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AARP Coronavirus Tele-Town Halls

Experts answer your questions related to COVID-19

Bill Walsh: Hello, I am AARP Vice President Bill Walsh, and I want to welcome you to this important discussion about the coronavirus. Before we begin, if you'd like to hear this telephone town hall in Spanish, press *0 on your telephone keypad now.

(Española)

 

Bill Walsh: AARP, a nonprofit, nonpartisan, membership organization has been working to promote the health and well-being of older Americans for more than 60 years. In face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them. While new coronavirus cases in some parts of the U.S. have started to decline, they are still dangerously high relative to previous surges. Many hospitals continue to be overrun, and Americans are wondering if the pandemic will ever end. And, once again, nursing homes are being hit hard. While deaths have increased just slightly, cases have increased significantly among nursing home residents and staff, stoking fears and concerns among their families. 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 before, you know this is similar to a radio talk show, and you have the opportunity to ask your question 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're joining on Facebook or YouTube, you can post your question in the comments.

 

We have some outstanding guests joining us today, including a top epidemiologist, a clinical testing expert and another on quality standards in nursing homes. We'll also be joined by my AARP colleague, Jesse Salinas, who will help facilitate your calls today.

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

Now I'd like to welcome our guests. Tom Talbot, MD, is the chief hospital epidemiologist at Vanderbilt University Medical Center. Welcome back to the program, Dr. Talbot.

 

Tom Talbot: Thanks Bill, I'm happy to be here.

 

Bill Walsh: All right, we're also joined today by Jennifer Goldman, a doctor of osteopathic medicine, family physician and chief of primary care at the Memorial Healthcare System. Welcome back to the program Dr. Goldman.

 

Jennifer Goldman: Thank you so much. Happy to be here as well.

 

Bill Walsh: All right, delighted to have you. And we also have with us today, Lori Smetanka, who is the executive director of the National Consumer Voice for Quality Long-Term Care. Welcome Lori, and thanks for joining us again.

 

Lori Smetanka: Thanks so much, Bill. Glad to be here today.

 

Bill Walsh: All right. Well thanks to all of you. Let's go ahead and get started. Dr. Talbot, a Reuters Analysis of Public Health Data released last week shows that COVID-19 infections are quickly plummeting in areas that were hit hardest during the holidays, while they're surging in the south and the west. How does this complicate public health messaging and efforts to tamp down omicron’s spread?

 

Tom Talbot: Yeah, that’s a really great question, and I think as we’ve seen in the last now two plus years, the messaging has been very confusing and often confounding. And so my advice to folks is, yes, indeed, we are seeing the start of the light at the end of the tunnel of cases coming down. And so we need to think globally when we hear that data, but we need to act locally. So, while I’m hearing the good news up north, where I’m at in Tennessee, we’re still on the uptick, and so we need to kind of act appropriately. But overall, it does show some hopeful signs. But don't feel like you should let off your guard and stop masking if your activity is going up, just because places north of you or east of you or elsewhere are improving. Just know that that hopefully is coming your way soon.

Bill Walsh: Yeah, I mean it seems like it kind of sends mixed messages to people, right? Some folks feel like it's time to let down their guard. Others aren't quite sure.

 

Tom Talbot: Yeah, yeah, exactly.

 

Bill Walsh: Yeah. Well, let me follow up on that, Dr. Talbot. I wonder if omicron, which is a highly contagious, but less virulent strain of COVID-19, signals a transition from a pandemic to an endemic, like the seasonal flu. You know, will things get back to normal this year? And I also want to know if there are any other variants that experts are keeping an eye on?

 

Tom Talbot: Yeah, so let's hit on the first part. So, I’m always a little hesitant to predict the future because if you go back to just Thanksgiving, omicron was just a word in the Greek alphabet. And so we saw how quickly omicron, as infectious as it is, took off, spread across the world phenomenally. So I always get nervous. I think that it's not going to be a light switch where all of a sudden we go from pandemic to endemic. It's going to be a transition. And that transition, germane to what we just talked about, may differ based on where you live, based on how many folks have gotten infected, how many folks have gotten a vaccine, and now we're learning even more importantly, boosted with their vaccine, to allow that protection so things can't continue to spread. In my part of the world, and we have some counties in Tennessee where we have over half the population has yet to receive a single dose of vaccine. So we're still not to where we would be endemic in those areas, but I think we're going to get there. And I think what you're seeing is folks kind of taking those baby steps, kind of learning what we can do carefully and safely and within kind of our own risk analysis and thinking of the surge to others. You know, that's why we're not locking down like we did early on, even though the case numbers are far more than they were before, but we've got to be careful. And we can't, it will not be a light switch where we just throw off our masks and be able to do everything we did before. We've got to learn how we do that, and that's through things like being safe, vaccinating, boosting, and if you're sick, stay away from people, early testing, wearing those masks, and kind of gradually getting back to normal.

 

I think in terms of other variants, there's one folks may have heard of this week that has the unfortunate term as the stealth variant of omicron, which makes people think that means we can't detect it in our tests, which is not true. It's a kind of sister of omicron that actually looks like it's been around for a while, and the stealth refers to a specific kind of signal that they do see on these testings that they didn't see with the original omicron. But they all can be tested. We don't know yet right now what that one means, if it's more infectious or cause more trouble, so I think we just have to kind of be patient and continue on with what we're doing. The next Greek letter is PI, so let's just hope it's a while before we get to that one.

 

Bill Walsh: All right. Very good. Thank you so much, Dr. Talbot. Let's turn to you, Dr. Goldman. Debilitating symptoms can last longer for some individuals, a condition that's some have called long COVID. Is long COVID real, and what do we know about it? And how common is it?

 

Jennifer Goldman: Absolutely. Long COVID is very, very real. It's known by quite a few names, actually. Long COVID, post-COVID, post-COVID long-haulers or even post-acute sequalae of COVID-19. Really, it's defined as symptoms lasting for more than four weeks after infection. And it can occur in anyone who's had COVID, even if the infection was mild. So it's not necessarily predicted based on severity of the infection initially. It can have symptoms like brain fog, which many people have heard of, which really is defined as difficulty concentrating, really difficult to get back to work, difficult to get back to normal; fatigue, cough, headaches that can be persistent; sleeping disorders; dizziness; even persistent shortness of breath. It's pretty common you know; on various studies it's shown really a range of about 20 to 40 percent of people will actually remain symptomatic at four to five weeks after infection. And so it's definitely something that is impacting, really at this point, millions of people around the world. We did start a post-COVID long-hauler clinic in our health care system at Memorial Healthcare System within primary care because what we've seen is that the majority of patients who have long COVID symptoms do well in an environment that is multidisciplinary and that is coordinated by effective, accessible primary care. And so we started a clinic locally and have seen hundreds of patients in that practice and are learning best practices and really how to address some of the symptoms that our patients are experiencing.

 

Bill Walsh: Well, that's remarkable. I hadn't heard before that 20 to 40 percent of people who get COVID could experience the symptoms of long COVID. And I mean, obviously we're still learning about that phenomenon. How long, if you know, can you tell us before the extreme fatigue and the brain fog will pass? When does taste and smell resume for those who haven't had it for months?

 

Jennifer Goldman: Sure, sure. So, like I said, long COVID by definition are symptoms lasting four weeks or longer. And that's really the most common timeframe — it's about four to 12 weeks that people have symptoms after initial infection. After 12 weeks, though, we are seeing that a number of people in some studies of almost half of people with post-COVID symptoms feel better after 12 weeks. However, we do see that some people continue to have symptoms lasting months afterwards, and even through a year. It is heartening to see, however, that many people do recover at one year; however, there are few that still remain symptomatic afterwards.

 

With regard to taste and smell, this is pretty common. About 40 percent of people in some studies have this loss of taste and smell. Most do recover after a month, so after that four-week time period. However, some people don't recover so fast, and they may remain without their taste or smell for many months. And again, through that year. The treatment for prolonged taste and smell is still being investigated. There is some smell training or olfactory training that can be done at specialized centers, but other research is yet to be done to find the most effective treatment. The good news, though, is that for the majority of people, most recover their sense of taste or smell after about a month.

 

Bill Walsh: Just a reminder of how much we're still learning about COVID-19. Thanks for that, Dr. Goldman. Lori, let's turn to you. What are the biggest challenges for families in dealing with facilities that care for elderly or disabled people as omicron surges? I know it's been spreading through those facilities. I mean, it makes perfect sense. Folks are living in such close proximity to each other.

 

Lori Smetanka: Right, it has been a concern for family members, for residents, and they're concerned about their loved one's safety and also that they're getting the care that they need, and the issues are really related to spread of the virus and making sure that they're well cared for. But also because there's significant short staffing in nursing homes — not enough people available provide the care in many homes. So many family members are concerned about that and also what that's going to mean for visitation, because we know, last year and the year before nursing homes were locked down for significant amounts of time. And so they're worried about being able to get in and see and assist their family member.

 

And despite the fact that federal guidance right now says that visitation needs to be allowed for all residents at all times, some states have been putting in place additional safety measures, such as requirements related to masking or testing in order to get at stemming the spread of the virus. So, while we all need do our part in stopping the spread, we've been strongly encouraging as AARP has, all residents, staff and family members to be vaccinated, including getting boosters, and following infection prevention protocols. It's also really critical that any additional measures that are put into place by states don't make visitation inaccessible for family members. And if masks or testing as required, which we think are reasonable efforts, they do need to be coordinating the federal and state governments with the facilities to ensure that those things are available at no cost to visitors, so that we don't have that separation again.

 

Bill Walsh: Right. OK, Lori, thanks so much for that. Lori, let me follow up with you. You know, one of the issues in nursing homes, even outside of nursing homes has been the uptake of booster shots, but I think it's been a particular issue in nursing homes. I wonder if you can talk a little bit more about what needs to be done to get nursing home residents and staff boosted.

 

Lori Smetanka: Absolutely. I think what we know is that the vaccines have made the biggest difference in stemming the spread of COVID. And so, ensuring that residents and staff are vaccinated, and the visitors, is really critical. We need a lot more education around how important boosters are. While we do have high percentages of residents that are boosted, not as high of staff, so that's something we also continue to need to work on. We're not quite there yet with the booster numbers. We need to really get those up in our communities and ensure that residents and staff and visitors have access to boosters. They need to be much more widely accessible, and they need to be given in facilities versus asking residents or staff to go out into the community to receive them, which often is very difficult for them in terms of getting there, making the time to do it. So I think if we replicated the efforts of the initial vaccine rollout, for example, and bring the vaccines to the nursing homes for residents, staff and visitors, that would make a big difference. And as we look at increasing requirements around vaccinations, it would really be helpful if, as we talk about being fully vaccinated, if the CDC would change that definition to include booster shots. I think that would also help make a difference.

 

Bill Walsh: Well, that's very interesting. So, if a family wants to make sure that their loved one in a facility gets boosted, they can't count on the facility to administer that? They have to arrange for a, what, an outside pharmacy to come in and do it?

 

Lori Smetanka: Well, certainly there should be coordination between the facility and the long-term care pharmacies that they are working with, but that's being done in better manners than others in some facilities. And so, certainly, it's something that families need to be asking about, asking their facility about getting the boosters, and working to coordinate and making sure that they don't have to take the resident out. But we can somehow work with the community to get vaccines and boosters into the facility.

 

Bill Walsh: All right, Lori. Thanks so much. We'll talk more about that in a moment. We are going to get to your live questions shortly. But before we do, I want to bring in Nancy LeaMond. Nancy is the executive vice president and chief advocacy and engagement officer for AARP. Welcome, Nancy.

 

Nancy LeaMond: Welcome to you and to our guests. I'm delighted to be here, Bill.

 

Bill Walsh: All right. So this week, AARP sent two important letters to the Department of Health and Human Services. One was urging lower Medicare premiums, and the other was asking for Medicare to cover at-home COVID tests. What can you tell us about those issues?

 

Nancy LeaMond: Well first, AARP is urging the government to reassess the Medicare Part B premium increase that was announced last year. Without a change, these premiums will go up 14.5 percent, which is just too much, especially considering the hefty increase is due to one outrageously priced prescription drug. It's unconscionable that a single high-priced drug is driving up premiums for all Medicare beneficiaries, many of whom are already struggling to make ends meet.

 

Bill Walsh: This issue comes up again and again. If we want to keep Medicare affordable, we've got to fix the underlying problem of out of control prescription drug prices.

 

Nancy LeaMond: Yes, absolutely. Prescription drug price reform is AARP's number one advocacy goal for good reason. Last year, an estimated 18 million Americans were unable to afford their medication due to high costs. And Americans are paying three times more than what people in other countries pay for the same brand name drugs. The big drug companies will continue to rip off seniors and taxpayers until Congress acts to reign them in. And we're working hard on this.

 

Bill Walsh: All right. Now, AARP is also urging Medicare to cover the cost of at-home COVID tests. Why is that so important?

 

Nancy LeaMond: Well, as we've heard from our experts, testing is one of the most effective ways to slow the spread of the coronavirus, which is why private insurers are now required to cover the cost of over-the-counter at-home tests. But Medicare is not covering them yet, even though older Americans are among the most vulnerable for serious complications from COVID. This is a glaring omission. AARP is fighting to ensure that the 64 million Americans on Medicare have the same access to no-cost tests as those with private insurance.

 

Bill Walsh: OK. Now until Medicare acts, all American households are still eligible to receive four free at-home tests through the mail. How can people order those tests?

 

Nancy LeaMond: Well, you can order your four free tests online or by calling a toll-free number. To request your at-home tests visit www.covidtests.gov or call 1-800-232-0233. Once you sign up, the tests will be mailed to your home.

 

Bill Walsh: All right, very good. That was www.covidtests.gov or call 800-232-0233. Since we're talking with our panel about nursing homes today, there was some news on that front this week too, wasn't there?

 

Nancy LeaMond: Yes, since the beginning of the pandemic, AARP has been sounding the alarm about the unfolding disaster in America's nursing homes. The pandemic brought to light problems that have plagued these facilities for decades, including staffing shortages, poor infection control, transparency and accountability. I'm happy to report that our work is making a difference. Just yesterday, the federal agency that regulates nursing homes announced that it has, for the first time ever, posted information about weekend staffing levels, staff turnover and weekend nurse coverage on the Medicare Care Compare website. So families can have access to that important information. We know that facilities with solid staffing and low staff turnover, have much better outcomes for the residents.

 

Bill Walsh: All right. Well, that's wonderful news. One last question. AARP's Fraud Watch Network has received complaints about fake COVID testing sites. Do you have any advice on how to choose a safe place to get tested?

 

Nancy LeaMond: Well, unfortunately, scammers are everywhere, and will try and take advantage of any situation. The safest bet is to use a testing site recommended by your health department or your doctor or visit an established clinic or pharmacy. If you do visit a pop-up testing site, be sure to only provide standard information, such as your health insurance card. If you're asked to provide your Social Security number or to pay money up front, those are absolutely red flags. And also, if the staff isn't wearing protective gear, or if you feel uncomfortable, listen to your gut and go somewhere else.

 

Bill Walsh: All right, that sounds like great advice. Well, Nancy, thanks so much for the update and thanks for being here with us today.

 

Nancy LeaMond: Thanks, Bill.

 

Bill Walsh: All right. It's now time to address your questions about the coronavirus with Dr. Tom Talbot, Dr. Jennifer Goldman and Lori Smetanka.

(Española)

 

Bill Walsh: All right, now I'd like to bring in my AARP colleague, Jesse Salinas, to help facilitate your calls today. Welcome, Jesse.

 

Jesse Salinas: Happy to be here today, Bill.

 

Bill Walsh: All right. Who do we have first on the line?

 

Jesse Salinas: Our first call is going to be from Rita in South Carolina.

 

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

 

Rita: Thank you. I have a concern about a facility, not a nursing home. It's a rehab place. And that they don't demand personnel to be vaccinated. And I have a problem with that, a very big one. My husband is there, and of age, and they have a change of personnel all the time, and it's very difficult for them, I understand. But it's worse if he gets contaminated by staff personnel.

 

Bill Walsh: Right.

 

Rita: How do you find out how much they are vaccinated and stuff. You don't want to be accusatorial at the place where he's been because it's hard to change or find something else.

 

Bill Walsh: Yep, Rita, let's ask Lori Smetanka about that situation. Lori, what can you tell Rita and other listeners with similar concerns?

 

Lori Smetanka: Sure, well vaccination of staff I think is critically important, and we do have a federal vaccine mandate that is being implemented for people that work in health facilities, like hospitals and nursing homes. It's in the process of being implemented right now and will be happening over the next two months and all staff need to be vaccinated. So that is definitely something that we're happy to see being put into place. I think Rita mentioned that this was not a nursing home. If it were a nursing home, there's vaccine rates for staff on the Care Compare website that Nancy referenced just a few minutes ago that the federal government operates. But in terms of questioning about vaccine rates for staff in the facility where her husband is, I would certainly talk to the administration about that. Maybe the Department of Health can provide some information, and the long-term care ombudsman program might be able to assist you in getting more information, as well. And you can find an ombudsman in your area through our website at www.the consumervoice.org.

 

Bill Walsh: OK, that was www.theconsumervoice.org, and Lori referenced the long-term care ombudsman. That’s a free service to help consumers advocate on their behalf with long-term care facilities. Let's take another question. Jesse, who do we have up next?

 

Jesse Salinas: Our next call is going to be Elizabeth in Arkansas.

 

Bill Walsh: Hey Elizabeth, welcome to the program.

 

Elizabeth: Thank you. My granddaughter tested positive on Monday for the virus, and it was recommended that she take ibuprofen and stay home. But she's had a lot of chest pain and just all of the symptoms. And I was just wondering what the recommended treatment at this time is for the coronavirus.

 

Bill Walsh: OK, well, let's ask one of our doctors. Dr. Talbot, can you weigh in on that?

 

Tom Talbot: Yeah, first off, I hope she starts feeling better soon, Elizabeth, but I think a lot of that depends on her underlying age and other kind of comorbidity conditions. But we have a variety of different treatments we can give folks that are at higher risk, those that may have a weaker immune system. We have at least one monoclonal antibody that still works against the omicron variant and some oral antivirals.

 

I think the biggest thing is, you know, if she's not feeling well or getting worse, to always link up with her primary provider and make sure that there's nothing else that needs to be done related to COVID. And hopefully she'll turn the corner and be feeling better. And hopefully everyone around her is vaccinated and boosted, so they're not at as much risk to get it too. But hopefully she's feeling better, and I would just reach out to her clinician to kind of help with her specifics, but there are some options for folks.

 

Bill Walsh: OK, very good. Thanks, Dr. Talbot for that. Jesse, let's go back to the phone lines. Who do we have next?

 

Jesse Salinas: Yep, let's take Linda in Indiana.

 

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

 

Linda: Hi. Yes, my question is, I have underlying conditions, and I have been vaccinated and boostered, and I am just now past my 10-day quarantine from having COVID. I still have a lot of congestion. I am really concerned as to if I would get this again, because I call myself being really, really careful. I was listening to what she was saying earlier about how these symptoms can linger for so long. And I'm 66 years old, I take medication for rheumatoid arthritis, which does affect my immune system. But I'm really concerned if I'm going to catch this again. 'Cause I didn't have to go to the hospital, but it was serious, really serious.

 

Bill Walsh: Sure. Well, Linda, let's ask Dr. Goldman about the symptoms of long COVID and the chances of someone who has been vaccinated and boosted and got COVID, of getting it again. Dr. Goldman?

 

Jennifer Goldman: Hi, and thank you, Linda, for that question. And first off, I'm glad that you're starting to feel better, and that you've turned the corner with this. That's fantastic news. And I'm also so glad that you've been vaccinated and boosted because we know that having been vaccinated and boosted that, not only is your chance of getting reinfected lower, but your chance, according to many studies now, of developing persistent long-COVID symptoms is also seeming to be lower. And so that's very good news.

 

You know, always with this pandemic is that there are other variants that we are hearing about. And so there is a potential of getting sick again. That does exist. But you've done absolutely everything you can to protect yourself. And what I would say going forward are a few things: Make sure that you continue to wear your mask, make sure you really continue to wash your hands, use hand sanitizer. Anytime that you go out, make sure that you avoid large gatherings, because there still can be spread in any place, and you want to lower your risk. And then lastly, and I really think most importantly, link up with your primary care doctor and make sure that you're talking to them about your symptoms. It's really common to have a little bit of a lingering cough or some congestion for a couple of weeks after COVID. If the symptoms, though, if they last for more than four weeks, then that's when sometimes we'll term that long COVID, and that's why having a relationship with your primary care provider and having access to care with them is the most important thing. They can probably see you over tele-health, or you could go into the office and be examined. And so I really recommend that you continue to do that.

 

Bill Walsh: OK, I wonder if the fact that Linda has just recently gotten over a bout of COVID mitigates the seriousness of symptoms if she were to contract it again.

 

Jennifer Goldman: Yeah, that is absolutely the thought. Again, we don't know for sure because everything is changing with this pandemic and potential other variants, but the data do look good, for sure, Bill, that reinfection, and especially severe re-infection, is much, much less likely if you've been vaccinated and boosted. And then, of course, if you've also had a recent infection.

 

Bill Walsh: OK, thanks very much for that, Dr. Goldman. Jesse, let's go back to the phones.

 

Jesse Salinas: Yeah, we're going to take Scott from New Mexico.

 

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

 

Scott: Hi. I'm actually scheduled to get my fourth injection at the end of February, and I was just curious — I am immuno-compromised and, again, I'm going to be taking my fourth injection. But my question to all of you is, why, if there's such unsurity about virus itself and the side effects, why don't they initiate a program where you get an injection 28 days after your last one, and keep this going until they get a handle on the omicron virus and whatever mutations there might be? Because my doctor made an analogy, which I thought was very accurate, he said getting these shots are like applying sunscreen, and the more sunscreen you apply, the less chance you have of getting sunburn because you're not going to eliminate the virus. So I was just curious — why don't they mandate, if you can get an injection every 28 days, why don't they do that?

 

Bill Walsh: Interesting, and relate sunscreen, yeah, thanks very much for that, Scott. Dr. Talbot, can you take that question from Scott in New Mexico?

 

Tom Talbot: Yeah, thanks Scott, and I want to first thank you for getting your booster. And for the listeners, too, folks like Scott need three doses for their regular series. So the fourth would be his booster. I think it's a good question. I think what we still have to remember is that even without the booster protection against severe complications from the virus have been really sustained with the vaccine; the booster's kind of added that in particular with the omicron surge, we've kind of needed that. But there is a concern from immunologists that if we vaccinate too frequently, it'll kind of overwhelm the T-cells to the point where they just don't react as nimbly when we need them to. So, there can be such a thing as too much stimulation of those T-cells. So, we want to avoid that as well. And so I think for right now, it really is just that single booster.

 

The big question I think on the booster front, is do we need a second booster? Israel has started doing that and the results are mixed. They seem to boost the antibodies, but are not seeing necessarily an impact in infection. So it's still not clear. So there's an immunologic concern that too frequent may not be helpful. And so that's kind of where we are. But I'm glad you've gotten boosted.

 

Bill Walsh: Yeah, OK, thank you, Dr. Talbot for that. And thanks for all those questions. We're going to take more of your questions shortly. Let me turn back to our experts for a moment. Lori Smetanka, how are nursing facilities addressing staff shortages? You mentioned this before. And what can families do to ensure that their loved ones aren't being ignored or overlooked?

 

Lori Smetanka: Sure. It's a good question. Inadequate staffing in nursing homes is a problem that predates the pandemic, but we're seeing critical shortages right now. Nursing homes are required to have sufficient staff to meet the needs of residents. I think people really need to understand that, but we also know that many families help provide support for care and additional care for their loved ones, like helping with meals or helping with grooming among other things. And this again is why visitation is also so important. So, a number of facilities are struggling to attract or keep staff, and some are increasing wages and offering bonuses, but we're also seeing a lot of temporary or agency staff and the use of staff who are not fully trained and certified, and that can put residents at risk. So, we do encourage families to visit as often as possible in person or virtually stay connected with their loved ones, pay attention to what's happening inside the facility. Nursing homes are required to post their staffing by shift every day. So look for that; it should be in a visible place. And if your loved one or the residents are not receiving the care and services that they need, the residents and families should absolutely raise concerns with the facility administration. And again, they can contact their long-term care ombudsman for help or file a complaint with their state survey agency. And they can get, again that contact information on the Consumer Voices website at www.theconsumervoice.org. But definitely raise questions and be vigilant about what's happening in the facility.

 

Bill Walsh: All right, Lori. Thanks so much for that. Dr. Goldman, let me turn back to you. Let me ask a threshold question. Why are vaccinated people still getting COVID-19 and what is the risk of reinfection for those who have been vaccinated?

Jennifer Goldman: And that is such a common question that we get really every day and in primary care. The answer is that no vaccine is 100 percent effective. And that's really the case for all vaccines. But you get vaccinated to prevent severe illness or death from COVID. You also get vaccinated to hopefully decrease the risk of living with long-COVID symptoms, because as we're seeing, there does seem to be a decreased chance of long-COVID in those that are vaccinated. But you can still get infected. You can still get a mild, relatively mild, infection compared to those that are not vaccinated. And so this is why vaccinated people really can still get COVID. The other reason is that the COVID-19 virus is trying to stay alive, and the way viruses do that is that they mutate, and that's what we're seeing with these variants. And so that's the reason why all of the experts on this panel have consistently recommended getting boosted, as well, because booster shots really do tend to decrease your risk of getting COVID in the first place.

 

With regard to the risk of reinfection for those vaccinated, we know from the studies that unvaccinated people are about two-and-a-half times more likely to get reinfected compared to those who have been fully vaccinated. But, again, as we've seen with some of our callers, and we certainly see in our communities, the risk is not zero. And this is because new variants, again, are continuing to emerge, and they do increase the risk of reinfection. And so most importantly, again, wear your mask, wash your hands, avoid large crowds, get vaccinated and get boosted. And really be smart about your choices during the ongoing pandemic.

 

Bill Walsh: OK, thank you very much for that. We've had a number of requests to repeat the details about how to get free at-home tests. Let me give you that information now. You can sign up online at www.covidtests.gov. Or you can call 1-800-232-0233. So go ahead and order your free in-home COVID test. Dr. Goldman, let me swing back to you. You know, last fall there was a lot of buzz about antivirals. Are they available now and how do they differ from other treatments?

 

Jennifer Goldman: Sure. So back in December 2021, the FDA did authorize emergency use authorization for two oral antivirals, so antiviral pills that you could take if you're at high risk of progressing to severe disease. Those are Pfizer's Paxlovid, and Merck's Molnupiravir, and again, both are pills that you would take. The Paxlovid is approved for mild-to-moderate COVID in patients who are 12 and older, and who are at high risk for progression. So how do you know if you're at high risk? If you are immunocompromised, if you've had a transplant, if you have cancer, if you're on dialysis, if you have very uncontrolled diabetes, lung disease and some other conditions, then that would make you at higher risk for progression to severe disease. These medicines are offered by prescription only. They have to be given as soon as possible after diagnosis if the person qualifies and within five days of the onset of symptoms. They're quite a lot of pills. The Paxlovid is three tablets twice a day for five days, and then the Molnupiravir is four tablets twice a day for five days. And they do have some side effects. They can cause diarrhea, they can increase blood pressure, they can cause muscle aches. And you can't take it if you have kidney or liver disease. But the good news is that with the Paxlovid, it reduces the risk of hospitalization and death by, it looks like 88 percent, and so that's good news for those that are at really high risk of getting very, very sick from COVID. I just want to emphasize though that these are not a substitute for getting vaccinated. Remember, getting vaccinated helps protect you from getting severe COVID in the first place. And just because we have pill form treatment now of antiviral treatment for COVID, doesn't mean that it's any less important to get vaccinated. The most important thing that you can do for yourself, your loved ones and your community right now is to prevent yourself from getting COVID in the first place. And if you do get it even after being vaccinated, the chances are that it's very mild, and you're not likely to progress to severe disease.

 

Bill Walsh: OK, thanks for that, Dr. Goldman. Dr. Talbot, let's talk a little bit about COVID tests. I wonder how the at-home tests differ from those administered by medical professionals, and is there a situation where somebody should choose one over the other?

 

Tom Talbot: Yeah, it's a good, question, and I'm excited because my home tests will be arriving later this afternoon by the mail. I got a notification. The way the tests work, the home tests are mainly what we call an antigen test or a lateral flow test. So, it measures a part of the viral protein, and the lab tests that you get from your medical provider often is what we call a PCR test that specifically looks for the viral kind of genomic material and try to amplify that up. Both are very good at identifying individuals with COVID. Probably the PCR is a little bit more sensitive, and so may detect cases earlier, but those home kits are very good. And I think the general advice is that have those at home. If you start having symptoms to take, use the kit, use the test. Make sure you follow the directions. They're very specific. You have to keep the test flat because it has to be lateral so the flow can be truly lateral. You have to make sure you read it and sometimes the lines can be a little faint. But they can be helpful. And if those are positive, then that's very reliable. You don't need to go to your provider and get it confirmed with a laboratory test. You need to act appropriately as infected.

 

The one caveat is early on with omicron, when you have symptoms the first day or two, you may have a false negative home-kit test. So the recommendations in the kit are, if you're feeling cruddy, you still stay away from folks 'cause even if it's not COVID, you don't want to spread other stuff to them, and retesting it in 24 to 36 hours with a home kit. Or that may be where you decide at that point to go get a test at your medical provider. But both are quite good to help us kind of identify if we've got COVID and how to act appropriately.

 

Bill Walsh: OK, let me follow up on that. You know, when people are tested for the virus, they aren't usually told which variant they have. But doesn't the treatment and the severity differ quite a bit, whether it's Delta or omicron.

 

Tom Talbot: Yeah, so it's interesting. For most things that we do to manage COVID it doesn't matter what variant you have, whether it was the original strain, the alpha, the delta, we're now at omicron. The different therapies work, the antivirals, the steroids we would use as well. The one exception that we're finding is that the monoclonal antibody is the one that's very specific. And so you may have seen this week, the FDA, at the manufacturer's request, pulled the [indecipherable] on two of the monoclonal antibodies because they don't work against omicron, they just don't work. And so that is where it would be slightly helpful. But now, with omicron so ubiquitous, we really assume everyone has omicron. The challenge is to identify the variant. It's a little bit more complicated testing, so you may not get those results back as quick as you'd like. And so it's kind of sacrificing identifying the infection rather than wait for a while to figure out, oh, not only do you have COVID, but you have X or Y. We'll see down the road if that changes, and variants are emerging so quickly, it may be hard to keep up with each one, but thankfully, most of our therapies have continued to work against all the variants today.

 

Bill Walsh: OK, Dr. Talbot. Thanks so much for that. Now it's time to address more of your questions with Dr. Tom Talbot, Dr. Jennifer Goldman and Lori Smetanka. Jesse, who do we have up next?

 

Jesse Salinas: Our first question is going to be from YouTube. Joanne asks, "Are you guys aware of any issues with false test results with the home kit?"

 

Bill Walsh: Hmm, Dr. Talbot, can you weigh in on that? You were just talking about testing. They were wondering about issues of false positives with the in-home tests.

 

Tom Talbot: Yeah, there have been some reports of some false positive testing, particularly in those that are maybe asymptomatic. I think if you've got clinical symptoms suggestive of COVID then more reliable. They do happen. They're fairly infrequent. We've had a couple instances of folks who may have, for travel reasons, then gone to get the laboratory tests. And I think that may be an instance where you may want to confirm that, but it's not very common with the home kits.

 

Bill Walsh: OK. All right, thank you very much. Jesse. let's go back to the lines.

 

Jesse Salinas: Let's bring Vanessa from New Mexico.

 

Bill Walsh: Hey, Vanessa, welcome to our program. Go ahead with your question.

 

Vanessa: Sure, yeah. You know, I was wondering, moving forward a little bit bigger picture kind of question. We have various national standardized certifications for companies or of the sectors, like say the ISO certifications. Are the nursing homes now certified for any kind of things like this — disaster response, pandemic/medical response — and if they are not, is there anything maybe being looked into for the future of developing them? Because we can maybe utilize something like this in making a decision on which nursing home to select. If we know they have some sort of response set up for stocking of supplies, response levels, staffing certifications, licenses, things of that nature, because it seems like early on in this pandemic, there was a lot of confusion and there wasn't any consistency with the nursing homes on how they responded to this pandemic medically.

 

Bill Walsh: You're absolutely right about that, Vanessa. Well, let's ask Lori Smetanka. She's an expert in this area. Lori, what can you tell us about any certifications moving forward and lessons learned from the COVID-19 pandemic so far?

 

Lori Smetanka: Sure. It's a great question. And we definitely need to be learning all the lessons we can from this pandemic, right? Nursing homes, and the vast majority of them, more than 95 percent of them, are certified for Medicare and Medicaid, meaning they have to meet certain requirements set by the federal governments. And that includes emergency preparedness, it also includes preparedness for a variety of different kinds of emergencies and disasters, including pandemic. So nursing homes are required to have emergency plans, to coordinate with their state and local health departments and to have policies and procedures in place for response. The caller is absolutely right that we saw a lot of confusion in the beginning, and that related quite a bit to the sharing of information and a lot of different types of guidance that was happening. So hopefully, we will learn from that moving forward, and there will be a more coordinated effort in terms of responding and requirements related to reporting of information.

 

But people should also educate themselves about the nursing homes that they're looking at. There's good information on the Care Compare website that is operated by the federal government. And you can access that at medicare.gov, and you can get information about staffing levels, about vaccine rates and about how the facilities do with their annual surveys. So you can get some pretty good information about quality levels in nursing homes.

 

And also, certainly ask questions of the facilities that you're working with, of your friends and neighbors, and also certainly contact your long-term care ombudsman for additional support and questions with respect to helping to choose a nursing home in your community.

 

Bill Walsh: Yeah, that's a great point. And a reminder to all of our listeners that there is an ombudsman service in every state, and that's a free service for consumers. And I'll just give a plug to AARP's own nursing home dashboard, where we are tracking infection rates and vaccination rates in facilities around the country. You can access that on our website at aarp.org\nursinghomedashboard. All right, Jesse, let's go back to the lines. Who do we have next?

 

Jesse Salinas: Our next caller is going to be Mike in Florida.

 

Bill Walsh: Hey, Mike, welcome to our program. Go ahead with your question.

 

Mike: Hey, thanks for taking my call. Just for one of the doctors, a quick question in terms of once you've had COVID. I'm actually scheduled for my booster. Should there be a certain timeframe from when you recover to when you get your next inoculation shot?

 

Bill Walsh: Until when you get your booster, is what you're asking? Yeah, OK. Dr. Talbot, why don't we take a run at that? Is there a recommended timeframe?

 

Tom Talbot: Yeah, so the general advice we give is if you have COVID, you need to wait until you're no longer infectious to go get your booster. And then after that, you actually may go ahead and get your booster. Now you probably do have some protective immunity from that COVID infection, but the issue is that may vary. We don't know, you know, with milder cases, how long that lasts. And so we worry with some folks saying, oh, you can wait X or Y months. You may kind of forget about that and then be vulnerable. So it is fine after you come out of isolation to go ahead and get your booster and kind of proceed from that. It's also OK if you want to wait a little bit, I just get reluctant on saying, ‘wait a little bit,’ because that may draw from one to two to five, six months, and then that's too far out. So I've been telling my patients, once you're out of isolation, just go ahead and go get that booster and get that knocked out.

 

Bill Walsh: OK. Thanks very much for that, Dr. Talbot. Jesse, who do we have up next?

 

Jesse Salinas: Yeah, our next question is from Marissa on Facebook and she asks, "Can my grandmother be vaccinated at 95? She seems in good health."

 

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

 

Jennifer Goldman: Yes, I can. I definitely recommend your grandmother being vaccinated. I recommend everybody's grandmother, grandfather and everybody else to be vaccinated. We haven't seen any concerning information about getting vaccinated later in age. And so, in fact, as we get older, our immune system can sometimes weaken. And so, vaccinating someone in their 90s is the best way to protect them from getting severely ill with COVID and needing to be hospitalized or worse.

 

Bill Walsh: OK, thanks very much for that, Dr. Goldman. Who do we have up next, Jessie?

 

Jesse Salinas: We're going to bring in Marlene from New Jersey.

 

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

 

Marlene: Yeah, thank you very much. I'm very interested in infection control. My brother died in a nursing home following surgery. He was there for his rehab, and unfortunately, they failed properly isolate residents who tested positive for COVID-19. They didn't adequately screen or test the employees. There was so much, it was just awful. And I can go on and on. It's a very sad story.

 

Bill Walsh: Yeah, that's terrible. I’m so sorry.

 

Marlene: What I would like to know is, the attorney general from New York recommended that every nursing home, as well as hospitals and all long-term care facilities, she felt should have a full-time infection preventionist in each home. How feasible is this to pay for something like this in each home, instead of giving these jobs… I'm retired, but I worked 43 years as a PT. And I noticed when people had to do infection control, they had a hundred other jobs to do. And can't we just hire full-time infection preventionists that their job is to keep that facility safe. And that's their full-time job. Is this possible? Because I thought the attorney general of New York had a wonderful idea.

 

Bill Walsh: Well, well, first I'm so sorry to hear about your brother. Let's turn to Lori Smetanka and talk about this proposal about having a full-time infection preventionist in facilities. Lori?

 

Lori Smetanka: Sure, and I'm also sorry to hear about your brother. Condolences to your family. That's an important proposal that has been suggested, and there's actually some legislation in Congress right now that does include that provision. It's something we are strongly supportive of, and we think it would go a long way to helping with infection prevention and control in facilities which is, by the way, even before the pandemic, the number one deficiency or problem that's been cited in nursing homes across the country. So even before we were dealing with the pandemic, infections and infection prevention and control has been a serious problem in nursing homes. And one we definitely need to get a better handle on, and I think the pandemic has really just reinforced that. So there is a proposal to support that in Congress right now. It's one that we are advocating for and would like to see across the finish line and get enacted.

 

Bill Walsh: OK, Lori, thanks so much for that. And Lori's mentioned a couple of times the long-term care ombudsman programs around the country. I wanted to give that website out again. It is the www.theconsumervoice.org. Go there to look up the ombudsman program in your state if you need some help working with your facilities. Let's take another question. Jesse, who do we have up next?

 

Jesse Salinas: Yeah, we're going to take Diane from Wisconsin.

 

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

 

Diane: Hi, my question is, I know we've been talking about nursing homes a lot, but I wanted to know ... can you hear me?

 

Bill Walsh: Yes, go ahead.

 

Diane: OK. I wanted to know, are nursing homes and assisted-living facilities held at the same standards. In other words, do they have like the same nursing homes and living assisted-living facilities?

 

Bill Walsh: Right? No, it's a great question. Lori, can you help Diane out with that?

 

Lori Smetanka: Sure, it's a great question and one that creates a lot of confusion for people. They are not held to the same standard. Nursing homes that are certified for Medicare and Medicaid, which is, as I mentioned earlier, more than 95 percent of them, have to meet standards set by the federal government. And they're bound by the rules that the federal government set and have to meet those. Assisted-living facilities are regulated and licensed at the state level. And so they have to meet state requirements. And as you can imagine, they vary widely across the country.

 

Bill Walsh: All right, Lori, thank you so much for that. And thank you to all our experts. This has been a really informative discussion.

 

And thank you, our AARP members, volunteers, and listeners for participating in the call today. AARP, a nonprofit, nonpartisan membership organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we're providing information and resources to help older adults and those caring for them protect themselves from the virus, prevent its spread to others, while taking care of themselves. All of the resources referenced today, including a recording of today's Q&A event, can be found at aarp.org\coronavirus beginning tomorrow, Jan. 28. And if you're looking for Medicare assistance during COVID-19, please visit shiphelp.org\COVID-19. That's shiphelp.org\COVID-19. Go there if your question was not addressed, and you'll find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please join us on Feb. 10 at 1:00 p.m. for another live coronavirus Q&A event. We hope you can join us. Thank you and have a good day. This concludes our call.

[00:00:00] 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.

[00:00:15] [Española]

[00:00:22] AARP, a nonprofit, nonpartisan, membership organization has been working to promote the health and well-being of older Americans for more than 60 years. In face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them. While new coronavirus cases in some parts of the U.S. have started to decline, they are still dangerously high relative to previous surges. Many hospitals continue to be overrun, and Americans are wondering if the pandemic will ever end. And, once again, nursing homes are being hit hard. While deaths have increased just slightly, cases have increased significantly among nursing home residents and staff, stoking fears and concerns among their families. Today we'll hear from an impressive panel of experts about these issues and more.

[00:01:17] If you've participated in one of our tele-town halls before, you know this is similar to a radio talk show, and you have the opportunity to ask your question 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're joining on Facebook or YouTube, you can post your question in the comments.

[00:01:47] We have some outstanding guests joining us today, including a top epidemiologist, a clinical testing expert and another on quality standards in nursing homes. We'll also be joined by my AARP colleague, Jesse Salinas, who will help facilitate your calls today.

[00:02:26] This event is being recorded, and you can access the recording at aarp.org/coronavirus, 24 hours after we wrap up.

[00:02:51] Now I'd like to welcome our guests. Tom Talbot, MD, is the chief hospital epidemiologist at Vanderbilt University Medical Center. Welcome back to the program, Dr. Talbot.

[00:03:03] Tom Talbot: Thanks Bill, I'm happy to be here.

[00:03:05] Bill Walsh: All right, we're also joined today by Jennifer Goldman, a doctor of osteopathic medicine, family physician and chief of primary care at the Memorial Healthcare System. Welcome back to the program Dr. Goldman.

[00:03:19] Jennifer Goldman: Thank you so much. Happy to be here as well.

[00:03:21] Bill Walsh: All right, delighted to have you. And we also have with us today, Lori Smetanka, who is the executive director of the National Consumer Voice for Quality Long-Term Care. Welcome Lori, and thanks for joining us again.

[00:03:35] Lori Smetanka: Thanks so much, Bill. Glad to be here today.

[00:03:37] Bill Walsh: All right. Well thanks to all of you. Let's go ahead and get started. Dr. Talbot, a Reuters Analysis of Public Health Data released last week shows that COVID-19 infections are quickly plummeting in areas that were hit hardest during the holidays, while they're surging in the south and the west. How does this complicate public health messaging and efforts to tamp down omicron’s spread?

[00:04:21] Tom Talbot: Yeah, that’s a really great question, and I think as we’ve seen in the last now two plus years, the messaging has been very confusing and often confounding. And so my advice to folks is, yes, indeed, we are seeing the start of the light at the end of the tunnel of cases coming down. And so we need to think globally when we hear that data, but we need to act locally. So, while I’m hearing the good news up north, where I’m at in Tennessee, we’re still on the uptick, and so we need to kind of act appropriately. But overall, it does show some hopeful signs. But don't feel like you should let off your guard and stop masking if your activity is going up, just because places north of you or east of you or elsewhere are improving. Just know that that hopefully is coming your way soon.

[00:05:05] Bill Walsh: Yeah, I mean it seems like it kind of sends mixed messages to people, right? Some folks feel like it's time to let down their guard. Others aren't quite sure.

[00:05:14] Tom Talbot: Yeah, yeah, exactly.

[00:05:15] Bill Walsh: Yeah. Well, let me follow up on that, Dr. Talbot. I wonder if omicron, which is a highly contagious, but less virulent strain of COVID-19, signals a transition from a pandemic to an endemic, like the seasonal flu. You know, will things get back to normal this year? And I also want to know if there are any other variants that experts are keeping an eye on?

[00:05:39] Tom Talbot: Yeah, so let's hit on the first part. So, I’m always a little hesitant to predict the future because if you go back to just Thanksgiving, omicron was just a word in the Greek alphabet. And so we saw how quickly omicron, as infectious as it is, took off, spread across the world phenomenally. So I always get nervous. I think that it's not going to be a light switch where all of a sudden we go from pandemic to endemic. It's going to be a transition. And that transition, germane to what we just talked about, may differ based on where you live, based on how many folks have gotten infected, how many folks have gotten a vaccine, and now we're learning even more importantly, boosted with their vaccine, to allow that protection so things can't continue to spread. In my part of the world, and we have some counties in Tennessee where we have over half the population has yet to receive a single dose of vaccine. So we're still not to where we would be endemic in those areas, but I think we're going to get there. And I think what you're seeing is folks kind of taking those baby steps, kind of learning what we can do carefully and safely and within kind of our own risk analysis and thinking of the surge to others. You know, that's why we're not locking down like we did early on, even though the case numbers are far more than they were before, but we've got to be careful. And we can't, it will not be a light switch where we just throw off our masks and be able to do everything we did before. We've got to learn how we do that, and that's through things like being safe, vaccinating, boosting, and if you're sick, stay away from people, early testing, wearing those masks, and kind of gradually getting back to normal.

[00:07:14] I think in terms of other variants, there's one folks may have heard of this week that has the unfortunate term as the stealth variant of omicron, which makes people think that means we can't detect it in our tests, which is not true. It's a kind of sister of omicron that actually looks like it's been around for a while, and the stealth refers to a specific kind of signal that they do see on these testings that they didn't see with the original omicron. But they all can be tested. We don't know yet right now what that one means, if it's more infectious or cause more trouble, so I think we just have to kind of be patient and continue on with what we're doing. The next Greek letter is PI, so let's just hope it's a while before we get to that one.

[00:07:57] Bill Walsh: All right. Very good. Thank you so much, Dr. Talbot. Let's turn to you, Dr. Goldman. Debilitating symptoms can last longer for some individuals, a condition that's some have called long COVID. Is long COVID real, and what do we know about it? And how common is it?

[00:08:17] Jennifer Goldman: Absolutely. Long COVID is very, very real. It's known by quite a few names, actually. Long COVID, post-COVID, post-COVID long-haulers or even post-acute sequalae of COVID-19. Really, it's defined as symptoms lasting for more than four weeks after infection. And it can occur in anyone who's had COVID, even if the infection was mild. So it's not necessarily predicted based on severity of the infection initially. It can have symptoms like brain fog, which many people have heard of, which really is defined as difficulty concentrating, really difficult to get back to work, difficult to get back to normal; fatigue, cough, headaches that can be persistent; sleeping disorders; dizziness; even persistent shortness of breath. It's pretty common you know; on various studies it's shown really a range of about 20 to 40 percent of people will actually remain symptomatic at four to five weeks after infection. And so it's definitely something that is impacting, really at this point, millions of people around the world. We did start a post-COVID long-hauler clinic in our health care system at Memorial Healthcare System within primary care because what we've seen is that the majority of patients who have long COVID symptoms do well in an environment that is multidisciplinary and that is coordinated by effective, accessible primary care. And so we started a clinic locally and have seen hundreds of patients in that practice and are learning best practices and really how to address some of the symptoms that our patients are experiencing.

[00:10:13] Bill Walsh: Well, that's remarkable. I hadn't heard before that 20 to 40 percent of people who get COVID could experience the symptoms of long COVID. And I mean, obviously we're still learning about that phenomenon. How long, if you know, can you tell us before the extreme fatigue and the brain fog will pass? When does taste and smell resume for those who haven't had it for months?

[00:10:40] Jennifer Goldman: Sure, sure. So, like I said, long COVID by definition are symptoms lasting four weeks or longer. And that's really the most common timeframe — it's about four to 12 weeks that people have symptoms after initial infection. After 12 weeks, though, we are seeing that a number of people in some studies of almost half of people with post-COVID symptoms feel better after 12 weeks. However, we do see that some people continue to have symptoms lasting months afterwards, and even through a year. It is heartening to see, however, that many people do recover at one year; however, there are few that still remain symptomatic afterwards.

[00:11:26] With regard to taste and smell, this is pretty common. About 40 percent of people in some studies have this loss of taste and smell. Most do recover after a month, so after that four-week time period. However, some people don't recover so fast, and they may remain without their taste or smell for many months. And again, through that year. The treatment for prolonged taste and smell is still being investigated. There is some smell training or olfactory training that can be done at specialized centers, but other research is yet to be done to find the most effective treatment. The good news, though, is that for the majority of people, most recover their sense of taste or smell after about a month.

[00:12:16] Bill Walsh: Just a reminder of how much we're still learning about COVID-19. Thanks for that, Dr. Goldman. Lori, let's turn to you. What are the biggest challenges for families in dealing with facilities that care for elderly or disabled people as omicron surges? I know it's been spreading through those facilities. I mean, it makes perfect sense. Folks are living in such close proximity to each other.

[00:12:42] Lori Smetanka: Right, it has been a concern for family members, for residents, and they're concerned about their loved one's safety and also that they're getting the care that they need, and the issues are really related to spread of the virus and making sure that they're well cared for. But also because there's significant short staffing in nursing homes — not enough people available provide the care in many homes. So many family members are concerned about that and also what that's going to mean for visitation, because we know, last year and the year before nursing homes were locked down for significant amounts of time. And so they're worried about being able to get in and see and assist their family member.

[00:13:23] And despite the fact that federal guidance right now says that visitation needs to be allowed for all residents at all times, some states have been putting in place additional safety measures, such as requirements related to masking or testing in order to get at stemming the spread of the virus. So, while we all need do our part in stopping the spread, we've been strongly encouraging as AARP has, all residents, staff and family members to be vaccinated, including getting boosters, and following infection prevention protocols. It's also really critical that any additional measures that are put into place by states don't make visitation inaccessible for family members. And if masks or testing as required, which we think are reasonable efforts, they do need to be coordinating the federal and state governments with the facilities to ensure that those things are available at no cost to visitors, so that we don't have that separation again.

[00:14:17] Bill Walsh: Right. OK, Lori, thanks so much for that. Lori, let me follow up with you. You know, one of the issues in nursing homes, even outside of nursing homes has been the uptake of booster shots, but I think it's been a particular issue in nursing homes. I wonder if you can talk a little bit more about what needs to be done to get nursing home residents and staff boosted.

[00:14:48] Lori Smetanka: Absolutely. I think what we know is that the vaccines have made the biggest difference in stemming the spread of COVID. And so, ensuring that residents and staff are vaccinated, and the visitors, is really critical. We need a lot more education around how important boosters are. While we do have high percentages of residents that are boosted, not as high of staff, so that's something we also continue to need to work on. We're not quite there yet with the booster numbers. We need to really get those up in our communities and ensure that residents and staff and visitors have access to boosters. They need to be much more widely accessible, and they need to be given in facilities versus asking residents or staff to go out into the community to receive them, which often is very difficult for them in terms of getting there, making the time to do it. So I think if we replicated the efforts of the initial vaccine rollout, for example, and bring the vaccines to the nursing homes for residents, staff and visitors, that would make a big difference. And as we look at increasing requirements around vaccinations, it would really be helpful if, as we talk about being fully vaccinated, if the CDC would change that definition to include booster shots. I think that would also help make a difference.

[00:16:04] Bill Walsh: Well, that's very interesting. So, if a family wants to make sure that their loved one in a facility gets boosted, they can't count on the facility to administer that? They have to arrange for a, what, an outside pharmacy to come in and do it?

[00:16:18] Lori Smetanka: Well, certainly there should be coordination between the facility and the long-term care pharmacies that they are working with, but that's being done in better manners than others in some facilities. And so, certainly, it's something that families need to be asking about, asking their facility about getting the boosters, and working to coordinate and making sure that they don't have to take the resident out. But we can somehow work with the community to get vaccines and boosters into the facility.

[00:16:45] Bill Walsh: All right, Lori. Thanks so much. We'll talk more about that in a moment. We are going to get to your live questions shortly. But before we do, I want to bring in Nancy LeaMond. Nancy is the executive vice president and chief advocacy and engagement officer for AARP. Welcome, Nancy.

[00:17:11] Nancy LeaMond: Welcome to you and to our guests. I'm delighted to be here, Bill.

[00:17:14] Bill Walsh: All right. So this week, AARP sent two important letters to the Department of Health and Human Services. One was urging lower Medicare premiums, and the other was asking for Medicare to cover at-home COVID tests. What can you tell us about those issues?

[00:17:33] Nancy LeaMond: Well first, AARP is urging the government to reassess the Medicare Part B premium increase that was announced last year. Without a change, these premiums will go up 14.5 percent, which is just too much, especially considering the hefty increase is due to one outrageously priced prescription drug. It's unconscionable that a single high-priced drug is driving up premiums for all Medicare beneficiaries, many of whom are already struggling to make ends meet.

[00:18:09] Bill Walsh: This issue comes up again and again. If we want to keep Medicare affordable, we've got to fix the underlying problem of out of control prescription drug prices.

[00:18:19] Nancy LeaMond: Yes, absolutely. Prescription drug price reform is AARP's number one advocacy goal for good reason. Last year, an estimated 18 million Americans were unable to afford their medication due to high costs. And Americans are paying three times more than what people in other countries pay for the same brand name drugs. The big drug companies will continue to rip off seniors and taxpayers until Congress acts to reign them in. And we're working hard on this.

[00:18:49] Bill Walsh: All right. Now, AARP is also urging Medicare to cover the cost of at-home COVID tests. Why is that so important?

[00:18:58] Nancy LeaMond: Well, as we've heard from our experts, testing is one of the most effective ways to slow the spread of the coronavirus, which is why private insurers are now required to cover the cost of over-the-counter at-home tests. But Medicare is not covering them yet, even though older Americans are among the most vulnerable for serious complications from COVID. This is a glaring omission. AARP is fighting to ensure that the 64 million Americans on Medicare have the same access to no-cost tests as those with private insurance.

[00:19:33] Bill Walsh: OK. Now until Medicare acts, all American households are still eligible to receive four free at-home tests through the mail. How can people order those tests?

[00:19:45] Nancy LeaMond: Well, you can order your four free tests online or by calling a toll-free number. To request your at-home tests visit www.covidtests.gov or call 1-800-232-0233. Once you sign up, the tests will be mailed to your home.

[00:20:09] Bill Walsh: All right, very good. That was www.covidtests.gov or call 800-232-0233. Since we're talking with our panel about nursing homes today, there was some news on that front this week too, wasn't there?

[00:20:27] Nancy LeaMond: Yes, since the beginning of the pandemic, AARP has been sounding the alarm about the unfolding disaster in America's nursing homes. The pandemic brought to light problems that have plagued these facilities for decades, including staffing shortages, poor infection control, transparency and accountability. I'm happy to report that our work is making a difference. Just yesterday, the federal agency that regulates nursing homes announced that it has, for the first time ever, posted information about weekend staffing levels, staff turnover and weekend nurse coverage on the Medicare Care Compare website. So families can have access to that important information. We know that facilities with solid staffing and low staff turnover, have much better outcomes for the residents.

[00:21:20] Bill Walsh: All right. Well, that's wonderful news. One last question. AARP's Fraud Watch Network has received complaints about fake COVID testing sites. Do you have any advice on how to choose a safe place to get tested?

[00:21:35] Nancy LeaMond: Well, unfortunately, scammers are everywhere, and will try and take advantage of any situation. The safest bet is to use a testing site recommended by your health department or your doctor or visit an established clinic or pharmacy. If you do visit a pop-up testing site, be sure to only provide standard information, such as your health insurance card. If you're asked to provide your Social Security number or to pay money up front, those are absolutely red flags. And also, if the staff isn't wearing protective gear, or if you feel uncomfortable, listen to your gut and go somewhere else.

[00:22:16] Bill Walsh: All right, that sounds like great advice. Well, Nancy, thanks so much for the update and thanks for being here with us today.

[00:22:23] Nancy LeaMond: Thanks, Bill.

[00:22:24] Bill Walsh: All right. It's now time to address your questions about the coronavirus with Dr. Tom Talbot, Dr. Jennifer Goldman and Lori Smetanka.

[00:22:52] [Española]

[00:22:53] All right, now I'd like to bring in my AARP colleague, Jesse Salinas, to help facilitate your calls today. Welcome, Jesse.

[00:23:01] Jesse Salinas: Happy to be here today, Bill.

[00:23:02] Bill Walsh: All right. Who do we have first on the line?

[00:23:06] Jesse Salinas: Our first call is going to be from Rita in South Carolina.

[00:23:09] Bill Walsh: Hey, Rita. Welcome to our program. Go ahead with your question.

[00:23:14] Rita: Thank you. I have a concern about a facility, not a nursing home. It's a rehab place. And that they don't demand personnel to be vaccinated. And I have a problem with that, a very big one. My husband is there, and of age, and they have a change of personnel all the time, and it's very difficult for them, I understand. But it's worse if he gets contaminated by staff personnel.

[00:24:01] Bill Walsh: Right.

[00:24:01] Rita: How do you find out how much they are vaccinated and stuff. You don't want to be accusatorial at the place where he's been because it's hard to change or find something else.

[00:24:17] Bill Walsh: Yep, Rita, let's ask Lori Smetanka about that situation. Lori, what can you tell Rita and other listeners with similar concerns?

[00:24:26] Lori Smetanka: Sure, well vaccination of staff I think is critically important, and we do have a federal vaccine mandate that is being implemented for people that work in health facilities, like hospitals and nursing homes. It's in the process of being implemented right now and will be happening over the next two months and all staff need to be vaccinated. So that is definitely something that we're happy to see being put into place. I think Rita mentioned that this was not a nursing home. If it were a nursing home, there's vaccine rates for staff on the Care Compare website that Nancy referenced just a few minutes ago that the federal government operates. But in terms of questioning about vaccine rates for staff in the facility where her husband is, I would certainly talk to the administration about that. Maybe the Department of Health can provide some information, and the long-term care ombudsman program might be able to assist you in getting more information, as well. And you can find an ombudsman in your area through our website at www.the consumervoice.org.

[00:25:38] Bill Walsh: OK, that was www.theconsumervoice.org, and Lori referenced the long-term care ombudsman. That’s a free service to help consumers advocate on their behalf with long-term care facilities. Let's take another question. Jesse, who do we have up next?

[00:26:02] Jesse Salinas: Our next call is going to be Elizabeth in Arkansas.

[00:26:05] Bill Walsh: Hey Elizabeth, welcome to the program.

[00:26:08] Elizabeth: Thank you. My granddaughter tested positive on Monday for the virus, and it was recommended that she take ibuprofen and stay home. But she's had a lot of chest pain and just all of the symptoms. And I was just wondering what the recommended treatment at this time is for the coronavirus.

[00:26:36] Bill Walsh: OK, well, let's ask one of our doctors. Dr. Talbot, can you weigh in on that?

[00:26:40] Tom Talbot: Yeah, first off, I hope she starts feeling better soon, Elizabeth, but I think a lot of that depends on her underlying age and other kind of comorbidity conditions. But we have a variety of different treatments we can give folks that are at higher risk, those that may have a weaker immune system. We have at least one monoclonal antibody that still works against the omicron variant and some oral antivirals.

[00:27:03] I think the biggest thing is, you know, if she's not feeling well or getting worse, to always link up with her primary provider and make sure that there's nothing else that needs to be done related to COVID. And hopefully she'll turn the corner and be feeling better. And hopefully everyone around her is vaccinated and boosted, so they're not at as much risk to get it too. But hopefully she's feeling better, and I would just reach out to her clinician to kind of help with her specifics, but there are some options for folks.

[00:27:30] Bill Walsh: OK, very good. Thanks, Dr. Talbot for that. Jesse, let's go back to the phone lines. Who do we have next?

[00:27:36] Jesse Salinas: Yep, let's take Linda in Indiana.

[00:27:39] Bill Walsh: Hey, Linda. Welcome to our program. Go ahead with your question.

[00:27:43] Linda: Hi. Yes, my question is, I have underlying conditions, and I have been vaccinated and boostered, and I am just now past my 10-day quarantine from having COVID. I still have a lot of congestion. I am really concerned as to if I would get this again, because I call myself being really, really careful. I was listening to what she was saying earlier about how these symptoms can linger for so long. And I'm 66 years old, I take medication for rheumatoid arthritis, which does affect my immune system. But I'm really concerned if I'm going to catch this again. 'Cause I didn't have to go to the hospital, but it was serious, really serious.

[00:28:38] Bill Walsh: Sure. Well, Linda, let's ask Dr. Goldman about the symptoms of long COVID and the chances of someone who has been vaccinated and boosted and got COVID, of getting it again. Dr. Goldman?

[00:28:52] Jennifer Goldman: Hi, and thank you, Linda, for that question. And first off, I'm glad that you're starting to feel better, and that you've turned the corner with this. That's fantastic news. And I'm also so glad that you've been vaccinated and boosted because we know that having been vaccinated and boosted that, not only is your chance of getting reinfected lower, but your chance, according to many studies now, of developing persistent long-COVID symptoms is also seeming to be lower. And so that's very good news.

[00:29:29] You know, always with this pandemic is that there are other variants that we are hearing about. And so there is a potential of getting sick again. That does exist. But you've done absolutely everything you can to protect yourself. And what I would say going forward are a few things: Make sure that you continue to wear your mask, make sure you really continue to wash your hands, use hand sanitizer. Anytime that you go out, make sure that you avoid large gatherings, because there still can be spread in any place, and you want to lower your risk. And then lastly, and I really think most importantly, link up with your primary care doctor and make sure that you're talking to them about your symptoms. It's really common to have a little bit of a lingering cough or some congestion for a couple of weeks after COVID. If the symptoms, though, if they last for more than four weeks, then that's when sometimes we'll term that long COVID, and that's why having a relationship with your primary care provider and having access to care with them is the most important thing. They can probably see you over tele-health, or you could go into the office and be examined. And so I really recommend that you continue to do that.

[00:30:53] Bill Walsh: OK, I wonder if the fact that Linda has just recently gotten over a bout of COVID mitigates the seriousness of symptoms if she were to contract it again.

[00:31:07] Jennifer Goldman: Yeah, that is absolutely the thought. Again, we don't know for sure because everything is changing with this pandemic and potential other variants, but the data do look good, for sure, Bill, that reinfection, and especially severe re-infection, is much, much less likely if you've been vaccinated and boosted. And then, of course, if you've also had a recent infection.

[00:31:34] Bill Walsh: OK, thanks very much for that, Dr. Goldman. Jesse, let's go back to the phones.

[00:31:39] Jesse Salinas: Yeah, we're going to take Scott from New Mexico.

[00:31:42] Bill Walsh: Hey, Scott, welcome to the program. Go ahead with your question.

[00:31:47] Scott: Hi. I'm actually scheduled to get my fourth injection at the end of February, and I was just curious — I am immuno-compromised and, again, I'm going to be taking my fourth injection. But my question to all of you is, why, if there's such unsurity about virus itself and the side effects, why don't they initiate a program where you get an injection 28 days after your last one, and keep this going until they get a handle on the omicron virus and whatever mutations there might be? Because my doctor made an analogy, which I thought was very accurate, he said getting these shots are like applying sunscreen, and the more sunscreen you apply, the less chance you have of getting sunburn because you're not going to eliminate the virus. So I was just curious — why don't they mandate, if you can get an injection every 28 days, why don't they do that?

[00:32:55] Bill Walsh: Interesting, and relate sunscreen, yeah, thanks very much for that, Scott. Dr. Talbot, can you take that question from Scott in New Mexico?

[00:33:03] Tom Talbot: Yeah, thanks Scott, and I want to first thank you for getting your booster. And for the listeners, too, folks like Scott need three doses for their regular series. So the fourth would be his booster. I think it's a good question. I think what we still have to remember is that even without the booster protection against severe complications from the virus have been really sustained with the vaccine; the booster's kind of added that in particular with the omicron surge, we've kind of needed that. But there is a concern from immunologists that if we vaccinate too frequently, it'll kind of overwhelm the T-cells to the point where they just don't react as nimbly when we need them to. So, there can be such a thing as too much stimulation of those T-cells. So, we want to avoid that as well. And so I think for right now, it really is just that single booster.

[00:33:51] The big question I think on the booster front, is do we need a second booster? Israel has started doing that and the results are mixed. They seem to boost the antibodies, but are not seeing necessarily an impact in infection. So it's still not clear. So there's an immunologic concern that too frequent may not be helpful. And so that's kind of where we are. But I'm glad you've gotten boosted.

[00:34:15] Bill Walsh: Yeah, OK, thank you, Dr. Talbot for that. And thanks for all those questions. We're going to take more of your questions shortly. Let me turn back to our experts for a moment. Lori Smetanka, how are nursing facilities addressing staff shortages? You mentioned this before. And what can families do to ensure that their loved ones aren't being ignored or overlooked?

[00:34:48] Lori Smetanka: Sure. It's a good question. Inadequate staffing in nursing homes is a problem that predates the pandemic, but we're seeing critical shortages right now. Nursing homes are required to have sufficient staff to meet the needs of residents. I think people really need to understand that, but we also know that many families help provide support for care and additional care for their loved ones, like helping with meals or helping with grooming among other things. And this again is why visitation is also so important. So, a number of facilities are struggling to attract or keep staff, and some are increasing wages and offering bonuses, but we're also seeing a lot of temporary or agency staff and the use of staff who are not fully trained and certified, and that can put residents at risk. So, we do encourage families to visit as often as possible in person or virtually stay connected with their loved ones, pay attention to what's happening inside the facility. Nursing homes are required to post their staffing by shift every day. So look for that; it should be in a visible place. And if your loved one or the residents are not receiving the care and services that they need, the residents and families should absolutely raise concerns with the facility administration. And again, they can contact their long-term care ombudsman for help or file a complaint with their state survey agency. And they can get, again that contact information on the Consumer Voices website at www.theconsumervoice.org. But definitely raise questions and be vigilant about what's happening in the facility.

[00:36:18] Bill Walsh: All right, Lori. Thanks so much for that. Dr. Goldman, let me turn back to you. Let me ask a threshold question. Why are vaccinated people still getting COVID-19 and what is the risk of reinfection for those who have been vaccinated?

[00:36:36] Jennifer Goldman: And that is such a common question that we get really every day and in primary care. The answer is that no vaccine is 100 percent effective. And that's really the case for all vaccines. But you get vaccinated to prevent severe illness or death from COVID. You also get vaccinated to hopefully decrease the risk of living with long-COVID symptoms, because as we're seeing, there does seem to be a decreased chance of long-COVID in those that are vaccinated. But you can still get infected. You can still get a mild, relatively mild, infection compared to those that are not vaccinated. And so this is why vaccinated people really can still get COVID. The other reason is that the COVID-19 virus is trying to stay alive, and the way viruses do that is that they mutate, and that's what we're seeing with these variants. And so that's the reason why all of the experts on this panel have consistently recommended getting boosted, as well, because booster shots really do tend to decrease your risk of getting COVID in the first place.

[00:37:47] With regard to the risk of reinfection for those vaccinated, we know from the studies that unvaccinated people are about two-and-a-half times more likely to get reinfected compared to those who have been fully vaccinated. But, again, as we've seen with some of our callers, and we certainly see in our communities, the risk is not zero. And this is because new variants, again, are continuing to emerge, and they do increase the risk of reinfection. And so most importantly, again, wear your mask, wash your hands, avoid large crowds, get vaccinated and get boosted. And really be smart about your choices during the ongoing pandemic.

[00:38:36] Bill Walsh: OK, thank you very much for that. We've had a number of requests to repeat the details about how to get free at-home tests. Let me give you that information now. You can sign up online at www.covidtests.gov. Or you can call 1-800-232-0233. So go ahead and order your free in-home COVID test. Dr. Goldman, let me swing back to you. You know, last fall there was a lot of buzz about antivirals. Are they available now and how do they differ from other treatments?

[00:39:27] Jennifer Goldman: Sure. So back in December 2021, the FDA did authorize emergency use authorization for two oral antivirals, so antiviral pills that you could take if you're at high risk of progressing to severe disease. Those are Pfizer's Paxlovid, and Merck's Molnupiravir, and again, both are pills that you would take. The Paxlovid is approved for mild-to-moderate COVID in patients who are 12 and older, and who are at high risk for progression. So how do you know if you're at high risk? If you are immunocompromised, if you've had a transplant, if you have cancer, if you're on dialysis, if you have very uncontrolled diabetes, lung disease and some other conditions, then that would make you at higher risk for progression to severe disease. These medicines are offered by prescription only. They have to be given as soon as possible after diagnosis if the person qualifies and within five days of the onset of symptoms. They're quite a lot of pills. The Paxlovid is three tablets twice a day for five days, and then the Molnupiravir is four tablets twice a day for five days. And they do have some side effects. They can cause diarrhea, they can increase blood pressure, they can cause muscle aches. And you can't take it if you have kidney or liver disease. But the good news is that with the Paxlovid, it reduces the risk of hospitalization and death by, it looks like 88 percent, and so that's good news for those that are at really high risk of getting very, very sick from COVID. I just want to emphasize though that these are not a substitute for getting vaccinated. Remember, getting vaccinated helps protect you from getting severe COVID in the first place. And just because we have pill form treatment now of antiviral treatment for COVID, doesn't mean that it's any less important to get vaccinated. The most important thing that you can do for yourself, your loved ones and your community right now is to prevent yourself from getting COVID in the first place. And if you do get it even after being vaccinated, the chances are that it's very mild, and you're not likely to progress to severe disease.

[00:42:08] Bill Walsh: OK, thanks for that, Dr. Goldman. Dr. Talbot, let's talk a little bit about COVID tests. I wonder how the at-home tests differ from those administered by medical professionals, and is there a situation where somebody should choose one over the other?

[00:42:28] Tom Talbot: Yeah, it's a good, question, and I'm excited because my home tests will be arriving later this afternoon by the mail. I got a notification. The way the tests work, the home tests are mainly what we call an antigen test or a lateral flow test. So, it measures a part of the viral protein, and the lab tests that you get from your medical provider often is what we call a PCR test that specifically looks for the viral kind of genomic material and try to amplify that up. Both are very good at identifying individuals with COVID. Probably the PCR is a little bit more sensitive, and so may detect cases earlier, but those home kits are very good. And I think the general advice is that have those at home. If you start having symptoms to take, use the kit, use the test. Make sure you follow the directions. They're very specific. You have to keep the test flat because it has to be lateral so the flow can be truly lateral. You have to make sure you read it and sometimes the lines can be a little faint. But they can be helpful. And if those are positive, then that's very reliable. You don't need to go to your provider and get it confirmed with a laboratory test. You need to act appropriately as infected.

[00:43:37] The one caveat is early on with omicron, when you have symptoms the first day or two, you may have a false negative home-kit test. So the recommendations in the kit are, if you're feeling cruddy, you still stay away from folks 'cause even if it's not COVID, you don't want to spread other stuff to them, and retesting it in 24 to 36 hours with a home kit. Or that may be where you decide at that point to go get a test at your medical provider. But both are quite good to help us kind of identify if we've got COVID and how to act appropriately.

[00:44:09] Bill Walsh: OK, let me follow up on that. You know, when people are tested for the virus, they aren't usually told which variant they have. But doesn't the treatment and the severity differ quite a bit, whether it's Delta or omicron.

[00:44:27] Tom Talbot: Yeah, so it's interesting. For most things that we do to manage COVID it doesn't matter what variant you have, whether it was the original strain, the alpha, the delta, we're now at omicron. The different therapies work, the antivirals, the steroids we would use as well. The one exception that we're finding is that the monoclonal antibody is the one that's very specific. And so you may have seen this week, the FDA, at the manufacturer's request, pulled the [indecipherable] on two of the monoclonal antibodies because they don't work against omicron, they just don't work. And so that is where it would be slightly helpful. But now, with omicron so ubiquitous, we really assume everyone has omicron. The challenge is to identify the variant. It's a little bit more complicated testing, so you may not get those results back as quick as you'd like. And so it's kind of sacrificing identifying the infection rather than wait for a while to figure out, oh, not only do you have COVID, but you have X or Y. We'll see down the road if that changes, and variants are emerging so quickly, it may be hard to keep up with each one, but thankfully, most of our therapies have continued to work against all the variants today.

[00:45:38] Bill Walsh: OK, Dr. Talbot. Thanks so much for that. Now it's time to address more of your questions with Dr. Tom Talbot, Dr. Jennifer Goldman and Lori Smetanka. Jesse, who do we have up next?

[00:46:02] Jesse Salinas: Our first question is going to be from YouTube. Joanne asks, "Are you guys aware of any issues with false test results with the home kit?"

[00:46:10] Bill Walsh: Hmm, Dr. Talbot, can you weigh in on that? You were just talking about testing. They were wondering about issues of false positives with the in-home tests.

[00:46:18] Tom Talbot: Yeah, there have been some reports of some false positive testing, particularly in those that are maybe asymptomatic. I think if you've got clinical symptoms suggestive of COVID then more reliable. They do happen. They're fairly infrequent. We've had a couple instances of folks who may have, for travel reasons, then gone to get the laboratory tests. And I think that may be an instance where you may want to confirm that, but it's not very common with the home kits.

[00:46:43] Bill Walsh: OK. All right, thank you very much. Jesse. let's go back to the lines.

[00:46:48] Jesse Salinas: Let's bring Vanessa from New Mexico.

[00:46:50] Bill Walsh: Hey, Vanessa, welcome to our program. Go ahead with your question.

[00:46:56] Vanessa: Sure, yeah. You know, I was wondering, moving forward a little bit bigger picture kind of question. We have various national standardized certifications for companies or of the sectors, like say the ISO certifications. Are the nursing homes now certified for any kind of things like this — disaster response, pandemic/medical response — and if they are not, is there anything maybe being looked into for the future of developing them? Because we can maybe utilize something like this in making a decision on which nursing home to select. If we know they have some sort of response set up for stocking of supplies, response levels, staffing certifications, licenses, things of that nature, because it seems like early on in this pandemic, there was a lot of confusion and there wasn't any consistency with the nursing homes on how they responded to this pandemic medically.

[00:48:08] Bill Walsh: You're absolutely right about that, Vanessa. Well, let's ask Lori Smetanka. She's an expert in this area. Lori, what can you tell us about any certifications moving forward and lessons learned from the COVID-19 pandemic so far?

[00:48:22] Lori Smetanka: Sure. It's a great question. And we definitely need to be learning all the lessons we can from this pandemic, right? Nursing homes, and the vast majority of them, more than 95 percent of them, are certified for Medicare and Medicaid, meaning they have to meet certain requirements set by the federal governments. And that includes emergency preparedness, it also includes preparedness for a variety of different kinds of emergencies and disasters, including pandemic. So nursing homes are required to have emergency plans, to coordinate with their state and local health departments and to have policies and procedures in place for response. The caller is absolutely right that we saw a lot of confusion in the beginning, and that related quite a bit to the sharing of information and a lot of different types of guidance that was happening. So hopefully, we will learn from that moving forward, and there will be a more coordinated effort in terms of responding and requirements related to reporting of information.

[00:49:24] But people should also educate themselves about the nursing homes that they're looking at. There's good information on the Care Compare website that is operated by the federal government. And you can access that at medicare.gov, and you can get information about staffing levels, about vaccine rates and about how the facilities do with their annual surveys. So you can get some pretty good information about quality levels in nursing homes.

[00:49:56] And also, certainly ask questions of the facilities that you're working with, of your friends and neighbors, and also certainly contact your long-term care ombudsman for additional support and questions with respect to helping to choose a nursing home in your community.

[00:50:12] Bill Walsh: Yeah, that's a great point. And a reminder to all of our listeners that there is an ombudsman service in every state, and that's a free service for consumers. And I'll just give a plug to AARP's own nursing home dashboard, where we are tracking infection rates and vaccination rates in facilities around the country. You can access that on our website at aarp.org\nursinghomedashboard. All right, Jesse, let's go back to the lines. Who do we have next?

[00:50:47] Jesse Salinas: Our next caller is going to be Mike in Florida.

[00:50:50] Bill Walsh: Hey, Mike, welcome to our program. Go ahead with your question.

[00:50:54] Mike: Hey, thanks for taking my call. Just for one of the doctors, a quick question in terms of once you've had COVID. I'm actually scheduled for my booster. Should there be a certain timeframe from when you recover to when you get your next inoculation shot?

[00:51:11] Bill Walsh: Until when you get your booster, is what you're asking? Yeah, OK. Dr. Talbot, why don't we take a run at that? Is there a recommended timeframe?

[00:51:21] Tom Talbot: Yeah, so the general advice we give is if you have COVID, you need to wait until you're no longer infectious to go get your booster. And then after that, you actually may go ahead and get your booster. Now you probably do have some protective immunity from that COVID infection, but the issue is that may vary. We don't know, you know, with milder cases, how long that lasts. And so we worry with some folks saying, oh, you can wait X or Y months. You may kind of forget about that and then be vulnerable. So it is fine after you come out of isolation to go ahead and get your booster and kind of proceed from that. It's also OK if you want to wait a little bit, I just get reluctant on saying, ‘wait a little bit,’ because that may draw from one to two to five, six months, and then that's too far out. So I've been telling my patients, once you're out of isolation, just go ahead and go get that booster and get that knocked out.

[00:52:08] Bill Walsh: OK. Thanks very much for that, Dr. Talbot. Jesse, who do we have up next?

[00:52:14] Jesse Salinas: Yeah, our next question is from Marissa on Facebook and she asks, "Can my grandmother be vaccinated at 95? She seems in good health."

[00:52:23] Bill Walsh: Dr. Goldman, can you weigh in on that?

[00:52:25] Jennifer Goldman: Yes, I can. I definitely recommend your grandmother being vaccinated. I recommend everybody's grandmother, grandfather and everybody else to be vaccinated. We haven't seen any concerning information about getting vaccinated later in age. And so, in fact, as we get older, our immune system can sometimes weaken. And so, vaccinating someone in their 90s is the best way to protect them from getting severely ill with COVID and needing to be hospitalized or worse.

[00:53:02] Bill Walsh: OK, thanks very much for that, Dr. Goldman. Who do we have up next, Jessie?

[00:53:07] Jesse Salinas: We're going to bring in Marlene from New Jersey.

[00:53:10] Bill Walsh: Hey, Marlene, welcome to the program. Hey there, go ahead with your question.

[00:53:14] Marlene: Yeah, thank you very much. I'm very interested in infection control. My brother died in a nursing home following surgery. He was there for his rehab, and unfortunately, they failed properly isolate residents who tested positive for COVID-19. They didn't adequately screen or test the employees. There was so much, it was just awful. And I can go on and on. It's a very sad story.

[00:53:41] Bill Walsh: Yeah, that's terrible. I’m so sorry.

[00:53:42] Marlene: What I would like to know is, the attorney general from New York recommended that every nursing home, as well as hospitals and all long-term care facilities, she felt should have a full-time infection preventionist in each home. How feasible is this to pay for something like this in each home, instead of giving these jobs… I'm retired, but I worked 43 years as a PT. And I noticed when people had to do infection control, they had a hundred other jobs to do. And can't we just hire full-time infection preventionists that their job is to keep that facility safe. And that's their full-time job. Is this possible? Because I thought the attorney general of New York had a wonderful idea.

[00:54:33] Bill Walsh: Well, well, first I'm so sorry to hear about your brother. Let's turn to Lori Smetanka and talk about this proposal about having a full-time infection preventionist in facilities. Lori?

[00:54:46] Lori Smetanka: Sure, and I'm also sorry to hear about your brother. Condolences to your family. That's an important proposal that has been suggested, and there's actually some legislation in Congress right now that does include that provision. It's something we are strongly supportive of, and we think it would go a long way to helping with infection prevention and control in facilities which is, by the way, even before the pandemic, the number one deficiency or problem that's been cited in nursing homes across the country. So even before we were dealing with the pandemic, infections and infection prevention and control has been a serious problem in nursing homes. And one we definitely need to get a better handle on, and I think the pandemic has really just reinforced that. So there is a proposal to support that in Congress right now. It's one that we are advocating for and would like to see across the finish line and get enacted.

[00:55:46] Bill Walsh: OK, Lori, thanks so much for that. And Lori's mentioned a couple of times the long-term care ombudsman programs around the country. I wanted to give that website out again. It is the www.theconsumervoice.org. Go there to look up the ombudsman program in your state if you need some help working with your facilities. Let's take another question. Jesse, who do we have up next?

[00:56:17] Jesse Salinas: Yeah, we're going to take Diane from Wisconsin.

[00:56:20] Bill Walsh: Hey, Diane, welcome to the program. Go ahead with your question.

[00:56:26] Diane: Hi, my question is, I know we've been talking about nursing homes a lot, but I wanted to know ... can you hear me?

[00:56:33] Bill Walsh: Yes, go ahead.

[00:56:35] Diane: OK. I wanted to know, are nursing homes and assisted-living facilities held at the same standards. In other words, do they have like the same nursing homes and living assisted-living facilities?

[00:56:48] Bill Walsh: Right? No, it's a great question. Lori, can you help Diane out with that?

[00:56:53] Lori Smetanka: Sure, it's a great question and one that creates a lot of confusion for people. They are not held to the same standard. Nursing homes that are certified for Medicare and Medicaid, which is, as I mentioned earlier, more than 95 percent of them, have to meet standards set by the federal government. And they're bound by the rules that the federal government set and have to meet those. Assisted-living facilities are regulated and licensed at the state level. And so they have to meet state requirements. And as you can imagine, they vary widely across the country.

[00:57:25] Bill Walsh: All right, Lori, thank you so much for that. And thank you to all our experts. This has been a really informative discussion.

[00:57:32] And thank you, our AARP members, volunteers, and listeners for participating in the call today. AARP, a nonprofit, nonpartisan membership organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we're providing information and resources to help older adults and those caring for them protect themselves from the virus, prevent its spread to others, while taking care of themselves. All of the resources referenced today, including a recording of today's Q&A event, can be found at aarp.org\coronavirus beginning tomorrow, Jan. 28. And if you're looking for Medicare assistance during COVID-19, please visit shiphelp.org\COVID-19. That's shiphelp.org\COVID-19. Go there if your question was not addressed, and you'll find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please join us on Feb. 10 at 1:00 p.m. for another live coronavirus Q&A event. We hope you can join us. Thank you and have a good day. This concludes our call.

[Teleasamblea de AARP]

 

Bill Walsh: Hola, Soy Bill Walsh, vicepresidente de AARP, y quiero darles la bienvenida a este importante debate sobre el coronavirus. Antes de comenzar, si desean escuchar esta teleasamblea en español, presionen *0 en el teclado de su teléfono ahora.

 

[En español]

 

Bill Walsh: AARP es una organización de membresía sin fines de lucro y sin afiliación política que ha estado trabajando para promover la salud y el bienestar de los adultos mayores en EE.UU. durante más de 60 años. Ante la pandemia mundial de coronavirus, AARP brinda información y recursos para ayudar a los adultos mayores y a quienes los cuidan.

 

Si bien los nuevos casos de coronavirus han comenzado a disminuir en algunas partes del país, siguen siendo peligrosamente altos en relación con los aumentos repentinos anteriores. Muchos hospitales continúan rebasados y las personas se preguntan si la pandemia terminará alguna vez. Y una vez más, en los hogares de ancianos continúan los contagios. Si bien las muertes han aumentado solo un poco, los casos han aumentado significativamente entre los residentes de hogares de ancianos y el personal, lo que aviva los temores y preocupaciones entre sus familias.

 

Hoy escucharemos a un impresionante panel de expertos hablar sobre estos temas y otros. Si ya han participado en alguna de nuestras teleasambleas, saben que esto es similar a un programa de entrevistas de radio y tienen la oportunidad de hacer una pregunta en vivo. Para aquellos de ustedes que se unan a nosotros 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 su pregunta y los ubicará en una cola para hacer esa pregunta en vivo. Si se unen a través de Facebook o YouTube, pueden publicar su pregunta en los comentarios.

 

Hola, si acaban de unirse, soy Bill Walsh de AARP y quiero darles la bienvenida a este importante debate sobre la pandemia mundial del coronavirus. Estaremos hablando con los principales expertos y respondiendo sus preguntas en vivo. Para hacer una pregunta, presionen *3. Y si se unen a través de Facebook o YouTube, dejen su pregunta en la sección de comentarios.

 

Hoy nos acompañan unos invitados destacados, incluido un epidemiólogo de primer nivel, una experta en pruebas clínicas y otra en estándares de calidad en hogares de ancianos. También nos acompañará mi colega de AARP, Jesse Salinas, quien ayudará a facilitar sus llamadas. Este evento se está grabando y podrán acceder a la grabación en aarp.org/coronavirus, 24 horas después de que terminemos. Nuevamente, para hacer una pregunta, presionen *3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP. O si se unen a través de Facebook o YouTube, coloquen su pregunta en los comentarios.

 

Ahora me gustaría dar la bienvenida a nuestros invitados. El doctor Tom Talbot es el jefe de Epidemiología Hospitalaria en el Centro Médico de Vanderbilt University. Bienvenido de nuevo al programa, Dr. Talbot.

 

Tom Talbot: Gracias, Bill. Un placer estar aquí.

 

Bill Walsh: Muy bien. También nos acompaña hoy Jennifer Goldman, doctora en Medicina Osteopática, médica de familia y jefa de Atención Primaria en Memorial Healthcare System. Bienvenida de nuevo al programa, Dra. Goldman.

 

Jennifer Goldman: Muchas gracias. Feliz de estar aquí también.

 

Bill Walsh: Muy bien, encantado de tenerla. Y también tenemos hoy con nosotros a Lori Smetanka, directora ejecutiva de National Consumer Voice for Quality Long-Term Care. Bienvenida, Lori, y gracias por acompañarnos nuevamente.

 

Lori Smetanka: Muchas gracias, Bill, me alegro de estar aquí hoy.

 

Bill Walsh: Muy bien. Bueno, gracias a todos ustedes. Vamos a comenzar con nuestro debate. Y un recordatorio para nuestros oyentes, presionen *3 en el teclado de su teléfono o dejen sus comentarios en la sección de comentarios en Facebook o YouTube. Comencemos. Dr. Talbot, un análisis de los datos de salud pública publicado la semana pasada muestra que las infecciones por COVID-19 están disminuyendo rápidamente en las áreas más afectadas durante las vacaciones, mientras que están aumentando en el sur y el oeste. ¿Cómo complica esto los mensajes de salud pública y los esfuerzos para reducir la propagación de ómicron?

 

Tom Talbot: Sí, esa es una buena pregunta. Y creo que, como hemos visto en los últimos dos años o más, los mensajes han sido muy confusos, y a menudo desconcertantes. Mi consejo para las personas es que sí, de hecho, estamos comenzando a ver la luz al final del túnel con el descenso en el número de casos. Y debemos pensar globalmente cuando escuchamos esos datos, pero debemos actuar localmente.

 

Entonces, mientras escucho las buenas noticias en el norte, donde estoy, en Tennessee, los casos todavía están en aumento y, por lo tanto, debemos actuar de manera apropiada, pero en general hay algunos signos esperanzadores. Pero no sientan que deben bajar la guardia y dejar de usar mascarilla si aumentan su actividad, solo porque los lugares al norte o al este de ustedes u otros lugares estén mejorando. Simplemente sepan que eso, con suerte, les llegará pronto.

 

Bill Walsh: Sí, parece que les llegan mensajes contradictorios a las personas, ¿verdad? Algunas personas sienten que es hora de bajar la guardia, otras no están muy seguras.

 

Tom Talbot: Sí, sí, exactamente.

 

Bill Walsh: Sí. Bueno, permítame continuar con eso, Dr. Talbot. Me pregunto si ómicron, que es una cepa altamente contagiosa pero menos virulenta de COVID-19, señala una transición de una pandemia a una endemia, como la gripe estacional. Ya sabe, ¿las cosas volverán a la normalidad este año? Y también quiero saber si hay otras variantes que los expertos estén vigilando.

 

Tom Talbot: Sí, empecemos con la primera parte. Siempre dudo un poco en predecir el futuro porque si volvemos al Día de Acción de Gracias, ómicron era solo una palabra en el alfabeto griego. Y vimos lo rápido que ómicron, tan infeccioso como es, despegó y se extendió increíblemente por todo el mundo. Así que siempre me pongo nervioso. Creo que no va a ser como presionar un interruptor de luz, donde de repente pasamos de pandemia a endemia. Va a ser una transición.

 

Y esa transición relacionada con lo que acabamos de hablar puede diferir según el lugar donde uno vive, según cuántas personas se infectaron, cuántas personas se vacunaron, y ahora estamos aprendiendo algo aún más importante, los refuerzos de la vacuna que otorgan esa protección, para que las cosas no puedan continuar propagándose. En mi parte del mundo, tenemos algunos condados en Tennessee donde más de la mitad de la población que aún no ha recibido ni una sola dosis de vacuna. Así que todavía no estamos en posición de endemia en esas áreas, pero creo que hacia eso vamos.

 

Y creo que lo que se está viendo es que la gente está dando esos pequeños pasos, aprendiendo lo que podemos hacer con cuidado y seguridad y dentro de nuestro propio análisis de riesgos y pensando en el aumento de los demás. Por eso no nos encerramos como al principio, aunque la cantidad de casos es mucho mayor que antes, pero tenemos que tener cuidado. Y no podemos, no será como un interruptor de luz con el que simplemente nos quitemos las mascarillas y podamos hacer todo lo que hacíamos antes.

 

Tenemos que aprender cómo hacer eso. Y eso se logra a través de cosas como estar seguros, vacunarse, recibir el refuerzo, si uno está enfermo, mantenerse alejado de las personas, realizar pruebas tempranas, usar mascarillas y volver gradualmente a la normalidad. Creo que en términos de otras variantes, hay una de la que la gente puede haber oído hablar esta semana que tiene el desafortunado término de variante sigilosa de ómicron, lo que hace que la gente piense que significa que no podemos detectarla en nuestras pruebas, lo que no es cierto.

 

Es una especie de hermana de ómicron que en realidad parece que ya ha existido durante un tiempo. Y el sigilo se refiere a un tipo específico de señal que ven en estas pruebas que no vieron con la ómicron original, pero todas se pueden detectar en una prueba. Todavía no sabemos qué significa eso, si es más infecciosa y causa más problemas. Así que creo que solo tenemos que ser pacientes y continuar con lo que estamos haciendo. Y la siguiente letra griega es Pi. Así que esperemos que pase un tiempo antes de que lleguemos a ella.

 

Bill Walsh: Muy bien, muy bien. Muchas gracias, Dr. Talbot. Vayamos a usted, Dra. Goldman. Los síntomas debilitantes pueden durar más en algunas personas, un trastorno que algunos han llamado COVID-19 prolongada. ¿La COVID-19 prolongada es real? ¿Qué sabemos al respecto y qué tan común es?

 

Jennifer Goldman: Absolutamente. La COVID-19 prolongada es muy, muy real. En realidad, se conoce por varios nombres: COVID-19 prolongada, post-COVID (pos-COVID-19), post-COVID long-haulers (pos-COVID-19 de larga duración) o incluso post-acute sequelae of COVID-19 (secuelas posagudas de COVID-19). Realmente, se define como síntomas que duran más de cuatro semanas después de la infección. Y le puede ocurrir a cualquier persona que haya tenido COVID-19, incluso si la infección fue leve. Por lo tanto, no se predice necesariamente en función de la gravedad de la infección inicial.

 

Pueden tener síntomas como confusión mental, de la que mucha gente ha oído hablar, que en realidad se define como dificultad para concentrarse, dificultad para volver al trabajo, para volver a la normalidad. Cansancio, tos, dolores de cabeza que pueden ser persistentes, trastornos del sueño, mareos, incluso persistentes, dificultad para respirar. Es bastante común; en varios estudios se ha demostrado que entre el 20 y el 40% de las personas siguen siendo sintomáticas a las cuatro o cinco semanas de la infección. Y definitivamente es algo que está impactando, realmente, en este momento a millones de personas en todo el mundo.

 

De hecho, comenzamos una clínica de COVID-19 prolongada en nuestro sistema de atención médica en el Memorial Healthcare System dentro de la atención primaria, porque lo que hemos visto es que a la mayoría de los pacientes que tienen síntomas prolongados de COVID-19 les va bien en un entorno que es multidisciplinario y que realmente está coordinado por una atención primaria eficaz y accesible. Entonces, comenzamos una clínica local y allí hemos visto cientos de pacientes, y estamos aprendiendo las mejores prácticas y realmente cómo abordar algunos de los síntomas que tienen nuestros pacientes.

 

Bill Walsh: Bueno, eso es increíble. No había escuchado antes que del 20% al 40% de las personas que contraen COVID-19 podrían tener los síntomas de COVID-19 prolongada. Y quiero decir, obviamente, todavía estamos aprendiendo sobre ese fenómeno. ¿Se sabe cuánto tiempo demoran en pasar la fatiga extrema y la confusión mental? ¿Y cuándo se recuperan el gusto y el olfato para aquellos que no lo han tenido durante meses?

 

Jennifer Goldman: Claro, claro. Como mencioné, la COVID-19 prolongada, por definición, son síntomas que duran cuatro semanas o más. Y ese es realmente el marco de tiempo más común, es alrededor de cuatro a 12 semanas que las personas tienen síntomas después de la infección inicial. Sin embargo, estamos viendo que en algunos estudios varias personas con síntomas pos-COVID-19 se sienten mejor después de 12 semanas. No obstante, vemos que algunas personas siguen teniendo síntomas durante meses después, e incluso durante un año.

 

No obstante, es alentador ver que muchas personas se recuperan al año, pero hay algunas que siguen sintomáticas después. Con respecto al gusto y el olfato, esto es bastante común, alrededor del 40% de las personas en algunos estudios sufrieron esta pérdida del gusto y el olfato. La mayoría los recupera después de un mes, es decir, después de ese período de cuatro semanas. Sin embargo, algunas personas no se recuperan tan rápido y pueden permanecer sin gusto ni olfato durante muchos meses y nuevamente, durante un año.

 

El tratamiento para recuperar la pérdida prolongada del gusto y el olfato aún se está investigando. Hay un entrenamiento del olfato que se puede realizar en centros especializados, pero aún se deben realizar otras investigaciones para encontrar el tratamiento más eficaz. Sin embargo, la buena noticia es que la mayoría de las personas recuperan el sentido del gusto o el olfato después de aproximadamente un mes.

 

Bill Walsh: Solo un recordatorio de cuánto aún estamos aprendiendo sobre la COVID-19. Gracias por eso, Dra. Goldman. Lori, volvamos a usted. ¿Cuáles son los mayores desafíos para las familias al tratar con establecimientos que atienden a personas mayores o discapacitadas a medida que avanza ómicron? Sé que se ha estado extendiendo por esos centros. Quiero decir, tiene mucho sentido en las personas que viven tan cerca unas de otras.

 

Lori Smetanka: Correcto. Ha sido una preocupación para los miembros de la familia o los residentes. Y están preocupados por sus seres queridos, la seguridad y también por recibir la atención que necesitan. Y los problemas están realmente relacionados con la propagación del virus y asegurarse de que estén bien atendidos, pero también porque hay una escasez significativa de personal en los hogares de ancianos, no hay suficientes personas disponibles para brindar atención en muchos hogares.

 

Muchos familiares están preocupados por eso, y también por lo que eso significará para las visitas porque ya sabe, el año pasado y el año anterior, los hogares de ancianos estuvieron cerrados durante una cantidad significativa de tiempo. Y por eso les preocupa poder entrar y ver y ayudar a su familiar. Y a pesar del hecho de que la guía federal en este momento dice que se deben permitir las visitas de todos los residentes en todo momento, algunos estados han implementado otras medidas de seguridad, como requisitos relacionados con el uso de mascarillas o pruebas para poder detener la propagación del virus.

 

Así que, aunque todos tenemos que poner de nuestra parte para detener la propagación, hemos animado encarecidamente, como lo ha hecho AARP, a todos los residentes, al personal y a los familiares a que se vacunen, incluso a que reciban refuerzos, y a que sigan los protocolos de prevención de infecciones. También es muy importante que las medidas adicionales que implementen los estados no hagan que las visitas sean inaccesibles para los miembros de la familia. Y si se requieren mascarillas o pruebas, que creemos que son esfuerzos razonables, deben coordinar los Gobiernos federal y estatal con los centros para garantizar que esas cosas estén disponibles sin costo para los visitantes para que no vivamos nuevamente esa separación.

 

Bill Walsh: De acuerdo. Bien, Lori, muchas gracias por eso. Y como recordatorio para nuestros oyentes presionen * 3 en el teclado de su teléfono si desean ponerse en fila para hacer su pregunta en vivo. Lori, permítame continuar con usted. Uno de los problemas en los hogares de ancianos, quiero decir, incluso fuera de los hogares de ancianos, ha sido la aceptación de las vacunas de refuerzo, pero creo que ha sido un problema particular en los hogares de ancianos. Me pregunto si puede hablar un poco más sobre lo que se debe hacer para que los residentes y el personal de los hogares de ancianos reciban el refuerzo.

 

Lori Smetanka: Absolutamente. Creo que lo que sabemos es que las vacunas han surtido un gran efecto para detener la propagación de COVID-19 y, por lo tanto, garantizar que los residentes y el personal estén vacunados y los visitantes fue realmente crítico. Necesitamos mucha más información sobre la importancia de los refuerzos, y mientras que tenemos un alto porcentaje de residentes que reciben refuerzos, no es tan alto entre el personal. Así que eso es algo en lo que también debemos seguir trabajando.

 

Todavía no hemos llegado a un buen número de refuerzos. Necesitamos realmente animarlos en nuestras comunidades y asegurarnos de que los residentes, el personal y los visitantes tengan acceso a los refuerzos. Deben ser mucho más accesibles y deben administrarse en los establecimientos en lugar de pedirles a los residentes o al personal que vayan a la comunidad para recibirlos, lo que a menudo es muy difícil para ellos en términos de llegar allí y tomarse el tiempo para hacerlo.

 

Entonces, creo que si replicamos los esfuerzos del lanzamiento inicial de la vacuna, por ejemplo, y llevamos las vacunas a los hogares de ancianos para los residentes, el personal y los visitantes, eso lograría grandes resultados. Y al considerar el aumento de los requisitos en relación con las vacunas, sería realmente útil que, al hablar de estar totalmente vacunados, los CDC cambiaran esa definición para incluir las vacunas de refuerzo. Creo que eso también ayudaría a producir cambios.

 

Bill Walsh: Bueno, eso es muy interesante. Entonces, si una familia quiere asegurarse de que su ser querido en un centro reciba la vacuna, no pueden contar con que el centro lo administre, tienen que hacer arreglos para que una farmacia externa venga y lo haga.

 

Jennifer Goldman: Bueno, ciertamente debería haber coordinación entre el centro y las farmacias de atención a largo plazo con las que están trabajando, pero eso se está haciendo de mejor manera en unos que en otros centros. Y ciertamente es algo sobre lo que las familias deben preguntar, averiguar en los centros cómo recibir los refuerzos y trabajar para coordinar y asegurarse de que no tengan que sacar al residente, pero de alguna manera podemos trabajar con la comunidad para obtener vacunas y refuerzos en el establecimiento.

 

Bill Walsh: Muy bien, Lori, muchas gracias. Hablaremos más sobre eso en un momento. Y como recordatorio para nuestros oyentes, para hacer una pregunta, presionen *3 en el teclado de su teléfono en cualquier momento. Vamos a llegar a esas preguntas en vivo en breve, pero antes de hacerlo, quiero traer a Nancy LeaMond. Nancy es la vicepresidenta ejecutiva Y directora de Activismo y Compromiso de AARP. Bienvenida, Nancy.

 

Nancy LeaMond: Bienvenidos a usted y a nuestros invitados. Estoy encantada de estar aquí, Bill.

 

Bill Walsh: Muy bien. Entonces, esta semana, AARP envió dos cartas importantes al Departamento de Salud y Servicios Humanos. Una pedía primas de Medicare más bajas y la otra pedía que Medicare cubriera las pruebas de COVID-19 en el hogar. ¿Qué nos puede decir sobre esos temas?

 

Nancy LeaMond: Bueno, primero, AARP insta al Gobierno a reevaluar el aumento de la prima de la Parte B de Medicare que se anunció el año pasado. Sin un cambio, estas primas subirán un 14.5%, lo cual es demasiado, especialmente si se considera que la mitad del aumento se debe a medicamentos recetados a precios escandalosos. Es inconcebible que un solo medicamento de alto precio esté aumentando las primas para todos los beneficiarios de Medicare, muchos de los cuales ya están luchando para llegar a fin de mes.

 

Bill Walsh: Este problema surge una y otra vez. Si queremos que Medicare siga siendo asequible, tenemos que solucionar el problema subyacente de los precios descontrolados de los medicamentos recetados.

 

Nancy LeaMond: Sí, absolutamente. La reforma del precio de los medicamentos recetados es el principal objetivo de promoción de AARP por una buena razón. El año pasado, aproximadamente 18 millones de personas en EE.UU. no pudieron pagar sus medicamentos debido a los altos costos. Y en este país se paga tres veces más de lo que pagan las personas en otros países por los mismos medicamentos de marca. Las grandes compañías farmacéuticas seguirán estafando a las personas mayores y a los contribuyentes hasta que el Congreso actúe para controlarlos. Y estamos trabajando arduamente en esto.

 

Bill Walsh: Muy bien. Ahora, AARP también insta a Medicare a cubrir el costo de las pruebas de detección de COVID-19 en el hogar. ¿Por qué es eso tan importante?

 

Nancy LeaMond: Bueno, como hemos escuchado de nuestros expertos, las pruebas son una de las formas más eficaces para frenar la propagación del coronavirus, razón por la cual ahora se requiere que las aseguradoras privadas cubran el costo de las pruebas caseras de venta libre. Pero Medicare aún no las cubre, a pesar de que los adultos mayores del país se encuentran entre los más vulnerables ante las complicaciones graves de la COVID-19. Esta es una omisión flagrante. AARP está luchando para garantizar que los 64 millones de beneficiarios de Medicare tengan el mismo acceso a las pruebas sin costo que quienes tienen un seguro privado.

 

Bill Walsh: Bien. Ahora, hasta que Medicare actúe, todos los hogares del país tienen derecho a recibir cuatro pruebas gratuitas a domicilio por correo. ¿Cómo pueden las personas solicitar esas pruebas?

 

Nancy LeaMond: Bueno, se pueden solicitar las cuatro pruebas gratuitas en línea o llamando a un número gratuito. Para solicitar sus pruebas en el hogar, visiten www.covidtests.gov o llamen al 1-800-232-0233. Una vez que se registren, las pruebas se enviarán por correo a su hogar.

 

Bill Walsh: Muy bien, muy bien. La página es www.covidtests.gov y el teléfono es 1-800-232-0233. Ya que estamos hablando con nuestro panel sobre hogares de ancianos hoy, también hubo algunas noticias en ese frente esta semana, ¿no?

 

Nancy LeaMond: Sí. Desde el comienzo de la pandemia, AARP ha hecho sonar la alarma sobre el desastre que se desarrolla en los hogares de ancianos de Estados Unidos. La pandemia sacó a la luz los problemas que han afectado a estos centros durante décadas, incluida la escasez de personal, el control deficiente de infecciones, la transparencia y la rendición de cuentas. Me complace informar que nuestro trabajo está surtiendo efecto.

 

Ayer mismo, la agencia federal que regula los hogares de ancianos anunció que, por primera vez, publicó información sobre los niveles de dotación de personal durante los fines de semana, la rotación de personal y la cobertura de enfermeros durante los fines de semana en el sitio web Medicare Care Compare. Así las familias puedan tener acceso a esa información importante. Sabemos que los centros con suficiente personal y baja rotación tienen resultados mucho mejores para los residentes.

 

Bill Walsh: Muy bien. Bueno, eso es una noticia maravillosa. Una última pregunta. La Red contra el Fraude, de AARP, ha recibido quejas sobre sitios falsos de pruebas de COVID-19. ¿Tiene algún consejo sobre cómo elegir un lugar seguro para hacerse la prueba?

 

Nancy LeaMond: Bueno, desafortunadamente, los estafadores están en todas partes y tratarán de aprovechar cualquier situación. La apuesta más segura es usar un sitio de pruebas recomendado por su departamento de salud o su médico, o visitar una clínica o farmacia establecida. Si visitan un sitio de pruebas de una página emergente, asegúrense de proporcionar solo información estándar, como su tarjeta de seguro médico. Si les pide que proporcionen su número de Seguro Social o que paguen dinero por adelantado, esas son señales absolutas de alerta. Y también, si el personal no lleva equipo de protección, o si se sienten incómodos, obedezcan a su instinto y vayan a otro lugar.

 

Bill Walsh: Muy bien, eso parece un gran consejo. Bueno, Nancy, muchas gracias por la actualización y gracias por estar aquí con nosotros hoy.

 

Nancy LeaMond: Gracias, Bill.

 

Bill Walsh: Muy bien. Ahora es el momento de abordar sus preguntas sobre el coronavirus con el Dr. Tom Talbot, la Dra. Jennifer Goldman y Lori Smetanka. Opriman *3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP y compartir su pregunta en vivo. Si desean escuchar en español, presionen *0 en el teclado de su teléfono ahora.

 

[En español]

 

Bill Walsh: Muy bien, ahora me gustaría traer a mi colega de AARP, Jesse Salinas, para ayudar a facilitar sus llamadas. Bienvenido, Jesse.

 

Jesse Salinas: Un placer estar aquí hoy, Bill.

 

Bill Walsh: Muy bien, ¿a quién tenemos primero en la línea?

 

Jesse Salinas: Nuestra primera llamada será de Rita en Carolina del Sur.

 

Bill Walsh: Hola, Rita, bienvenida a nuestro programa. Adelante con su pregunta.

 

Rita: Gracias. Tengo una inquietud sobre un centro o un hogar de ancianos, es un lugar de rehabilitación. Y que no exigen que el personal se vacune. Y tengo un problema con eso, muy grande. Mi esposo está allí, y ya es muy mayor, y tienen un cambio de personal todo el tiempo, y es muy difícil para ellos, lo entiendo. Pero es peor si se contagia del personal.

 

Bill Walsh: De acuerdo.

 

Rita: ¿Cómo puedo saber cuántos están vacunados y el personal? No quiero acusar al lugar donde está porque es difícil cambiar o encontrar algo más.

 

Bill Walsh: Sí. Rita, preguntémosle a Lori Smetanka sobre esa situación. Lori, ¿qué puede decirle a Rita y a otros oyentes que tienen preocupaciones similares?

 

Lori Smetanka: Claro, bueno, creo que la vacunación del personal es de vital importancia. Y tenemos un mandato federal de vacunas que se está implementando para las personas que trabajan en centros de salud como hospitales y hogares de ancianos. Está en proceso de implementación en este momento y sucederá durante los próximos dos meses y, bueno, todo el personal deberá vacunarse. Eso es definitivamente algo que estamos felices de ver que se implemente.

 

Creo que Rita mencionó que esto no era un hogar de ancianos. Si fuera un hogar de ancianos, hay tasas de vacunas del personal en el sitio web Care Compare que Nancy mencionó hace unos minutos que opera el Gobierno federal. Pero en términos de preguntar sobre las tasas de vacunación del personal en el centro donde está su esposo, ciertamente hablaría con la administración sobre eso, tal vez el Departamento de Salud pueda proporcionar alguna información y el programa del Defensor del pueblo para el cuidado a largo plazo podría ayudarla a obtener más información también. Y puede encontrar un defensor en su área en nuestro sitio web en www.theconsumervoice.org

 

Bill Walsh: Bien. Eso es www.theconsumervoice.org y Lori hace referencia al Defensor del pueblo para el cuidado a largo plazo, que es un servicio gratuito para ayudar a los consumidores a abogar en su nombre con los centros de atención a largo plazo. Tomemos otra pregunta. Jesse, ¿a quién tenemos ahora?

 

Jesse Salinas: Nuestra próxima llamada será de Elizabeth en Arkansas.

 

Bill Walsh: Hola, Elizabeth, bienvenida al programa.

 

Elizabeth: Gracias. Mi nieta dio positivo el lunes al virus y le recomendaron que tomara ibuprofeno y se quedara en casa. Pero ha tenido mucho dolor en el pecho y todos los síntomas. Y me preguntaba cuál es el tratamiento recomendado en este momento para el coronavirus.

 

Bill Walsh: Está bien. Bueno, preguntemos a uno de nuestros médicos. Dr. Talbot, ¿puede opinar sobre eso?

 

Tom Talbot: Sí. En primer lugar, espero que empiece a sentirse mejor pronto, Elizabeth. Pero creo que mucho de eso depende de su edad subyacente y otro tipo de enfermedades comórbidas. Pero tenemos una variedad de tratamientos diferentes. Podemos dar a las personas que tienen un mayor riesgo, aquellas que pueden tener un sistema inmunitario más débil, tenemos al menos un anticuerpo monoclonal que todavía funciona contra la variante ómicron y algunos antivirales orales.

 

Creo que lo más importante es que, si no se siente bien o empeora, se comunique con su proveedor primario y se asegure de que no haya nada más que hacer en relación con la COVID-19. Y con suerte, al poco tiempo se sentirá mejor y, con suerte, todos a su alrededor estén vacunados y hayan recibido el refuerzo para que no corran tanto riesgo de contraerlo también, pero con suerte ella se sentirá mejor. Y simplemente me comunicaría con su médico para ayudarla con sus detalles, pero hay algunas opciones para la gente.

 

Bill Walsh: Está bien, muy bien. Gracias, Dr. Talbot. Jesse, volvamos a las líneas telefónicas. ¿A quién tenemos ahora?

 

Jesse Salinas: Vamos a atender a Linda a Indiana.

 

Bill Walsh: Hola, Linda, bienvenida a nuestro programa.

 

Linda: Sí.

 

Bill Walsh: Continúe con su pregunta.

 

Linda: Hola. Sí, mi pregunta es, tengo enfermedades subyacentes y he recibido la vacuna y el refuerzo. Y acabo de pasar mi cuarentena de diez días por tener COVID-19. Todavía tengo mucha congestión. Y estoy realmente preocupada de volver a tener esto porque me sorprendí, estaba siendo muy, muy cuidadosa. Y estaba escuchando lo que ella decía antes sobre cómo los síntomas pueden persistir durante tanto tiempo, y tengo 66 años. Y tengo 66 años, tomo medicación para la artritis reumatoide, que sí afecta a mi sistema inmunitario. Pero me preocupa mucho si voy a contraer esto de nuevo. Porque no tuve que ir al hospital, pero fue grave, muy grave.

 

Bill Walsh: Sí, claro. Bueno, Linda, preguntémosle a la Dra. Goldman sobre los síntomas de la COVID-19 prolongada y las posibilidades de que alguien que haya recibido las vacunas y el refuerzo y haya contraído COVID-19 vuelva a contraerla. ¿Doctora Goldman?

 

Jennifer Goldman: Hola, y gracias, Linda, por esa pregunta. Antes que nada, me alegro de que esté empezando a sentirse mejor y de que haya salido bien de esto. Esa es una noticia fantástica. Y también estoy muy contenta de que haya recibido la vacuna y el refuerzo porque sabemos que al haber sido vacunada y recibir el refuerzo, no solo son más bajas sus posibilidades de volver a infectarse, sino que según muchos estudios, sus posibilidades de tener síntomas prolongados persistentes de COVID-19 también parecen ser menores. Y esa es una muy buena noticia.

 

Ya sabe, el tema con esta pandemia es que hay otras variantes de las que estamos escuchando y, por lo tanto, existe la posibilidad de enfermarse nuevamente. Eso existe, pero ha hecho absolutamente todo lo posible para protegerse. Y lo que diría en el futuro sería que se asegure de continuar usando su mascarilla. Asegúrese de continuar lavándose las manos, use desinfectante para manos cada vez que salga. Asegúrese de evitar las grandes reuniones porque aún se pueden propagar en cualquier lugar, y deseará reducir el riesgo.

 

Y, por último, y creo que lo más importante es comunicarse con su médico de atención primaria y asegurarse de hablar con él sobre sus síntomas. Es muy común tener un poco de tos persistente o algo de congestión durante un par de semanas después de la COVID-19. Sin embargo, si los síntomas duran más de cuatro semanas, entonces, ya sabe, es lo que a veces llamamos COVID-19 prolongada. Y es por eso por lo que tener una relación con un proveedor de atención primaria y tener acceso a la atención con ellos es lo más importante. Probablemente puedan verla por medio de telesalud o podría ir al consultorio y ser examinada. Entonces realmente recomiendo que continúe haciéndolo.

 

Bill Walsh: Bien, me pregunto si el hecho de que Linda haya superado recientemente la COVID-19 mitiga la gravedad de los síntomas si volviera a contraerla.

 

Jennifer Goldman: Sí, esa es absolutamente la idea. Una vez más, no lo sabemos con seguridad porque todo está cambiando con esta pandemia y otras posibles variantes. Pero los datos parecen buenos, Bill, que la reinfección y especialmente la reinfección grave es mucho, mucho menos probable si uno ha sido vacunado y tiene el refuerzo, y luego, por supuesto, si también ha tenido una infección reciente.

 

Bill Walsh: Muy bien, muchas gracias, Dra. Goldman. Jesse, volvamos a los teléfonos.

 

Jesse Salinas: Sí, vamos a atender a Scott de Nuevo México.

 

Bill Walsh: Hola, Scott, bienvenido al programa. Adelante con su pregunta.

 

Scott: Hola. Tengo programado recibir mi cuarta inyección a fines de febrero, y solo tenía curiosidad. Estoy inmunocomprometido y nuevamente, voy a recibir mi cuarta inyección. Pero mi pregunta para todos ustedes es, ¿por qué hay tanta incertidumbre sobre el virus en sí y los efectos secundarios? ¿Por qué no inician un programa en el que puede recibir una inyección 28 días después de la última y continúan así hasta que controlen el virus ómicron y cualquier mutación que pueda haber? Porque mi médico hizo una analogía, que me pareció muy acertada, dijo que ponerse estas inyecciones es como aplicarse protector solar, y cuanto más protector solar se aplique, menos posibilidades tendrá de quemarse porque no va a eliminar el virus. Así que me quedé con la curiosidad de saber por qué no se ordena, si se puede recibir una inyección cada 28 días, por qué no se hace eso.

 

Bill Walsh: De acuerdo.

 

Scott: Tenía curiosidad por saber por qué no lo exigen, si uno puede recibir una inyección cada 28 días, ¿por qué no lo hacen?

 

Bill Walsh: Interesante, como protector solar... Sí. Muchas gracias por eso, Scott. Dr. Talbot, ¿puede responder esa pregunta de Scott, Nuevo México?

 

Tom Talbot: Sí. Gracias, Scott. Y primero quiero agradecerle por recibir el refuerzo. Y para los oyentes también, la gente como Scott necesita tres dosis para su serie habitual, por lo que la cuarta sería su refuerzo. Creo que es una buena pregunta. Creo que lo que todavía tenemos que recordar es que, incluso sin el refuerzo, la protección contra las complicaciones graves del virus se ha mantenido realmente con la vacuna.

 

El refuerzo ha sido agregado, en particular con el aumento de ómicron, lo hemos necesitado. Pero existe la preocupación de los inmunólogos de que, si vacunamos con demasiada frecuencia, abrumará a las células T hasta el punto en que simplemente no reaccionarán tan ágilmente cuando las necesitemos. Así que puede haber demasiada estimulación de esas células T. Así que queremos evitar eso también. Y creo que, por ahora, realmente solo necesitamos ese refuerzo único.

 

La gran pregunta, creo que en lo que respecta al refuerzo, es si necesitamos un segundo refuerzo. Israel ha comenzado a administrarlo y los resultados son mixtos. Parecen potenciar los anticuerpos, pero no se ha visto un cierto impacto en la infección. Así que todavía no está claro. Así que hay una preocupación inmunitaria. Demasiado frecuente puede no ser útil. Y así es como estamos. Y me alegro de que haya recibido el refuerzo.

 

Bill Walsh: Sí. Bueno. Gracias, Dr. Talbot. Y gracias por todas esas preguntas. Vamos a tomar más de sus preguntas en breve. Y recuerden, si quieren hacer una pregunta, presionen *3 en el teclado de su teléfono. Si están en Facebook o YouTube, simplemente dejen la pregunta en la sección de comentarios. Permítanme volver a nuestros expertos por un momento. Lori Smetanka, ¿cómo abordan los centros de enfermería la escasez de personal? Mencionó esto antes. ¿Y qué pueden hacer las familias para asegurarse de que sus seres queridos no sean ignorados o pasados ​​por alto?

 

Lori Smetanka: Claro. Es una buena pregunta. La falta de personal en los hogares de ancianos es un problema anterior a la pandemia, pero estamos viendo una escasez crítica en este momento. Se requiere que los hogares de ancianos tengan suficiente personal para responder a las necesidades de los residentes. Creo que la gente realmente necesita entender eso, pero también sabemos que muchas familias ayudan a brindar apoyo y cuidado adicional de sus seres queridos, como ayudar con las comidas o con el aseo personal, entre otras cosas. Y esta es la razón por la que las visitas también son tan importantes.

 

Varios centros luchan por atraer y mantener al personal y algunas aumentan los salarios y ofrecen bonificaciones. Pero también estamos viendo una gran cantidad de personal temporal o de agencias y el uso de personal que no estaba completamente capacitado y certificado, y eso puede poner en riesgo a los residentes. Por lo tanto, alentamos a las familias a visitar con la mayor frecuencia posible en persona o virtualmente mantenerse en contacto con sus seres queridos. Presten atención a lo que sucede dentro de los establecimientos. Los hogares de ancianos deben publicar su personal por turno todos los días. Así que búsquenlo, debe estar en un lugar visible.

 

Y si su ser querido o los residentes no reciben la atención y los servicios que necesitan, los residentes y las familias deben plantear sus inquietudes a la administración del establecimiento. Y nuevamente, pueden comunicarse con el Defensor del pueblo para el cuidado a largo plazo para obtener ayuda o presentar una queja ante su Agencia Estatal de Inspección. Y pueden obtener nuevamente esa información de contacto en el sitio web de Consumer Voices en www.theconsumervoice.org. Pero definitivamente hagan preguntas y estén atentos a lo que sucede en los centros.

 

Bill Walsh: Muy bien, Lori, muchas gracias. Dra. Goldman, déjeme volver a usted. Permítanme hacer una pregunta. ¿Por qué las personas vacunadas siguen contrayendo COVID-19? ¿Y cuál es el riesgo de reinfección para los que han sido vacunados?

 

Jennifer Goldman: Y esa es una pregunta tan común que recibimos todos los días en Atención Primaria. La respuesta es que ninguna vacuna es un 100% eficaz. Y ese es realmente el caso de todas las vacunas, pero uno se vacuna para prevenir una enfermedad grave o la muerte por COVID-19. También se vacuna para disminuir el riesgo de vivir con síntomas prolongados de COVID-19 porque, como estamos viendo, parece haber una menor probabilidad de COVID-19 prolongada en aquellos que están vacunados, pero uno aún puede infectarse, aún puede obtener una infección leve, relativamente leve en comparación con los que no están vacunados.

 

Y es por lo que las personas vacunadas realmente aún pueden contraer COVID-19. Ya sabe, la otra razón es que el virus de la COVID-19 está tratando de mantenerse con vida. Y la forma en que los virus logran eso es mutando, y eso es lo que estamos viendo con estas variantes. Y esa es la razón por la que todos los expertos en este panel han recomendado constantemente que también reciban el refuerzo, porque las inyecciones de refuerzo realmente tienden a disminuir el riesgo de contraer COVID-19 en primer lugar.

 

Con respecto al riesgo de reinfección para las personas vacunadas, sabemos por estudios que las personas no vacunadas tienen aproximadamente dos veces y media más probabilidades de volver a infectarse en comparación con aquellas que han sido vacunadas por completo. Pero nuevamente, como hemos visto con algunas de nuestras personas que llaman, y ciertamente lo hemos visto en nuestras comunidades, el riesgo no es cero. Y esto se debe a que, de nuevo, siguen surgiendo nuevas variantes que aumentan el riesgo de reinfección. Y lo más importante, una vez más, usar la mascarilla, lavarse las manos, evitar las grandes multitudes, vacunarse y colocarse el refuerzo. Y ser realmente inteligente con las elecciones durante la pandemia actual.

 

Bill Walsh: Muchas gracias. Hemos recibido una serie de solicitudes para repetir los detalles sobre cómo obtener pruebas gratuitas en el hogar. Déjenme darles esa información ahora. Pueden inscribirse en línea en www.covidtests.gov, www.covidtests.gov, o pueden llamar al 18002320233. El número es 18002320233. Así que adelante, soliciten su prueba gratuita de COVID-19 para el hogar. Dra. Goldman, permítame volver a usted. Sabe, el otoño pasado hubo mucho alboroto sobre los antivirales. ¿Están disponibles ahora y en qué se diferencian de otros tratamientos?

 

Jennifer Goldman: Claro, en diciembre del 2021, la FDA emitió la autorización de uso de emergencia para dos antivirales orales, es decir, píldoras antivirales que uno podría tomar si tiene un alto riesgo de progresar a una enfermedad grave. Esos son paxlovid de Pfizer y molnupiravir de Merck. Y nuevamente, ambas son píldoras que tomaría. El paxlovid está aprobado para COVID-19 de leve a moderado en pacientes mayores de 12 años y, nuevamente, que tienen un alto riesgo de progresión. Entonces, ¿cómo saber si uno tiene un alto riesgo? Si está inmunocomprometido, si ha tenido un trasplante, si tiene cáncer, si está en diálisis, si tiene diabetes muy descontrolada, enfermedad pulmonar y algunas otras enfermedades, entonces eso haría que tuviese un mayor riesgo de progresión a una enfermedad grave.

 

Estos medicamentos se ofrecen únicamente con receta. Deben administrarse lo antes posible después del diagnóstico si la persona califica, y dentro de los cinco días posteriores al inicio de los síntomas. Hay bastantes pastillas, el paxlovid son tres tabletas dos veces al día durante cinco días, y luego el molnupiravir son cuatro tabletas dos veces al día durante cinco días. Y tienen algunos efectos secundarios, ya sabe, pueden causar diarrea, pueden aumentar la presión arterial, pueden causar dolores musculares y no puede tomarlos si tiene una enfermedad renal o hepática. Pero la buena noticia es que el paxlovid, parece reducir el riesgo de hospitalización y muerte en un 88%. Y entonces, esas son buenas noticias para aquellos que tienen un riesgo realmente alto de enfermarse mucho, muy gravemente por la COVID-19.

 

Sin embargo, solo quiero enfatizar que estos medicamentos no son un sustituto para la vacuna. Recuerden, vacunarse ayuda a protegerse de contraer COVID-19 grave en primer lugar. Y el hecho de que ahora tengamos un tratamiento en forma de píldora antiviral contra la COVID-19 no significa que sea menos importante vacunarse. Lo más importante que puede hacer por uno mismo, por sus seres queridos y su comunidad en este momento, es evitar contraer COVID-19 en primer lugar. Y si uno la contrae, incluso después de haber sido vacunado, lo más probable es que sea muy leve y no es probable que progrese a una enfermedad grave.

 

Bill Walsh: Bien, gracias, Dra. Goldman. Dr. Talbot, hablemos un poco sobre las pruebas de COVID-19. Me pregunto en qué se diferencian las pruebas caseras de las administradas por profesionales médicos. ¿Y existe alguna situación en la que alguien deba elegir una en lugar de la otra?

 

Tom Talbot: Sí, son buenas preguntas, disculpe. Y estoy emocionado porque mi prueba casera llegará esta tarde por correo, recibí una notificación. La forma en que funcionan las pruebas, es que las pruebas caseras son principalmente lo que llamamos prueba de antígeno o prueba de flujo lateral. Entonces, mide una parte de la proteína viral. Y las pruebas de laboratorio que obtiene su proveedor médico a menudo la llamamos una prueba PCR. Esa busca específicamente el material genómico viral y trata de amplificarlo. Ambas son muy buenas para identificar a las personas con COVID-19.

 

Probablemente, la PCR es un poco más sensible y, por lo tanto, puede detectar casos antes. Pero esos kits para el hogar son muy buenos. Y creo que el consejo general es que los tengan en casa, si empiezan a tener síntomas, usar el kit, usar la prueba. Asegúrense de seguir las instrucciones, son muy específicas, deben mantener la prueba plana porque tiene que ser lateral para que el flujo pueda ser realmente lateral. Tienen que asegurarse de leerlo y, a veces, las líneas pueden ser un poco débiles. Pero pueden ser útiles. Y si esas pruebas dan positivo, entonces el resultado es muy confiable. No necesitan ir a un proveedor y confirmarlo con una prueba de laboratorio. Deben actuar apropiadamente como personas infectadas.

 

La única advertencia es que desde el principio con ómicron, cuando uno tiene síntomas el primer o segundo día, es posible que tenga un resultado falso negativo en la prueba del kit casero. Entonces, las recomendaciones para el kit son, si se sienten mal, aún mantenerse alejados de la gente porque incluso si no es COVID-19, no quisieran contagiarles otras enfermedades, y luego volver a hacer la prueba en 24 a 36 horas con el kit para el hogar o ahí puede ser que decidan en ese momento ir a hacerse una prueba con su proveedor médico. Pero ambas son bastante buenas para ayudarnos a identificar si tenemos COVID-19 y cómo actuar adecuadamente.

 

Bill Walsh: Está bien. Bueno, déjeme continuar con el tema. Ya sabe, cuando a las personas se les hace la prueba del virus, generalmente no se les dice qué variante tienen, pero ¿no difieren bastante el tratamiento y la gravedad dependiendo de si es delta u ómicron?

 

Tom Talbot: Sí, es interesante. Para la mayoría de las cosas que hacemos para tratar la COVID-19, no importa qué variante tenga, ya sea la cepa original, alfa, delta o ahora ómicron. Las diferentes terapias funcionan con los antivirales, los esteroides que usaríamos también. La única excepción que estamos encontrando es que el anticuerpo monoclonal es el que es muy específico. Y es posible que hayan visto esta semana que la FDA, a pedido del fabricante, retiró la autorización para uso de emergencia de dos de los anticuerpos monoclonales porque no funcionan contra ómicron. Simplemente no funcionan.

 

Y ahí es donde sería un poco útil, pero ahora que ómicron es tan omnipresente, realmente suponemos que todos tienen ómicron. El desafío es identificar la variante. Es una prueba un poco más complicada, por lo tanto, es posible que no obtengan esos resultados tan rápido como nos gustaría. Entonces, es como sacrificar la identificación de la infección en lugar de esperar un tiempo para descubrir, "oh, no solo tiene COVID-19, sino que tiene X o Y". Veremos más adelante si eso cambia. Y las variantes están surgiendo tan rápido que puede ser difícil mantenerse al día con cada una. Pero afortunadamente, en este momento la mayoría de nuestras terapias continúan surtiendo efecto contra todas las variantes.

 

Bill Walsh: Bien, Dr. Talbot, muchas gracias por eso. Ahora es el momento de abordar más preguntas con el Dr. Tom Talbot, la Dra. Jennifer Goldman y Lori Smetanka. Como recordatorio, presionen *3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP y hacer su pregunta en vivo. Jesse, ¿a quién tenemos ahora?

 

Jesse Salinas: Nuestra primera pregunta será de YouTube. Joanne pregunta: "¿Están al tanto de algún problema con los resultados falsos de las pruebas con el kit para el hogar?"

 

Bill Walsh: Hmmm… Dr. Talbot, ¿puede opinar sobre eso? Justo estaba hablando de las pruebas. Se preguntaban acerca de los problemas de falsos positivos con las pruebas en el hogar.

 

Tom Talbot: Sí, ha habido algunos informes de algunos falsos positivos en las pruebas, particularmente en aquellos que pueden ser asintomáticos. Creo que si uno tiene síntomas clínicos que sugieren COVID-19, entonces es más confiable. Suceden, aunque son bastante infrecuentes. Hemos tenido un par de casos de personas que puede que por razones de viaje fueron a hacerse las pruebas de laboratorio. Y creo que ese puede ser un caso en el que quizás uno quiera confirmarlo, pero no es muy común con los kits de casa.

 

Bill Walsh: Está bien. Muy bien, muchas gracias, Jesse, volvamos a las líneas.

 

Jesse Salinas: Traigamos a Vanessa de Nuevo México.

 

Bill Walsh: Hola, Vanessa, bienvenida a nuestro programa. Hola, Adelante con su pregunta.

 

Vanessa: Claro, sí. Me estaba preguntando, avanzando un poco más en el panorama general de la pregunta. Disponemos de diversas certificaciones estandarizadas a nivel nacional para empresas o de los sectores como, por ejemplo, la certificación ISO. ¿Los hogares de ancianos ahora están certificados para cualquier tipo de cosas como respuesta a desastres, pandemia o respuesta médica? Y si no es así, ¿se está investigando algo para el futuro de su desarrollo? Porque tal vez podamos utilizar algo como esto para tomar una decisión sobre qué hogar de ancianos seleccionar si sabemos que tienen algún tipo de configuración de respuesta para el almacenamiento de suministros, niveles de respuesta, certificaciones de personal, licencias, cosas de ese tipo, porque parece que al principio de esta pandemia, había mucha confusión y no había ninguna coherencia con los hogares de ancianos sobre cómo responder a esta pandemia desde el punto de vista médico.

 

Bill Walsh: Correcto. Tiene toda la razón en eso, Vanessa. Bueno, preguntémosle a Lori Smetanka. Ella es una experta en esta área. Lori, ¿qué nos puede decir sobre las certificaciones que se están realizando y las lecciones aprendidas de la pandemia de COVID-19 hasta el momento?

 

Lori Smetanka: Claro. Es una buena pregunta. Y definitivamente necesitamos aprender todas las lecciones que podamos de esta pandemia, ¿verdad? Los hogares de ancianos, y la gran mayoría de ellos, más del 95% de ellos están certificados para Medicare y Medicaid, lo que significa que deben cumplir con ciertos requisitos establecidos por los Gobiernos federales. Y eso incluye la preparación para emergencias que también incluye la preparación para una variedad de diferentes tipos de emergencias y desastres, incluida una pandemia. Por lo tanto, los hogares de ancianos deben tener planes de emergencia para coordinar con sus departamentos de salud estatales y locales, y tener políticas y procedimientos establecidos para la respuesta.

 

La persona que llama tiene toda la razón, vimos mucha confusión al principio. Y eso se relacionó bastante con el intercambio de información y muchos tipos diferentes de orientación que estaban ocurriendo. Entonces, con suerte, aprenderemos de eso en el futuro y habrá una labor más coordinada en términos de respuesta y requisitos relacionados con la transmisión de información. Pero las personas también deberían informarse sobre los hogares de ancianos que están buscando. Hay buena información en el sitio web de Care Compare que es operado por el Gobierno federal y pueden acceder a ella en medicare.gov.

 

Y pueden obtener información sobre los niveles de personal, sobre las tasas de vacunación y sobre cómo les va a los centros con sus encuestas anuales, por lo que pueden obtener información bastante buena sobre los niveles de calidad en los hogares de ancianos. Y también, sin duda, hagan preguntas a sus amigos y vecinos sobre los establecimientos con los que están trabajando. Y también, por supuesto, comuníquense con su Defensor del pueblo para el cuidado a largo plazo para obtener apoyo adicional y preguntas con respecto a ayudar a elegir un hogar de ancianos en su comunidad.

 

Bill Walsh: Sí, ese es un buen punto. Y un recordatorio para todos nuestros oyentes de que existe un servicio de defensor del pueblo en todos los estados, y ese es un servicio gratuito para los consumidores. Y les pasaré el panel de control de hogares de ancianos de AARP, donde estamos rastreando las tasas de infección y las tasas de vacunación en los centros de todo el país. Pueden acceder a esa información en nuestro sitio web en aarp.org/nursinghomedashboard. Muy bien, Jesse, volvamos a las líneas. ¿A quién tenemos ahora?

 

Jesse Salinas: Nuestra próxima llamada será de Mike en Florida.

 

Bill Walsh: Hola, Mike, bienvenido a nuestro programa. Adelante con su pregunta.

 

Mike: Hola, gracias por atender mi llamada. Para uno de los médicos, una pregunta rápida en términos de una vez que haya tenido COVID-19, y tengo programado mi refuerzo, ¿debería haber un cierto intervalo desde que uno se recupera hasta que recibe su próxima vacuna?

 

Bill Walsh: Para cuándo recibir su refuerzo, ¿es eso lo que está preguntando? Sí, bueno. Bueno, Dr. Talbot, ¿quiere responder? ¿Hay un plazo recomendado?

 

Tom Talbot: Sí, el consejo general que damos es que, si uno tiene COVID-19, debe esperar hasta que ya no sea infeccioso para recibir el refuerzo. Y luego, después de eso, puede seguir adelante y recibirlo. Ahora, probablemente tenga cierta inmunidad protectora contra esa infección por COVID-19, pero el problema es que eso puede variar. No sabemos, con casos más leves, cuánto dura eso.

 

Y entonces nos preocupamos con algunas personas que dicen, oh, puede esperar tantos meses. Puede olvidarse de eso y luego ser vulnerable. Por lo tanto, está bien después de salir del aislamiento ir a buscar su refuerzo y proceder a partir de eso. También está bien si quiere esperar un poco. Simplemente me resisto a decir que esperen un poco porque eso puede llevar de uno a dos a cinco, seis meses, y entonces eso es demasiado. Así que les he estado diciendo a mis pacientes que una vez que estén fuera del aislamiento, vayan y reciban el refuerzo y listo.

 

Bill Walsh: Está bien. Muchas gracias por eso, Dr. Talbot. Jesse, ¿a quién tenemos ahora?

 

Jesse Salinas: Sí, nuestra próxima pregunta es de Marissa en Facebook. Y ella pregunta: "¿Se puede vacunar mi abuela a los 95 años? Parece que goza de buena salud".

 

Bill Walsh: Dra. Goldman, ¿puede opinar sobre eso?

 

Jennifer Goldman: Sí, claro. Definitivamente recomiendo que su abuela se vacune. Recomiendo que la abuela, el abuelo y todos los demás se vacunen. No hemos visto ninguna información preocupante sobre vacunarse a una edad más avanzada. Y, de hecho, a medida que envejecemos, el sistema inmunitario a veces puede debilitarse, y, de hecho, vacunar a alguien de 90 años es la mejor manera de protegerlo de enfermarse gravemente por COVID-19 y necesitar ser hospitalizado o algo peor.

 

Bill Walsh: Muy bien, muchas gracias, Dra. Goldman. ¿A quién tenemos ahora, Jesse?

 

Jesse Salinas: Vamos a traer a Marlene de Nueva Jersey.

 

Bill Walsh: Hola, Marlene, bienvenida al programa. Hola, adelante con su pregunta.

 

Marlene: Sí, muchas gracias. Estoy muy interesada en el control de infecciones. Mi hermano murió en un hogar de ancianos después de una cirugía. Estuvo allí para su rehabilitación y, lamentablemente, no pudieron aislar adecuadamente a los residentes que dieron positivo por COVID-19. No seleccionaron ni evaluaron adecuadamente a los empleados. Había tantos. Fue horrible. Y puedo seguir y seguir. Es una historia muy triste.

 

Bill Walsh: Sí. Es terrible. Lo siento mucho.

 

Marlene: Y lo que me gustaría saber es que el fiscal general de Nueva York recomendó que todos los hogares de ancianos, así como los hospitales y todos los centros de atención a largo plazo deberían tener un especialista en prevención de infecciones a tiempo completo en cada hogar. ¿Qué tan factible es esto de pagar algo así en cada hogar en lugar de dar estos trabajos? Estoy jubilada, pero trabajé 43 años como fisioterapeuta, y noté que cuando la gente tenía que hacer el control de infecciones, tenían otros 100 trabajos que hacer. ¿Y no podemos simplemente contratar a especialistas en prevención de infecciones a tiempo completo para que su trabajo sea mantener seguro ese establecimiento? Y que ese sea un trabajo de tiempo completo. ¿Es posible? Porque pensé que el fiscal general de Nueva York tuvo una idea maravillosa.

 

Bill Walsh: Bueno, primero, siento mucho lo de tu hermano. Pasemos a Lori Smetanka y hablemos de esta propuesta sobre tener un especialista en prevención de infecciones a tiempo completo en los centros. ¿Lori?

 

Lori Smetanka: Sí, seguro. Y también siento lo de su hermano, mis condolencias a su familia. Esa es una propuesta importante que se ha sugerido. Y en realidad hay una legislación en el Congreso en este momento que incluye esa disposición. Y es algo que apoyamos firmemente. Y creemos que contribuiría en gran medida a ayudar con la prevención y el control de infecciones en los centros, que es, por cierto, incluso antes de la pandemia, la deficiencia o problema principal que se ha citado en los hogares de ancianos de todo el país.

 

Entonces, incluso antes de que estuviéramos lidiando con la pandemia, las infecciones y la prevención y el control de infecciones ha sido un problema grave en los hogares de ancianos, y definitivamente debemos manejarlo mejor y creo que la pandemia realmente ha reforzado la necesidad de hacerlo. Así que hay una propuesta para apoyar eso en el Congreso en este momento. Es algo por lo que estamos abogando, y nos gustaría que cruzara la línea de meta y sea promulgado.

 

Bill Walsh: Bien, Lori, muchas gracias. Y Lori mencionó un par de veces los programas del Defensor del pueblo para el cuidado a largo plazo en todo el país. Quería dar a conocer ese sitio web nuevamente, es www.theconsumervoice.org. Vayan allí para buscar el programa del Defensor del pueblo para el cuidado a largo plazo su estado, si necesitan ayuda para trabajar con sus centros. Tomemos otra pregunta. Jesse, ¿a quién tenemos ahora?

 

Jesse Salinas: Sí, vamos a atender a Diane de Wisconsin.

 

Bill Walsh: Hola, Diane, bienvenida al programa. Continúe con su pregunta.

 

Diana: Hola. Mi pregunta es, sé que hemos estado hablando mucho sobre los hogares de ancianos, pero quiero saber... ¿Me oyen?

 

Bill Walsh: Sí, adelante.

 

Diana: Está bien. Quiero saber si los hogares de ancianos y los centros de vida asistida tienen las mismas normas. En otras palabras, ¿tienen las mismas normas los hogares de ancianos y los centros de vida asistida?

 

Bill Walsh: Claro. Es una buena pregunta. Lori, ¿puede ayudar a Diane con eso?

 

Lori Smetanka: Claro. Es una buena pregunta, una que crea mucha confusión para la gente. No se les aplica el mismo nivel de exigencia. Los hogares de ancianos que están certificados por Medicare y Medicaid que, como mencioné anteriormente, significa que más del 95% de ellos tienen que cumplir con la normativa establecida por el Gobierno federal. Y están sujetos a las reglas que establece el Gobierno federal y tienen que cumplirlas. Los centros de vida asistida están regulados y autorizados a nivel estatal, por lo que deben cumplir con los requisitos estatales. Y como puede imaginar, varían ampliamente en todo el país.

 

Bill Walsh: Muy bien, Lori, muchas gracias. Y gracias a todos nuestros expertos. Esta ha sido una discusión muy informativa. Y gracias a nuestros socios, voluntarios y oyentes de AARP por participar en la llamada de hoy. AARP, una organización de membresía, sin fines de lucro ni afiliación política, ha estado trabajando para promover la salud y el bienestar de los adultos mayores en EE.UU. durante más de 60 años.

 

Ante esta crisis, estamos brindando información y recursos para ayudar a los adultos mayores y a quienes los cuidan a protegerse del virus, prevenir la propagación a otros mientras se cuidan a sí mismos. Todos los recursos a los que se hizo referencia hoy, incluida una grabación del evento de preguntas y respuestas de hoy, se podrán encontrar en aarp.org/coronavirus a partir de mañana, 28 de enero.

 

Y si necesitan asistencia de Medicare durante la COVID-19, visiten shiphelp.org/COVID-19. Eso es "ship" S-H-I-P H-E-L-P.org/COVID-19. Vayan allí si su pregunta no fue respondida, y encontrarán 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. Regresen el 10 de febrero a la 1:00 p.m. para participar en otro evento de preguntas y respuestas en vivo sobre el coronavirus. Esperamos que puedan participar. Gracias y que tengan un buen día. Con esto concluye nuestra llamada.

Coronavirus: Omicron, Looking Ahead, and the Impact on Nursing Homes

Listen to a replay of the event above.

Coronavirus cases in the U.S. are still dangerously high relative to previous surges, and once again, nursing homes are being hit hard. Americans are scared, frustrated, and wondering if the pandemic will ever end. Our expert panel will address your questions related to Omicron and how to stay safe and protected as the virus continues to disrupt our lives.

Meet our experts:

Tom Talbot, M.D.
Chief Hospital Epidemiologist
Vanderbilt University Medical Center

Jennifer Goldman, D.O.
Family Physician & Chief of Primary Care
Memorial Healthcare System

Lori Smetanka
Executive Director
The National Consumer Voice for Quality Long-Term Care


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


Replay previous AARP Coronavirus Tele-Town Halls

  • May 5 - Coronavirus: Life Beyond the Pandemic
  • April 14Coronavirus: Boosters, Testing and Nursing Home Safety
  • March 24Coronavirus: Impact on Older Adults and Looking Ahead
  • March 10Coronavirus: What We’ve Learned and Moving Forward
  • February 24Coronavirus: Current State, What to Expect, and Heart Health
  • February 10 - Coronavirus: Omicron, Vaccines and Mental Wellness
  • January 27 - Coronavirus: Omicron, Looking Ahead, and the Impact on Nursing Homes
  • January 13 - Coronavirus: Staying Safe During Changing Times
  • December 16 - Coronavirus: What You Need to Know About Boosters, Vaccines & Variants
  • December 9 - Coronavirus: Boosters, Vaccines and Your Health
  • November 18 - Coronavirus: Your Questions Answered — Vaccines, Misinformation & Mental Wellness
  • November 4 - Coronavirus: Boosters, Health & Wellness
  • October 21 - Coronavirus: Protecting Your Health & Caring for Loved Ones
  • October 7 - Coronavirus: Boosters, Flu Vaccines and Wellness Visits
  • September 23 - Coronavirus: Delta Variant, Boosters & Self Care
  • September 9 - Coronavirus: Staying Safe, Caring for Loved Ones & New Work Realities
  • August 26 - Coronavirus: Staying Safe, New Work Realities & Managing Finances
  • August 12 - Coronavirus: Staying Safe in Changing Times
  • June 24 - The State of LGBTQ Equality in the COVID Era
  • June 17 - Coronavirus: Vaccines And Staying Safe During “Reopening”
  • June 3 - Coronavirus: Your Health, Finances & Housing
  • May 20 - Coronavirus: Vaccines, Variants and Coping
  • May 6 - Coronavirus: Vaccines, Variants and Coping
  • April 22 - Your Vaccine Questions Answered and Coronavirus: Vaccines and Asian American and Pacific Islanders
  • April 8 - Coronavirus and Latinos: Safety, Protection and Prevention and Vaccines and Caring for Grandkids and Loved Ones
  • April 1 - Coronavirus and The Black Community: Your Vaccine Questions Answered
  • March 25 - Coronavirus: The Stimulus, Taxes and Vaccine
  • March 11 - One Year of the Pandemic and Managing Personal Finances and Taxes
  • February 25 - Coronavirus Vaccines and You
  • February 11 - Coronavirus Vaccines: Your Questions Answered
  • January 28 - Coronavirus: Vaccine Distribution and Protecting Yourself
    & A Virtual World Awaits: Finding Fun, Community and Connections
  • January 14 - Coronavirus: Vaccines, Staying Safe & Coping and Prevention, Vaccines & the Black Community
  • January 7 - Coronavirus: Vaccines, Stimulus & Staying Safe
  • Dec 3 - Coronavirus: Staying Safe & Coping This Winter
  • Nov 19 - Coronavirus: Vaccines, Staying and A Caregiver's Thanksgiving
  • Nov 12 - Coronavirus: Coping and Maintaining Your Well-Being
  • Oct 1 - Coronavirus: Vaccines & Coping During the Pandemic
  • Sept 17 - Coronavirus: Prevention, Treatments, Vaccines & Avoiding Scams
  • Sept 3 - Coronavirus: Your Finances, Health & Family (6 months in)
  • Aug 20 - Your Health and Staying Protected
  • Aug 6 - Coronavirus: Answering Your Most Frequent Questions
  • July 23 - Coronavirus: Navigating the New Normal
  • July 16 - The Health and Financial Security of Latinos
  • July 9 - Coronavirus: Your Most Frequently Asked Questions
  • June 18 and 20 - Strengthening Relationships Over Time and  LGBTQ Non-Discrimination Protections
  • June 11 – Coronavirus: Personal Resilience in the New Normal