only thing with this faith group is they’re wanting to get together in person. And there are a couple of the couples that are part of this group that refuse to get vaccinated. I feel that that’s going to harm me. I mean, it’s not good for us. And then these people that are a part of this faith group are out in amongst the public, in family members, young people, on a regular basis. So I feel that they’re amongst the virus, and then when we get together, what’s my chance of being sick, and what, how can I handle getting together in person with these people and stay safe?

Bill Walsh: All right, Linda, thanks so much for that question. Dr. Farro, why don’t we start with you? Maybe both our experts could weigh in on this. Dr. Farro?

Samantha Farro: Sure, so you know I think, and one of the things that has been really challenging in the past year is that as we are all trying to stay safe in the midst of this pandemic, it has brought up different levels of how people are protecting themselves. So wearing masks all the time versus staying home all the time versus some people are socially distancing, others aren’t. And that variability, I think, can be very distressing for people when they’re trying to navigate that within their interpersonal relationships. So it sounds like, Linda, you have this faith group that has been real wonderful support to you over the past year, which is wonderful, but they’re wanting to get together in person and some of the members of that group are not necessarily taking the level of precautions that you are. And this is part of, you know, as I mentioned a little bit earlier, this is part of where we are seeing some increased tension and conflict in interpersonal relationships, with friends, with family, with community members. And there’s no real, you know, perfect answer for that. The biggest thing I can recommend is that you try to be very honest and open in communicating your concerns. I think communication about your experience of needing to feel safe, to be able to gather in this way, is probably not something that’s only happening for you; others may have these same concerns. And the more that we can be able to, you know, communicate and talk openly about that, the more that we can kind of try to navigate some of these more sticky, you know, relationship issues.

That said, I think it’s also important at the end of the day, first and foremost, we want to make sure that you stay safe. And so if those conversations don’t lead to, you know, don’t result in changes in either policy or changes in how folks are willing to accommodate what your needs are, then you would have to make a choice of if getting together in person is something that you’re willing to do in terms of the risk and the benefits of that. And again, I think these conversations have been very difficult throughout the year. It’s, we’re trying to, you know, discuss our sense of safety, we’re trying to discuss our sense of consent to be able to participate in activities where other people’s decisions and actions, you know, can very intimately and personally impact us. And so all of those are challenging, but I encourage folks to be honest, and to be open about their needs, not necessarily in a judgmental way, but just about what, how you’re feeling and what your needs are for safety.

Bill Walsh: Okay, Dr. Rapaka, did you want to add anything to that?

Rekha Rapaka: I appreciate everything Dr. Farro said, and I also just think, too, I think it’s okay to, you know, the CDC guidelines are there to guide, truly. I mean, so we should use them and, I mean, so you can always reference that when you’re talking to your group, you know, because a lot of our decisions are not really, for these kinds of things, can be guided by data a little bit, you know, and you can talk about, well, right now it doesn’t necessarily seem the safest to have indoor meetings with several people, right, and in this kind of environment without masks, for example. That obviously wouldn’t go. But I think, you know, navigating it with the data, letting people know that there’s some guidelines that exist that can help us make these decisions better together, and maybe that means you all meet outside, you know, for a while and as the time goes on. So you, you can sort of use the guidelines to help navigate that kind of challenging conversation.

Bill Walsh: Okay, thank you both for that. And thanks for all the questions so far. We’re going to take more questions shortly. As a reminder, to ask your question, please press *3 on your telephone.

Let’s get back to our experts. Dr. Rapaka, you know a few weeks ago the distribution of the Johnson & Johnson vaccine was paused and then it was restarted. Some people may be concerned about the safety of this vaccine. What should everyone know about the pause and the restarting of the distribution?

Rekha Rapaka: Sure. So the Johnson & Johnson vaccine is kind of the more recently approved vaccine, and it is very, you know, very beneficial in preventing hospitalization and deaths. And it, actually about 8 million doses have been given in the U.S. So there was a pause in the middle of April, and it halted use of the vaccine for about a week and a half. And the reason for that was there was a really, you know, some events related to rare, basically blood clots that had been observed, very rare events. So basically of the 8 million doses given, there were observed to be about, about seven cases. And, you know, the population was, where this effect was being seen, this rare effect was being seen, was mainly in younger women, so women under the age of 50. In older women and in men, that rate is far less, closer to less than 1 case per million. So basically the reason this pause occurred was because they wanted the scientists and physicians to really look at the data and make a very careful judgment and decision about whether the vaccine’s benefits outweighed the risk, and it very clearly did. And so a lot of, a lot of people I know now probably have some hesitation about this vaccine, but I want people to know that, you know, the risk of clots from, for example, COVID-19 disease itself is in the range of 160,000 per 1 million. So you can, there’s a high risk of clots, I don’t know if many people know this, from just getting COVID-19 disease. You know, the risk of clots here is about 1 case per million. And to give you a sense of other behaviors and medications as far as risks of clots, for example: So oral contraceptive pills are in the range of 500 to 1,000 per 1 million, and smoking itself is in the range of 1,700 per million. So that risk is just considered to be so significantly low compared to the risk of getting COVID-19 for the vaccine. And so that’s why it’s been approved. And there are other just major benefits of this vaccine, including, you know, really one dose and you’re done. And we want to get to the point where, you know, this virus is just not spreading very much in this country, and to get there, we have to get the vaccines on board. So hopefully this answers that question and gives people more information about what the pause was about and now resuming use.

Bill Walsh: Well, thanks for those data points. That’s very helpful to put it in some perspective. You know, Dr. Rapaka, we continue to hear about the possibility of needing booster shots to protect from the COVID-19 variants. What do we know about that?

Rekha Rapaka: Yeah, so I think this is an important discussion. So boosters may be needed for the vaccines that we have. The first point is we don’t know how long the immunity from the vaccine lasts, and that’s basically because we’ve only been using these vaccines since, you know, around December, January. So we don’t know how long it lasts. We have some studies from the trial, so the trial data, which has a little bit longer duration of information. So there’s that, I think, that we have to contend with. And I think also this question about variants. So, as many of you have heard, there are different kinds of strains of the virus. So the virus can slowly make changes to itself as it propagates, as it spreads through the populations and in different countries. And so, you know, there’s a chance that the vaccines we have may not be as efficacious as a newly emerged variant, against a variant that’s emerged. And that’s, you know, something we’re going to just have to be very closely watching. So right now, just to give you an educated guess, you know, I think the vaccine durability, meaning how long the effect lasts, I’m pretty sure, given the context of other vaccines, at least a year of immunity is what I hope. But we may need, you know, new boosters or new vaccines as we go along. And I will also just say that because of that concern, there are studies going on right now to test potential boosters that they have efficacy against say the South African strain that is there and could spread and other strains.

Bill Walsh: Okay. All right. Well more to come on boosters. Thank you for that, Dr. Rapaka. Dr. Farro, back to you. Many family caregivers may be stressed and burned out and overwhelmed in a normal year. But of course this year has only amplified all of those feelings. If someone’s caring for a loved one and feeling the strain, what can they do?

Samantha Farro: Yes, there is absolutely no doubt that this past year has been a tremendous challenge for caregivers. You know with the pandemic restrictions, caregivers have had oftentimes more responsibility with fewer support resources, such as, you know, respite care and whatnot. My main recommendation whenever I’m working with caregivers is to not neglect yourself. I think it’s very common when caregiving demands are high, which they often are, it is very easy to fall into a routine that does not prioritize our own needs. But it’s absolutely vital to balance caregiving with self-care, for a number of reasons, for it to be sustainable, for it also, you know, caregiver health we know is very related to the patient health. So there’s just really no way around it.

There’s two strategies that I think can be helpful. You know, I think everybody has their own kind of personalized circumstances. And so, you know, getting tailored support might be important. But two strategies that I think can be helpful across the board include, first and foremost, maintaining a consistent and predictable daily schedule as much as is possible. I mentioned earlier that one of the things that has been so difficult about the past year is that our daily routines have been turned upside-down. And so making sure that you have kind of a daily routine, a daily schedule that includes consistent sleep and wake times, that includes consistent mealtimes, that includes, you know, regular exercise activity during the daytime, having that kind of daily routine of healthy behaviors, that really helps provide a sense of stability when we’re faced with so much uncertainty and stress. And it sounds very simple, but I know it’s not for caregivers. And that’s why I say, you do the best that you can, you do this as much as possible. And know that the more that you do this, you know, hopefully the easier things will feel in terms of your stress level being able to be managed.

The next thing, I also really encourage caregivers to use a strategy called mindfulness. Most caregivers are ridiculously busy, but the wonderful thing about mindfulness is that it can be used in the chores and activities that you are already doing. Mindfulness is a technique or a strategy that helps us to savor the moments that are already available to us. So if you can, sit and meditate for 45 minutes and benefit, but you don’t have to set aside that kind of time to be able to benefit from mindfulness. Rather you can find creative ways that actually fit into your routines already, but that help you to deeply connect with the present moment and your experience, using your body, your senses, and even daily chores. So some examples of how some of my patients have used this is this can look like, you know, you take 30-second breath breaks in between activities where you really just close your eyes, focus on taking one or two deep breaths, and you do that throughout the day. It doesn’t have to take a long time for it to have a settling effect on our body and on our mind. Another option, something that I’ve talked with some of my patients about is when you’re doing chores like washing dishes, it can, you can use mindfulness by just really focusing on and feeling the warm water and soap on your hands as you scrub a dish. It sounds kind of silly to do that, but mindfulness is all about how can we connect with either neutral or even, you know, happy moments throughout our day in a different way that helps them to settle our body and to settle our minds.

Another strategy, and this is one of my personal favorites, is you can use this at lunchtime, you know, closing your eyes to take one bite of food and really savor that bite. One of my favorite ways to use this is I love to take a bite of an orange slice and really, you know, taste that orange or other types of fruit. All of these strategies are all meant to help us to connect with our immediate experience in that current moment. A lot of times when we’re really stressed, we are, we are worried about the future, or we might be, you know, regretting or thinking about the past. And so these strategies try to help us bring into this moment and to connect with what is right in front of us. And a lot of times, you know, I’ve talked with many caregivers who say this has been really helpful because they can’t necessarily take a lot of time for themselves, but this helps make some of the things that they’re already doing feel like self-care.

So these kinds of strategies with mindfulness, they’ve been shown to be very practical and helpful for reducing stress. And even though it can be difficult to change our circumstances as a caregiver, we do have a lot of ability in changing our relationship to those circumstances and stressors.

Bill Walsh: Okay, Dr. Farro. Thanks. Savoring the moments. Very good advice.

Let’s get back to our callers. This is your time to pose your questions to Dr. Rekha Rapaka and Dr. Samantha Farro. And a reminder, press *3 at any time on your telephone keypad to be connected. Jean, who is our next caller?

Jean Setzfand: Our next caller is Mercy from California.

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

Mercy: My question is, is it beneficial for a senior who has been hospitalized with COVID and then been discharged from the hospital, should, would it be beneficial for this person to have a vaccine?

Bill Walsh: Dr. Rapaka, do you want to take that one on?

Rekha Rapaka: Sure. So the data that we have right now suggests that getting the vaccine after you’ve recovered from COVID-19 is the way to go. So I would encourage the individual you described to go ahead and get vaccinated, once they’re recovered from their earlier illness; it sounds like they have already recovered. So, yeah. Go for it.

Bill Walsh: So get the vaccine. All right. Very good. All right, Jean, who’s up next?

Jean Setzfand: Our next caller is Lynn from Illinois.

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

Lynn: Thank you, yes, sir. Thank you for taking my call. I have a great-grandbaby that’s 10 months old, and they, that son, grandson, great-grandson has parents that just refuse, you know, they have some kind of conspiracy theory going on, and they just refuse to take the vaccine, but yet from different times they want me to keep the baby. Well, I have kept the baby, but I keep the baby at a distance, and I keep my mask on. So I’m wondering if it’s safe. The baby has never seen me without a mask. You know, I want to interact with this baby and not just keep him like he’s a suspect and a germ and I might, you know, experience a death sentence from having come in contact with him. So, tell me what to do.

Bill Walsh: Hey, Lynn, have you been vaccinated?

Lynn: I have. I have. I took the Pfizer. I took both the shots back in January because I’m part of the University of Chicago. And so they called us first after the front-runners.

Bill Walsh: Okay, Dr. Farro, I wonder if you might weigh in on that. That’s a tricky situation for Lynn.

Samantha Farro: Again, I so appreciate that question, Lynn, because it kind of hearkens back to what I mentioned earlier about, we’re all having to navigate these very sticky situations within our relationships, within our families where different beliefs and different ideas about risk are, result in different, you know, practices. And so, you know, your question about how to navigate that— I don’t think that there is an easy answer. It sounds like you are, you are doing a really good job of on the one hand trying to prioritize your safety when you’re around your grandbaby, but also by wearing a mask and whatnot, but also trying to, you know, figure out how can you have some conversations with the parents of this child to talk about that. I think it’s wonderful that you have been able to receive your vaccine and that there is some level of protection before you, you know, were around other people that, that maybe don’t have theirs. But I would just continue to encourage, try to continue to have open conversations. I think for lots of folks, when we have difficult conversations where we might disagree, really trying to use statements that start with, I feel, or I am concerned about this, and really owning your experience can help, you know, lower the sense of defensiveness that can sometimes come. If it does start to get escalated, taking breaks to take some deep breaths and reiterating that, you know, the intention behind this conversation is, is one of love and one of care. All of those things can sometimes help those conversations to go a little bit better, but there really is no answer when we are at odds with people that we love in the context of this pandemic. So I really appreciate how challenging that is, and I wish you the best of luck, and hopefully some of those tips are helpful.

Bill Walsh: Okay, Jean, let’s take another question.

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

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

William: Hello.

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

William: Yes, yes. I took both the shots. I took Pfizer, and I would like to know if, am I still, can I still get you know, the pandemic? And how long does it take before I have to have another shot?

Bill Walsh: Yeah. William, how long ago did you get your second shot?

William: I took it here about two weeks ago.

Bill Walsh: About two weeks ago. Okay. Dr. Rapaka, do you want to walk William through that? And it sounds like he’s also asking about booster shots as well.

Rekha Rapaka: Yeah, sure. I mean, so you’ve, it sounds like you’ve received the, your first and your second immunization from Pfizer and you’ve had two weeks since that second shot, so you’re in the category where, you know, some of the looser restrictions that I described earlier regarding, you know, wearing masks in, among other, like no need, no need for wearing a mask when you’re among other vaccinated adults, those kinds of things apply. So you can look at all of those details on the CDC website, which I would point out. The other thing I would say is with regards to a booster, I think your question is good. You know, like how long will this last, am I still susceptible to the virus? So as I said earlier, the vaccine is not a hundred percent effective, but it’s very effective so I think that should rest some of your concern. And I think you know, we’re all sort of faced with this concern about how long will this vaccine protect me. And I think that’s something we’re just going to have to keep our eyes and ears open for as time goes on and as the pandemic progresses. But I think for now, you should rest assured that some of these loosening of restrictions that I described earlier apply to you.

Bill Walsh: Okay, thank you. And thanks to both of our experts. I wonder, Dr. Rapaka and Dr. Farro, if you have any closing thoughts or recommendations that our listeners should understand from today. Dr. Rapaka, do you want to, you want to start off?

Rekha Rapaka: Yeah, thank you so much for having me, and I just really enjoyed this opportunity to speak with you all and learn from you. And I just wanted to say, you know, it’s been a really hard year-plus that we’ve been dealing with this and, you know, the keys I think to really get through this is to just continue to stay in touch, continue to keep learning. Use what you’ve learned to help the people around you, people in your family, your community. Advocate for yourself and do, and, you know, as Dr. Farro was suggesting, when you feel ready, do take advantage of some of these looser restrictions that I described, you know, so some of the things that you’ve been holding back, when you feel ready and it’s the right time. But I do feel a lot of optimism for the future, and I just hope that we’ll continue to learn together and continue to fight this virus as best we can together.

Bill Walsh: Okay, thank you, Dr. Rapaka. Dr. Farro, any closing thoughts?

Samantha Farro: Yes. Thank you so much for having me today. I really appreciate our listener questions and can really just acknowledge that it has been a challenging year and continues to be challenging as we navigate some of these, you know, difficult, sticky situations within families and communities. I think the best thing I can do is just remember that you have gotten through many challenges in your life. Remember how resilient you are, and if you’re feeling stuck in a rut, try to remember what helps you to get, to overcome adversity. One of the reasons I love working with older adults, because you’re very resourceful, we’re very experienced in being able to cope with challenges, and sometimes we forget that. And so I just think it’s really important to remember those parts of yourself as well. This last year we have all kind of been confined a little bit, but there are many, many strengths that you bring to the table and, like Dr. Rapaka, I have a lot of optimism for the future, and I believe that we will be able to, you know, have meaningful, purposeful, fulfilling, daily experiences every single day, no matter what our circumstances are.

Bill Walsh: A very optimistic note to go out on. Thank you, Dr. Farro, really appreciate this. Thanks to both of our experts for answering our questions. And thank you, our AARP members, our volunteers and listeners for participating in the discussion. AARP, a nonprofit, nonpartisan member organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we’re providing information and resources to help older adults and those caring for them protect themselves from the virus, protect and prevent its spread to others while taking care of themselves. All of the resources referenced today, including a recording of today’s Q&A event can be found at aarp.org/coronavirus starting tomorrow, May 7th. Again, that web address is aarp.org/coronavirus. Go there if your question was not addressed and you’ll find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please tune in May 20th at 1 p.m. for another live event answering your questions about the coronavirus, as well as a special 7 p.m. event on misinformation and the coronavirus. 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. Before we begin, if you’d like to hear this telephone town hall in Spanish, press *0 on your telephone keypad now. 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. The good news is that vaccine access is improving across the country, with all people 16 and older now eligible for the vaccine in every state. While over 82 percent of adults 65 and older have received at least one dose, some younger people are resistant to getting the vaccine. Some people are struggling to get doses, and new variants of COVID-19 continue to spread. What’s more after a year in the shadow of the pandemic, many Americans are feeling emotionally wrung out. In fact, new AARP research suggests that large numbers of the 50-plus population feel depressed, anxious, lonely, and as much as they want to return to life as normal, they also have concerns about the future as we emerge from the pandemic.

[00:01:27] Today, we’ll hear from an impressive panel of experts about these issues and more. 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 a question about the coronavirus pandemic, press *3 on your telephone keypad to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. If you’d like to listen in Spanish, press *0 on your telephone keypad now, and if you’re joining on Facebook or YouTube, you can put your question in the comments section.

[00:02:09] Hello, if you’re just joining, I’m Bill Walsh with AARP, and I want to welcome you to this important discussion on the global coronavirus pandemic. We’re talking with leading experts today 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. We have some outstanding guests joining us today, including health experts from the Division of Infectious Diseases at the University of Maryland, Baltimore, and the University of Colorado Anschutz Medical Campus Multidisciplinary Center on Aging. We’ll also be joined by my AARP colleague, Jean Setzfand, who will help facilitate your calls today. This event is being recorded and you can access the recording at aarp.org/coronavirus 24 hours after we wrap up. 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.

[00:03:16] Now I’d like to welcome our guests. Rekha Rapaka, M.D., Ph.D. is an assistant professor of medicine at the Center for Vaccine Development and Global Health at the University of Maryland Medical Center. Welcome back to the program, Dr. Rapaka.

[00:03:33]Rehka Rapaka:  Thank you so much for having me.

[00:03:35]Bill Walsh:  All right. And Samantha Farro, Ph.D., is a licensed psychologist at the University of Colorado Anschutz Medical Campus Multidisciplinary Center on Aging. Welcome, Dr. Farro.

[00:03:48]Samantha Farro:  It’s a pleasure to be here.

[00:03:50]Bill Walsh:  All right, it’s a pleasure to have you. Let’s, let’s get started with our discussion. Just a reminder, to ask your question, please press *3 on your telephone keypad or drop it in the comments on Facebook or YouTube.

[00:04:01] Dr. Rapaka, let’s start with you. The CDC recently released new guidance on mask wearing and traveling for vaccinated people. What should people listening today know about the new guidance?

[00:04:16]Rekha Rapaka:  Yes, it’s important for everyone listening to know there have been updates to the guidance on mask wearing and traveling for individuals that have been vaccinated. So this specifically applies to people who’ve had at least two weeks after their second Moderna or Pfizer vaccine, or two weeks after the single dose Johnson & Johnson vaccine. So, the new, the new guidance is that individuals that have been meeting these criteria and have been vaccinated can meet indoors with others who are also vaccinated, other adults, without a mask. Secondly, as someone in this group of being vaccinated, you can also visit a single, up to one household of individuals that may not have been vaccinated, unless there is a member of that family with increased risk of severe COVID-19. And I can talk more about that if there are questions. As well, outdoors, it’s considered now, if you’ve been vaccinated, generally to be okay to not need to wear a mask, unless you’re in a crowded situation.

[00:05:27] And then there are also some updates related to travel specifically, you know, in the past there was a period of quarantine when traveling between states and, you know, a need for testing. That’s no longer required. It is recommended if you’re doing international travel to be tested afterwards when you return home and, you know, I think there is some examples that I can give you just to kind of clarify what the guidance looks like. So, for example, dining outdoors might be something you could consider as a vaccinated person, small outdoor gatherings; but, you know, in the setting of other situations, like, for example, anytime you’re in public transport you should be wearing a mask even though you’re vaccinated, and in settings like going grocery shopping, going to church, going to the gym, things like that, you should continue to wear a mask. It’s often a point of using your best judgment and kind of taking a look at what’s available, but I would say overall, there’s been some restrictions that have been lifted for those that have been vaccinated. And I think it’s a good sign and a good kind of reward for getting vaccinated, so to speak, getting back to some of these things.

[00:06:42]Bill Walsh:  Right. And very quickly, I mean, some people I think are wondering why they have to wear a mask at all if they’ve been vaccinated and they’re past that 14-day period. Can you just very quickly explain what the purpose of wearing a mask is if you’ve been vaccinated.

[00:06:57]Rekha Rapaka:  Yeah, so the purpose is that, you know, we right now don’t know everything about the benefits of the vaccine. And we also, we know there’s a strong benefit, right? The efficacy is excellent but we don’t know— you know there’s still a risk of catching the infection. So you still have that risk. It’s not a hundred percent, right, this vaccine, these vaccines. So it’s important from that perspective. And I think also, you know, there’s a situation where you could also be a carrier of the virus without having any symptoms, and we want to prevent risk of transmission to others as well. So those are part of the calculations. But really crowded settings, situations where you’re near people coughing, talking, laughing, really close type settings are still risky. And so those are situations where at this point, we’re not ready to say, you know, take, stop wearing the mask. We still need that mask going. So.

[00:07:55]Bill Walsh:  Right. Dr. Rapaka, I mean we’re seeing, the good news is we’re seeing cases generally on a downward trend nationally. But there’s still a few states, and Michigan’s an example, where there’s a surge of new infections, even as people are getting vaccinated. Do we know what’s going on there? What’s driving this?

[00:08:14]Rekha Rapaka:  Yeah. So this is an interesting, really interesting question. I don’t think we know everything about why, but there’s, there’s some factors I think, to take into account. So Michigan has been surging for the past month with numbers of cases, and it’s just starting to decline. Minnesota and Illinois are also kind of states in this category, you know, where it, rates of like 15 percent of people that are getting tested for COVID are actually COVID positive, which is very high. And I think the factors that go into this are: One, you know the vaccination rate does impact things. Two, the kinds of strains that are circulating are important to take into consideration. And then I think thirdly and probably the most impactful is, you know, the intensity of restrictions and when they were lifted. So, for example, states like Texas and Florida, they’ve had more infections early on in the pandemic. And so those people, too, have some level of immunity; once you’re infected, you have some level of immunity that persists for at least six months. And so they’ve had lower restrictions and that’s kind of continued, and they have about the same vaccination rate as Michigan. So I would contrast Michigan as being a situation where they had a lot more of the quarantine in the beginning, and now that’s being, those factors are being more lifted and there’s been less restrictions. And I think that’s coming in the context of having, you know, the new variants. So I think that combination is what’s the challenge. And as we’re seeing, the numbers are declining now, but I think it’s a testament to probably the vaccine being approached more and more people just having immunity from either having been exposed or being vaccinated.

[00:09:57]Bill Walsh:  Right, okay, well thanks for that. Let’s turn to you, Dr. Farro, on the topic of mental well-being. I mentioned earlier that AARP has a new poll that we just conducted that showed that 70 percent of older adults feel sad, depressed, anxious, lonely, and they have concerns about the future as a result of the pandemic. So while the pandemic has had a well-documented and devastating toll on physical health, can you talk about some of the impacts on mental well-being and why so many people are feeling this way? I’d also like to hear if there are long-term consequences to this.

[00:10:33]Samantha Farro:  Absolutely. I really appreciate your attention to this topic because I think there’s been so much focus on, you know, trying to stay safe and trying to stay physically healthy during this pandemic. But we have definitely seen emotional health impacts from the upheaval of the past year. You know, similar to what you’ve said, I would say most commonly I’m hearing about how lonely people have felt having to stay at home or distance, you know, physically distance and isolate from friends and family. I think also really common is that there has been a lot of boredom for folks that are staying home and, you know, they’ve lost some of the normal activities and interests that they used to do. They’re not, you know, at a certain point you’ve read lots of books, you’ve done lots of puzzles, you’ve watched lots of Netflix, and you kind of are trying to figure out what to do. And so boredom has been by far one of the most common things I’ve heard.

[00:11:36] And then something else that I don’t think a lot of folks have necessarily talked about, but that has definitely been true, is that the pandemic has really turned our daily routines upside-down. And so something that I’m hearing a lot of folks are doing is that they’re noticing a lot of sleep disruption. So maybe they’re more bored during the daytime. So they’re napping more, then they’re having trouble sleeping at night. And so it just kind of becomes this cumulative effect where we know that sleep disruptions relate to our mental well-being and our emotional health. And so these are some of the things that I think have been, throughout the entire pandemic, very common. Now, for some of these people who have experienced some of those, those things, those difficulties have led to more serious concerns. So, things like increased alcohol and substance use; as you mentioned, anxiety and depression was very common as we faced so much uncertainty and so much was unknown. That was a very common thing that folks were feeling. And then we’re also seeing a lot more as people are staying home and maybe you and your spouse or you and your family are confined to being at home, there’s been a lot more tension and conflict within relationships. So I definitely think the pandemic has been very impactful on mental wellness.

[00:13:03] You asked a question about, you know, what are the long-term consequences of this. One of the things that’s really wonderful about older adults, and as we age, we get lots of experience and we have more kind of resiliency. We have more, you know, we faced many challenges in our lifetime, and we’ve overcome that. And so I think something that is actually a real wonderful thing about — you know, I personally work with older adults, and I’m in a geriatrics clinic — one of the things that’s really wonderful is how resilient we are. Having had lots of life experience, we may have already developed coping strategies. So certainly there can be long-term impacts when mental wellness and emotional health are impacted it in the way that they have been for the past year, but I encourage folks to also connect with and remember what are the things that they’ve done previously when they’ve faced challenges that have been helpful to them? I think that that is one way that we can really curtail some of those long-term effects. And so even though the pandemic has definitely been impactful on mental wellness, we all have strengths and resiliency and coping strategies that we can kind of remember and try to rely on.

[00:14:28]Bill Walsh:  Well, let me dig into that a little bit and look forward a little bit. You know, we’ve been living under this pandemic for over a year and, you know, over 60 percent of older adults are meeting and socializing less with family and friends, which of course only adds to anxiety and depression and sadness. You know, while many people are anxious to get back to normal activities after receiving their vaccine doses, others are really anxious about venturing back into this new normal. I wonder what guidance you’d have for people who are grappling with those conflicted emotions.

[00:15:04]Samantha Farro:  Absolutely. This is so common that, you know, on the one hand, people are really wanting to go back out into the world and reconnect with loved ones and friends and neighbors that maybe they haven’t seen in many months, but the act of actually doing that can be quite uncomfortable because it is so different from the past 12-plus months. And so I think first and foremost, it’s important for all of us to know that there is going to be a relearning process to making those changes. You know, some of the things that I recommend that can help us as we transition back to some semblance of normalcy is to make a plan that allows you to gradually begin to experience that kind of novelty with new places and being around, you know, people again. This is not something that we’ve done, you know, for almost over a year. And so I don’t recommend that you go from, you know, staying safe at home and not seeing people to going to a super-crowded event. Even if you are vaccinated, that can be a real intense experience for a lot of people. But rather, try to take it slow. You know, how can you do this and be really gentle with yourself? Allow yourself time to get used to being in the world again, and know that the first time you do anything, it’s going to be a little bit uncomfortable and that’s normal. So, taking it slow, giving yourself room to take breaks, even just pausing to take a couple of deep breaths as you get used to being back out. And certainly, you know, that might be enough for a lot of people, but if these anxieties persist or if they become so severe that you feel really stuck and maybe it’s just, you know, terrifying to leave your home, or it’s terrifying the thought of, you know, going back out, then you might want to try to seek out professional help from a therapist. You may not need that long-term, but it can definitely be helpful during the transition of getting back into the world where you have a professional who can give you very specific strategies on how to manage those kinds of more severe symptoms.

[00:17:24]Bill Walsh:  Yeah. All right. Thanks for that, Dr. Farro. We’re going to be talking more about mental well-being later on in the program. As a reminder to our listeners, to ask your question, please press *3 on your telephone keypad. And we’re going to get to those live questions shortly, but before we do, I wanted to bring in Nancy LeaMond. Nancy is the executive vice president and chief advocacy and engagement officer here at AARP. Welcome, Nancy.

[00:17:50]Nancy LeaMond:  Hey, Bill. How are you?

[00:17:51]Bill Walsh:  Very good. There’s been a lot of action on COVID-19 on Capitol Hill over the last few months. What are the big things that our listeners should know about?

[00:18:01]Nancy LeaMond:  Well, as you say, it’s been a very busy stretch, with AARP really pushing Congress to help 50-plus Americans protect themselves and their families and navigate financially through this pandemic. For example, in March, Congress passed, and President Biden has signed, the American Rescue Plan Act, which included a number of AARP priorities: delivering $1,400 payments to millions of older adults, including Social Security beneficiaries; expanding paid-leave tax credits and the child tax credit; helping more people receive care in their homes and communities; making health insurance more affordable through expanded subsidies under the Affordable Care Act; extending unemployment benefits for people who were pushed out of work during the pandemic; expanding the COVID vaccination efforts, as both of our guests have talked about; and improving infection control in nursing homes.

[00:19:03] Now, in addition to this work in the Congress, AARP is also working with governors and state legislators across the country to allocate funding in ways that address the needs of older Americans. For example, AARP West Virginia is urging the governor to prioritize vaccinating homebound residents, and AARP Massachusetts successfully advocated for legislation that provides emergency paid leave for those who need to take time off to get vaccinated, or to take care of someone who has COVID, or to get themselves taken care of if they get COVID themselves. So these are just a couple of the examples of the many things we’re working on across the country.

[00:19:48]Bill Walsh:  Right. Well, thanks for that. What should we expect moving forward?

[00:19:52]Nancy LeaMond:  Well, looking ahead, Congress will soon begin working on an infrastructure plan and AARP will continue to fight for the financial and health security of those over 50. We were very heartened to hear President Biden in his recent remarks to Congress address many of the concerns Americans over 50 feel: continuing to increase access to vaccines, especially for folks who are hard to reach or homebound; improving long-term care; providing more support for the 48 million people who are voluntarily caring for loved ones; lowering the skyrocketing price of prescription drugs that continue to cripple family budgets; and improving access to high-speed internet, safe transportation and better housing options across the country. COVID has certainly shined a light on all of these challenges older Americans face. And if it’s taught us anything, it’s that America’s care infrastructure and physical infrastructure are failing, and there is a lot of work that has to be done. It’s a busy time on Capitol Hill and AARP staff and volunteers, and maybe activists like those of you on the line, will continue to work hard to make sure the needs of older adults across this country are a priority, and that your voices are heard, and that we at AARP advocate on issues that matter to you the most.

[00:21:20]Bill Walsh:  Okay. And finally, as the vaccine distribution process continues, where is AARP focusing its efforts?

[00:21:29]Nancy LeaMond:  Well, since the beginning of this pandemic, AARP has been fighting for you, calling for big investments in research around treatments and vaccines for this virus. And I’m glad to say those efforts are paying off. Once the vaccines were available, we knew that this was the issue that mattered most to our constituency. And that’s why we worked with the Trump administration and then with the Biden administration and in every single state to make older people a priority. That’s also why we’ve published online guides for every state explaining how to get the vaccine where you live. And you can find those at aarp.org/vaccineinfo. Based on our work, governments prioritize long-term care facilities and older Americans. Cases in nursing homes have, thankfully, finally dropped drastically, although we still have serious concerns in some places. And more than 80 percent of people over 65 have now received at least one dose of a COVID-19 vaccine. This is a monumental accomplishment and means so much to people who can now safely visit with their families and their grandchildren again. There’s a lot of work to do to ensure that everyone who wants a vaccine can get it, and people may still have questions, and we need to help them get them answered in sessions like today. We’re going to be focused on ensuring that older adults, particularly older adults of color and those who are homebound, have access. And as the rollout continues, we’ll keep the pressure on elected leaders and continue to provide critical information to our members.

[00:23:12] As I mentioned before, AARP State Offices are hard at work reaching out to older adults across the country. For example, AARP California is reaching out to Latinos about COVID-19 and vaccine information through a targeted Spanish-language Facebook Live series; AARP volunteers in states like Connecticut, Alaska, Indiana and many more are making phone calls to older adults to provide them with the information about vaccines, and in some cases, we’re actually able to help people get registered. And AARP Pennsylvania is a lead partner working with Black Doctors Consortium on a multistate event to focus on vaccine education and hesitancy among Black Americans. We have lots else going on; I won’t go into it now, but to stay up to date on all of these efforts, please take a minute and go to our website, www.aarp.org/coronavirus. And with that, back to you, Bill, and back to our terrific panel.

[00:24:17]Bill Walsh:  All right, thanks for that update, Nancy. I very much appreciate it. And we’re going to get to our listener questions in just a moment. Before we do, I wanted to address an important issue.

[00:24:27] We know that many of you are having challenges registering for vaccines in your states or communities because many places require signups through online forms and if you don’t have access to a computer, this can be a real challenge. AARP wants to help. We’ve established an AARP Vaccine Finder Support Team to try to assist in these cases. So, if you’re listening today and you don’t have a computer and can’t register for a vaccine because of that, please press 1 to be added to a list to receive a phone call from AARP staff to assist you. Again, if you’re listening today, and you do not have access to a computer or the internet, and you can’t register for a vaccine because of that, please press 1 to be added to a list to receive a phone call and we will try to help you out. When you do, when you hit 1, you’ll listen to a brief message and then be returned to this call.

[00:25:27] It’s now time to address your questions about the coronavirus with Dr. Rekha Rapaka and Dr. Samantha Farro. Please press *3 at any time on your telephone keypad to be connected with an AARP staff member to share your question. Now I’d like to bring in my AARP colleague, Jean Setzfand, to help facilitate your calls. Welcome, Jean.

[00:25:49]Jean Setzfand:  Thanks so much, Bill. Delighted to be here for this important conversation.

[00:25:52]Bill Walsh:  All right, who is our first caller today?

[00:25:55]Jean Setzfand:  Our first caller is Karen from Pennsylvania.

[00:26:00]Bill Walsh:  Hey, Karen, welcome to the program. Go ahead with your question.

[00:26:03]Karen:  Okay. Thank you for taking my call. I had my first dose of the Pfizer vaccine. My question is how much leeway do you have to get the second dose? Because I heard that you shouldn’t wait too long to get the second dose of the vaccine.

[00:26:22]Bill Walsh:  Okay, let’s ask Dr. Rapaka about that. Dr. Rapaka, can you answer Karen’s question?

[00:26:26]Rekha Rapaka:  Yes, Karen, that’s a really good question. So, you know the way the vaccine was tested was in this situation of a clinical trial. And we typically, you know, in that context, there was a three-week interval between the first and the second dose. That’s sort of the ideal situation, but if it can’t be, you know, if you can’t get the booster vaccine at three weeks, you know, a little bit extra time is okay. And I think not straying too far from that goal is probably for the best, because we have the most information on how effective the vaccine is in that context. But some time, you know, a few weeks or even a little longer should be okay.

[00:27:13]Bill Walsh:  Okay. And, and that goes for the other vaccines as well.

[00:27:17]Rekha Rapaka:  Well, so, for the Moderna, which has a booster, that booster’s at four weeks, and that should be basically, again, try to be as close as you can to that point, but if you need to go later, that’s okay.

[00:27:30]Bill Walsh:  We’re hearing that a fair number of people aren’t getting their second shots. I saw a data point the other day that 8 percent had not done that for various reasons. How much protection do you have with a single dose of Moderna or Pfizer?

[00:27:46]Rekha Rapaka:  Yeah, that’s a really great question. So actually, the single dose of Moderna and Pfizer from the data that we have as far as protection in that short period of time is pretty, pretty darn good. It’s around, actually almost that same range of 90 percent. I will say that though with a caveat that the immune response is a complicated thing, and the booster, the effect of giving that second booster really strengthens the immune response, not just from the perspective of how good it is, but also how long it might last. And right now we have very little data about duration. So I would advise people to really follow that protocol of the two doses if they can because that’s where we have the most information. And when we, if we end up in a situation where we might need to give boosters and things that, you know, being kind of on that schedule will help. So since, that’s how I’d answer that. With the information we have now, stick to the, if you can, stick to the published time course.

[00:28:47]Bill Walsh:  Okay, very good. Jean, who is our next caller?

[00:28:51]Jean Setzfand:  Our next caller is Betty from Pennsylvania.

[00:28:54]Bill Walsh:  Hey, Betty. Welcome to the show. Go ahead with your question.

[00:28:59]Betty:  Yes, a little while ago, I don’t remember who it was, they mentioned that if you still have a problem getting out, if you have both your shots, to see a therapist, how do, how do I get to see a therapist when none of them will take my Medicare insurance. The psychiatrist won’t take them, and neither will the psychotherapist. They want cash only.

[00:29:22]Bill Walsh:  Dr. Farro, yeah. All right. Well, let’s ask Dr. Farro about what she recommends. Dr. Farro?

[00:29:33]Samantha Farro:  Thank you, Betty. I really appreciate this question because I think that is a huge issue, and it is definitely a barrier to access when we don’t have enough people paneled on our Medicare insurance plans to be able to meet the demand. And I think that’s been a tremendous challenge in the past year. My recommendation— there’s a couple of ways that you can try to find a therapist or a psychiatrist to work with. So the first thought that I have is, one, contact your insurance, whether it’s Medicare or an Advantage plan or whatever your insurance situation is, contacting them, they are required to be able to provide you with a list of providers. And if you go through their paneled, you know, providers on the insurance list, and you’re not able to receive care, they are required to find you a provider. So sometimes insurances can make exceptions and things like that depending on what your insurance coverage is. So that’s one strategy is to reach out to your insurance and to talk with them.

[00:30:49] I also would recommend if you have a primary care doctor, which I recommend everybody do have that, because I do work in primary care and I think that it’s a tremendously important, you know, service. If you do have a primary care physician, then talk with them about who they might recommend. A lot of times primary care providers may know of resources that you may not. For example, I work in geriatric primary care at the University of Colorado Hospital, and I am, I serve as an integrated behavioral health provider in our clinic. And so I am kind of a liaison. I act as a consultant to our patients to one, either help them try to resolve if they’re having behavioral health concerns, or two, if it’s something that’s more severe, part of my role is to help connect them to providers in the community for long-term follow-up. And so I think another resource that might be of help is to go through your primary care provider. The last resource I just want to give you is the Substance Abuse Mental Health Services Administration is a federal government agency. They actually have a national hotline that helps folks to try to find providers in their immediate area. And so they have a hotline phone number that is 1-800-662-4357. And I’ll repeat that again in just a minute, but this phone number, this hotline is really meant to try to help folks who are struggling with mental health to be able to connect to providers in their local community. Again, Betty, I think your question is really important, and there is, you know, it represents an issue that I think has been pretty well documented, that Medicare providers are few and far between in some areas of the country. But some of these are some of the resources that might be helpful. And again, that SAMHSA National Hotline is 1-800-662-4357. So hopefully that helps.

[00:33:12]Bill Walsh:  Thank you very much, Dr. Farro, very helpful. Jean, who is our next caller?

[00:33:17]Jean Setzfand:  We have several questions coming in from YouTube, and here’s a question from John. John’s asking, “I’d like to know about what I heard from one of the objectors to the vaccine. They said it could cause an immune system to attack the body. Something called a ‘cycloklin storm.’ Is that true?”

[00:33:36]Bill Walsh:  Hmm, Dr. Rapaka, can you weigh in on that?

[00:33:39]Rekha Rapaka:  I’m not, yeah, so I’m not totally sure about the phrase that was use, I believe he said he might’ve been referring to something called cytokine storm. So we have not observed cytokine storm, which is a very intense immune response basically, we’ve not observed that with any of the COVID vaccines that have been tested. It’s not an adverse event that we’ve seen. You know, I think perhaps this question, though, drives at the fear of maybe what kind of side effects one might experience with the vaccine and, typically, for most people they are, for the vaccines, the three that are approved and in use in the United States, they’re mild and self-limited. So hopefully that gives some reassurance to John about that.

[00:34:27]Bill Walsh:  Okay. Jean, let’s take another question.

[00:34:31]Jean Setzfand:  Next caller is Linda from Colorado.

[00:34:34]Bill Walsh:  Hey, Linda, welcome to the program. Go ahead with your question.

[00:34:41] Hello. Go ahead with your question.

[00:34:45]Linda:  Hello?

[00:34:46]Bill Walsh:  Hi, is this Linda? Go ahead with your question.

[00:34:49]Linda:  Oh yes. I belong to a faith group that it has been wonderful to be part of during this last year. Only thing with this faith group is they’re wanting to get together in person. And there are a couple of the couples that are part of this group that refuse to get vaccinated. I feel that that’s going to harm me. I mean, it’s not good for us. And then these people that are a part of this faith group are out in amongst the public, in family members, young people, on a regular basis. So I feel that they’re amongst the virus, and then when we get together, what’s my chance of being sick, and what, how can I handle getting together in person with these people and stay safe?

[00:35:56]Bill Walsh:  All right, Linda, thanks so much for that question. Dr. Farro, why don’t we start with you? Maybe both our experts could weigh in on this. Dr. Farro?

[00:36:03]Samantha Farro:  Sure, so you know I think, and one of the things that has been really challenging in the past year is that as we are all trying to stay safe in the midst of this pandemic, it has brought up different levels of how people are protecting themselves. So wearing masks all the time versus staying home all the time versus some people are socially distancing, others aren’t. And that variability, I think, can be very distressing for people when they’re trying to navigate that within their interpersonal relationships. So it sounds like, Linda, you have this faith group that has been real wonderful support to you over the past year, which is wonderful, but they’re wanting to get together in person and some of the members of that group are not necessarily taking the level of precautions that you are. And this is part of, you know, as I mentioned a little bit earlier, this is part of where we are seeing some increased tension and conflict in interpersonal relationships, with friends, with family, with community members. And there’s no real, you know, perfect answer for that. The biggest thing I can recommend is that you try to be very honest and open in communicating your concerns. I think communication about your experience of needing to feel safe, to be able to gather in this way, is probably not something that’s only happening for you; others may have these same concerns. And the more that we can be able to, you know, communicate and talk openly about that, the more that we can kind of try to navigate some of these more sticky, you know, relationship issues.

[00:37:58] That said, I think it’s also important at the end of the day, first and foremost, we want to make sure that you stay safe. And so if those conversations don’t lead to, you know, don’t result in changes in either policy or changes in how folks are willing to accommodate what your needs are, then you would have to make a choice of if getting together in person is something that you’re willing to do in terms of the risk and the benefits of that. And again, I think these conversations have been very difficult throughout the year. It’s, we’re trying to, you know, discuss our sense of safety, we’re trying to discuss our sense of consent to be able to participate in activities where other people’s decisions and actions, you know, can very intimately and personally impact us. And so all of those are challenging, but I encourage folks to be honest, and to be open about their needs, not necessarily in a judgmental way, but just about what, how you’re feeling and what your needs are for safety.

[00:39:07]Bill Walsh:  Okay, Dr. Rapaka, did you want to add anything to that?

[00:39:11]Rekha Rapaka:  I appreciate everything Dr. Farro said, and I also just think, too, I think it’s okay to, you know, the CDC guidelines are there to guide, truly. I mean, so we should use them and, I mean, so you can always reference that when you’re talking to your group, you know, because a lot of our decisions are not really, for these kinds of things, can be guided by data a little bit, you know, and you can talk about, well, right now it doesn’t necessarily seem the safest to have indoor meetings with several people, right, and in this kind of environment without masks, for example. That obviously wouldn’t go. But I think, you know, navigating it with the data, letting people know that there’s some guidelines that exist that can help us make these decisions better together, and maybe that means you all meet outside, you know, for a while and as the time goes on. So you, you can sort of use the guidelines to help navigate that kind of challenging conversation.

[00:40:08]Bill Walsh:  Okay, thank you both for that. And thanks for all the questions so far. We’re going to take more questions shortly. As a reminder, to ask your question, please press *3 on your telephone.

[00:40:19] Let’s get back to our experts. Dr. Rapaka, you know a few weeks ago the distribution of the Johnson & Johnson vaccine was paused and then it was restarted. Some people may be concerned about the safety of this vaccine. What should everyone know about the pause and the restarting of the distribution?

[00:40:38]Rekha Rapaka:  Sure. So the Johnson & Johnson vaccine is kind of the more recently approved vaccine, and it is very, you know, very beneficial in preventing hospitalization and deaths. And it, actually about 8 million doses have been given in the U.S. So there was a pause in the middle of April, and it halted use of the vaccine for about a week and a half. And the reason for that was there was a really, you know, some events related to rare, basically blood clots that had been observed, very rare events. So basically of the 8 million doses given, there were observed to be about, about seven cases. And, you know, the population was, where this effect was being seen, this rare effect was being seen, was mainly in younger women, so women under the age of 50. In older women and in men, that rate is far less, closer to less than 1 case per million. So basically the reason this pause occurred was because they wanted the scientists and physicians to really look at the data and make a very careful judgment and decision about whether the vaccine’s benefits outweighed the risk, and it very clearly did. And so a lot of, a lot of people I know now probably have some hesitation about this vaccine, but I want people to know that, you know, the risk of clots from, for example, COVID-19 disease itself is in the range of 160,000 per 1 million. So you can, there’s a high risk of clots, I don’t know if many people know this, from just getting COVID-19 disease. You know, the risk of clots here is about 1 case per million. And to give you a sense of other behaviors and medications as far as risks of clots, for example: So oral contraceptive pills are in the range of 500 to 1,000 per 1 million, and smoking itself is in the range of 1,700 per million. So that risk is just considered to be so significantly low compared to the risk of getting COVID-19 for the vaccine. And so that’s why it’s been approved. And there are other just major benefits of this vaccine, including, you know, really one dose and you’re done. And we want to get to the point where, you know, this virus is just not spreading very much in this country, and to get there, we have to get the vaccines on board. So hopefully this answers that question and gives people more information about what the pause was about and now resuming use.

[00:43:15]Bill Walsh:  Well, thanks for those data points. That’s very helpful to put it in some perspective. You know, Dr. Rapaka, we continue to hear about the possibility of needing booster shots to protect from the COVID-19 variants. What do we know about that?

[00:43:30]Rekha Rapaka:  Yeah, so I think this is an important discussion. So boosters may be needed for the vaccines that we have. The first point is we don’t know how long the immunity from the vaccine lasts, and that’s basically because we’ve only been using these vaccines since, you know, around December, January. So we don’t know how long it lasts. We have some studies from the trial, so the trial data, which has a little bit longer duration of information. So there’s that, I think, that we have to contend with. And I think also this question about variants. So, as many of you have heard, there are different kinds of strains of the virus. So the virus can slowly make changes to itself as it propagates, as it spreads through the populations and in different countries. And so, you know, there’s a chance that the vaccines we have may not be as efficacious as a newly emerged variant, against a variant that’s emerged. And that’s, you know, something we’re going to just have to be very closely watching. So right now, just to give you an educated guess, you know, I think the vaccine durability, meaning how long the effect lasts, I’m pretty sure, given the context of other vaccines, at least a year of immunity is what I hope. But we may need, you know, new boosters or new vaccines as we go along. And I will also just say that because of that concern, there are studies going on right now to test potential boosters that they have efficacy against say the South African strain that is there and could spread and other strains.

[00:45:11]Bill Walsh:  Okay. All right. Well more to come on boosters. Thank you for that, Dr. Rapaka. Dr. Farro, back to you. Many family caregivers may be stressed and burned out and overwhelmed in a normal year. But of course this year has only amplified all of those feelings. If someone’s caring for a loved one and feeling the strain, what can they do?

[00:45:35]Samantha Farro:  Yes, there is absolutely no doubt that this past year has been a tremendous challenge for caregivers. You know with the pandemic restrictions, caregivers have had oftentimes more responsibility with fewer support resources, such as, you know, respite care and whatnot. My main recommendation whenever I’m working with caregivers is to not neglect yourself. I think it’s very common when caregiving demands are high, which they often are, it is very easy to fall into a routine that does not prioritize our own needs. But it’s absolutely vital to balance caregiving with self-care, for a number of reasons, for it to be sustainable, for it also, you know, caregiver health we know is very related to the patient health. So there’s just really no way around it.

[00:46:33] There’s two strategies that I think can be helpful. You know, I think everybody has their own kind of personalized circumstances. And so, you know, getting tailored support might be important. But two strategies that I think can be helpful across the board include, first and foremost, maintaining a consistent and predictable daily schedule as much as is possible. I mentioned earlier that one of the things that has been so difficult about the past year is that our daily routines have been turned upside-down. And so making sure that you have kind of a daily routine, a daily schedule that includes consistent sleep and wake times, that includes consistent mealtimes, that includes, you know, regular exercise activity during the daytime, having that kind of daily routine of healthy behaviors, that really helps provide a sense of stability when we’re faced with so much uncertainty and stress. And it sounds very simple, but I know it’s not for caregivers. And that’s why I say, you do the best that you can, you do this as much as possible. And know that the more that you do this, you know, hopefully the easier things will feel in terms of your stress level being able to be managed.

[00:47:52] The next thing, I also really encourage caregivers to use a strategy called mindfulness. Most caregivers are ridiculously busy, but the wonderful thing about mindfulness is that it can be used in the chores and activities that you are already doing. Mindfulness is a technique or a strategy that helps us to savor the moments that are already available to us. So if you can, sit and meditate for 45 minutes and benefit, but you don’t have to set aside that kind of time to be able to benefit from mindfulness. Rather you can find creative ways that actually fit into your routines already, but that help you to deeply connect with the present moment and your experience, using your body, your senses, and even daily chores. So some examples of how some of my patients have used this is this can look like, you know, you take 30-second breath breaks in between activities where you really just close your eyes, focus on taking one or two deep breaths, and you do that throughout the day. It doesn’t have to take a long time for it to have a settling effect on our body and on our mind. Another option, something that I’ve talked with some of my patients about is when you’re doing chores like washing dishes, it can, you can use mindfulness by just really focusing on and feeling the warm water and soap on your hands as you scrub a dish. It sounds kind of silly to do that, but mindfulness is all about how can we connect with either neutral or even, you know, happy moments throughout our day in a different way that helps them to settle our body and to settle our minds.

[00:49:44] Another strategy, and this is one of my personal favorites, is you can use this at lunchtime, you know, closing your eyes to take one bite of food and really savor that bite. One of my favorite ways to use this is I love to take a bite of an orange slice and really, you know, taste that orange or other types of fruit. All of these strategies are all meant to help us to connect with our immediate experience in that current moment. A lot of times when we’re really stressed, we are, we are worried about the future, or we might be, you know, regretting or thinking about the past. And so these strategies try to help us bring into this moment and to connect with what is right in front of us. And a lot of times, you know, I’ve talked with many caregivers who say this has been really helpful because they can’t necessarily take a lot of time for themselves, but this helps make some of the things that they’re already doing feel like self-care.

[00:50:43] So these kinds of strategies with mindfulness, they’ve been shown to be very practical and helpful for reducing stress. And even though it can be difficult to change our circumstances as a caregiver, we do have a lot of ability in changing our relationship to those circumstances and stressors.

[00:51:03]Bill Walsh:  Okay, Dr. Farro. Thanks. Savoring the moments. Very good advice.

[00:51:08] Let’s get back to our callers. This is your time to pose your questions to Dr. Rekha Rapaka and Dr. Samantha Farro. And a reminder, press *3 at any time on your telephone keypad to be connected. Jean, who is our next caller?

[00:51:27]Jean Setzfand:  Our next caller is Mercy from California.

[00:51:31]Bill Walsh:  Welcome to the program. Go ahead with your question.

[00:51:35]Mercy:  My question is, is it beneficial for a senior who has been hospitalized with COVID and then been discharged from the hospital, should, would it be beneficial for this person to have a vaccine?

[00:51:55]Bill Walsh:  Dr. Rapaka, do you want to take that one on?

[00:51:58]Rekha Rapaka:  Sure. So the data that we have right now suggests that getting the vaccine after you’ve recovered from COVID-19 is the way to go. So I would encourage the individual you described to go ahead and get vaccinated, once they’re recovered from their earlier illness; it sounds like they have already recovered. So, yeah. Go for it.

[00:52:21]Bill Walsh:  So get the vaccine. All right. Very good. All right, Jean, who’s up next?

[00:52:27]Jean Setzfand:  Our next caller is Lynn from Illinois.

[00:52:30]Bill Walsh:  Hey, Lynn, welcome to the program. Go ahead with your question.

[00:52:34]Lynn:  Thank you, yes, sir. Thank you for taking my call. I have a great-grandbaby that’s 10 months old, and they, that son, grandson, great-grandson has parents that just refuse, you know, they have some kind of conspiracy theory going on, and they just refuse to take the vaccine, but yet from different times they want me to keep the baby. Well, I have kept the baby, but I keep the baby at a distance, and I keep my mask on. So I’m wondering if it’s safe. The baby has never seen me without a mask. You know, I want to interact with this baby and not just keep him like he’s a suspect and a germ and I might, you know, experience a death sentence from having come in contact with him. So, tell me what to do.

[00:53:17]Bill Walsh:  Hey, Lynn, have you been vaccinated?

[00:53:19]Lynn:  I have. I have. I took the Pfizer. I took both the shots back in January because I’m part of the University of Chicago. And so they called us first after the front-runners.

[00:53:30]Bill Walsh:  Okay, Dr. Farro, I wonder if you might weigh in on that. That’s a tricky situation for Lynn.

[00:53:37]Samantha Farro:  Again, I so appreciate that question, Lynn, because it kind of hearkens back to what I mentioned earlier about, we’re all having to navigate these very sticky situations within our relationships, within our families where different beliefs and different ideas about risk are, result in different, you know, practices. And so, you know, your question about how to navigate that— I don’t think that there is an easy answer. It sounds like you are, you are doing a really good job of on the one hand trying to prioritize your safety when you’re around your grandbaby, but also by wearing a mask and whatnot, but also trying to, you know, figure out how can you have some conversations with the parents of this child to talk about that. I think it’s wonderful that you have been able to receive your vaccine and that there is some level of protection before you, you know, were around other people that, that maybe don’t have theirs. But I would just continue to encourage, try to continue to have open conversations. I think for lots of folks, when we have difficult conversations where we might disagree, really trying to use statements that start with, I feel, or I am concerned about this, and really owning your experience can help, you know, lower the sense of defensiveness that can sometimes come. If it does start to get escalated, taking breaks to take some deep breaths and reiterating that, you know, the intention behind this conversation is, is one of love and one of care. All of those things can sometimes help those conversations to go a little bit better, but there really is no answer when we are at odds with people that we love in the context of this pandemic. So I really appreciate how challenging that is, and I wish you the best of luck, and hopefully some of those tips are helpful.

[00:55:49]Bill Walsh:  Okay, Jean, let’s take another question.

[00:55:52]Jean Setzfand:  Our next caller is William from New York.

[00:55:56]Bill Walsh:  Hey, William, welcome to the program. Go ahead with your question. Hey, William, go ahead with your question.

[00:56:07]William:  Hello.

[00:56:08]Bill Walsh:  Hey, William, welcome to the program. Go ahead with your question.

[00:56:12]William:  Yes, yes. I took both the shots. I took Pfizer, and I would like to know if, am I still, can I still get you know, the pandemic? And how long does it take before I have to have another shot?

[00:56:36]Bill Walsh:  Yeah. William, how long ago did you get your second shot?

[00:56:41]William:  I took it here about two weeks ago.

[00:56:44]Bill Walsh:  About two weeks ago. Okay. Dr. Rapaka, do you want to walk William through that? And it sounds like he’s also asking about booster shots as well.

[00:56:53]Rekha Rapaka:  Yeah, sure. I mean, so you’ve, it sounds like you’ve received the, your first and your second immunization from Pfizer and you’ve had two weeks since that second shot, so you’re in the category where, you know, some of the looser restrictions that I described earlier regarding, you know, wearing masks in, among other, like no need, no need for wearing a mask when you’re among other vaccinated adults, those kinds of things apply. So you can look at all of those details on the CDC website, which I would point out. The other thing I would say is with regards to a booster, I think your question is good. You know, like how long will this last, am I still susceptible to the virus? So as I said earlier, the vaccine is not a hundred percent effective, but it’s very effective so I think that should rest some of your concern. And I think you know, we’re all sort of faced with this concern about how long will this vaccine protect me. And I think that’s something we’re just going to have to keep our eyes and ears open for as time goes on and as the pandemic progresses. But I think for now, you should rest assured that some of these loosening of restrictions that I described earlier apply to you.

[00:58:04]Bill Walsh:  Okay, thank you. And thanks to both of our experts. I wonder, Dr. Rapaka and Dr. Farro, if you have any closing thoughts or recommendations that our listeners should understand from today. Dr. Rapaka, do you want to, you want to start off?

[00:58:19]Rekha Rapaka:  Yeah, thank you so much for having me, and I just really enjoyed this opportunity to speak with you all and learn from you. And I just wanted to say, you know, it’s been a really hard year-plus that we’ve been dealing with this and, you know, the keys I think to really get through this is to just continue to stay in touch, continue to keep learning. Use what you’ve learned to help the people around you, people in your family, your community. Advocate for yourself and do, and, you know, as Dr. Farro was suggesting, when you feel ready, do take advantage of some of these looser restrictions that I described, you know, so some of the things that you’ve been holding back, when you feel ready and it’s the right time. But I do feel a lot of optimism for the future, and I just hope that we’ll continue to learn together and continue to fight this virus as best we can together.

[00:59:11]Bill Walsh:  Okay, thank you, Dr. Rapaka. Dr. Farro, any closing thoughts?

[00:59:16]Samantha Farro:  Yes. Thank you so much for having me today. I really appreciate our listener questions and can really just acknowledge that it has been a challenging year and continues to be challenging as we navigate some of these, you know, difficult, sticky situations within families and communities. I think the best thing I can do is just remember that you have gotten through many challenges in your life. Remember how resilient you are, and if you’re feeling stuck in a rut, try to remember what helps you to get, to overcome adversity. One of the reasons I love working with older adults, because you’re very resourceful, we’re very experienced in being able to cope with challenges, and sometimes we forget that. And so I just think it’s really important to remember those parts of yourself as well. This last year we have all kind of been confined a little bit, but there are many, many strengths that you bring to the table and, like Dr. Rapaka, I have a lot of optimism for the future, and I believe that we will be able to, you know, have meaningful, purposeful, fulfilling, daily experiences every single day, no matter what our circumstances are.

[01:00:35]Bill Walsh:  A very optimistic note to go out on. Thank you, Dr. Farro, really appreciate this. Thanks to both of our experts for answering our questions. And thank you, our AARP members, our volunteers and listeners for participating in the discussion. AARP, a nonprofit, nonpartisan member organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we’re providing information and resources to help older adults and those caring for them protect themselves from the virus, protect and prevent its spread to others while taking care of themselves. All of the resources referenced today, including a recording of today’s Q&A event can be found at aarp.org/coronavirus starting tomorrow, May 7th. Again, that web address is aarp.org/coronavirus. Go there if your question was not addressed and you’ll find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please tune in May 20th at 1 p.m. for another live event answering your questions about the coronavirus, as well as a special 7 p.m. event on misinformation and the coronavirus. Thank you and have a good day. This concludes our call.

[01:02:08]

BILL WALSH: Hola. Soy el vicepresidente de AARP, Bill Walsh, y quiero darles la bienvenida a esta importante discusión sobre el coronavirus. Antes de comenzar, si deseas escuchar esta teleasamblea en español, presiona * 0 en el teclado de tu teléfono ahora.

 

AARP, una organización con membresía, sin fines de lucro y no partidista, ha estado trabajando para promover la salud y el bienestar de los adultos mayores durante más de 60 años. Frente a la pandemia mundial de coronavirus, AARP proporciona información y recursos para ayudar a los adultos mayores y a quienes los cuidan.

 

La buena noticia es que el acceso a la vacuna está mejorando en todo el país y todas las personas mayores de 16 años ahora son aptas para recibir la vacuna en todos los estados, mientras que más del 82% de los adultos de 65 años o más han recibido al menos una dosis. Algunas personas más jóvenes se resisten a recibir la vacuna. Algunas personas están luchando por obtener dosis y las nuevas variantes de COVID-19 continúan propagándose.

 

Es más, después de un año a la sombra de la pandemia, muchas personas se sienten emocionalmente exprimidas. De hecho, una nueva investigación de AARP sugiere que un mayor número de personas mayores de 50 años se sienten deprimidas, ansiosas y solas. Por mucho que quieran volver a la vida con normalidad, también les preocupa el futuro a medida que salimos de la pandemia. Hoy, escucharemos a un impresionante panel de expertas sobre estos temas y más.

 

Si ya has participado en alguna de nuestras teleasambleas, sabes que esto es similar a un programa de entrevistas regular y tienes la oportunidad de hacer tus preguntas en vivo. Para aquellos de ustedes que nos acompañan por teléfono, si desean hacer una pregunta sobre la pandemia de coronavirus, presionen * 3 en el teclado de su teléfono para conectarse con un miembro del personal de AARP que anotará su nombre y pregunta, y los pondrá en la cola para hacer esa pregunta en vivo. Si desean escuchar en español, presionen * 0 en el teclado de su teléfono ahora. Y si se unen a través de Facebook o YouTube, pueden poner su 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 la pandemia mundial de coronavirus. Estaremos hablando con expertas líderes hoy y respondiendo sus preguntas en vivo. Para hacer una pregunta, presiona * 3. Si te unes a través de Facebook o YouTube, puedes publicar tu pregunta en los comentarios.

 

Tenemos unas invitadas sobresalientes que nos acompañan hoy, incluidas expertas en salud de la División de Enfermedades Infecciosas de University of Maryland Baltimore y el Centro Multidisciplinario sobre el Envejecimiento del Campus Médico Anschutz de University of Colorado. También nos acompañará mi colega de AARP, Jean Setzfand, quien ayudará a facilitar sus llamadas hoy. Este evento está siendo grabado y podrán acceder a la grabación en aarp.org/elcoronavirus 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 dar la bienvenida a nuestra invitada, la Dra. Rekha Rapaka, Ph.D., y profesora asistente de Medicina en el Centro para el Desarrollo de Vacunas y Salud Global en el Centro Médico de University of Maryland. Bienvenida de nuevo al programa, Dra. Rapaka.

 

REKHA RAPAKA: Muchas gracias por invitarme.

 

BILL WALSH: Muy bien. Samantha Farro, Ph.D. es psicóloga con licencia en el Centro Multidisciplinario sobre el Envejecimiento del Campus Médico Anschutz de University of Colorado. Bienvenida, Dra. Farro.

 

SAMANTHA FARRO: Es un placer estar aquí.

 

BILL WALSH: Muy bien Es un placer tenerla. Comencemos con nuestra discusión. Solo un recordatorio, para hacer una pregunta, presiona * 3 en el teclado de tu teléfono o déjala en los comentarios en Facebook o YouTube.

 

Dra. Rapaka, comencemos con usted. Los CDC publicaron recientemente una nueva guía sobre el uso de mascarillas y los viajes para las personas vacunadas. ¿Qué deberían saber las personas que escuchan hoy sobre la nueva guía?

 

REKHA RAPAKA: Sí. Es importante que todos los que escuchan sepan que se han actualizado las directrices sobre el uso de mascarillas y los viajes para las personas que han sido vacunadas. Esto se aplica específicamente a las personas que pasaron al menos dos semanas después de recibir la segunda dosis de la vacuna de Moderna o de Pfizer, o dos semanas después de recibir la dosis única de Johnson & Johnson.

 

La nueva guía dispone que las personas que han cumplido con estos criterios y han sido vacunadas pueden reunirse en el interior con otras personas que también están vacunadas, otros adultos, sin mascarilla. En segundo lugar, como alguien en este grupo de personas que están siendo vacunadas, también puede visitar hasta una casa de personas que pueden no haber sido vacunadas a menos que haya un miembro de esa familia con mayor riesgo de COVID-19. Puedo hablar más sobre eso si hay preguntas.

 

Además, al aire libre, ahora se considera que, si has sido vacunado, generalmente está bien no necesitar usar una mascarilla a menos que estés en una situación de hacinamiento. También hay algunas actualizaciones relacionadas con los viajes. Específicamente, en el pasado, hubo un período de cuarentena cuando se viajaba entre estados y era necesario realizar pruebas. Eso ya no es necesario.

 

Se recomienda que si vas a realizar un viaje internacional te hagas la prueba cuando regreses a casa. Creo que hay algunos ejemplos que puedo darles para aclarar cómo se ve la guía. Por ejemplo, cenar al aire libre puede ser algo que puedas considerar al ser una persona vacunada, pequeñas reuniones al aire libre. En el contexto de otras situaciones como, por ejemplo, cada vez que estés en transporte público, debes usar una mascarilla aunque estés vacunado.

 

En situaciones como ir de compras, ir a la iglesia, ir al gimnasio, cosas así, debes seguir usando mascarilla. En general se trata de un plan para utilizar su mejor criterio y echar un vistazo a lo que está disponible. Yo diría que, en general, se han levantado algunas restricciones para aquellos que han sido vacunados. Creo que es una buena señal y una buena recompensa por vacunarse, por así decirlo, volver a algunas de estas cosas.

 

BILL WALSH: Correcto. Muy rápidamente, creo que algunas personas se preguntan por qué tienen que usar mascarilla si han sido vacunadas y han pasado ese período de 14 días. ¿Puede explicar muy rápidamente cuál es el propósito de usar mascarilla si uno ha sido vacunado?

 

REKHA RAPAKA: Sí. El propósito es que, en este momento no lo sabemos todo sobre los beneficios de la vacuna. Sabemos que hay un gran beneficio, ¿verdad? La eficacia es excelente. Todavía existe el riesgo de contraer la infección. Todavía tenemos ese riesgo. No son 100% efectivas, estas vacunas. Entonces, es importante desde esa perspectiva.

 

Además, existe una situación en la que también puedes ser portador del virus sin tener ningún síntoma y también queremos prevenir el riesgo de transmisión a otras personas. Eso forma parte del cálculo. Escenarios realmente abarrotados, situaciones en las que estás cerca de gente tosiendo, hablando, riendo. Los lugares realmente estrechos y ajustados siguen siendo riesgosos. Esas son situaciones en las que, en este punto, no estamos listos para decir que dejemos de usar mascarilla. Todavía necesitamos usarlas.

 

BILL WALSH: Dra. Rapaka, la buena noticia es que estamos viendo casos con una tendencia descendente a nivel nacional, todavía hay algunos estados. Míchigan es un ejemplo en el que hay un aumento de nuevas infecciones incluso cuando las personas se vacunan. ¿Sabemos lo que está pasando ahí? ¿Qué está impulsando esto?

 

REKHA RAPAKA: Sí. Esta es una pregunta realmente interesante. No creo que sepamos todo sobre por qué, pero hay algunos factores a tener en cuenta. En Míchigan ha estado aumentando, durante el último mes, el número de casos. Está empezando a declinar. Minnesota e Illinois también son estados en esta categoría donde se elevó a como el 15% las personas que se hacen la prueba de COVID-19 y resultan positivo, que es muy alto.

 

Creo que los factores que intervienen en esto son, primero la tasa de vacunación tiene un impacto en las cosas. Segundo, es importante tener en cuenta los tipos de cepas que circulan. En tercer lugar, y probablemente el más impactante, es la intensidad de las restricciones y cuándo se levantaron. Por ejemplo, estados como Texas y Florida tuvieron más infecciones al principio de la pandemia.

 

Estas personas también tienen cierto nivel de inmunidad. Una vez que estás infectado, tienes cierto nivel de inmunidad que persiste durante al menos seis meses. Han tenido restricciones más bajas y eso es algo que ha continuado y tienen aproximadamente la misma tasa de vacunación que Míchigan. Diría que Míchigan está en una situación en la que tenían mucha más cuarentena al principio.

 

Ahora, esos factores se están eliminando más y ha habido menos restricciones. Creo que eso viene en el contexto de tener la nueva variación. Creo que esa combinación es el desafío. Como estamos viendo, las cifras están disminuyendo ahora. Creo que es un testimonio de que probablemente más y más personas se acercan a la vacuna, y simplemente que las personas tienen inmunidad por haber estado expuestas o haber sido vacunadas.

 

BILL WALSH: De acuerdo. Está bien, gracias. Volvamos a usted, Dra. Farro, sobre el tema del bienestar mental. Mencioné anteriormente que AARP tiene una nueva encuesta que acabamos de realizar y que demostró que el 70% de los adultos mayores se sienten tristes, deprimidos, ansiosos, solos y tienen preocupaciones sobre el futuro como resultado de la pandemia. Si bien la pandemia ha tenido un costo devastador y bien documentado en la salud física, ¿puede hablar sobre algunos de los impactos en el bienestar mental y por qué tantas personas se sienten así? También me gustaría saber si esto tiene consecuencias a largo plazo.

 

SAMANTHA FARRO: Por supuesto. Aprecio su atención a este tema porque creo que se ha prestado mucha atención a tratar de mantenerse a salvo y físicamente saludable durante esta pandemia, pero definitivamente hemos visto impactos en la salud emocional por la agitación del año pasado. De manera similar a lo que dijiste, diría que lo más común que escucho es que las personas se sienten solas al tener que quedarse en casa o estar alejadas, distanciadas físicamente y aisladas de amigos y familiares.

 

También creo que es muy común que haya mucho aburrimiento para la gente que se queda en casa. Han perdido algunas de las actividades e intereses normales que solían hacer. Llega un punto en que has leído muchos libros, has hecho muchos acertijos, has visto mucho Netflix y empiezas a tratar de averiguar qué hacer.

 

El aburrimiento ha sido, con mucho, una de las cosas más comunes que he escuchado. Algo más de lo que no creo que mucha gente haya hablado necesariamente, pero que definitivamente ha sido cierto es que la pandemia realmente ha cambiado nuestra rutina diaria. Algo que escucho mucho es que mucha gente está notando muchas interrupciones del sueño.

 

Tal vez están más aburridos durante el día, por lo que duermen más y tienen problemas para dormir por la noche. Simplemente se convierte en este efecto acumulativo en el que sabemos que las interrupciones del sueño se relacionan con nuestro bienestar mental y nuestra salud emocional. Entonces, estas son algunas de las cosas que creo que han sido muy comunes durante toda la pandemia.

 

Para algunas de estas personas que han experimentado algunas de esas cosas, esas dificultades han generado preocupaciones más serias, cosas como mayor consumo de alcohol y sustancias. Como mencionaste, la ansiedad y la depresión eran muy comunes. Como enfrentamos tanta incertidumbre y lo desconocido, eso era algo muy común que la gente estaba sintiendo.

 

También estamos viendo, a medida que las personas se quedan en casa y tal vez uno y su cónyuge, o uno y su familia, limitados a estar en casa, han vivido mucha más tensión y conflicto dentro de las relaciones. Definitivamente creo que la pandemia ha tenido un gran impacto en el bienestar mental.

 

Hiciste una pregunta sobre cuáles son las consecuencias a largo plazo de esto. Una de las cosas realmente maravillosas de los adultos mayores es que a medida que envejecemos, adquirimos mucha experiencia y tenemos más capacidad de resiliencia. Hemos enfrentado muchos desafíos en nuestra vida y los hemos superado.

 

Entonces, creo que hay algo que es realmente maravilloso. Trabajo con adultos mayores y estoy en una clínica de geriatría, y una de las cosas que es realmente maravillosa es lo resilientes que somos al haber tenido mucha experiencia en la vida, es posible que ya hayamos desarrollado estrategias de afrontamiento.

 

Ciertamente, puede haber impactos a largo plazo cuando el bienestar mental y la salud emocional se ven afectados de la forma en que lo hicieron durante el año pasado, pero animo a las personas a conectarse y recordar cuáles son las cosas que han hecho anteriormente cuando han enfrentado desafíos, ¿qué les fue útil?

 

Creo que esa es una forma en que realmente podemos reducir algunos de esos efectos a largo plazo. Aunque la pandemia definitivamente ha tenido un efecto en el bienestar mental, todos tenemos fortalezas, resiliencia y estrategias de afrontamiento que podemos recordar y en las que podemos confiar.

 

BILL WALSH: Permítanme profundizar en eso y mirar hacia adelante un poco. Hemos vivido bajo esta pandemia durante más de un año y más del 60% de los adultos se reúnen y socializan menos con familiares y amigos, lo que, por supuesto, solo suma a la ansiedad, la depresión y la tristeza. Si bien muchas personas están ansiosas por volver a sus actividades normales después de recibir sus dosis de vacuna, otras están realmente ansiosas por aventurarse nuevamente en esta nueva normalidad. Me pregunto qué orientación tiene para las personas que están lidiando con esas emociones conflictivas.

 

SAMANTHA FARRO: Por supuesto. Esto es tan común. Por un lado, las personas realmente quieren volver al mundo y volver a conectarse con sus seres queridos, amigos y vecinos que tal vez no han visto en muchos meses, pero el acto de hacerlo puede ser bastante incómodo, porque es muy diferente de los últimos 12 meses o más.

 

Creo que, ante todo, es importante que todos sepamos que habrá un proceso de reaprendizaje para hacer esos cambios. Algunas de las cosas que recomiendo que pueden ayudarnos a medida que volvemos a una apariencia de normalidad es hacer un plan que permita comenzar gradualmente a experimentar ese tipo de novedad con nuevos lugares y estar rodeado de personas nuevamente.

 

Esto es algo que no hemos hecho durante casi más de un año. No te recomiendo que pases de estar seguro en casa y no ver gente a ir a un evento muy concurrido. Incluso si estás vacunado, puede ser una experiencia realmente intensa para muchas personas, más bien, trata de tomártelo con calma.

 

¿Cómo puedes hacer esto y ser realmente amable contigo mismo? Tómate un tiempo para acostumbrarte a estar en el mundo nuevamente. Ten en cuenta que la primera vez que hagas algo, será un poco incómodo y eso es normal. Tómatelo con calma, dándote espacio para tomar descansos, incluso haciendo una pausa para respirar profundamente un par de veces mientras te acostumbras a salir.

 

Ciertamente, eso podría ser suficiente para muchas personas, pero si estas ansiedades persisten o se vuelven tan graves que te sientes realmente estancado, tal vez simplemente es aterrador salir de tu casa, o es aterradora la idea de volver a salir, entonces podrías intentar buscar ayuda profesional de un terapeuta. Es posible que no lo necesites a largo plazo, pero definitivamente puede ser útil durante la transición de regresar al mundo, tener un profesional que puede brindarte estrategias muy específicas sobre cómo manejar ese tipo de síntomas más graves.

 

BILL WALSH: Está bien. Gracias, Dra. Farro. Hablaremos más sobre el bienestar mental más adelante en el programa. Como recordatorio para nuestros oyentes, para hacer una pregunta, por favor presiona * 3 en el teclado de tu teléfono. Vamos a llegar a esas preguntas en vivo en breve, pero antes de hacerlo, quería traer a Nancy LeaMond. Nancy es la vicepresidenta ejecutiva y directora de Promoción y Participación aquí en AARP. Bienvenida, Nancy.

 

NANCY LEAMOND: Hola, Bill. ¿Cómo estás?

 

BILL WALSH: Muy bien. Ha habido mucha acción sobre la COVID-19 en el Capitolio en los últimos meses. ¿Cuáles son las cosas importantes que nuestros oyentes deben saber?

 

NANCY LEAMOND: Como bien dices, ha sido un período muy ajetreado con AARP realmente presionando al Congreso para ayudar a los adultos de más de 50 años a protegerse a sí mismos y a sus familias y navegar financieramente a través de esta pandemia.

 

Por ejemplo, en marzo, el Congreso aprobó y el presidente Biden firmó la Ley del Plan de Rescate de Estados Unidos, que incluía una serie de prioridades de AARP, como enviar pagos de $1400 a millones de adultos mayores, incluidos los beneficiarios del Seguro Social, ampliar los créditos fiscales por vacaciones pagadas y el crédito fiscal por hijos, ayudar a más personas a recibir atención en sus hogares y comunidades, hacer que el seguro médico sea más asequible a través de subsidios expandidos según la Ley del Cuidado de la Salud a Bajo Precio, extender los beneficios de desempleo para las personas que quedaron sin trabajo durante la pandemia, expandir el esfuerzo de vacunación contra la COVID-19 como nuestras dos invitadas han dicho, y mejorar el control de infecciones en los hogares de ancianos.

 

Además de este trabajo en el Congreso, AARP también está trabajando con gobernadores y legisladores estatales en todo el país para asignar fondos de manera que aborden las necesidades de los adultos mayores. Por ejemplo, AARP West Virginia está instando al gobernador a priorizar la vacunación de los residentes confinados en su hogar.

 

AARP Massachusetts abogó con éxito por una legislación que proporcione licencia pagada de emergencia para aquellos que necesitan tomarse un tiempo libre para vacunarse, o para cuidar a alguien que tiene COVID-19, o para cuidarse ellos mismos si contraen COVID-19. Estos son solo algunos ejemplos de las muchas cosas en las que estamos trabajando en todo el país.

 

BILL WALSH: Bien. Gracias por eso. ¿Qué debemos esperar al seguir adelante?

 

NANCY LEAMOND: De cara al futuro, el Congreso pronto trabajará en un plan de infraestructura y AARP continuará luchando por la seguridad financiera y sanitaria de las personas mayores de 50 años. Nos sentimos muy alentados por el presidente Biden y sus recientes comentarios ante el Congreso.

 

Se abordaron muchas de las preocupaciones que sienten los adultos mayores de 50 años, continuar aumentando el acceso a las vacunas, especialmente para las personas a las que es difícil llegar o están confinadas en el hogar, mejorar la atención a largo plazo, brindar más apoyo a los 48 millones de personas que cuidan voluntariamente a sus seres queridos, disminuir el precio vertiginoso de los medicamentos recetados que continuamente paralizan los presupuestos familiares y la mejora del acceso a internet de alta velocidad, transporte seguro y mejores opciones de vivienda en todo el país.

 

La COVID-19 ciertamente ha arrojado luz sobre todos estos desafíos que enfrentan los adultos mayores. Si algo nos ha enseñado, es que la infraestructura de atención y la infraestructura física de Estados Unidos están fallando y hay mucho trabajo por hacer. Es un momento de mucho trabajo para el personal del Capitolio, y AARP y sus voluntarios, activistas pequeños como los que están en la línea, continuarán trabajando arduamente para asegurarse de que las necesidades de los adultos mayores en todo el país sean una prioridad, que sus voces sean escuchadas y que en AARP aboguemos por los problemas que más les importan.

 

BILL WALSH: De acuerdo. Finalmente, a medida que continúa el proceso de distribución de vacunas, ¿dónde está enfocando AARP sus esfuerzos?

 

NANCY LEAMOND: Desde el comienzo de esta pandemia, AARP ha estado luchando por ustedes, solicitando grandes inversiones para investigaciones sobre tratamientos y vacunas para este virus. Me alegra decir que esos esfuerzos están dando sus frutos. Una vez que las vacunas estuvieron disponibles, supimos que este era el tema que más importaba a nuestros socios.

 

Es por eso que trabajamos con la Administración de Trump y luego con la Administración de Biden y en todos los estados para hacer de las personas mayores una prioridad. Por eso también hemos publicado guías en línea para cada estado que explican cómo obtener la vacuna en el lugar donde vives. Puedes encontrarlas en aarp.org/infovacuna. Gracias a nuestro trabajo, los Gobiernos priorizaron los centros de atención a largo plazo y a los adultos mayores.

 

Afortunadamente, los casos en hogares de ancianos finalmente han disminuido drásticamente. Aunque todavía tenemos algunas preocupaciones en algunos lugares. Más del 80% de las personas mayores de 65 años han recibido al menos una dosis de la vacuna contra la COVID-19. Este es un logro monumental. Significa mucho para las personas que ahora pueden volver a visitar con seguridad a sus familias y nietos.

 

Hay mucho trabajo por hacer para garantizar que todos los que quieran una vacuna puedan recibirla. La gente todavía tiene preguntas y debemos ayudar a que se respondan en sesiones como la de hoy. Nos centraremos en garantizar que los adultos mayores, en particular los adultos mayores de color y aquellos que están confinados a su hogar, tengan acceso.

 

A medida que continúe la implementación, mantendremos la presión sobre los líderes electos y continuaremos brindando información crítica a nuestros socios. Como mencioné antes, las oficinas estatales de AARP están trabajando arduamente para llegar a los adultos mayores en todo el país. Por ejemplo, AARP California se está acercando a los latinos con cuestiones referentes a la COVID-19 e información sobre vacunas a través de una serie de Facebook Live dirigida en español.

 

Los voluntarios de AARP en estados como Connecticut, Alaska, Indiana y muchos más, están haciendo llamadas telefónicas a los adultos mayores para brindarles información sobre las vacunas. En algunos casos, podemos ayudar a algunas personas a registrarse. AARP Pennsylvania es un socio principal que trabaja con Black Doctors Consortium en un evento multiestatal para centrarse en la educación sobre vacunas y las dudas entre los afroamericanos.

 

Tenemos muchas más cosas que hacer. No entraré en eso ahora, pero para estar al día de todos estos esfuerzos, tómate un minuto y visita nuestro sitio web, www.aarp.org/elcoronavirus. Dicho eso, volvamos a ti, Bill, y volvamos a nuestro magnífico panel.

 

BILL WALSH: Está bien. Gracias por esa actualización, Nancy. Muy apreciada. Vamos a llegar a las preguntas de nuestros oyentes en un momento. Antes de hacerlo, quería abordar un tema importante.

 

Sabemos que muchos de ustedes tienen dificultad para recibir la vacuna en su estado o comunidad porque muchos lugares requieren suscripciones a través de formularios en línea, y si no tienen acceso a una computadora, esto puede ser un verdadero desafío. AARP quiere ayudar. Hemos establecido un equipo de apoyo de vacunas de AARP para tratar de ayudar en estos casos.

 

Por lo tanto, si estás escuchando hoy y no tienes una computadora y no puedes registrarte para recibir una vacuna debido a eso, presiona 1 para que te agreguen a una lista y recibir una llamada telefónica del personal de AARP para ayudarte. Nuevamente, si estás escuchando hoy y no tienes acceso a una computadora o internet y no puedes registrarte para recibir una vacuna debido a eso, presiona 1 para ser agregado a una lista para recibir una llamada telefónica e intentaremos ayudarte. Cuando marques 1, escucharás un breve mensaje y luego volverás a esta llamada.

 

Ahora es el momento de abordar sus preguntas sobre el coronavirus con la Dra. Rekha Rapaka y la Dra. Samantha Farro. 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: Muchas gracias, Bill. Encantada de estar aquí para esta importante conversación.

 

BILL WALSH: Muy bien. ¿Quién es la primera persona que llama hoy?

 

JEAN SETZFAND: Nuestra primera llamada es Karen de Pensilvania.

 

BILL WALSH: Hola, Karen. Bienvenida al programa. Continúa con tu pregunta.

 

KAREN: Gracias por atender mi llamada. Recibí mi primera dosis de la vacuna de Pfizer. Mi pregunta es, ¿cuánto margen se tiene para recibir la segunda dosis? Porque escuché que no debes esperar demasiado para recibir la segunda dosis de la vacuna.

 

BILL WALSH: Está bien. Preguntémosle a la Dra. Rapaka sobre eso. Dra. Rapaka, ¿puede responder la pregunta de Karen?

 

REKHA RAPAKA: Sí, Karen. Esa es una muy buena pregunta. La forma en que se probó la vacuna fue en un ensayo clínico. En ese contexto, hay un intervalo de 3 semanas entre la primera y la segunda dosis. Esa es la situación ideal, pero si no puedes recibir la vacuna de refuerzo a las 3 semanas, está bien un poco de tiempo adicional.

 

Creo que no alejarse demasiado de ese objetivo es probablemente lo mejor porque tenemos la mayor cantidad de información sobre cuán efectiva es la vacuna en ese contexto. A veces, unas pocas semanas, o incluso un poco más, debería estar bien.

 

BILL WALSH: Está bien. Eso también se aplica a las otras vacunas.

 

REKHA RAPAKA: Excepto por la de Moderna, que tiene un refuerzo. Ese refuerzo es a las 4 semanas. Deberías básicamente tratar de estar lo más cerca posible de ese punto, pero si necesitas ir más tarde, está bien.

 

BILL WALSH: Estamos escuchando que un buen número de personas no están recibiendo la segunda dosis. El otro día vi un dato que indicaba que el 8% no lo habían hecho por varias razones. ¿Cuánta protección tiene uno con una sola dosis de la vacuna de Moderna o de Pfizer?

 

REKHA RAPAKA: Esa es una buena pregunta. En realidad, la dosis única de la vacuna de Moderna y de Pfizer, a partir de los datos que tenemos en cuanto a protección en ese corto período de tiempo, es bastante buena. En realidad, está alrededor del mismo rango, al 90%. Lo digo, sin embargo, con la salvedad de que la respuesta inmunitaria es algo complicado. El efecto de dar ese refuerzo realmente fortalece la respuesta inmunitaria. No solo desde la perspectiva de lo buena que es, sino también de cuánto tiempo podría durar.

 

En este momento, tenemos muy pocos datos sobre la duración. Aconsejaría a las personas que sigan realmente ese protocolo de las 2 dosis si pueden, porque de eso tenemos la mayor cantidad de información. Si terminamos en una situación en la que podríamos necesitar dar refuerzos y otras cosas, estar en ese tiempo ayudará. Así es como respondería a eso. Según la información que tenemos ahora, si puedes, cumple con los tiempos publicados.

 

BILL WALSH: Está bien. Muy bien. Jean, ¿de quién es nuestra próxima llamada?

 

JEAN SETZFAND: Nuestra próxima llamada es de Betty de Pensilvania.

 

BILL WALSH: Hola, Betty. Bienvenida al programa. Continúa con tu pregunta.

 

BETTY: Hace un rato, no recuerdo quién era, mencionaron que si todavía tienes problemas para salir, y tienes las dos vacunas, debes ver a un terapeuta. ¿Cómo veo a un terapeuta cuando ninguno de ellos acepta mi seguro de Medicare? El psiquiatra no acepta y tampoco el psicoterapeuta. Solo quieren dinero en efectivo.

 

BILL WALSH: Sí. Está bien. Preguntémosle a la Dra. Farro qué recomienda. Dra. Farro.

 

SAMANTHA FARRO: Gracias, Betty. Realmente aprecio esta pregunta porque creo que es un gran problema. Definitivamente es una barrera de acceso cuando no tenemos suficientes paneles en nuestro plan de seguro de Medicare para poder satisfacer la demanda. Creo que fue un gran desafío el año pasado.

 

Mi recomendación es que hay un par de formas en las que puedes intentar encontrar un terapeuta o un psiquiatra con quien trabajar. La primera idea que tengo es contactar a tu seguro, ya sea Medicare, un plan Advantage o cualquiera que sea tu situación de seguro, contactarlos. Deben poder proporcionarte una lista de proveedores.

 

Si revisas el panel de proveedores que figuran en la lista de seguros y no puedes recibir atención, deben buscarte un proveedor. A veces, los seguros pueden hacer excepciones y cosas por el estilo, dependiendo de cuál sea tu cobertura de seguro, pero esa es una estrategia, comunicarse con tu seguro y hablar con ellos.

 

También recomendaría si tienes un médico de atención primaria, lo cual recomiendo a todos que tengan, porque yo trabajo en atención primaria y creo que es un servicio tremendamente importante. Si tienes un médico de atención primaria, habla con él o ella sobre a quién podrían recomendar. Muchas veces, los proveedores de atención primaria pueden conocer recursos que uno quizás no conoce.

 

Por ejemplo, trabajo en atención primaria geriátrica en el Hospital de University of Colorado y sirvo como proveedora de salud integrada en nuestra clínica. Soy una especie de enlace. Actúo como consultora para nuestros pacientes para, uno, ayudarlos a tratar de resolver si tienen problemas de salud conductual, o dos, si es algo más grave.

 

Parte de mi función es ayudar a conectarlos con los proveedores de la comunidad para hacer seguimientos a largo plazo. Creo que otro recurso que podría ser de ayuda es acudir a tu proveedor de atención primaria. El último recurso que solo quiero brindarte es la Administración de Servicios de Salud Mental por Abuso de Sustancias, una agencia del Gobierno federal.

 

De hecho, tienen una línea directa nacional que ayuda a las personas a tratar de encontrar proveedores en su área inmediata. Tienen un número de teléfono de línea directa que es 1-800-662-4357. Lo repetiré de nuevo en un minuto. Este número de teléfono, esta línea directa, está realmente destinada a ayudar a las personas que enfrentan dificultades de salud mental a poder conectarse con proveedores en su comunidad local.

 

Una vez más, Betty, creo que tu pregunta es realmente importante y representa un problema que creo que ha sido bastante bien documentado, que los proveedores de Medicare son pocos y distantes en algunas áreas del país. Estos son algunos de los recursos que pueden resultar útiles. Nuevamente, la línea directa nacional de SAMHSA es 1-800-662-4357. Con suerte, eso sea de ayuda.

 

BILL WALSH: Muchas gracias, Dra. Farro. Muy útil. Jean, ¿de quién es nuestra próxima llamada?

 

JEAN SETZFAND: Tenemos varias preguntas provenientes de YouTube. Aquí tienes una pregunta de John. John está preguntando, "Me gustaría saber sobre lo qué escuché de una persona que se opone a la vacuna. Dijeron que puede hacer que el sistema inmunitario ataque al cuerpo. Algo llamado una tormenta de ciclocina. ¿Es eso cierto?"

 

BILL WALSH: Hmm. Dra. Rapaka, ¿puede opinar sobre eso?

 

REKHA RAPAKA: Sí. No estoy totalmente segura de la frase que se utilizó. Creo que podría haberse referido a algo llamado tormenta de citoquinas. No hemos observado tormentas de citoquinas, que básicamente es una respuesta inmunitaria muy intensa. No hemos observado eso con ninguna de las vacunas contra la COVID-19 que se han probado.

 

No es un efecto adverso que hayamos visto. Creo que tal vez, esta pregunta impulsa el temor de qué tipo de efecto secundario se podría experimentar con la vacuna. Por lo general, para la mayoría de las personas, las 3 vacunas aprobadas y en uso en Estados Unidos son leves y autolimitadas. Con suerte, eso le da algo de tranquilidad a John sobre eso.

 

BILL WALSH: Está bien. Jean, tomemos otra pregunta.

 

JEAN SETZFAND: La siguiente persona que llama es Linda de Colorado.

 

BILL WALSH: Hola, Linda. Bienvenida al programa. Continúa con tu pregunta. Hola, sigue adelante con tu pregunta.

 

LINDA: ¿Hola?

 

BILL WALSH: Hola. ¿Habla Linda? Continúa con tu pregunta.

 

LINDA: Sí. Pertenezco a un grupo de fe del que ha sido maravilloso formar parte durante este último año. Lo único, con este grupo de fe, es que quieren reunirse en persona. Hay un par de parejas que forman parte de este grupo que se niegan a vacunarse. Siento que eso me va a hacer daño. No es bueno para nosotros.

 

Las personas que forman parte de este grupo de fe salen en público y con miembros de la familia, jóvenes, de forma regular. Siento que están entre el virus. Cuando nos reunamos, ¿cuál es mi probabilidad de enfermarme y cómo puedo manejar el reunirme en persona con estas personas y mantenerme a salvo?

 

BILL WALSH: Sí. Linda, muchas gracias por esa pregunta. Dra. Farro, ¿por qué no empezamos por usted? Quizás nuestras dos expertas puedan opinar sobre esto. Dra. Farro.

 

SAMANTHA FARRO: Claro. Creo que una de las cosas que ha sido realmente un desafío en el último año es que, dado que todos estamos tratando de mantenernos seguros en medio de esta pandemia, han surgido diferentes niveles de cómo las personas se protegen a sí mismas, usar mascarillas todo el tiempo versus quedarse en casa todo el tiempo versus algunas personas que se distancian socialmente, y otras que no.

 

Creo que esa variabilidad puede ser muy angustiosa para las personas cuando intentan navegar eso, dentro de su relación interpersonal. Parece que, Linda, tienes este grupo de fe que ha sido un apoyo realmente maravilloso para ti durante el año pasado, lo cual es fantástico, pero quieren reunirse en persona y algunos de los miembros de ese grupo no están necesariamente tomando el mismo nivel de precauciones que tú.

 

Como mencioné un poco antes, esto es parte de donde estamos viendo un aumento de la tensión y el conflicto en las relaciones interpersonales con amigos, familiares y miembros de la comunidad. No hay una respuesta real y perfecta para eso. Lo más importante que puedo recomendar es que intentes ser muy honesta y abierta al comunicar tus inquietudes.

 

Creo que la comunicación sobre tu experiencia de necesitar sentirte segura para poder reunirte de esta manera probablemente no sea algo que solo te esté sucediendo a ti. Otros pueden tener estas mismas preocupaciones. Cuanto más podamos comunicarnos y hablar abiertamente sobre eso, más podremos intentar navegar por algunos de estos problemas de relación más difíciles.

 

Dicho esto, creo que también es importante, al final del día, en primer lugar, queremos asegurarnos de que te mantengas a salvo, de modo que si esas conversaciones no provocan cambios en ninguna de las políticas o no cambia la forma en que las personas están dispuestas a adaptarse a tus necesidades, entonces tendrías que elegir si reunirse es algo que estás dispuesta a hacer en términos de los riesgos y los beneficios que tiene.

 

Nuevamente, creo que estas conversaciones han sido muy difíciles durante todo el año. Estamos tratando de discutir nuestro sentido de seguridad, estamos tratando de discutir nuestro sentido de consentimiento para poder participar en actividades donde las decisiones y acciones de otras personas pueden impactarnos de manera muy íntima y personal. Todo esto es difícil, pero animo a la gente a ser honesta y abierta sobre sus necesidades. No necesariamente de una manera crítica, sino solo sobre cómo se siente y qué necesitan para sentirse a salvo.

 

BILL WALSH: Está bien. Dra. Rapaka, ¿quería agregar algo a eso?

 

REKHA RAPAKA: Agradezco todo lo que dijo la Dra. Farro. También pienso, creo que está bien... Las pautas de los CDC están ahí para guiar. Realmente. Deberíamos usarlas. Siempre puedes hacer referencia a eso cuando hables con tu grupo. Muchas de nuestras decisiones no son realmente para este tipo de cosas, pueden guiarse un poco por los datos.

 

De lo que se puede hablar ahora, no necesariamente parece lo más seguro tener reuniones en interiores con varias personas en este tipo de ambiente sin mascarillas, por ejemplo. Eso obviamente no funcionaría. Creo que navegarlo con los datos, hacer que la gente sepa que existen algunas pautas que pueden ayudarnos a tomar mejores decisiones juntos.

Tal vez eso signifique que todos se encontrarán afuera por un tiempo. A medida que pasa el tiempo, puedes usar las pautas para ayudarte a navegar esa conversación desafiante.

 

BILL WALSH: Gracias a ambas por eso. Gracias por todas las preguntas hasta ahora. Responderemos más preguntas en breve. Como recordatorio, para hacer una pregunta, presionen * 3 en su teléfono. Volvamos a nuestras expertas.

 

Dra. Rapaka, hace unas semanas se detuvo la distribución de la vacuna de Johnson & Johnson y luego se reinició. Algunas personas pueden estar preocupadas por la seguridad de esta vacuna. ¿Qué deberían saber todos sobre la pausa y el reinicio de la distribución?

 

REKHA RAPAKA: Claro. La vacuna de Johnson & Johnson es la vacuna aprobada más recientemente y es muy beneficiosa para prevenir la hospitalización y la muerte. Se han administrado alrededor de 8 millones de dosis en EE.UU. Hubo una pausa a mediados de abril y se detuvo el uso de la vacuna durante aproximadamente una semana y media.

 

La razón de esto fue que se observaron algunos eventos relacionados con coágulos de sangre. Eventos muy raros. Básicamente, entre las 8 millones de dosis administradas, se observó que hubo alrededor de 7 casos. La población, antes de que se observara este raro efecto, era principalmente en mujeres más jóvenes, mujeres menores de 50 años.

 

En mujeres mayores y en hombres, es mucho menor. Hay menos de un caso por millón. Básicamente, la razón por la que se produjo esta pausa fue que querían que los científicos y médicos observaran realmente los datos y tomaran una decisión muy cuidadosa sobre si los beneficios de la vacuna superan los riesgos. Claramente fue así.

 

Mucha gente, lo sé ahora, probablemente tenga algunas dudas sobre esta vacuna, pero quiero que la gente sepa que el riesgo de coágulos de, por ejemplo, la enfermedad COVID-19 en sí está en el rango de 160,000 por 1 millón. Existe un alto riesgo de formación de coágulos, no sé si la gente lo sabe, simplemente por contraer la enfermedad de COVID-19.

 

El riesgo de que se formen coágulos aquí es de aproximadamente 1 caso por millón. Para darles una idea de otros comportamientos y medicamentos en cuanto al riesgo de coágulos, por ejemplo, las píldoras anticonceptivas orales están en el rango de 500 a 1,000 por 1 millón. El tabaquismo en sí está en el rango de 1,700 por millón.

 

Se considera que ese riesgo es significativamente bajo en comparación con el riesgo de contraer COVID-19, para la vacuna. Por eso ha sido aprobada. Hay otros beneficios importantes de esta vacuna, incluida la dosis única. Queremos llegar al punto en que este virus no se esté propagando mucho en el país. Para llegar allí, necesitamos las vacunas. Con suerte, esto responda esa pregunta y brinde a las personas más información sobre el motivo de la pausa.

 

BILL WALSH: Gracias por esos datos. Eso es muy útil para ponerlo en perspectiva. Dra. Rapaka, seguimos escuchando sobre la posibilidad de necesitar inyecciones de refuerzo para protegerse de las variantes de COVID-19. ¿Qué sabemos sobre eso?

 

REKHA RAPAKA: Sí. Creo que esta es una discusión importante. Los refuerzos pueden ser necesarios para las vacunas que tenemos. Este primer punto es que no sabemos cuánto tiempo dura la inmunidad de la vacuna. Eso es básicamente porque solo hemos estado usando estas vacunas desde aproximadamente diciembre, enero, por lo que no sabemos cuánto tiempo duran. Tenemos algunos estudios de los datos del ensayo que tienen una duración de información un poco más larga. Eso es contra lo que creo que tenemos que lidiar.

 

Pienso también, esta pregunta sobre variantes. Como muchos han escuchado, existen diferentes cepas del virus. El virus puede cambiar lentamente en sí mismo a medida que se propaga y a medida que se transmite entre las poblaciones y en diferentes países. Existe la posibilidad de que las vacunas que tenemos no sean tan eficaces contra una variante recién surgida, frente a una variante que ha surgido. Eso es algo que tendremos que vigilar muy de cerca.

 

En este momento, para darte una suposición fundamentada, creo que la durabilidad de la vacuna, es decir, cuánto dura el efecto, estoy bastante segura, dado el contexto de otras vacunas, al menos un año de inmunidad es lo que espero, pero puede que necesitemos nuevos refuerzos o nuevas vacunas a medida que avanzamos. También diré que debido a esa preocupación, se están realizando estudios en este momento para probar los refuerzos potenciales que tienen eficacia contra las cepas sudafricanas y pueden propagarse en otras cepas.

 

BILL WALSH: Está bien. Hablaremos más sobre los refuerzos. Gracias por eso, Dra. Rapaka. Dra. Farro, volviendo a usted. Muchos cuidadores familiares pueden estar estresados, agotados y abrumados en un año normal. Por supuesto, este año solo ha amplificado todos esos sentimientos. Si alguien está cuidando a un ser querido y siente la tensión, ¿qué puede hacer?

 

SAMANTHA FARRO: Sí. No hay absolutamente ninguna duda de que el año pasado ha sido un gran desafío para los cuidadores. Con las restricciones de la pandemia, los cuidadores a menudo han tenido más responsabilidad, con menos recursos de apoyo, como el cuidado de relevo y otras cosas.

 

Mi recomendación principal cuando trabajo con cuidadores es no descuidarse. Creo que es muy común cuando las demandas de cuidados son altas, lo que suele ser así, es muy fácil caer en una rutina que no prioriza nuestras propias necesidades, pero es absolutamente vital equilibrar la prestación de cuidados con el autocuidado, por una serie de razones, para que sea sostenible.

 

Sabemos que la salud del cuidador está muy relacionada con la salud del paciente. Realmente no hay forma de evitarlo. Hay dos estrategias que creo que pueden ser útiles. Creo que todo el mundo tiene su propio tipo de circunstancias personalizadas, por lo que conseguir un apoyo personalizado puede ser importante.

 

Dos estrategias que creo que pueden ser útiles en todos los ámbitos incluyen, en primer lugar, mantener un horario diario consistente y predecible tanto como sea posible. Mencioné anteriormente que una de las cosas que ha sido tan difícil durante el año pasado es que nuestras rutinas diarias se han puesto patas arriba.

 

Por lo tanto, asegúrate de tener una especie de rutina cotidiana, un horario diario que incluya horarios constantes para dormir, despertarse y comer y que incluyan actividad física regular durante el día. Tener ese tipo de rutina diaria o comportamientos saludables realmente ayuda a proporcionar una sensación de estabilidad cuando nos enfrentamos a tanta incertidumbre y estrés. Suena muy simple, pero sé que no lo es para cuidadores. Por eso digo que hagas lo mejor que puedas.

 

Haz esto tanto como sea posible y ten en cuenta que cuanto más lo hagas, con suerte, las cosas se sentirán más fáciles en términos de poder manejar el nivel de estrés. A continuación, también animo a los cuidadores a que utilicen una estrategia llamada conciencia plena. La mayoría de los cuidadores están ridículamente ocupados, pero lo maravilloso de la conciencia plena es que se puede utilizar en las tareas y actividades que ya estás haciendo. La conciencia plena es una técnica, o una estrategia, que nos ayuda a saborear los momentos que ya están disponibles para nosotros.

 

Puedes sentarte y meditar durante 45 minutos y beneficiarte, pero no tienes que apartar ese tipo de tiempo para poder beneficiarte de la conciencia plena. Más bien, puedes encontrar formas creativas que realmente encajen en tus rutinas, pero que te ayuden a conectarte profundamente con el momento presente y tu experiencia al usar tu cuerpo, tus sentidos e incluso tus tareas diarias.

 

Algunos ejemplos de cómo algunos de mis pacientes han usado esto incluyen tomar descansos de 30 segundos para respirar entre actividades en los que realmente solo cierras los ojos, te concentras en hacer 1 o 2 respiraciones profundas y lo haces a lo largo del día. No tiene que pasar mucho tiempo para que tenga un efecto de calma en el cuerpo y en la mente.

 

Otra opción, algo de lo que he hablado con mis pacientes es cuando estás haciendo tareas domésticas como lavar platos, puedes usar conciencia plena simplemente concentrándote y sintiendo el agua tibia y el jabón en tus manos mientras frotas un plato. Suena un poco tonto hacer eso, pero la conciencia plena se trata de cómo podemos conectarnos con momentos neutrales o incluso felices a lo largo del día de una manera diferente que nos ayude a calmar el cuerpo y la mente.

 

Otra estrategia, esta es una de mis favoritas personales, es que puedes usarla a la hora del almuerzo. Cerrar los ojos para tomar un bocado y saborear realmente ese bocado. Una de mis formas favoritas de usar esto es que me encanta darle un mordisco a una rodaja de naranja y saborear realmente esa naranja u otro tipo de fruta.

 

Todas estas estrategias están destinadas a ayudarnos a conectarnos con nuestra experiencia inmediata en ese momento actual. Muchas veces, cuando estamos realmente estresados, nos preocupa el futuro o podemos estar arrepintiéndonos o pensando en el pasado. Estas estrategias intentan ayudarnos a estar en este momento y conectarnos con lo que está justo frente a nosotros.

 

Muchas veces, he hablado con muchos cuidadores que dicen que esto ha sido realmente útil porque no necesariamente pueden tomarse mucho tiempo para sí mismos. Esto ayuda a que algunas de las cosas que ya están haciendo se sientan como cuidado personal. Estos tipos de estrategias con la conciencia plena han demostrado ser muy prácticos y útiles para reducir el estrés. Aunque puede ser difícil cambiar nuestra circunstancia como cuidadores, tenemos mucha capacidad para cambiar nuestra relación con esas circunstancias y factores estresantes.

 

BILL WALSH: Muy bien, Dra. Farro, gracias. Saborear el momento. Es un muy buen consejo. Volvamos a las personas que nos llamaron. Este es el momento de plantear sus preguntas a la Dra. Rekha Rapaka y a la Dra. Samantha Farro. Un recordatorio, presionen * 3 en cualquier momento en el teclado de su teléfono para conectarse. Jean, ¿de quién es nuestra próxima llamada?

 

JEAN SETZFAND: Nuestra próxima llamada es Marcy de California.

 

BILL WALSH: Bienvenida al programa. Continúa con tu pregunta.

 

MARCY: Mi pregunta es, ¿es beneficioso para una persona mayor que ha sido hospitalizada con COVID-19 y luego ha sido dada de alta del hospital, recibir la vacuna?

 

BILL WALSH: Dra. Rapaka, ¿quiere responder?

 

REKHA RAPAKA: Claro. A partir de los datos que tenemos en este momento, se sugiere que recibir la vacuna después de recuperarse de COVID-19 es el camino a seguir. Animaría a la persona que describió a que se vacune una vez que se haya recuperado de la enfermedad anterior. Parece que ya se han recuperado, así que, adelante.

 

BILL WALSH: Está bien. Muy bien. Jean, ¿quién sigue?

 

JEAN SETZFAND: Nuestra próxima llamada es Lynn de Illinois.

 

BILL WALSH: Hola, Lynn, bienvenida al programa. Continúa con tu pregunta.

 

LYNN: Gracias por atender mi llamada. Tengo un bisnieto de 10 meses. Ese bisnieto tiene padres que simplemente se niegan, tienen una especie de teoría de conspiración y simplemente se niegan a vacunarse, pero por momentos quieren que me quede con el bebé. Me he quedado con el bebé, pero mantengo al bebé a distancia y me dejo puesta la mascarilla. Me pregunto si es seguro. El bebé nunca me ha visto sin mascarilla. Quiero interactuar con este bebé y no solo mantenerlo como si fuera un sospechoso y un germen de que podría experimentar una sentencia de muerte al entrar en contacto con él.

 

BILL WALSH: Oye, Lynn, ¿te has vacunado?

 

LYNN: Sí. Recibí ambas dosis de la vacuna de Pfizer en enero porque soy parte de University of Chicago. Nos llamaron primero después de los primeros.

 

BILL WALSH: Dra. Farro, me pregunto si podría opinar sobre eso. Esa es una situación complicada para Lynn.

 

SAMANTHA FARRO: Una vez más, aprecio mucho esa pregunta, Lynn, porque se remonta a lo que mencioné antes acerca de que todos tenemos que atravesar estas situaciones muy difíciles dentro de nuestras relaciones, dentro de nuestras familias donde diferentes creencias y diferentes ideas sobre el riesgo dan como resultado prácticas diferentes.

 

Tu pregunta sobre cómo manejar eso, no creo que haya una respuesta fácil. Parece que estás haciendo un muy buen trabajo, por un lado, tratando de priorizar tu seguridad cuando estás cerca de tu nieto, usar mascarilla y todo eso, pero también tratando de descubrir cómo puedes tener algunas conversaciones con los padres de este niño para hablar de eso.

 

Creo que es maravilloso que hayas podido recibir la vacuna y que haya cierto nivel de protección antes de estar con otras personas que tal vez no tengan la suya. Simplemente continuaría alentando... Trata de continuar teniendo conversaciones abiertas. Creo que para muchas personas, cuando tenemos conversaciones difíciles en las que podríamos estar en desacuerdo, realmente tratar de usar declaraciones que comiencen con "siento que" o "me preocupa esto" y realmente reconocer tu experiencia puede ayudar a reducir la sensación de actitud defensiva que a veces puede ocurrir.

 

Si comienza a intensificarse, toma descansos para respirar profundamente y reitera que la intención detrás de esta conversación es de amor y cuidado. Todas esas cosas a veces pueden ayudar a que las conversaciones vayan un poco mejor, pero realmente no hay respuesta para cuando estamos en desacuerdo con las personas que amamos en el contexto de esta pandemia. Realmente aprecio lo desafiante que es y te deseo la mejor de las suertes. Con suerte, algunos de esos consejos sean útiles.

 

BILL WALSH: Está bien. Jean, tomemos otra pregunta.

 

JEAN SETZFAND: Nuestro próximo interlocutor es William de Nueva York.

 

BILL WALSH: Hola, William, bienvenido al programa. Continúa con tu pregunta. Oye, William, sigue adelante con tu pregunta.

 

WILLIAM: ¿Hola?

 

BILL WALSH: Hola, William, bienvenido al programa. Continúa con tu pregunta.

 

WILLIAM: Sí, recibí las dos dosis de la vacuna de Pfizer y me gustaría saber si... ¿todavía puedo tener... la pandemia? ¿Y cuánto tiempo pasará antes de que tenga que recibir otra inyección?

 

BILL WALSH: William, ¿hace cuánto tiempo recibiste tu segunda vacuna?

 

WILLIAM: Hace unas dos semanas.

 

BILL WALSH: Hace unas dos semanas. Bueno. Dra. Rapaka, ¿quiere explicarle a William eso? Parece que también está preguntando acerca de las inyecciones de refuerzo.

 

REKHA RAPAKA: Sí, claro. Parece que recibió su primera y segunda inmunización de Pfizer y han pasado dos semanas desde su segunda vacuna, por lo que está en la categoría donde hay algunas restricciones más flexibles que describí anteriormente con respecto al uso de mascarillas, entre otras, no es necesario usarla cuando te encuentras entre otros adultos vacunados.

 

Ese tipo de cosas se aplican. Puedes ver todos los detalles en el sitio web de los CDC que señalaré. La otra cosa que diría es, con respecto a un refuerzo, creo que su pregunta es buena. ¿Cuánto tiempo durará esto? ¿Sigo siendo susceptible al virus? Como dije antes, la vacuna no es 100% efectiva, pero es muy efectiva.

 

Creo que eso debería relajar algunas de sus preocupaciones. Creo que todos estamos seguros, con esta preocupación sobre cuánto tiempo me protegerá esta vacuna. Creo que es algo para lo que mantendremos los ojos y los oídos abiertos a medida que pase el tiempo y la pandemia avance. Creo que, por ahora, debes estar seguro de que algunas de estas flexibilizaciones de las restricciones que describí anteriormente se aplican a ti.

 

BILL WALSH: Está bien. Gracias. Gracias a nuestras dos expertas. Me pregunto, Dra. Rapaka y Dra. Farrow, ¿tienen algún pensamiento final o recomendación que nuestros oyentes deban entender de hoy? Dra. Rapaka, ¿quiere empezar?

 

REKHA RAPAKA: Sí. Muchas gracias por invitarme. Realmente disfruté esta oportunidad de hablar con todos ustedes y aprender de ustedes. Solo quería decir que ha sido un año realmente difícil y que hemos estado lidiando con esto. Creo que la clave para superar esto es simplemente seguir en contacto, seguir aprendiendo, usar lo que han aprendido para ayudar a las personas que los rodean, a las personas de su familia, a la comunidad, a defenderse a sí mismos.

 

Como sugirió la Dra. Farro, cuando se sientan listos, aprovechen algunas de estas restricciones más flexibles que describí, algunas de las cosas que han estado reteniendo, cuando se sientan listos y sea el momento adecuado. Siento mucho optimismo por el futuro y solo espero que sigamos aprendiendo juntos y continuemos luchando contra este virus juntos lo mejor que podamos.

 

BILL WALSH: Está bien. Gracias, Dra. Rapaka. Dra. Farro, ¿algún pensamiento final?

 

SAMANTHA FARRO: Sí. Muchas gracias por invitarme hoy. Realmente aprecio las preguntas de nuestros oyentes y realmente puedo reconocer que ha sido un año realmente desafiante y sigue siendo un reto a medida que enfrentamos algunas de estas situaciones difíciles dentro de las familias y comunidades.

 

Creo que lo mejor que puedo hacer es recordar que has superado muchos desafíos en tu vida. Recuerda lo resiliente que eres. Si te sientes atrapado en una rutina, trata de recordar qué te ayuda a superar la adversidad. Una de las razones por las que me encanta trabajar con adultos mayores es que tienen muchos recursos. Tenemos mucha experiencia en hacer frente a los desafíos. A veces, lo olvidamos.

 

Creo que también es muy importante recordar esas partes de ti mismo. Este último año, todos hemos estado limitados un poco, pero hay muchas, muchas fortalezas que ustedes aportan. Al igual que la Dra. Rapaka, tengo mucho optimismo para el futuro y creo que seremos capaces de tener experiencias diarias significativas, con propósito y satisfactorias todos los días, sin importar cuáles sean nuestras circunstancias.

 

BILL WALSH: Nota muy optimista para terminar. Gracias, Dra. Farro. Realmente aprecio esto. Gracias a nuestras dos expertas por responder a nuestras preguntas y gracias a ustedes, nuestros socios, voluntarios y oyentes de AARP por participar en la discusión.

 

AARP, una organización con membresía, sin fines de lucro y no partidista, ha estado trabajando para promover la salud y el bienestar de los adultos mayores durante más de 60 años. Frente a esta crisis, estamos brindando información y recursos para ayudar a los adultos mayores y a quienes los cuidan a protegerse del virus y evitar que se propague a otras personas 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/elcoronavirus a partir de mañana, 7 de mayo. Nuevamente, esa dirección web es aarp.org/elcoronavirus. Ve allí si tu pregunta no fue respondida y encontrarás las últimas actualizaciones, así como información creada específicamente para adultos mayores y cuidadores familiares.

 

Esperamos que hayan aprendido algo que pueda ayudarlos a ustedes y a sus seres queridos a mantenerse saludables. Sintonicen el 20 de mayo a la 1 p.m. para ver otro evento en vivo que responderá a sus preguntas sobre el coronavirus, así como un evento especial a las 7 p.m. sobre información errónea y el coronavirus. Gracias y que tengan un buen día. Con esto concluye nuestra llamada.