Skip to content
 

   

 

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.

(Espanola)

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 the face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them. At long last we're seeing some good news with the pandemic. New coronavirus cases have declined significantly, and deaths are showing a modest downturn as well. Still many questions around booster shots, subvariants and the confusing safety guidelines as communities around the country try to figure out whether to lift restrictions. And even as the pandemic appears to be dissipating, new studies are showing an increase in COVID-related heart disease. Today, we'll hear from an impressive panel of experts about these issues and more. We'll also get an update from Capitol Hill on legislation affecting older Americans. 

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, 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 and a top cardiologist. 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. Again, to ask your question, press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you're joining on Facebook or YouTube, drop your question in the comments section. 

Now I'd like to welcome our guests. Katie Passaretti, M.D., is vice president and enterprise chief epidemiologist at Atrium Health. Welcome back to the program, Dr. Passaretti.

Katie Passaretti: Thank you, a pleasure to be here. 

Bill Walsh: All right, a pleasure to have you. Ralph Levy, M.D., is the chief of Adult Cardiac Medical Services at Memorial Cardiac and Vascular Institute in Florida. Welcome to the program, Dr. Levy.

Ralph Levy: Thank you so much, Bill. Glad to be here. 

Bill Walsh: All right. Let's get started with our discussion … Dr. Passaretti, COVID infections quickly increased and then fell in the last couple of months. What's the status of COVID-19 and the omicron variant today?

Katie Passaretti: Yeah, a great question. So, you know, as quickly as we saw the increase in COVID-related cases and hospitalizations with the rise of the omicron variant, we're seeing an equally rapid descent. So COVID-related hospitalizations are declining to levels around where we were prior to this new variant entering our population. The number of new cases continues to decrease and the percent of tasks in a given day that are positive is coming down. So by all metrics, we're on the downward, we continue to be on the downward swing of this particular surge in this particular variant.

Bill Walsh: Now it would seem that breakthrough infections, which are those infections that occur among people who have been vaccinated, that they're more common with omicron. Why is that? 

Katie Passaretti: Yeah, absolutely. So, you know, every different variant that comes along has different mutations that impact the behavior of that particular strain of the virus. So with omicron, we saw many more mutations than we've seen with, say, delta or prior variants. With that comes, you know, it was more easily spread, so more people infected. And it had higher levels of what we call immune escape, which means either prior infection with past variants, or with vaccines we saw a higher number of quote-unquote breakthrough or post-vaccine reinfection type cases. Now the good news is while we saw more breakthrough infections, the vaccines continue to be very, very protective against what we need them most to do, which is to prevent against hospitalizations, deaths and severe cases of COVID. So, definitely saw more breakthrough infections. The good news is that … the vaccines continue to be protective against more severe disease.

Bill Walsh: All right. Well, that's great to hear. Let me follow up on that though. New research suggests that the omicron variant BA.2, which is nicknamed the stealth omicron, spreads faster and may cause more severe illness. So how widespread is the stealth omicron subvariant? And what should people know about it? 

Katie Passaretti: So the BA.2 — or what  in the media is called the stealth omicron subvariant, as of most recent data from the CDC, accounts for less than 4 percent of the cases in the United States. We fully anticipate that that number will increase and we are — you know this is still a relatively new subvariant, so definitely in the still learning phase. What we know so far, or what's suggested so far is that yes, this subvariant may be a bit more transmissible, so may spread more easily than the prior omicron lineage. You know, there was some concern based on hamster studies that omicron, the BA.2, may cause more severe disease. Over the past couple of days, fortunately, several studies have come out that really push. back on those hamster studies and suggest that in actual kind of human places where this variant is circulating widely, that we are not seeing more hospitalizations, more deaths compared to the initial omicron strain. And you know the other thing that has come up as a potential area of concern is will this BA.2, can you get reinfection with BA.2 after you had omicron, say, a couple of weeks, the initial omicron variant a couple of weeks ago. And it does look like many people in our country and the world have had omicron over the past one to two months that that initial omicron strain does seem to protect against reinfection. So we're not seeing huge numbers of people that had the BA.1, or initial omicron strain, getting infected with BA.2. So good news on that front. It doesn't seem like right now there's huge data suggesting that BA.2 causes more severe illness, probably a bit more transmissible, but I will say in the areas where, outside of the United States where BA.2 accounts for a large chunk of current cases … it isn't turning the tide on trends, you know, downward as far as number of cases and hospitalization. So mixed baggage, still watching it very closely. But right now, you know, some promising signs.

Bill Walsh: And do we know how effective the vaccines that have been approved in this country are against BA.2?

Katie Passaretti: Yeah, a great question. So fortunately again, the vaccines, and particularly if you're vaccinated and boosted, continue to protect against severe disease from BA.2 like they did for BA.1. So, good news on that front as well. 

Bill Walsh: Very good. Thanks for that, Dr. Passaretti. Dr. Levy, let me turn to you. Now, after COVID, even with mild cases, the risks of heart problems remain elevated for about a year, according to a study released this month. A recent German study found three-quarters of individuals post-COVID had heart abnormalities. How significant are the risks and what are the warning signs?

Ralph Levy: OK, Bill. Well, it's very important to put these studies into context, and I'll explain what I mean. … When the German study came in, it's actually quite a while ago, it was a study of a hundred patients post-COVID infection, and we saw a lot of abnormalities in an MRI of the heart. But you have to think about it this way. … We saw these changes, and many of these changes, over 70 percent, there were mild changes. So we didn't know exactly what that meant. And we kind of shrug our shoulders, and we waited for more information. Well, now we have that information, and it's important information. In this study, in this journal called Nature of Medicine, VA investigators published some research that compared what happened in terms of cardiac events between 500,000 patients who have COVID. They were compared to 5 million contemporary patients without COVID and 5 million patients before the COVID era. And what they did discover is that there was an increased signal of harm or risk in patients after COVID, even patients that had mild symptoms. And those patients had an increased rate of heart attacks, strokes, clotting problems, all kinds of vascular issues. So now it's very different, right? We went from an abnormal test to now real clinical events. What is the magnitude? It was in my view — you know, percentage-wise, it looked like a big magnitude, but we're talking about three, four or more heart attacks per thousand people. You know, the same thing with strokes. So it is an increased number, but it's not an overwhelming number. It has to be taken with caution as well, as if it's just VA patients. It doesn't apply necessarily to the rest of the population. But it's the first thing that tells us, listen, something real happened here. We need to find out why we're having more heart attacks, and we need to intervene before this gets out of hand. 

Bill Walsh: All right. And you anticipate my next question, which is about risk factors. It sounded from what you were saying that there are increased risks because of preexisting conditions. But are things like vaccination status, age or other factors, also risk factors for developing heart abnormalities from COVID?

Ralph Levy: Yeah, absolutely. So the question is why this happened and it can be many things. A funny story happened when COVID started. We stopped seeing patients come into the hospital with heart attacks, and it's not like COVID was curing heart attacks, it was that patients were so afraid to come to the hospital, they were dying at home because of heart attacks. Well, you can extrapolate that and say, well listen, these patients are still not coming to the office or delay visits, or maybe they've not, they're not taking their medication for blood pressure or finding out that they have blood pressure or finding out that they have high cholesterol and not treating it, or patients who already have preexisting conditions with high blood pressure, actual heart disease, they're not being as careful or they're not taking their medications like they should, or it may be a virus factor. Some patients do get an infection in their heart. It's not very common because of the virus. Some patients get severe lung disease and in the body things will come by themselves, so you're going to have significant lung disease. Your heart is going to be an innocent bystander, it's going to get hurt as well. And we're going to have long-term consequences from that. Certainly, the vaccine is going to protect you. The vaccine is not going to harm you. I want to be very clear on that. And it's very important that the audience understands that we need to be fully vaccinated — and boostered, as a matter of fact. Finally in terms of age, of course, the older we are, the more concomitant medical conditions we have from high blood pressure to diabetes, to obesity, to inactivity, to, you know, high cholesterol. Some of the audience may have had heart attacks before, they may have problems with the valves in their heart, previous problems with the muscle in the heart. They may have a condition called heart failure, and certainly, if you get this virus, you're going to be at risk of more complications if you have those conditions.

Bill Walsh: OK, and do you have any advice for folks who might be listening who do have preexisting heart conditions if they end up being diagnosed with COVID?

Ralph Levy: Yeah, my advice is to contact your physician and to follow instructions in terms of your medications. You know, we have the ability to control most of the conditions in cardiology. We can control high blood pressure, we can lower the cholesterol to unbelievably low levels. We can make sure those patients with heart failure feel better and live longer, but it requires that you reach out to us, that you are compliant with your diet, your medication. I need you guys to be super active. Exercise is one of those super powerful medications that nobody ever uses, and yet it's free, readily available. It makes you live longer, feel better, allow you to live independently, so that kind of stuff.

Bill Walsh: All right, thanks so much, Dr. Levy, and I love hearing about exercise as a medication. Very good. As a reminder to our listeners, if you'd like to get in the queue to ask your question live, go ahead and press *3 on your telephone key pad. And if you're on a YouTube or Facebook, go ahead and drop it into the comments section. We're going to take your live questions shortly, but before we do, I wanted to bring in my AARP colleague Cristina Martin Firvida, who is the vice president of government affairs here at AARP. Welcome, Cristina. 

Cristina Martin Firvida: Delighted to be here, Bill.

Bill Walsh: All right, we're delighted to have you. Now, in addition to sharing the most recent news on the coronavirus, we'd like to take a few minutes to update our listeners about advocacy news in a segment we call, Fighting for You. Christina, any news you can share with us on the advocacy front?

Cristina Martin Firvida: Absolutely, Bill. AARP is still urging the United States Senate to allow Medicare to negotiate for lower prescription drug prices. We know that more than 80 percent of voters across parties support this change, and that it would save seniors and Medicare billions of dollars. Congress has promised for years to address the price of prescription drugs, and now is the time to get the job done. We have also endorsed recently a bipartisan plan to protect Social Security recipients from identity theft. Protecting older Americans from fraud and scams is one of our top priorities.

Bill Walsh: OK. Now, in addition to fighting for change on Capitol Hill, I know AARP advocates in every state as well. Are there some recent successes in the states that you can share with us? 

Cristina Martin Firvida: Absolutely. AARP is for sure hard at work advocating in every state nationwide. In addition to our federal activity on prescription drug affordability, last year AARP State Offices helped to achieve 26 prescription drug affordability victories in 17 states. For example, right at the end of 2021, AARP Pennsylvania was instrumental in passing two bills that make more older people eligible for a state program that provides financial assistance to pay for prescription drugs. Now, with the 2022 state sessions in full swing, AARP state offices across the country are right back at it pushing for new policies to bring down the prices of prescription drugs.

Bill Walsh: Well, that's fantastic to hear. Now, in addition to prescription drug prices, AARP is also fighting to help people stay financially secure. Can you share some current examples of that? 

Cristina Martin Firvida: Yes, absolutely. Right now, we continue to support legislative proposals to reduce or even eliminate state income taxes on Social Security benefits, including in Nebraska, Minnesota and Vermont. In New Mexico, an AARP-supported proposal to significantly reduce taxes on Social Security benefits is headed to the governor for signature. And we're also supporting legislative proposals to reduce or eliminate state income taxes on retirement distributions from 401k plans, 403 B plans, and traditional pensions in states such as Maryland, Connecticut and Iowa. Finally, AARP has been instrumental in supporting IRA work and save programs in states around the country to help people save for retirement, including a recent program in Connecticut that's seeing fantastic results.

Bill Walsh: Oh, that's all great news. Now we've also seen progress with rental and utility aid. Isn't that correct? 

Cristina Martin Firvida: That's right. We're advocating at the state level for rental and utility assistance. For example, in 2021 AARP New York lobbied the newly appointed governor to increase the use of federal emergency rental assistance funds to eligible households, leading New York from an increase of just 5 percent of funds New York was allocated, distributed in June and July, to 85 percent of the funds distributed by September. In addition, AARP New York protected consumers from utility disconnections by filing an emergency petition to increase relief for those struggling to pay their bills during the pandemic.

Bill Walsh: All right. Well, that's a lot of work going on. Finally, AARP has seen some recent advances in health and caregiving, too, especially improvements in long-term services and supports, and home- and community-based services. Is that right? 

Cristina Martin Firvida: That's right. In 2021, AARP State Offices helped achieve 27 legislative wins related to improving home- and community-based services, and 18 wins related to long-term services and support systems. These positive changes expanded or enhanced access services, made advancements toward rebalancing care from facilities and institutions to home- and community-based services, and provided opportunities and support for family caregivers. This year we're continuing to fight for improvements in local services and systems, because we want older adults to receive the quality care they need and deserve. Ultimately, we want people be able to remain living in their homes and their communities, where they prefer to be for as long as possible.

Bill Walsh: Well, that's exactly what they're looking for. Thanks so much, Christina. That's great news and a lot of great work across the country. Thanks for those updates. All right, now it's time to address your questions about the coronavirus with Dr. Katie Passaretti and Dr. Ralph Levy. … I'd now like to bring in my AARP colleague Jesse Salinas to help facilitate your calls. Welcome, Jesse.

Jesse Salinas: I'm glad to be here today, Bill.

Bill Walsh: All right, let's take our first question. 

Jesse Salinas: Our first question today is going to come from George on YouTube. And George asks, “Now that mask mandates are being lifted, do we need to avoid public places or busy places like theaters, buses or airports?”

Bill Walsh: Dr. Passaretti, can you take a crack at that one? We are kind of in an in-between transitional time as it relates to masks. So what precautions should people be taking?

Katie Passaretti: Yeah, definitely in a transitional time, for sure. You know, I would say that … we're getting into the stage of COVID where it's an assessment of your personal risk. So individuals that are most at risk need to look at things like, you know, where they're going — if it's indoors, if it's a crowded situation, potentially higher risk of exposure. Are there more cases, a significant number of cases, or are cases increasing in that particular community? Those individuals need to weigh the risks and benefits of kind of doing those activities. And … in my mind those highest risk may want to continue to take precautions like masking, giving yourself a little bit of space, and potentially avoiding those really crowded indoor settings, especially if there's trends in the community that are concerning. But, in the other kind of caveat I would throw out there, the other group of people that may want to consider when to wear masks, you know, if they're in a higher risk situation, are individuals who interact with or have at home someone that is very high risk, someone with a weakened immune system, someone that can't be vaccinated for whatever reasons. I think lots of good news, lots of decreases in cases, but certainly … we're still in the pandemic and some risk, so taking a look at your personal kind of risk, if you get an infection, whether you're vaccinated, and making a decision based on that combination of risk of where you're going, personal risk, the risk of those you spend a lot of time with and want to protect, and you're in your individual decision-making about whether to wear masks. 

Bill Walsh: OK, very good. Thanks so much, Dr. Passaretti. Jesse, who do we have up next?

Jesse Salinas: Our next caller is Ida from Nevada. 

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

Ida: Yeah, my question, is they found out the effects coronavirus COVID on some patients, and I was just wondering, is there a specific condition on the heart that would differentiate it from other causes of heart condition? I mean, specific for coronavirus. 

Bill Walsh: Let's ask Dr. Levy about that. Dr. Levy?

Ralph Levy: Yeah, thank you for your question. No, there is no specific test that says this is caused by coronavirus. I think it's important to know that coronavirus, as in other viruses, can cause inflammation of the heart, something called myocarditis, yet in COVID patients we see this really rarely. I think what we see a lot is other problems such as problems with the rhythm of the heart. As I mentioned before, the heart can be an innocent bystander and can suffer when the patient has lung disease, for example. Some patients do have heart attacks, and the other condition that these patients tend to have is this thing called stress cardiomyopathy; it's kind of a funny name, but sometimes the stress of the infection can make the heart weak. These patients usually recover. It's not something that we see long term, but in terms of your question of specific tests that tells us the heart was affected by COVID, no, we do not have that.

Bill Walsh: OK, thanks so much, Dr. Levy. Jesse, let's go back to the phones. 

Jesse Salinas: Yeah, our next question is going to come from Jessie in Alaska.

Bill Walsh: All right. Hey, Jessie. Welcome to the program. Go ahead with your question. 

Jessie: Thank you. I'm interested in learning about the efficacy and availability of oral medications like Paxlovid. And also, I know that one of the other ones is a potent mutagen, and I'm concerned about the possibility for genetic damage even to DNA, even while it's being used against an RNA virus. And the second one is what's the horizon looking like for oral preventative medication or intravenous? Thank you.

Bill Walsh: Great questions, Jessie. Dr. Passaretti, can you tackle those?

Katie Passaretti: Yeah, absolutely. So really good questions and really important right now, especially as we're kind of in this transition phase that we were talking about. So, first off, your question about Paxlovid, oral medication that in studies and in use so far works very well if given early in disease and high-risk individuals at preventing hospitalization. That drug is relatively new, but … especially as we're seeing decrease in the number of cases in our various communities in the United States, the availability of that drug is increasing and becoming more and more accessible. So, unfortunately during omicron, … Paxlovid came out kind of smack dab in the middle, and as supply was ramping up cases were super high; we're now continuing to have increased supply, which is a good thing. And our cases are coming down. So people should find that availability of that medication is increasing pretty decently across the United States. The second medication you mentioned that impacts kind of RNA is called Molnupiravir, so that medication also does have a role to play in treatment. You know, the studies, the mechanism of action has raised some concerns about potential mutations. Those have not played out clinically as of yet, and it does — while not as effective as Paxlovid — does have some efficacy, again, if given soon after symptom onset in preventing more severe disease. So certainly my go-to, my first line oral medication for people that can get it, is Paxlovid. If there's a reason that Paxlovid can't be given, either because of a medication interaction or whatever reason, then Molnupiravir, I wouldn't completely rule out Molnupiravir. And then I think your final question, which also is very good, was about prophylactic medications. So currently there are not any oral prophylactic medications available. You know, hopefully over time, those will become available and certainly candidates are being studied actively, but nothing that has kind of risen to being recommended for clinical use. There are potential, either intravenous or potentially intramuscular, medications that can be used for either post-exposure prophylaxis, meaning I am high risk, I had a family member in my household that had COVID and am not sick yet, but I want to prevent getting sick. So the monoclonal antibodies that have been used for treatment of COVID can also be used in that situation, where supply allows. Finally, there is another medication called, that goes by the trade name Evusheld. Again, intravenous medication, and supply is still being kind of increased. So may not be available for all populations, but for the highly immunocompromised is who Evusheld is recommended for. Intravenous medicine that can hang out in the system, and, you know, in the studies up to six months of protection. So for people that had transplants or significant weakened immune system due to chemotherapy, inability to kind of respond to vaccine, that's another option that's out there. So I think the, you know, the treatment landscape is looking brighter and brighter and prophylaxis, starting to be some options there as well. 

Bill Walsh: Great. Thanks for walking us through that, Dr. Passaretti. Jesse, who is our next caller?

Jesse Salinas: Our next caller is Debbie in Texas. 

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

Debbie: Yes, hi. This is just a real kind of vague question. I was just wondering if there's been any findings on the timeframe between actually contracting COVID and developing some heart issues. I'm just … it's a personal issue because I was, I was diagnosed, I had a baseline a year ago. Everything was fine. Heart was fine. Nuclear stress test, everything good. Then I contracted COVID in January, last month, and then just about a week ago, I went the cardiologist for something, you know, just a check-up, and the EKG was abnormal. And they said that I probably had had a silent heart attack. And I'm wondering, I'm thinking, is that more than coincidence, or did the COVID already, even before I read this article from AARP and heard about this, you know, going on today, there was a connection in my brain that, oh my gosh, you know, maybe it has something to do with the COVID. But then I thought, well, I only had COVID two month, you know, six, seven weeks ago. So ... 

Bill Walsh: Well, let's ask the experts. Let's ask Dr. Levy. He's an expert in this area. Dr. Levy, what can you tell Debbie and others who might have similar concerns?

Ralph Levy: Yeah, it's a very interesting question. It is difficult to tell, Debbie, because I don't know what your risk factors are to have heart attacks. So risk factors are things like high blood pressure, diabetes, smoking cigarettes, having a high cholesterol or a family history for premature coronary artery disease … that's number one. Number two, it is likely that you had the omicron variant. You had it last month because it was the dominant variant. And this variant was naturally associated with an increased prevalence of heart disease, or lung disease for that matter. We're just not seeing much of that. Having said that if, for example, you had significant risk factors and you had COVID, you know, COVID is like any stress in your body, it could have been just bleeding, for example, from an ulcer or a polyp in the colon, or it maybe could have been just like a pneumonia or anything else like that. Anything that stresses the heart in somebody who is prone to have a heart attack could have caused a heart attack conceivably. If we are arguing that it's the virus that caused this, I think that it's unlikely. As I mentioned before the virus can cause an inflammation in the heart, but we don't see that very often. It can cause problems with clotting, and sometimes when we clot too much, our arteries can clot as well in the heart, and you can have a heart attack because of that. But usually those patients have symptoms. It is possible to have had a silent heart attack, but again, it's a little bit unusual unless somebody has things like advanced diabetes. You could have had that other conditioner that I mentioned before, this stress cardiomyopathy. That's one in which the hearts suffers because of the generalized infection. But again, my assumption is that you were not in the hospital, you were not very sick. So yes, sometimes we have coincidences and it may have been that you were at risk and this is what happened in the interim. I think the lesson for all of us is that COVID can, as I mentioned at the beginning of the broadcast, it seems like it can increase the risk of cardiovascular events of different types. And the most important thing is to do what you just did, which is to go to your doctor and take care of your health. Take a look at those risk factors, such as high blood pressure and diabetes and cholesterol, and things pretty much will work themselves out after that.

Bill Walsh: Let me just follow up on that. Debbie had started off by asking about a timeframe when such symptoms might develop. And I imagine there may be a lot of listeners out there wondering, well, I had COVID, am I going to start developing some symptoms of heart disease or hypertension or something? Have the studies shown us that there's a particular timeframe when these sorts of symptoms typically appear?

Ralph Levy: No. I mean, that particular study, it was at one year. My bet is that we're going to continue to see that signal of harm in years to come. There's, I think 17 million patients who have COVID in the United States thus far, but there's no specific standout telling us that. I think that the patient that needs to be concerned, that really needs to reach to the doctor is the patient who has, you know, already heart disease or who is at risk to have heart disease and who has those conditions that I just mentioned — the blood pressure, the diabetes, anybody who's obese or, you know, overweight, as I just mentioned patients who have concomitant conditions, such as advanced lung disease, advanced kidney disease. Those are the patients that I would be particularly concerned about, that they may have an increased risk, but nothing in terms of timing thus far. We have to remember, Bill, that this is a young disease, you know, only 2½ years, and we're still trying to figure it out. It's like if you drop on me right now and told me, you know, we just have this condition called cancer. Figure it out. And you know, it's not so easy. It takes a little while. 

Bill Walsh: All right. Thanks Dr. Levy, and Dr. Passaretti as well. And thank you for all your questions. We're going to take more of your questions shortly. And remember, if you'd like to get in the queue to ask your question live, go ahead and press *3, or if you're on Facebook or YouTube, drop your question in the comments section. I would like to turn back to our experts in the meantime. Dr. Passaretti, states and communities are dropping indoor mask requirements, as we've already mentioned, and by the end of March, every state, except Hawaii, will have ended mask mandates. Could you talk a little bit about the circumstances where people should continue to wear masks?

Katie Passaretti: Yeah, absolutely. And you know, to some extent, regardless of whether mask mandates have been in effect, I know I can speak at least for North Carolina, my geographic area, adherence to the mask mandate has been variable for quite some time. You go out and about and there's a lot of people, whether there's a mask mandate in place or not, that are not wearing masks. So I do think, as we kind of talked about in your listeners’ very good questions, we are continuing to be, and perhaps even more so, entering a phase where it's individual looking at their risk, their personal risk of severe disease. So again, the people at risk for severe disease are unvaccinated, very elderly, at the extremes of age, and people with compromised immune systems, multiple medical problems. Those groups need to take a look at where am I going, what's the risk in that setting, is it, you know, if it's an indoor setting, jam-packed with people and cases are going up in your community, certainly I would recommend erring on the side of caution wearing a mask, or if I'm going home to someone that's very susceptible and even if I have a mild illness, you know that I want to protect that individual. Those are the people that need to look at their very individualized situation and make kind of a risk-benefit analysis on wearing a mask. You know, we're in that kind of stage of the pandemic where we have a decent amount of community protection due to vaccines, boosters, and to some extent, prior infection, so the most important thing is people that are at highest risk or close contact with highest risk, you know, be a bit more cautious about throwing their masks, all their masks in the garbage. 

Bill Walsh: All right. Let me ask a follow-up question. Last week, a White House official said, “We're approaching a phase of COVID that'll, where it will become a treatable risk.” What does that mean for people in practical terms?

Katie Passaretti: Yeah, so really good question and really important. We've seen for the past two-plus years now that the pandemic takes a tremendous toll on us, right? Not only because of my world, people with infection, but all the associated risks of COVID, whether that's the burden of mental health illness that's kind of sharply increased over the past couple of years, whether it's delays in treatment for all the other medical problems that don't stop coming just because there's a pandemic going on, that, you know, there are trade-offs to some of the mitigation steps, the staying home, the hospitals having to push off elective surgeries. We are getting to a point where enough people have been vaccinated, previously infected, that you know the overwhelming burden is a little bit less. And, on top of that, we have things that can protect us — that's vaccines and boosters, and that's the medications we talked about a little bit ago that can help mitigate when there are high-risk individuals that happen to get infected. So, we're getting to that point where, you know, the overall, not just infection-related risks of the pandemic and the mitigation steps have to be balanced, and we start edging out into … this kind of new normal for the pandemic. 

Bill Walsh: All right. Thanks so much, Dr. Passaretti. Dr. Levy, Dr. Passaretti was just referencing one of the outcomes of COVID, which is people delaying ongoing health and medical treatment. And, you know, an additional concern during the pandemic is a significant increase in uncontrolled hypertension. How widespread is this and how serious are the risks? And are there particular groups more affected than others?

Ralph Levy: Yes, there was a recent article published in the American Heart Association journal and (inaudible) circulation, and it was quite interesting. It showed that in a wide group of patients that were taking care of their health in a particular system, they show a mild increase in blood pressure. It was only like about two millimeters in systolic, that's the high number, and about half a millimeter in the dystolic, that's the low number; however, we do know, Bill, that these numbers can be significant. We see concomitant increases in the number of heart attacks and strokes and kidney disease, which are the things that high blood pressure will do to you. So these can be a potential problem. For context again, I remember when the pandemic started, there were two kinds of responses with our patients. There were a few who said, “Well, I'm going to try to get healthier here. I'm going to try to exercise and more stuff.” And then there were patients who said, “Ah, the world is coming to an end, might as well do whatever I want, eat whatever I want. I want to just sit down in a chair and watch TV 24 hours a day.” So I suspect that a little bit of that in here, patients who decided that, you know, this is crazy. “I'm depressed because I'm home by myself all the time. I don't care anymore. So I'm not going to exercise. And perhaps I'm not going to take my medications, or I'm going to eat whatever I want to eat.” And I think that reflects a little bit what has happened. Also, probably there's a little bit of delaying care, patients who were afraid to come to the office. So they decided that they can stay away from the doctor and, you know, sometimes they didn't renew their prescriptions, or they gained weight during the pandemic. We talk about the COVID-19, the COVID-30 and the COVID-50 in my practice in terms of how much weight people have gained. So those are all risk factors in this. So for the audience, I would say that if you have gained a significant amount of weight during the pandemic, if you have become more inactive, you know, it's time to change gears and get back to life. 

Bill Walsh: All right. Well, we're talking about getting back to life, Dr. Levy. You know, we've heard about moderate or mild complications post-COVID — that is, people suffering symptoms long after they've had the, a lot of the infection, in some cases, shortness of breath or low energy. Is it a matter of time before these sorts of symptoms dissipate?

Ralph Levy: Yeah, you know, so this syndrome called Long COVID, it's one of those things that we are writing as we speak because we are getting the experience right now. Clearly, there's a group of patients that get affected by COVID long-term. And some of those consequences, as we described before, can be cardiac issues, but also there are issues like brain fog that probably the audience have listened about, chronic fatigue — being tired all the time, being depressed. There are patients who have significant lung disease during COVID that they're not going to recover, the lungs are completely scarred, and there's some persons who suffered heart damage because they had heart attacks. So this is going to be an issue for years to come. It's going to be a huge burden in our health system to take care of — remember, 17 million patients thus far in the United States. So, some of those patients — not everybody by any stretch of the imagination, most people will heal — but a few patients will have this syndrome and we'll have to take care of them. 

Bill Walsh: OK, thank you very much, Dr. Levy. Now, misinformation continues to undermine public health efforts to end the pandemic. With the pandemic now entering its third year, we're going to address misinformation for the next few minutes in a segment we call, The Four-Minute Fact Check. We'll ask our experts to help us debunk misleading claims and understand why misinformation is so problematic. Dr. Levy, let's start with you. Misinformation about widespread cardiac events among professional athletes has resurfaced. Widely shared social media posts say hundreds of professional athletes have collapsed and died after receiving a COVID vaccine in recent months. Is there any truth to these reports? Is the vaccine a heightened risk to professional athletes? And why do you think these rumors continue to spread?

Ralph Levy: OK, this is one of those that drives me really crazy because I have no clue where this came from. It is absolutely false. There's just no data that demonstrates that that is true. Think about it. I'm a big sports fan, and I watch hockey and golf and soccer and basketball, and, you know, if there was a true signal of harm in these athletes, we would have heard about it, right? I mean, all these guys that are playing sports, it's thousands of them and they're still alive kicking and doing well and earning the world to serve, you know, money. So this is completely false. Now at the beginning of the pandemic, there were issues from that German study that showed some damage in the heart after having COVID, and there were a lot of sports systems in the country that stopped seasons, like in football, for example, college football and stuff like that. And then we discovered that it was just not true. These patients, athletes that are highly in shape anf developed COVID, they did just fine. You know, we do have protocols to make sure that they're OK. We do an EKG, we do some blood tests, we do an ultrasound of the heart. But if those things are OK, these patients go on to have great careers and they do very well. So this particular rumor has been completely bunked, and you know, please be careful with stuff like this. 

Bill Walsh: OK, thanks for setting the record straight. Dr. Passaretti, let me turn to you. I was hoping you could address some of the misleading social media headlines that just continued to linger after two years. So let me tick through a few of them and maybe you can address each one. Are any of the following true? The first is the government is exaggerating or hiding the number of COVID-19 deaths. True or false?

Katie Passaretti: I would say false on this, for sure. You know, this is one that taunted us throughout the pandemic, and there are a lot of people that all of a sudden have become experts in epidemiology over the past couple of years. You know, medicine has a lot of gray areas. And we've been talking about for this past hour … you can get very sick from the virus itself, COVID-19 infection, and … as someone that sees patients in the hospital, I've certainly seen my fair share of patients that have passed away directly due to COVID infection. There's also a lot of patients that they are sick with COVID and have down-the- road complications; the stress of the infection as we've kind of been talking about can affect others. So is the data clean? No. Is any health care data ever perfectly clean? The reality and the truth is that we have seen a tremendous number of deaths due to COVID-19, and the excess mortality due to COVID-19 for the past two years has had a tremendous impact on our society.

Bill Walsh: All right, let me toss another one at you that we continue to see, particularly in social media. Pregnant women should not get the COVID vaccine. What do you say about that? 

Katie Passaretti: False, false, false. This is one where social media has done a lot of harm. You know, there is ever-increasing data that vaccination in a pregnant woman protects that woman and protects the infant. And we're getting more and more data over time that continue to reinforce that vaccines, COVID-19 vaccines, are safe in this population. So I would strongly, strongly encourage anyone who is pregnant to go ahead and get vaccinated for themselves, for their future baby. You know, pretty clear in my mind the vaccine is protective in this population, and we also have seen the tremendous impact of COVID-19 infection causing increased deaths in young, otherwise healthy, pregnant women, and impacts on early birth and impact to the baby.

Bill Walsh:  OK, let me hit you with one more. We keep seeing that the COVID-19 vaccines have been shown to cause infertility and reduce sexual function. True or false? 

Katie Passaretti: Also false. What we do … have seen data to suggest is that COVID-19 infection can impact those male and female fertility, but we have not had any evidence that the vaccines themselves cause infertility, reduced sexual function, have any impact on that. So that is also a social media kind of misinformation.

Bill Walsh: OK, thanks so much both Dr. Levy and Dr. Passaretti for that. Now it's time to address more of your questions with Dr. Katie Passaretti and Dr. Ralph Levy. Jesse, who do we have on the line? 

Jesse Salinas: Our next caller is going to be Mark from Ohio.

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

Mark: Yes, I have a-fib in a right branch bundle block and my heart is not pumping like it should. I'm under cardiac care. I was wondering, should I be asking for a fourth booster shot?

Bill Walsh: Dr. Levy, can you take that question from Mark? 

Ralph Levy: Yes, thank you, Mark. The answer to that is — not just yet. Actually, I checked with my infectious disease chief this morning because I kind of knew this question was coming up. So the actual recommendations were immunocompromised patients — patients that are, for example, medications called steroids at a high dose, or have certain kinds of hematological malignancies, like an (inaudible)  leukemia, so who underwent something called stem cell transplant or who have uncontrolled HIV infection; stuff that produces a decrease in immunity. You're not in that category. So, I would say to hold off for now.

Bill Walsh: Thanks so much, Dr. Levy. Jesse, who do we have next? 

Jesse Salinas: Our next question is from Facebook. And this is Laura and she asks, “For people with type 1 diabetes, is there any evidence that type 1 diabetes by itself puts people more at risk for severe COVID?”

Bill Walsh: Dr. Passaretti?

Katie Passaretti: Diabetes is one of the medical conditions that has been associated with more severe illness due to COVID. It's also one of the conditions that's been associated with individuals who are more prone to the long COVID, or post-acute COVID. So diabetes and, oftentimes with diabetes, obesity, both have been persistent risk factors for more severe disease from once you get infected with COVID. 

Bill Walsh: OK. Thanks very much, Dr. Passaretti. Jesse, who do we have next on the line?

Jesse Salinas: Our next caller is William. 

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

William: Yes. I have a friend who had COVID, and she is 62. And she has a heart valve, and I had no idea that COVID could lead to some type of heart condition. 

Bill Walsh: OK. Dr. Levy, I wonder if you could address that for William. Talk about the incidents of heart conditions among people who have gotten the COVID infection.

Ralph Levy: Again, I'll go back to the things that I mentioned before. I think that I understood, he mentioned something about a heart valve maybe. So valves are these things that we have in our hearts that direct blood from chamber to chamber. And those valves can have two types of problems. Sometimes they are very tight. Sometimes they can get very leaky or they are supposed to allow blood to flow in one direction, and sometimes they allow the blood to come, to go back to the chamber from where they came from. So patients who have very severe valve disease and they get COVID, you know, COVID can affect them adversely, just because they have a preexisting target condition. So that is one thing. The second thing is, I wasn't sure if it was a broad issue because I couldn't quite understand it, but in terms of heart conditions, it is what I mentioned before. If you have a preexisting condition such as high blood pressure, diabetes, a previous heart condition such as heart failure or a heart attack, for sure you are at risk of complications in the next year, as we just saw in that study from the VA hospital. And those patients have to be particularly vigilant to reach out to their physicians and make sure that they are in optimal medical therapy to try to prevent those complications. 

Bill Walsh: All right, thanks so much for that, Dr. Levy. Jessie, who do we have up next?

Jesse Salinas: Our next question is going to be from Vicki in Massachusetts. 

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

Vicki: Hi, this is really a personal question. I was vaccinated with the Johnson & Johnson in March of '21, and then eight months later when allowed, I got the Moderna half-dose. And I want to know if I'm sufficiently vaccinated. 

Bill Walsh: Hmm, Dr. Passaretti, can you address that?

Katie Passaretti: Yeah, so you would … as long as you're not considered immunocompromised, don't have any underlying medical problems that would make your immune system significantly weak, you would be considered up-to-date on your vaccines. So you had your initial Johnson & Johnson, and then that Moderna acted as your booster. Do you happen to be immunocompromised … so for immunocompromised populations, because it takes more kind of stimulus to get the same amount of antibody response with vaccine, the primary series for immunocompromised people includes extra dose. So if you had Johnson & Johnson … and were immunocompromised, should have gotten ideally an mRNA, so Pfizer or Moderna booster kind of following, or second dose following that initial dose, and then your booster would be recommended two months after that for immunocompromised. So slight difference based on your underlying risk immune system kind of factors. But if you're kind of not, don't have immunocompromising conditions, regular kind of medical comorbidities, then you would be considered fully vaccinated at this point in time. 

Bill Walsh: OK. Very good. Jesse, let's take another call.

Jesse Salinas: Our next question is from Lisa in Virginia. And she asks, “Should people like me with cardiovascular conditions, what do we do to manage sort of going back to work, and should we be wearing masks or how should we be sort of managing our heart condition with also the potential exposure to COVID?” 

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

Ralph Levy: Yes, absolutely. This is a super interesting question because we don't have clear answers. I can tell you what I do because I have some patients, for example, that are brittle diabetics, they have known heart disease. So I try to protect them. I think they will be at an incredibly high risk of complications if you get COVID. So I actually write letters to their employers and I tell them, listen, this patient has to be working from home because he's just too high of a risk. And most people listen and they accommodate the patient. So if you are in a particular risk category, I would say, yes, recommendations should continue. Now it's a work in progress as COVID gets less dangerous, let's put it that way. We hope they will continue to evolve that way. Maybe the risk won't be as high and we can allow those patients to mingle and to go back to work. But in the meantime, I try to isolate those patients that I consider at high risk.

Bill Walsh: OK. Thanks. Thanks so much, Dr. Levy. You know, this has been a really informative discussion and thanks to both of our expert panelists for answering our questions today. And thank you, our AARP members, volunteers and listeners for participating in this discussion. 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 the recording of the Q&A event can be found at aarp.org/coronavirus starting Feb. 25. 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. And if you're looking for Medicare assistance during COVID-19, please visit the following website: shiphelp.org/covid-19. That's shiphelp.org/covid-19. We hope you learned something today that can help keep you and your loved ones healthy. Please join us again March 10 for a special live coronavirus Q&A event that marks two years into the COVID pandemic. We hope you can join us at that time. In the meantime, 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.

[00:00:16] [Espanola]

[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 the face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them. At long last we're seeing some good news with the pandemic. New coronavirus cases have declined significantly, and deaths are showing a modest downturn as well. Still many questions around booster shots, subvariants and the confusing safety guidelines as communities around the country try to figure out whether to lift restrictions. And even as the pandemic appears to be dissipating, new studies are showing an increase in COVID-related heart disease. Today, we'll hear from an impressive panel of experts about these issues and more. We'll also get an update from Capitol Hill on legislation affecting older Americans. 

[00:01:23] 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, 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.

[00:02:16] We have some outstanding guests joining us today including a top epidemiologist and a top cardiologist. 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. Again, to ask your question, press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you're joining on Facebook or YouTube, drop your question in the comments section. 

[00:02:55] Now I'd like to welcome our guests. Katie Passaretti, M.D., is vice president and enterprise chief epidemiologist at Atrium Health. Welcome back to the program, Dr. Passaretti.

[00:03:07] Katie Passaretti: Thank you, a pleasure to be here. 

[00:03:08] Bill Walsh: All right, a pleasure to have you. Ralph Levy, M.D., is the chief of Adult Cardiac Medical Services at Memorial Cardiac and Vascular Institute in Florida. Welcome to the program, Dr. Levy.

[00:03:21] Ralph Levy: Thank you so much, Bill. Glad to be here. 

[00:03:23] Bill Walsh: All right. Let's get started with our discussion … Dr. Passaretti, COVID infections quickly increased and then fell in the last couple of months. What's the status of COVID-19 and the omicron variant today?

[00:03:51] Katie Passaretti: Yeah, a great question. So, you know, as quickly as we saw the increase in COVID-related cases and hospitalizations with the rise of the omicron variant, we're seeing an equally rapid descent. So COVID-related hospitalizations are declining to levels around where we were prior to this new variant entering our population. The number of new cases continues to decrease and the percent of tasks in a given day that are positive is coming down. So by all metrics, we're on the downward, we continue to be on the downward swing of this particular surge in this particular variant.

[00:04:33] Bill Walsh: Now it would seem that breakthrough infections, which are those infections that occur among people who have been vaccinated, that they're more common with omicron. Why is that? 

[00:04:45] Katie Passaretti: Yeah, absolutely. So, you know, every different variant that comes along has different mutations that impact the behavior of that particular strain of the virus. So with omicron, we saw many more mutations than we've seen with, say, delta or prior variants. With that comes, you know, it was more easily spread, so more people infected. And it had higher levels of what we call immune escape, which means either prior infection with past variants, or with vaccines we saw a higher number of quote-unquote breakthrough or post-vaccine reinfection type cases. Now the good news is while we saw more breakthrough infections, the vaccines continue to be very, very protective against what we need them most to do, which is to prevent against hospitalizations, deaths and severe cases of COVID. So, definitely saw more breakthrough infections. The good news is that … the vaccines continue to be protective against more severe disease.

[00:05:59] Bill Walsh: All right. Well, that's great to hear. Let me follow up on that though. New research suggests that the omicron variant BA.2, which is nicknamed the stealth omicron, spreads faster and may cause more severe illness. So how widespread is the stealth omicron subvariant? And what should people know about it? 

[00:06:19] Katie Passaretti: So the BA.2 — or what in the media is called the stealth omicron subvariant, as of most recent data from the CDC, accounts for less than 4 percent of the cases in the United States. We fully anticipate that that number will increase and we are — you know this is still a relatively new subvariant, so definitely in the still learning phase. What we know so far, or what's suggested so far is that yes, this subvariant may be a bit more transmissible, so may spread more easily than the prior omicron lineage. You know, there was some concern based on hamster studies that omicron, the BA.2, may cause more severe disease. Over the past couple of days, fortunately, several studies have come out that really push. back on those hamster studies and suggest that in actual kind of human places where this variant is circulating widely, that we are not seeing more hospitalizations, more deaths compared to the initial omicron strain. And you know the other thing that has come up as a potential area of concern is will this BA.2, can you get reinfection with BA.2 after you had omicron, say, a couple of weeks, the initial omicron variant a couple of weeks ago. And it does look like many people in our country and the world have had omicron over the past one to two months that that initial omicron strain does seem to protect against reinfection. So we're not seeing huge numbers of people that had the BA.1, or initial omicron strain, getting infected with BA.2. So good news on that front. It doesn't seem like right now there's huge data suggesting that BA.2 causes more severe illness, probably a bit more transmissible, but I will say in the areas where, outside of the United States where BA.2 accounts for a large chunk of current cases … it isn't turning the tide on trends, you know, downward as far as number of cases and hospitalization. So mixed baggage, still watching it very closely. But right now, you know, some promising signs.

[00:08:54] Bill Walsh: And do we know how effective the vaccines that have been approved in this country are against BA.2?

[00:08:59] Katie Passaretti: Yeah, a great question. So fortunately again, the vaccines, and particularly if you're vaccinated and boosted, continue to protect against severe disease from BA.2 like they did for BA.1. So, good news on that front as well. 

[00:09:17] Bill Walsh: Very good. Thanks for that, Dr. Passaretti. Dr. Levy, let me turn to you. Now, after COVID, even with mild cases, the risks of heart problems remain elevated for about a year, according to a study released this month. A recent German study found three-quarters of individuals post-COVID had heart abnormalities. How significant are the risks and what are the warning signs?

[00:09:45] Ralph Levy: OK, Bill. Well, it's very important to put these studies into context, and I'll explain what I mean. … When the German study came in, it's actually quite a while ago, it was a study of a hundred patients post-COVID infection, and we saw a lot of abnormalities in an MRI of the heart. But you have to think about it this way. … We saw these changes, and many of these changes, over 70 percent, there were mild changes. So we didn't know exactly what that meant. And we kind of shrug our shoulders, and we waited for more information. Well, now we have that information, and it's important information. In this study, in this journal called Nature of Medicine, VA investigators published some research that compared what happened in terms of cardiac events between 500,000 patients who have COVID. They were compared to 5 million contemporary patients without COVID and 5 million patients before the COVID era. And what they did discover is that there was an increased signal of harm or risk in patients after COVID, even patients that had mild symptoms. And those patients had an increased rate of heart attacks, strokes, clotting problems, all kinds of vascular issues. So now it's very different, right? We went from an abnormal test to now real clinical events. What is the magnitude? It was in my view — you know, percentage-wise, it looked like a big magnitude, but we're talking about three, four or more heart attacks per thousand people. You know, the same thing with strokes. So it is an increased number, but it's not an overwhelming number. It has to be taken with caution as well, as if it's just VA patients. It doesn't apply necessarily to the rest of the population. But it's the first thing that tells us, listen, something real happened here. We need to find out why we're having more heart attacks, and we need to intervene before this gets out of hand. 

[00:11:53] Bill Walsh: All right. And you anticipate my next question, which is about risk factors. It sounded from what you were saying that there are increased risks because of preexisting conditions. But are things like vaccination status, age or other factors, also risk factors for developing heart abnormalities from COVID?

[00:12:17] Ralph Levy: Yeah, absolutely. So the question is why this happened and it can be many things. A funny story happened when COVID started. We stopped seeing patients come into the hospital with heart attacks, and it's not like COVID was curing heart attacks, it was that patients were so afraid to come to the hospital, they were dying at home because of heart attacks. Well, you can extrapolate that and say, well listen, these patients are still not coming to the office or delay visits, or maybe they've not, they're not taking their medication for blood pressure or finding out that they have blood pressure or finding out that they have high cholesterol and not treating it, or patients who already have preexisting conditions with high blood pressure, actual heart disease, they're not being as careful or they're not taking their medications like they should, or it may be a virus factor. Some patients do get an infection in their heart. It's not very common because of the virus. Some patients get severe lung disease and in the body things will come by themselves, so you're going to have significant lung disease. Your heart is going to be an innocent bystander, it's going to get hurt as well. And we're going to have long-term consequences from that. Certainly, the vaccine is going to protect you. The vaccine is not going to harm you. I want to be very clear on that. And it's very important that the audience understands that we need to be fully vaccinated — and boostered, as a matter of fact. Finally in terms of age, of course, the older we are, the more concomitant medical conditions we have from high blood pressure to diabetes, to obesity, to inactivity, to, you know, high cholesterol. Some of the audience may have had heart attacks before, they may have problems with the valves in their heart, previous problems with the muscle in the heart. They may have a condition called heart failure, and certainly, if you get this virus, you're going to be at risk of more complications if you have those conditions.

[00:14:12] Bill Walsh: OK, and do you have any advice for folks who might be listening who do have preexisting heart conditions if they end up being diagnosed with COVID?

[00:14:23] Ralph Levy: Yeah, my advice is to contact your physician and to follow instructions in terms of your medications. You know, we have the ability to control most of the conditions in cardiology. We can control high blood pressure, we can lower the cholesterol to unbelievably low levels. We can make sure those patients with heart failure feel better and live longer, but it requires that you reach out to us, that you are compliant with your diet, your medication. I need you guys to be super active. Exercise is one of those super powerful medications that nobody ever uses, and yet it's free, readily available. It makes you live longer, feel better, allow you to live independently, so that kind of stuff.

[00:15:12] Bill Walsh: All right, thanks so much, Dr. Levy, and I love hearing about exercise as a medication. Very good. As a reminder to our listeners, if you'd like to get in the queue to ask your question live, go ahead and press *3 on your telephone key pad. And if you're on a YouTube or Facebook, go ahead and drop it into the comments section. We're going to take your live questions shortly, but before we do, I wanted to bring in my AARP colleague Cristina Martin Firvida, who is the vice president of government affairs here at AARP. Welcome, Cristina. 

[00:15:46] Cristina Martin Firvida: Delighted to be here, Bill.

[00:15:47] Bill Walsh: All right, we're delighted to have you. Now, in addition to sharing the most recent news on the coronavirus, we'd like to take a few minutes to update our listeners about advocacy news in a segment we call, Fighting for You. Christina, any news you can share with us on the advocacy front?

[00:16:06] Cristina Martin Firvida: Absolutely, Bill. AARP is still urging the United States Senate to allow Medicare to negotiate for lower prescription drug prices. We know that more than 80 percent of voters across parties support this change, and that it would save seniors and Medicare billions of dollars. Congress has promised for years to address the price of prescription drugs, and now is the time to get the job done. We have also endorsed recently a bipartisan plan to protect Social Security recipients from identity theft. Protecting older Americans from fraud and scams is one of our top priorities.

[00:16:43] Bill Walsh: OK. Now, in addition to fighting for change on Capitol Hill, I know AARP advocates in every state as well. Are there some recent successes in the states that you can share with us? 

[00:16:55] Cristina Martin Firvida: Absolutely. AARP is for sure hard at work advocating in every state nationwide. In addition to our federal activity on prescription drug affordability, last year AARP State Offices helped to achieve 26 prescription drug affordability victories in 17 states. For example, right at the end of 2021, AARP Pennsylvania was instrumental in passing two bills that make more older people eligible for a state program that provides financial assistance to pay for prescription drugs. Now, with the 2022 state sessions in full swing, AARP state offices across the country are right back at it pushing for new policies to bring down the prices of prescription drugs.

[00:17:43] Bill Walsh: Well, that's fantastic to hear. Now, in addition to prescription drug prices, AARP is also fighting to help people stay financially secure. Can you share some current examples of that? 

[00:17:57] Cristina Martin Firvida: Yes, absolutely. Right now, we continue to support legislative proposals to reduce or even eliminate state income taxes on Social Security benefits, including in Nebraska, Minnesota and Vermont. In New Mexico, an AARP-supported proposal to significantly reduce taxes on Social Security benefits is headed to the governor for signature. And we're also supporting legislative proposals to reduce or eliminate state income taxes on retirement distributions from 401k plans, 403 B plans, and traditional pensions in states such as Maryland, Connecticut and Iowa. Finally, AARP has been instrumental in supporting IRA work and save programs in states around the country to help people save for retirement, including a recent program in Connecticut that's seeing fantastic results.

[00:18:51] Bill Walsh: Oh, that's all great news. Now we've also seen progress with rental and utility aid. Isn't that correct? 

[00:18:58] Cristina Martin Firvida: That's right. We're advocating at the state level for rental and utility assistance. For example, in 2021 AARP New York lobbied the newly appointed governor to increase the use of federal emergency rental assistance funds to eligible households, leading New York from an increase of just 5 percent of funds New York was allocated, distributed in June and July, to 85 percent of the funds distributed by September. In addition, AARP New York protected consumers from utility disconnections by filing an emergency petition to increase relief for those struggling to pay their bills during the pandemic.

[00:19:38] Bill Walsh: All right. Well, that's a lot of work going on. Finally, AARP has seen some recent advances in health and caregiving, too, especially improvements in long-term services and supports, and home- and community-based services. Is that right? 

[00:19:52] Cristina Martin Firvida: That's right. In 2021, AARP State Offices helped achieve 27 legislative wins related to improving home- and community-based services, and 18 wins related to long-term services and support systems. These positive changes expanded or enhanced access services, made advancements toward rebalancing care from facilities and institutions to home- and community-based services, and provided opportunities and support for family caregivers. This year we're continuing to fight for improvements in local services and systems, because we want older adults to receive the quality care they need and deserve. Ultimately, we want people be able to remain living in their homes and their communities, where they prefer to be for as long as possible.

[00:20:41] Bill Walsh: Well, that's exactly what they're looking for. Thanks so much, Christina. That's great news and a lot of great work across the country. Thanks for those updates. All right, now it's time to address your questions about the coronavirus with Dr. Katie Passaretti and Dr. Ralph Levy. … I'd now like to bring in my AARP colleague Jesse Salinas to help facilitate your calls. Welcome, Jesse.

[00:21:28] Jesse Salinas: I'm glad to be here today, Bill.

[00:21:30] Bill Walsh: All right, let's take our first question. 

[00:21:33] Jesse Salinas: Our first question today is going to come from George on YouTube. And George asks, “Now that mask mandates are being lifted, do we need to avoid public places or busy places like theaters, buses or airports?”

[00:21:46] Bill Walsh: Dr. Passaretti, can you take a crack at that one? We are kind of in an in-between transitional time as it relates to masks. So what precautions should people be taking?

[00:21:57] Katie Passaretti: Yeah, definitely in a transitional time, for sure. You know, I would say that … we're getting into the stage of COVID where it's an assessment of your personal risk. So individuals that are most at risk need to look at things like, you know, where they're going — if it's indoors, if it's a crowded situation, potentially higher risk of exposure. Are there more cases, a significant number of cases, or are cases increasing in that particular community? Those individuals need to weigh the risks and benefits of kind of doing those activities. And … in my mind those highest risk may want to continue to take precautions like masking, giving yourself a little bit of space, and potentially avoiding those really crowded indoor settings, especially if there's trends in the community that are concerning. But, in the other kind of caveat I would throw out there, the other group of people that may want to consider when to wear masks, you know, if they're in a higher risk situation, are individuals who interact with or have at home someone that is very high risk, someone with a weakened immune system, someone that can't be vaccinated for whatever reasons. I think lots of good news, lots of decreases in cases, but certainly … we're still in the pandemic and some risk, so taking a look at your personal kind of risk, if you get an infection, whether you're vaccinated, and making a decision based on that combination of risk of where you're going, personal risk, the risk of those you spend a lot of time with and want to protect, and you're in your individual decision-making about whether to wear masks. 

[00:23:49] Bill Walsh: OK, very good. Thanks so much, Dr. Passaretti. Jesse, who do we have up next?

[00:23:55] Jesse Salinas: Our next caller is Ida from Nevada. 

[00:23:59] Bill Walsh: Hey, Ida, welcome to our program. Go ahead with your question.

[00:24:03] Ida: Yeah, my question, is they found out the effects coronavirus COVID on some patients, and I was just wondering, is there a specific condition on the heart that would differentiate it from other causes of heart condition? I mean, specific for coronavirus. 

[00:24:28] Bill Walsh: Let's ask Dr. Levy about that. Dr. Levy?

[00:24:32] Ralph Levy: Yeah, thank you for your question. No, there is no specific test that says this is caused by coronavirus. I think it's important to know that coronavirus, as in other viruses, can cause inflammation of the heart, something called myocarditis, yet in COVID patients we see this really rarely. I think what we see a lot is other problems such as problems with the rhythm of the heart. As I mentioned before, the heart can be an innocent bystander and can suffer when the patient has lung disease, for example. Some patients do have heart attacks, and the other condition that these patients tend to have is this thing called stress cardiomyopathy; it's kind of a funny name, but sometimes the stress of the infection can make the heart weak. These patients usually recover. It's not something that we see long term, but in terms of your question of specific tests that tells us the heart was affected by COVID, no, we do not have that.

[00:25:35] Bill Walsh: OK, thanks so much, Dr. Levy. Jesse, let's go back to the phones. 

[00:25:41] Jesse Salinas: Yeah, our next question is going to come from Jessie in Alaska.

[00:25:44] Bill Walsh: All right. Hey, Jessie. Welcome to the program. Go ahead with your question. 

[00:25:49] Jessie: Thank you. I'm interested in learning about the efficacy and availability of oral medications like Paxlovid. And also, I know that one of the other ones is a potent mutagen, and I'm concerned about the possibility for genetic damage even to DNA, even while it's being used against an RNA virus. And the second one is what's the horizon looking like for oral preventative medication or intravenous? Thank you.

[00:26:28] Bill Walsh: Great questions, Jessie. Dr. Passaretti, can you tackle those?

[00:26:32] Katie Passaretti: Yeah, absolutely. So really good questions and really important right now, especially as we're kind of in this transition phase that we were talking about. So, first off, your question about Paxlovid, oral medication that in studies and in use so far works very well if given early in disease and high-risk individuals at preventing hospitalization. That drug is relatively new, but … especially as we're seeing decrease in the number of cases in our various communities in the United States, the availability of that drug is increasing and becoming more and more accessible. So, unfortunately during omicron, … Paxlovid came out kind of smack dab in the middle, and as supply was ramping up cases were super high; we're now continuing to have increased supply, which is a good thing. And our cases are coming down. So people should find that availability of that medication is increasing pretty decently across the United States. The second medication you mentioned that impacts kind of RNA is called Molnupiravir, so that medication also does have a role to play in treatment. You know, the studies, the mechanism of action has raised some concerns about potential mutations. Those have not played out clinically as of yet, and it does — while not as effective as Paxlovid — does have some efficacy, again, if given soon after symptom onset in preventing more severe disease. So certainly my go-to, my first line oral medication for people that can get it, is Paxlovid. If there's a reason that Paxlovid can't be given, either because of a medication interaction or whatever reason, then Molnupiravir, I wouldn't completely rule out Molnupiravir. And then I think your final question, which also is very good, was about prophylactic medications. So currently there are not any oral prophylactic medications available. You know, hopefully over time, those will become available and certainly candidates are being studied actively, but nothing that has kind of risen to being recommended for clinical use. There are potential, either intravenous or potentially intramuscular, medications that can be used for either post-exposure prophylaxis, meaning I am high risk, I had a family member in my household that had COVID and am not sick yet, but I want to prevent getting sick. So the monoclonal antibodies that have been used for treatment of COVID can also be used in that situation, where supply allows. Finally, there is another medication called, that goes by the trade name Evusheld. Again, intravenous medication, and supply is still being kind of increased. So may not be available for all populations, but for the highly immunocompromised is who Evusheld is recommended for. Intravenous medicine that can hang out in the system, and, you know, in the studies up to six months of protection. So for people that had transplants or significant weakened immune system due to chemotherapy, inability to kind of respond to vaccine, that's another option that's out there. So I think the, you know, the treatment landscape is looking brighter and brighter and prophylaxis, starting to be some options there as well. 

[00:30:30] Bill Walsh: Great. Thanks for walking us through that, Dr. Passaretti. Jesse, who is our next caller?

[00:30:38] Jesse Salinas: Our next caller is Debbie in Texas. 

[00:30:40] Bill Walsh: Hey, Debbie, welcome to our program. Go ahead with your question.

[00:30:45] Debbie: Yes, hi. This is just a real kind of vague question. I was just wondering if there's been any findings on the timeframe between actually contracting COVID and developing some heart issues. I'm just … it's a personal issue because I was, I was diagnosed, I had a baseline a year ago. Everything was fine. Heart was fine. Nuclear stress test, everything good. Then I contracted COVID in January, last month, and then just about a week ago, I went the cardiologist for something, you know, just a check-up, and the EKG was abnormal. And they said that I probably had had a silent heart attack. And I'm wondering, I'm thinking, is that more than coincidence, or did the COVID already, even before I read this article from AARP and heard about this, you know, going on today, there was a connection in my brain that, oh my gosh, you know, maybe it has something to do with the COVID. But then I thought, well, I only had COVID two month, you know, six, seven weeks ago. So ... 

[00:32:08] Bill Walsh: Well, let's ask the experts. Let's ask Dr. Levy. He's an expert in this area. Dr. Levy, what can you tell Debbie and others who might have similar concerns?

[00:32:18] Ralph Levy: Yeah, it's a very interesting question. It is difficult to tell, Debbie, because I don't know what your risk factors are to have heart attacks. So risk factors are things like high blood pressure, diabetes, smoking cigarettes, having a high cholesterol or a family history for premature coronary artery disease … that's number one. Number two, it is likely that you had the omicron variant. You had it last month because it was the dominant variant. And this variant was naturally associated with an increased prevalence of heart disease, or lung disease for that matter. We're just not seeing much of that. Having said that if, for example, you had significant risk factors and you had COVID, you know, COVID is like any stress in your body, it could have been just bleeding, for example, from an ulcer or a polyp in the colon, or it maybe could have been just like a pneumonia or anything else like that. Anything that stresses the heart in somebody who is prone to have a heart attack could have caused a heart attack conceivably. If we are arguing that it's the virus that caused this, I think that it's unlikely. As I mentioned before the virus can cause an inflammation in the heart, but we don't see that very often. It can cause problems with clotting, and sometimes when we clot too much, our arteries can clot as well in the heart, and you can have a heart attack because of that. But usually those patients have symptoms. It is possible to have had a silent heart attack, but again, it's a little bit unusual unless somebody has things like advanced diabetes. You could have had that other conditioner that I mentioned before, this stress cardiomyopathy. That's one in which the hearts suffers because of the generalized infection. But again, my assumption is that you were not in the hospital, you were not very sick. So yes, sometimes we have coincidences and it may have been that you were at risk and this is what happened in the interim. I think the lesson for all of us is that COVID can, as I mentioned at the beginning of the broadcast, it seems like it can increase the risk of cardiovascular events of different types. And the most important thing is to do what you just did, which is to go to your doctor and take care of your health. Take a look at those risk factors, such as high blood pressure and diabetes and cholesterol, and things pretty much will work themselves out after that.

[00:34:53] Bill Walsh: Let me just follow up on that. Debbie had started off by asking about a timeframe when such symptoms might develop. And I imagine there may be a lot of listeners out there wondering, well, I had COVID, am I going to start developing some symptoms of heart disease or hypertension or something? Have the studies shown us that there's a particular timeframe when these sorts of symptoms typically appear?

[00:35:17] Ralph Levy: No. I mean, that particular study, it was at one year. My bet is that we're going to continue to see that signal of harm in years to come. There's, I think 17 million patients who have COVID in the United States thus far, but there's no specific standout telling us that. I think that the patient that needs to be concerned, that really needs to reach to the doctor is the patient who has, you know, already heart disease or who is at risk to have heart disease and who has those conditions that I just mentioned — the blood pressure, the diabetes, anybody who's obese or, you know, overweight, as I just mentioned patients who have concomitant conditions, such as advanced lung disease, advanced kidney disease. Those are the patients that I would be particularly concerned about, that they may have an increased risk, but nothing in terms of timing thus far. We have to remember, Bill, that this is a young disease, you know, only 2½ years, and we're still trying to figure it out. It's like if you drop on me right now and told me, you know, we just have this condition called cancer. Figure it out. And you know, it's not so easy. It takes a little while. 

[00:36:26] Bill Walsh: All right. Thanks Dr. Levy, and Dr. Passaretti as well. And thank you for all your questions. We're going to take more of your questions shortly. And remember, if you'd like to get in the queue to ask your question live, go ahead and press *3, or if you're on Facebook or YouTube, drop your question in the comments section. I would like to turn back to our experts in the meantime. Dr. Passaretti, states and communities are dropping indoor mask requirements, as we've already mentioned, and by the end of March, every state, except Hawaii, will have ended mask mandates. Could you talk a little bit about the circumstances where people should continue to wear masks?

[00:37:07] Katie Passaretti: Yeah, absolutely. And you know, to some extent, regardless of whether mask mandates have been in effect, I know I can speak at least for North Carolina, my geographic area, adherence to the mask mandate has been variable for quite some time. You go out and about and there's a lot of people, whether there's a mask mandate in place or not, that are not wearing masks. So I do think, as we kind of talked about in your listeners’ very good questions, we are continuing to be, and perhaps even more so, entering a phase where it's individual looking at their risk, their personal risk of severe disease. So again, the people at risk for severe disease are unvaccinated, very elderly, at the extremes of age, and people with compromised immune systems, multiple medical problems. Those groups need to take a look at where am I going, what's the risk in that setting, is it, you know, if it's an indoor setting, jam-packed with people and cases are going up in your community, certainly I would recommend erring on the side of caution wearing a mask, or if I'm going home to someone that's very susceptible and even if I have a mild illness, you know that I want to protect that individual. Those are the people that need to look at their very individualized situation and make kind of a risk-benefit analysis on wearing a mask. You know, we're in that kind of stage of the pandemic where we have a decent amount of community protection due to vaccines, boosters, and to some extent, prior infection, so the most important thing is people that are at highest risk or close contact with highest risk, you know, be a bit more cautious about throwing their masks, all their masks in the garbage. 

[00:38:59] Bill Walsh: All right. Let me ask a follow-up question. Last week, a White House official said, “We're approaching a phase of COVID that'll, where it will become a treatable risk.” What does that mean for people in practical terms?

[00:39:15] Katie Passaretti: Yeah, so really good question and really important. We've seen for the past two-plus years now that the pandemic takes a tremendous toll on us, right? Not only because of my world, people with infection, but all the associated risks of COVID, whether that's the burden of mental health illness that's kind of sharply increased over the past couple of years, whether it's delays in treatment for all the other medical problems that don't stop coming just because there's a pandemic going on, that, you know, there are trade-offs to some of the mitigation steps, the staying home, the hospitals having to push off elective surgeries. We are getting to a point where enough people have been vaccinated, previously infected, that you know the overwhelming burden is a little bit less. And, on top of that, we have things that can protect us — that's vaccines and boosters, and that's the medications we talked about a little bit ago that can help mitigate when there are high-risk individuals that happen to get infected. So, we're getting to that point where, you know, the overall, not just infection-related risks of the pandemic and the mitigation steps have to be balanced, and we start edging out into … this kind of new normal for the pandemic. 

[00:40:50] Bill Walsh: All right. Thanks so much, Dr. Passaretti. Dr. Levy, Dr. Passaretti was just referencing one of the outcomes of COVID, which is people delaying ongoing health and medical treatment. And, you know, an additional concern during the pandemic is a significant increase in uncontrolled hypertension. How widespread is this and how serious are the risks? And are there particular groups more affected than others?

[00:41:21] Ralph Levy: Yes, there was a recent article published in the American Heart Association journal and [inaudible] circulation, and it was quite interesting. It showed that in a wide group of patients that were taking care of their health in a particular system, they show a mild increase in blood pressure. It was only like about two millimeters in systolic, that's the high number, and about half a millimeter in the dystolic, that's the low number; however, we do know, Bill, that these numbers can be significant. We see concomitant increases in the number of heart attacks and strokes and kidney disease, which are the things that high blood pressure will do to you. So these can be a potential problem. For context again, I remember when the pandemic started, there were two kinds of responses with our patients. There were a few who said, “Well, I'm going to try to get healthier here. I'm going to try to exercise and more stuff.” And then there were patients who said, “Ah, the world is coming to an end, might as well do whatever I want, eat whatever I want. I want to just sit down in a chair and watch TV 24 hours a day.” So I suspect that a little bit of that in here, patients who decided that, you know, this is crazy. “I'm depressed because I'm home by myself all the time. I don't care anymore. So I'm not going to exercise. And perhaps I'm not going to take my medications, or I'm going to eat whatever I want to eat.” And I think that reflects a little bit what has happened. Also, probably there's a little bit of delaying care, patients who were afraid to come to the office. So they decided that they can stay away from the doctor and, you know, sometimes they didn't renew their prescriptions, or they gained weight during the pandemic. We talk about the COVID-19, the COVID-30 and the COVID-50 in my practice in terms of how much weight people have gained. So those are all risk factors in this. So for the audience, I would say that if you have gained a significant amount of weight during the pandemic, if you have become more inactive, you know, it's time to change gears and get back to life. 

[00:43:35] Bill Walsh: All right. Well, we're talking about getting back to life, Dr. Levy. You know, we've heard about moderate or mild complications post-COVID — that is, people suffering symptoms long after they've had the, a lot of the infection, in some cases, shortness of breath or low energy. Is it a matter of time before these sorts of symptoms dissipate?

[00:44:01] Ralph Levy: Yeah, you know, so this syndrome called Long COVID, it's one of those things that we are writing as we speak because we are getting the experience right now. Clearly, there's a group of patients that get affected by COVID long-term. And some of those consequences, as we described before, can be cardiac issues, but also there are issues like brain fog that probably the audience have listened about, chronic fatigue — being tired all the time, being depressed. There are patients who have significant lung disease during COVID that they're not going to recover, the lungs are completely scarred, and there's some persons who suffered heart damage because they had heart attacks. So this is going to be an issue for years to come. It's going to be a huge burden in our health system to take care of — remember, 17 million patients thus far in the United States. So, some of those patients — not everybody by any stretch of the imagination, most people will heal — but a few patients will have this syndrome and we'll have to take care of them. 

[00:44:58] Bill Walsh: OK, thank you very much, Dr. Levy. Now, misinformation continues to undermine public health efforts to end the pandemic. With the pandemic now entering its third year, we're going to address misinformation for the next few minutes in a segment we call, The Four-Minute Fact Check. We'll ask our experts to help us debunk misleading claims and understand why misinformation is so problematic. Dr. Levy, let's start with you. Misinformation about widespread cardiac events among professional athletes has resurfaced. Widely shared social media posts say hundreds of professional athletes have collapsed and died after receiving a COVID vaccine in recent months. Is there any truth to these reports? Is the vaccine a heightened risk to professional athletes? And why do you think these rumors continue to spread?

[00:45:54] Ralph Levy: OK, this is one of those that drives me really crazy because I have no clue where this came from. It is absolutely false. There's just no data that demonstrates that that is true. Think about it. I'm a big sports fan, and I watch hockey and golf and soccer and basketball, and, you know, if there was a true signal of harm in these athletes, we would have heard about it, right? I mean, all these guys that are playing sports, it's thousands of them and they're still alive kicking and doing well and earning the world to serve, you know, money. So this is completely false. Now at the beginning of the pandemic, there were issues from that German study that showed some damage in the heart after having COVID, and there were a lot of sports systems in the country that stopped seasons, like in football, for example, college football and stuff like that. And then we discovered that it was just not true. These patients, athletes that are highly in shape anf developed COVID, they did just fine. You know, we do have protocols to make sure that they're OK. We do an EKG, we do some blood tests, we do an ultrasound of the heart. But if those things are OK, these patients go on to have great careers and they do very well. So this particular rumor has been completely bunked, and you know, please be careful with stuff like this. 

[00:47:27] Bill Walsh: OK, thanks for setting the record straight. Dr. Passaretti, let me turn to you. I was hoping you could address some of the misleading social media headlines that just continued to linger after two years. So let me tick through a few of them and maybe you can address each one. Are any of the following true? The first is the government is exaggerating or hiding the number of COVID-19 deaths. True or false?

[00:47:58] Katie Passaretti: I would say false on this, for sure. You know, this is one that taunted us throughout the pandemic, and there are a lot of people that all of a sudden have become experts in epidemiology over the past couple of years. You know, medicine has a lot of gray areas. And we've been talking about for this past hour … you can get very sick from the virus itself, COVID-19 infection, and … as someone that sees patients in the hospital, I've certainly seen my fair share of patients that have passed away directly due to COVID infection. There's also a lot of patients that they are sick with COVID and have down-the- road complications; the stress of the infection as we've kind of been talking about can affect others. So is the data clean? No. Is any health care data ever perfectly clean? The reality and the truth is that we have seen a tremendous number of deaths due to COVID-19, and the excess mortality due to COVID-19 for the past two years has had a tremendous impact on our society.

[00:49:11] Bill Walsh: All right, let me toss another one at you that we continue to see, particularly in social media. Pregnant women should not get the COVID vaccine. What do you say about that? 

[00:49:21] Katie Passaretti: False, false, false. This is one where social media has done a lot of harm. You know, there is ever-increasing data that vaccination in a pregnant woman protects that woman and protects the infant. And we're getting more and more data over time that continue to reinforce that vaccines, COVID-19 vaccines, are safe in this population. So I would strongly, strongly encourage anyone who is pregnant to go ahead and get vaccinated for themselves, for their future baby. You know, pretty clear in my mind the vaccine is protective in this population, and we also have seen the tremendous impact of COVID-19 infection causing increased deaths in young, otherwise healthy, pregnant women, and impacts on early birth and impact to the baby.

[00:50:19] Bill Walsh: OK, let me hit you with one more. We keep seeing that the COVID-19 vaccines have been shown to cause infertility and reduce sexual function. True or false? 

[00:50:32] Katie Passaretti: Also false. What we do … have seen data to suggest is that COVID-19 infection can impact those male and female fertility, but we have not had any evidence that the vaccines themselves cause infertility, reduced sexual function, have any impact on that. So that is also a social media kind of misinformation.

[00:50:56] Bill Walsh: OK, thanks so much both Dr. Levy and Dr. Passaretti for that. Now it's time to address more of your questions with Dr. Katie Passaretti and Dr. Ralph Levy. Jesse, who do we have on the line? 

[00:51:15] Jesse Salinas: Our next caller is going to be Mark from Ohio.

[00:51:18] Bill Walsh: Hey, Mark, welcome to the program. Go ahead with your question. 

[00:51:23] Mark: Yes, I have a-fib in a right branch bundle block and my heart is not pumping like it should. I'm under cardiac care. I was wondering, should I be asking for a fourth booster shot?

[00:51:36] Bill Walsh: Dr. Levy, can you take that question from Mark? 

[00:51:42] Ralph Levy: Yes, thank you, Mark. The answer to that is — not just yet. Actually, I checked with my infectious disease chief this morning because I kind of knew this question was coming up. So the actual recommendations were immunocompromised patients — patients that are, for example, medications called steroids at a high dose, or have certain kinds of hematological malignancies, like an [inaudible] leukemia, so who underwent something called stem cell transplant or who have uncontrolled HIV infection; stuff that produces a decrease in immunity. You're not in that category. So, I would say to hold off for now.

[00:52:28] Bill Walsh: Thanks so much, Dr. Levy. Jesse, who do we have next? 

[00:52:32] Jesse Salinas: Our next question is from Facebook. And this is Laura and she asks, “For people with type 1 diabetes, is there any evidence that type 1 diabetes by itself puts people more at risk for severe COVID?”

[00:52:44] Bill Walsh: Dr. Passaretti?

[00:52:48] Katie Passaretti: Diabetes is one of the medical conditions that has been associated with more severe illness due to COVID. It's also one of the conditions that's been associated with individuals who are more prone to the long COVID, or post-acute COVID. So diabetes and, oftentimes with diabetes, obesity, both have been persistent risk factors for more severe disease from once you get infected with COVID. 

[00:53:17] Bill Walsh: OK. Thanks very much, Dr. Passaretti. Jesse, who do we have next on the line?

[00:53:22] Jesse Salinas: Our next caller is William. 

[00:53:25] Bill Walsh: Hey, William, welcome to the program. Go ahead with your question.

[00:53:30] William: Yes. I have a friend who had COVID, and she is 62. And she has a heart valve, and I had no idea that COVID could lead to some type of heart condition. 

[00:53:48] Bill Walsh: OK. Dr. Levy, I wonder if you could address that for William. Talk about the incidents of heart conditions among people who have gotten the COVID infection.

[00:54:04] Ralph Levy: Again, I'll go back to the things that I mentioned before. I think that I understood, he mentioned something about a heart valve maybe. So valves are these things that we have in our hearts that direct blood from chamber to chamber. And those valves can have two types of problems. Sometimes they are very tight. Sometimes they can get very leaky or they are supposed to allow blood to flow in one direction, and sometimes they allow the blood to come, to go back to the chamber from where they came from. So patients who have very severe valve disease and they get COVID, you know, COVID can affect them adversely, just because they have a preexisting target condition. So that is one thing. The second thing is, I wasn't sure if it was a broad issue because I couldn't quite understand it, but in terms of heart conditions, it is what I mentioned before. If you have a preexisting condition such as high blood pressure, diabetes, a previous heart condition such as heart failure or a heart attack, for sure you are at risk of complications in the next year, as we just saw in that study from the VA hospital. And those patients have to be particularly vigilant to reach out to their physicians and make sure that they are in optimal medical therapy to try to prevent those complications. 

[00:55:21] Bill Walsh: All right, thanks so much for that, Dr. Levy. Jessie, who do we have up next?

[00:55:25] Jesse Salinas: Our next question is going to be from Vicki in Massachusetts. 

[00:55:29] Bill Walsh: Hey, Vicki, welcome to our program. Go ahead with your question.

[00:55:33] Vicki: Hi, this is really a personal question. I was vaccinated with the Johnson & Johnson in March of '21, and then eight months later when allowed, I got the Moderna half-dose. And I want to know if I'm sufficiently vaccinated. 

[00:55:52] Bill Walsh: Hmm, Dr. Passaretti, can you address that?

[00:55:55] Katie Passaretti: Yeah, so you would … as long as you're not considered immunocompromised, don't have any underlying medical problems that would make your immune system significantly weak, you would be considered up-to-date on your vaccines. So you had your initial Johnson & Johnson, and then that Moderna acted as your booster. Do you happen to be immunocompromised … so for immunocompromised populations, because it takes more kind of stimulus to get the same amount of antibody response with vaccine, the primary series for immunocompromised people includes extra dose. So if you had Johnson & Johnson … and were immunocompromised, should have gotten ideally an mRNA, so Pfizer or Moderna booster kind of following, or second dose following that initial dose, and then your booster would be recommended two months after that for immunocompromised. So slight difference based on your underlying risk immune system kind of factors. But if you're kind of not, don't have immunocompromising conditions, regular kind of medical comorbidities, then you would be considered fully vaccinated at this point in time. 

[00:57:20] Bill Walsh: OK. Very good. Jesse, let's take another call.

[00:57:25] Jesse Salinas: Our next question is from Lisa in Virginia. And she asks, “Should people like me with cardiovascular conditions, what do we do to manage sort of going back to work, and should we be wearing masks or how should we be sort of managing our heart condition with also the potential exposure to COVID?” 

[00:57:41] Bill Walsh: Dr. Levy, do you want to take that one?

[00:57:44] Ralph Levy: Yes, absolutely. This is a super interesting question because we don't have clear answers. I can tell you what I do because I have some patients, for example, that are brittle diabetics, they have known heart disease. So I try to protect them. I think they will be at an incredibly high risk of complications if you get COVID. So I actually write letters to their employers and I tell them, listen, this patient has to be working from home because he's just too high of a risk. And most people listen and they accommodate the patient. So if you are in a particular risk category, I would say, yes, recommendations should continue. Now it's a work in progress as COVID gets less dangerous, let's put it that way. We hope they will continue to evolve that way. Maybe the risk won't be as high and we can allow those patients to mingle and to go back to work. But in the meantime, I try to isolate those patients that I consider at high risk.

[00:58:43] Bill Walsh: OK. Thanks. Thanks so much, Dr. Levy. You know, this has been a really informative discussion and thanks to both of our expert panelists for answering our questions today. And thank you, our AARP members, volunteers and listeners for participating in this discussion. 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 the recording of the Q&A event can be found at aarp.org/coronavirus starting Feb. 25. 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. And if you're looking for Medicare assistance during COVID-19, please visit the following website: shiphelp.org/covid-19. That's shiphelp.org/covid-19. We hope you learned something today that can help keep you and your loved ones healthy. Please join us again March 10 for a special live coronavirus Q&A event that marks two years into the COVID pandemic. We hope you can join us at that time. In the meantime, thank you and have a good day. This concludes our call.

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

Por fin, estamos viendo buenas noticias con la pandemia. Los casos nuevos de coronavirus han disminuido significativamente y las muertes también muestran una modesta disminución. Todavía hay muchas preguntas sobre las vacunas de refuerzo, las subvariantes y las confusas pautas de seguridad, a medida que las comunidades de todo el país intentan averiguar si deben levantar o no las restricciones. E incluso, cuando la pandemia parece estar disipándose, nuevos estudios muestran un aumento en la enfermedad cardíaca relacionada con la COVID-19.

Hoy escucharemos a un impresionante panel de expertos hablar sobre estos temas y otros. También recibiremos una actualización del Capitolio sobre la legislación que afecta a los adultos mayores del país. Si ya participaron en alguna de nuestras teleasambleas, saben que es similar a un programa de entrevistas de radio y tienen la oportunidad de hacer sus preguntas en vivo.

Para aquellos de ustedes que se unan a nosotros por teléfono, si desean hacer una pregunta, 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 colocará en turno 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 importantes expertos y respondiendo sus preguntas en vivo. Para hacer una pregunta, presionen *3 en el teclado de su teléfono y, si se unen a través de Facebook o YouTube, pueden publicar su pregunta en la sección de comentarios.

Tenemos algunos invitados destacados que nos acompañan hoy, incluida una epidemióloga y un cardiólogo de primer nivel. 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 participan a través de Facebook o YouTube, dejen sus preguntas en la sección de comentarios.

Ahora me gustaría dar la bienvenida a nuestros invitados. La Dra. Katie Passaretti, vicepresidenta y epidemióloga principal de Atrium Health. Bienvenida de nuevo al programa, Dra. Passaretti.

Katie Passaretti: Gracias. Es un placer estar aquí.

Bill Walsh: Muy bien, un placer tenerla. El Dr. Ralph Levy, director de Servicios médicos cardíacos para adultos en el Memorial Cardiac and Vascular Institute de Florida. Bienvenido al programa, Dr. Levy.

Ralph Levy: Muchas gracias, Bill. Encantado de estar aquí.

Bill Walsh: Muy bien. Comencemos con nuestra discusión. Y solo un recordatorio para nuestros oyentes, para hacer una pregunta, presionen * 3 en cualquier momento en el teclado de su teléfono o colóquenla en la sección de comentarios en Facebook o YouTube. Empecemos. Dra. Passaretti, las infecciones por COVID-19 aumentaron rápidamente y luego disminuyeron en los últimos meses. ¿Cuál es el estado actual de la COVID-19 y la variante ómicron?

Katie Passaretti: Sí, buena pregunta. Bueno, así como vimos un aumento de casos y hospitalizaciones relacionados con COVID-19 con el aumento de la variante ómicron, estamos viendo un descenso igualmente rápido. Por lo tanto, las hospitalizaciones relacionadas con la COVID-19 están disminuyendo a niveles similares a los que teníamos antes de que esta nueva variante ingresara a nuestra población. La cantidad de casos nuevos continúa disminuyendo y el porcentaje de pruebas positivas diarias está disminuyendo. Entonces, según todas las cifras, continuamos en descenso de esta oleada particular, de esta variante en particular.

Bill Walsh: Ya habíamos visto que las infecciones posvacunación, que son aquellas infecciones que ocurren entre las personas que han sido vacunadas, son más comunes con ómicron. ¿Por qué es eso?

Katie Passaretti: Sí, absolutamente. Bueno, cada variante diferente que aparece tiene diferentes mutaciones que afectan el comportamiento de esa cepa particular del virus. Entonces, con ómicron, vimos muchas más mutaciones de las que hemos visto con, digamos, delta o variantes anteriores. Es por eso que, entonces, se propagó más fácilmente, por lo que más personas se infectaron.

Además, hubo niveles más altos de lo que llamamos escape inmunitario, lo que significa que, ya sea con una infección previa con variantes pasadas o con vacunas, vimos un número más alto de casos de tipo "irruptivo" o reinfección posvacunación. Ahora, la buena noticia es que, aunque vimos más casos de la infección, las vacunas continúan siendo muy, muy protectoras contra lo que más necesitamos que hagan, que es prevenir hospitalizaciones, muertes y, ya sabe, casos graves de COVID-19. Así que definitivamente vimos más infecciones posvacunación. La buena noticia es que la vacuna continúa protegiendo contra enfermedades más graves.

Bill Walsh: Muy bien. Bueno, es genial escuchar eso. Permítanme hacer un seguimiento de eso. Una nueva investigación sugiere que la variante ómicron BA.2, apodada “ómicron sigilosa”, se propaga más rápido y puede causar una enfermedad más grave. Entonces, ¿qué tan extendida está la subvariante “ómicron sigilosa”? ¿Y qué debe saber la gente al respecto?

Katie Passaretti: Sí. Entonces, la BA.2 o como la llaman en los medios, subvariante “ómicron sigilosa”, según los datos más recientes de los CDC, representa menos del 4% de los casos en Estados Unidos. Anticipamos que sin duda ese número aumentará y estamos… sabe, sigue siendo una subvariante relativamente nueva, así que definitivamente aún estamos en la fase de aprendizaje.

Lo que sabemos hasta ahora, o lo que se sugiere hasta ahora es que, sí, esta subvariante puede ser un poco más transmisible, por lo que puede propagarse más fácilmente que el linaje ómicron anterior. Hubo cierta preocupación basada en estudios con hámsteres de que ómicron, la BA.2 podría causar una enfermedad más grave. En los últimos días, afortunadamente, surgieron varios estudios que realmente pusieron en duda esos estudios con hámsteres y sugieren que en humanos, en lugares donde esta variante está circulando ampliamente, no estamos viendo más hospitalizaciones ni más muertes en comparación con la cepa inicial de ómicron.

Y la otra cosa que ha surgido como un posible área de preocupación es si esta BA.2, si es posible volver a infectarse con BA.2 después de haber tenido ómicron, la variante inicial de ómicron, hace un par de semanas. Y parece que muchas personas en nuestro país y en el mundo han tenido ómicron durante los últimos uno o dos meses que esa cepa inicial de ómicron parece proteger contra la reinfección. Entonces, no estamos viendo un gran número de personas que hayan tenido la BA.1 o la cepa ómicron inicial que se infecten con BA.2. Así que son buenas noticias en ese frente.

No parece que en este momento haya una gran cantidad de datos que sugieran que la BA.2 causa una enfermedad más grave, probablemente un poco más transmisible, pero diré que en las áreas fuera de Estados Unidos, donde la BA.2 representa una gran parte de los casos actuales, no está cambiando la tendencia a disminuir el número de casos y hospitalizaciones. Entonces, un poco de todo, todavía estamos observándolo muy de cerca. Pero, ya sabe, en este momento hay algunas señales prometedoras.

Bill Walsh: ¿Y sabemos qué tan eficaces son las vacunas que han sido aprobadas en este país contra la BA.2?

Katie Passaretti: Sí, buena pregunta. Afortunadamente, nuevamente, las vacunas, y particularmente si uno está vacunado y recibió el refuerzo, continúan protegiendo contra la enfermedad grave de BA.2 como lo hicieron con BA.1. Entonces, buenas noticias en ese frente también.

Bill Walsh: Muy bien. Gracias por eso, Dra. Passaretti. Dr. Levy, permítame hablar con usted. Ahora, después de la COVID-19, incluso con casos leves, los riesgos de problemas cardíacos siguen siendo elevados durante aproximadamente un año, según un estudio publicado este mes. Un estudio alemán reciente encontró que tres cuartas partes de las personas después de la COVID-19 tenían anomalías cardíacas. ¿Qué tan significativos son los riesgos y cuáles son las señales de advertencia?

Ralph Levy: Bien. Bueno, es muy importante poner estos estudios en contexto. Y explicaré lo que quiero decir. Cuando llegó el estudio alemán, en realidad, fue hace bastante tiempo, era un estudio de 100 pacientes después de la infección por COVID-19 y vimos muchas anomalías en una resonancia magnética del corazón, pero hay que pensarlo de esta manera. Esto era solo una prueba, ¿verdad?

Vimos estos cambios, y muchos de estos cambios ya dicen que más del 70% fueron cambios leves. Así que no sabíamos exactamente lo que eso significaba. Y nos encogimos de hombros, esperábamos más información. Bueno, ahora tenemos esa información. En este estudio, en esta revista llamada Nature of Medicine, los investigadores de la VA publicaron una investigación que comparaba lo que ocurría en términos de episodios cardíacos entre 500,000 pacientes que tenían COVID-19.

Los compararon con 5 millones de pacientes contemporáneos sin COVID-19 y 5 millones de pacientes antes de la era COVID-19. Y lo que descubrieron es que hubo una mayor señal de daño o riesgo en pacientes después de tener COVID-19, incluso pacientes que tenían síntomas leves. Y esos pacientes tenían un mayor índice de ataques cardíacos, accidentes cerebrovasculares, problemas de coagulación, todo tipo de problemas vasculares.

Así que ahora es muy diferente, ¿verdad? Pasamos de un pasado anómalo a ahora, con hechos clínicos reales. ¿Cuál es la magnitud? En mi opinión, en términos porcentuales, parece una gran magnitud, pero estamos hablando de tres a cuatro ataques cardíacos más, por cada mil personas, lo mismo con los accidentes cerebrovasculares. Por lo tanto, es un número mayor, pero no es un número abrumador.

También debe tomarse con cautela, como si se tratara solo de pacientes del VA. No se aplica necesariamente al resto de la población. Pero lo primero que nos dice es: "Escucha, algo real sucedió aquí. Tenemos que averiguar por qué vemos más ataques al corazón, tenemos que intervenir antes de que esto se nos vaya de las manos".

Bill Walsh: Muy bien, y usted anticipó mi siguiente pregunta, que trata sobre los factores de riesgo. Por lo que estaba diciendo, parecía haber un mayor riesgo debido a enfermedades preexistentes, pero ¿son cosas como el estado de vacunación, la edad u otros factores, también factores de riesgo para manifestar anomalías cardíacas a causa de la COVID-19?

Ralph Levy: Sí, absolutamente. Así que la pregunta es por qué sucedió esto. Y, ya sabe, pueden ser muchas cosas. Algo curioso sucedió cuando comenzó la pandemia de COVID-19. Empezamos a ver pacientes que llegaban al hospital con infartos. Y no es que la COVID-19 estuviera provocando infartos, es que los pacientes tenían tanto miedo de venir al hospital que se morían en casa a causa de los infartos.

Bueno, se puede extrapolar eso y decir, bueno, escuchen, estos pacientes todavía no vienen al consultorio o retrasan las visitas, o tal vez no están tomando sus medicamentos para la presión arterial, o descubren que tienen presión arterial alta, o que tienen el colesterol alto y no lo tratan, o pacientes que ya tienen enfermedades preexistentes con presión arterial alta, enfermedad cardíaca real, no están siendo tan cuidadosos o no están tomando sus medicamentos como deberían, o puede ser un factor viral.

Algunos pacientes tienen una infección en el corazón. No es muy común que sea debido al virus. Algunos pacientes tienen una enfermedad pulmonar grave y en el cuerpo las cosas vendrán por sí solas, así que tendrán una enfermedad pulmonar significativa. Su corazón será un espectador inocente, también se enfermará. Y vamos a tener consecuencias a largo plazo de eso. Ciertamente, la vacuna lo va a proteger, la vacuna no le va a hacer daño. Quiero ser muy claro en eso. Y es muy importante que la audiencia entienda que necesitamos estar completamente vacunados y recibir el refuerzo, de hecho.

Finalmente, en términos de edad, por supuesto, cuanto más viejos somos, más enfermedades concomitantes tenemos, desde presión arterial alta hasta diabetes, obesidad, inactividad, colesterol alto... Algunos de los espectadores pueden haber tenido ataques cardíacos, es posible que tengan problemas con las válvulas del corazón. Puede tener problemas previos con el músculo del corazón, pueden tener una afección llamada insuficiencia cardíaca. Y ciertamente, si uno contrae este virus, tendrá un riesgo de padecer más complicaciones si tiene esas enfermedades.

Bill Walsh: Está bien. ¿Y tiene algún consejo para las personas que podrían estar escuchando y que tienen enfermedades cardíacas preexistentes, si terminan siendo diagnosticadas con COVID-19?

Ralph Levy: Sí, mi consejo es que se comuniquen con su médico y sigan las instrucciones en cuanto a sus medicamentos. Ya sabe, tenemos la capacidad de controlar la mayoría de las enfermedades cardiológicas. Podemos controlar la presión arterial alta, podemos reducir el colesterol a niveles increíblemente bajos, podemos asegurarnos de que los pacientes con insuficiencia cardíaca se sientan mejor y vivan más tiempo, pero requiere que se comuniquen con nosotros para saber si están cumpliendo con su dieta, con su medicamento. Necesito que sean muy activos. El ejercicio es uno de esos medicamentos muy poderosos que nadie usa y, sin embargo es gratis y está fácilmente disponible. Nos hace vivir más tiempo, sentirnos mejor, nos permite vivir de forma independiente y ese tipo de cosas.

Bill Walsh: Muy bien, muchas gracias, Dr. Levy, y me encanta escuchar sobre el ejercicio como medicamento. Muy bien. Como recordatorio para nuestros oyentes, si desean ponerse en turno para hacer su pregunta en vivo, presionen *3 en el teclado de su teléfono. Y si están en YouTube o Facebook, déjenla en la sección de comentarios. Vamos a responder sus preguntas en vivo en breve, pero antes de hacerlo, quiero traer a mi colega de AARP, Cristina Martin Firvida, que es la vicepresidenta de Asuntos Gubernamentales en AARP. Bienvenida Cristina.

Cristina Martín Firvida: Encantada de estar aquí, Bill.

Bill Walsh: Muy bien, estamos encantados de tenerla. Ahora, además de compartir las noticias más recientes sobre el coronavirus, tomemos unos minutos para actualizar a nuestros oyentes sobre las noticias sobre la defensa de los derechos y un segmento que llamamos Fighting For You. Cristina, ¿alguna noticia que pueda compartir con nosotros en el frente de la defensa?

Cristina Martín Firvida: Absolutamente, Bill. AARP sigue instando al Senado de Estados Unidos a permitir que Medicare negocie precios más bajos de los medicamentos recetados. Sabemos que más del 80% de los votantes de todos los partidos apoyan este cambio y que ahorraría miles de millones de dólares a las personas mayores y a Medicare.

Durante años, el Congreso ha prometido abordar el precio de los medicamentos recetados, y ahora es el momento de hacer el trabajo. También respaldamos recientemente un plan bipartidista para proteger a los beneficiarios del Seguro Social contra el robo de identidad. Proteger a los adultos mayores del país contra el fraude y las estafas es una de nuestras principales prioridades.

Bill Walsh: Bien, además de luchar por el cambio en el Congreso, también conozco a defensores de AARP en todos los estados. ¿Hay algunos logros recientes en los estados que pueda compartir con nosotros?

Cristina Martín Firvida: Absolutamente. Sin duda, AARP está trabajando arduamente para abogar en todos los estados del país. Además de nuestra actividad federal sobre la asequibilidad de medicamentos recetados, el año pasado, las oficinas estatales de AARP ayudaron a lograr 26 victorias en la asequibilidad de medicamentos recetados en 17 estados.

Por ejemplo, justo a fines del 2021, AARP Pensilvania jugó un papel decisivo en la aprobación de dos proyectos de ley que hacen que más personas mayores sean aptas para un programa estatal que brinda asistencia financiera para pagar medicamentos recetados. Ahora, con las sesiones estatales del 2022 en pleno apogeo, las oficinas estatales de AARP en todo el país están de nuevo presionando para que se adopten nuevas políticas para reducir los precios de los medicamentos recetados.

Bill Walsh: Bueno, es fantástico escuchar eso. Ahora, además de los precios de los medicamentos recetados, AARP también lucha para ayudar a las personas a mantener su seguridad financiera. ¿Puede compartir algunos ejemplos actuales de eso?

Cristina Martín Firvida: Sí, absolutamente. En este momento seguimos apoyando las propuestas legislativas para reducir o incluso eliminar los impuestos estatales sobre la renta en los beneficios del Seguro Social, incluso en Nebraska, Minnesota y Vermont. En Nuevo México, una propuesta respaldada por AARP para reducir significativamente los impuestos sobre los beneficios del Seguro Social, se dirige al gobernador para que firme.

Y también apoyamos propuestas legislativas para reducir o eliminar los impuestos estatales sobre la renta en las distribuciones de jubilación de los planes 401(k), planes 403(b) y pensiones tradicionales en estados como Maryland, Connecticut e Iowa. Finalmente, AARP ha sido fundamental en el apoyo a los programas de Trabajo y Ahorro en estados de todo el país para ayudar a las personas a ahorrar para la jubilación, incluido un programa reciente en Connecticut que está obteniendo resultados fantásticos.

Bill Walsh: Oh, todas esas son buenas noticias. Ahora también hemos visto progreso con la ayuda para el alquiler y los servicios públicos, ¿no es así?

Cristina Martín Firvida: Así es. Estamos abogando a nivel estatal por la asistencia para el alquiler y los servicios públicos. Por ejemplo, en el 2021, AARP Nueva York presionó a la gobernadora recién nombrada para que aumentara el uso de los fondos federales de asistencia de emergencia para el alquiler de ciertos hogares en Nueva York, de un aumento de solo el 5% de los fondos que se asignaron a Nueva York distribuidos en junio y julio, a 85% de los fondos distribuidos en septiembre. Además, AARP Nueva York protegió a los consumidores contra las desconexiones de los servicios públicos al presentar una petición de emergencia para aumentar el alivio para quienes les cuesta pagar sus facturas durante la pandemia.

Bill Walsh: Muy bien, bueno, eso es mucho trabajo. Finalmente, AARP ha visto algunos avances recientes en salud y cuidado, especialmente mejoras en servicios y apoyos a largo plazo y servicios en el hogar y la comunidad. ¿No es así?

Cristina Martín Firvida: Así es. En el 2021, las oficinas estatales de AARP ayudaron a lograr 27 victorias legislativas relacionadas con la mejora de los servicios comunitarios y en el hogar, y 18 victorias relacionadas con servicios a largo plazo y sistemas de apoyo. Estos cambios positivos ampliaron o mejoraron los servicios de acceso, permitieron progresar en el reequilibrio de la atención desde los centros e instituciones a los servicios domiciliarios y comunitarios, y ofrecieron oportunidades y apoyo a los cuidadores familiares.

Este año, continuaremos luchando para lograr mejoras en los servicios y sistemas locales porque queremos que los adultos mayores reciban la atención de calidad que necesitan y merecen. En última instancia, queremos que las personas puedan seguir viviendo en su hogar y en su comunidad, donde prefieren estar, durante el mayor tiempo posible.

Bill Walsh: Bueno, eso es exactamente lo que están buscando. Muchas gracias, Cristina. Esa es una gran noticia y un gran trabajo en todo el país. Gracias por esas actualizaciones. Muy bien, ahora es el momento de abordar sus preguntas sobre el coronavirus con la Dra. Katie Passaretti y el Dr. Ralph Levy. Como recordatorio, presionen *3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP para compartir su pregunta en vivo. Y si desean escuchar en español, presionen *0 en el teclado de su teléfono ahora.

[En español]

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

Jesse Salinas: Me alegro de estar aquí hoy, Bill.

Bill Walsh: Muy bien, tomemos nuestra primera pregunta.

Jesse Salinas: Nuestra primera pregunta de hoy vendrá de George en YouTube. Y George pregunta: "Ahora que se están levantando los mandatos de usar mascarilla, ¿hay que evitar lugares públicos o lugares concurridos como teatros, autobuses o aeropuertos?"

Bill Walsh: Dra. Passaretti, ¿puede tomar esa pregunta? Estamos en un momento de transición en lo que respecta a las mascarillas. Entonces, ¿qué precauciones debería tomar la gente?

Katie Passaretti: Sí, definitivamente en un momento de transición, sin duda. Ya sabe, yo diría que ... estamos entrando en la etapa de COVID-19 en la que se trata de evaluar su riesgo personal. Así que las personas que corren más riesgo deben tener en cuenta cosas como, ya sabe, el lugar al que van, si es en un lugar cerrado, si es un lugar lleno de gente, un riesgo posiblemente mayor de exposición. ¿Hay más casos, una gran cantidad de casos, o están aumentando los casos en esa comunidad en particular?

Esas personas, ya sabe, necesitan sopesar los riesgos y beneficios de hacer esas actividades. Y, en mi opinión, quienes corren mayor riesgo pueden querer seguir tomando precauciones como usar mascarilla, darse un poco de espacio y posiblemente evitar esos espacios interiores realmente llenos de gente, especialmente si hay tendencias en la comunidad que son preocupantes.

Pero, en el otro tipo de advertencia que quisiera hacer, el otro grupo de personas que pueden querer considerar cuándo usar mascarilla, ya sabe, si están en una situación de mayor riesgo, son personas que interactúan con alguien o tienen en casa a alguien que es de muy alto riesgo, alguien con un sistema inmunitario debilitado, alguien que no puede ser vacunado por alguna razón.

Creo que muchas buenas noticias, muchas disminuciones en los casos, pero ciertamente, todavía estamos en la pandemia y existen algunos riesgos. Entonces, hay que analizar el tipo de riesgo personal, si se contrae una infección, si se está vacunado, y tomar una decisión basada en esa combinación de riesgo del lugar al que se va, el riesgo personal, el riesgo de las personas con las que se pasa mucho tiempo y se quiere proteger, y se debe tomar una decisión personal sobre el uso de mascarilla.

Bill Walsh: Está bien, muy bien. Muchas gracias, Dra. Passaretti. Jesse, ¿a quién tenemos ahora?

Jesse Salinas: Nuestra próxima llamada es Ida de Nevada.

Bill Walsh: Hola, Ida, bienvenida a nuestro programa. Continúe con su pregunta.

Ida: Sí. Mi pregunta es, averiguaron el efecto del coronavirus en algunos pacientes. Y me preguntaba, ¿hay alguna enfermedad específica que lo diferencie de otras causas de afección cardíaca, es decir, específica para el coronavirus?

Bill Walsh: Preguntémosle al Dr. Levy sobre eso. Dr. Levy.

Ralph Levy: Sí. Gracias por su pregunta. No, no hay una prueba específica que diga que esto es causado por el coronavirus. Creo que es importante saber que los coronavirus y todos los virus pueden causar una inflamación del corazón llamada miocarditis. Sí, en los pacientes con COVID-19 vemos esto muy raramente, creo que vemos muchos otros problemas, como problemas con el ritmo del corazón.

Como mencioné antes, el corazón puede ser un espectador inocente y puede sufrir cuando el paciente tiene una enfermedad pulmonar, por ejemplo. Algunos pacientes tienen ataques al corazón. Y la otra enfermedad que estos pacientes tienden a tener es esta cosa llamada miocardiopatía por estrés, es un nombre gracioso, pero a veces el estrés o la infección pueden debilitar el corazón. Estos pacientes generalmente se recuperan. No es algo que veamos a largo plazo. Pero en términos de su pregunta sobre pruebas específicas, que nos diga que el corazón se vio afectado por la COVID-19, no, no tenemos eso.

Bill Walsh: Está bien. Muchas gracias, Dr. Levy. Jesse, volvamos a los teléfonos.

Jesse Salinas: Sí. Nuestra próxima pregunta vendrá de Jessie en Alaska.

Bill Walsh: Muy bien. Hola, Jessie, bienvenida al programa. Continúe con su pregunta.

Jessie: Gracias. Estoy interesada en conocer la eficacia y disponibilidad de medicamentos orales como Paxlovid. Y también, sé que uno de los otros es un mutágeno potente. Y me preocupa la posibilidad de daño genético, incluso en el ADN, incluso mientras se usa contra un virus de ARN. Y la segunda es ¿cómo se ve el horizonte para la medicación preventiva oral o intravenosa? Gracias.

Bill Walsh: Buenas preguntas, Jessie. Dra. Passaretti, ¿puede abordarlas?

Katie Passaretti: Sí, absolutamente. Muy buenas preguntas. Y realmente importantes en este momento, especialmente porque estamos en esta fase de transición de la que hablábamos. En primer lugar, su pregunta sobre el medicamento oral Paxlovid que en estudios y en uso hasta ahora funciona muy bien si se administra temprano en la enfermedad y en personas de alto riesgo para prevenir la hospitalización.

Esa droga es relativamente nueva, especialmente porque estamos viendo una disminución en la cantidad de casos en nuestras diversas comunidades en Estados Unidos, la disponibilidad de esa droga está aumentando y se vuelve cada vez más accesible. Entonces, desafortunadamente, durante ómicron, el Paxlovid salió a la venta en un punto intermedio, y a medida que aumentaba el suministro, los casos eran muy elevados; ahora seguimos teniendo un mayor suministro, lo que es bueno. Y nuestros casos están bajando.

Entonces, las personas deberían ver que la disponibilidad de ese medicamento está aumentando bastante en Estados Unidos. El segundo medicamento que mencionó, que afecta el tipo de ARN, se llama Molnupiravir, así que ese medicamento también tiene un papel que desempeñar en el tratamiento. Los estudios, el mecanismo de acción ha generado algunas preocupaciones sobre posibles mutaciones.

Todavía no se ha demostrado, y si bien no es tan eficaz como el Paxlovid, tiene cierta eficacia, nuevamente, si se administra poco después del inicio de los síntomas para prevenir una enfermedad más grave. Así que, sin duda, mi medicamento oral de preferencia para las personas que pueden obtenerlo es Paxlovid. Si hay una razón por la que Paxlovid no se puede administrar debido a la interacción con medicamentos o, por cualquier razón, entonces Molnupiravir, no descartaría por completo a Molnupiravir.

Y luego creo que su pregunta final, que también es muy buena, fue sobre los medicamentos profilácticos. Así que actualmente no hay ningún medicamento profiláctico oral disponible. Esperemos que con el tiempo estén disponibles y ciertamente se están estudiando activamente los candidatos, pero no hay nada que haya sido recomendado para uso clínico.

Existen medicamentos intravenosos o potencialmente intramusculares que se pueden usar para la profilaxis posterior a la exposición, lo que significa: "Soy de alto riesgo, tuve un familiar en mi hogar que tenía COVID-19 y aún no estoy enfermo, pero quiero evitar enfermarme". Los anticuerpos monoclonales que se han usado para el tratamiento de COVID-19 también se pueden usar en esa situación donde el suministro lo permite.

Finalmente, hay otro medicamento que se conoce con el nombre comercial de Evusheld. Una vez más, es una medicación intravenosa, y el suministro todavía se está incrementando. Por lo tanto, es posible que no esté disponible para todas las poblaciones, pero el Evusheld se recomienda para las personas altamente inmunocomprometidas. Medicamentos intravenosos que pueden permanecer en el sistema y, según los estudios brindar hasta seis meses de protección.

Entonces, está disponible para las personas que se sometieron a un trasplante o tienen el sistema inmunitario significativamente debilitado debido a la quimioterapia y la incapacidad de responder a la vacuna. Esa es otra opción que hay. Así que creo que el panorama del tratamiento se ve cada vez más brillante y la profilaxis también comienza a ser una opción.

Bill Walsh: Genial. Gracias por guiarnos, Dra. Passaretti. Jesse, ¿de quién es nuestra próxima llamada?

Jesse Salinas: Nuestra próxima llamada es de Debbie en Texas.

Bill Walsh: Hola, Debbie, bienvenida a nuestro programa. Continúe con su pregunta.

Debbie: Sí, hola. Esta es una pregunta muy general. Me preguntaba si ha habido algún descubrimiento sobre el tiempo que transcurre entre que se contrae la COVID-19 y se producen algunos problemas cardíacos. Yo sólo ... es una cuestión personal porque yo estaba, me diagnosticaron, tuve una línea de base hace un año. Todo estaba bien. El corazón estaba bien. Prueba de esfuerzo nuclear, todo bien. Luego contraje COVID-19 en enero, el mes pasado. Y luego, hace aproximadamente una semana, fui al cardiólogo por algo, solo para revisar, y el electrocardiograma era anormal. Y dijeron que probablemente tuve un infarto silencioso. Y me pregunto, estoy pensando, ¿es eso más que una coincidencia? O la COVID-19 realmente... Incluso antes de leer este artículo de AARP y escuchar sobre esto, lo que sucede hoy, hubo una conexión en mi cerebro que decía: "Oh, Dios mío, tal vez tenga algo que ver con la COVID-19". Pero luego pensé bueno, tuve COVID-19 hace dos meses, hace seis o siete semanas, así que...

Bill Walsh: Bueno, preguntémosles a los expertos. Preguntemos al Dr. Levy. Es un experto en esta área. Dr. Levy, ¿qué puede decirle a Debbie y a otras personas que puedan tener inquietudes similares?

Ralph Levy: Sí, es una pregunta muy interesante. Es difícil saberlo, Debbie, porque no sé cuáles son sus factores de riesgo para sufrir ataques cardíacos. Los factores de riesgo son cosas como la presión arterial alta, la diabetes, fumar cigarrillos, tener colesterol alto o antecedentes familiares de enfermedad arterial coronaria prematura. Eso primero.

Segundo, es probable que tuviera la variante ómicron, si la ha tenido el mes pasado porque esa era la variante dominante. Y esta variante se asoció naturalmente con una mayor prevalencia de enfermedades cardíacas o pulmonares. Simplemente no hemos visto mucho de eso. Habiendo dicho eso, si, por ejemplo, tiene factores de riesgo significativos y ha tenido COVID-19, la COVID-19 es como cualquier estrés en el cuerpo, podría haber sido solo un sangrado, por ejemplo, de una úlcera o un pólipo en el colon, o o tal vez podría haber sido sólo como una neumonía o cualquier otra cosa así.

Cualquier cosa que estrese el corazón de alguien que es propenso a tener un ataque al corazón podría haber causado un ataque al corazón, posiblemente. Si estamos argumentando que es el virus el que lo causó, creo que es poco probable, como mencioné antes, que el virus pueda causar una inflamación en el corazón, pero no vemos eso muy a menudo. Puede causar problemas de coagulación y, a veces, cuando la coagulación es excesiva, las arterias pueden coagularse también en el corazón, y se puede sufrir un infarto a causa de ello.

Pero por lo general, esos pacientes tienen síntomas. Es posible que hayan tenido un ataque cardíaco silencioso, pero nuevamente, es un poco inusual, a menos que alguien tenga problemas como diabetes avanzada. Pudo haber tenido esa otra enfermedad que mencioné antes, esta cardiomiopatía por estrés, esa es aquella en la que el corazón sufre a causa de la infección generalizada. Pero nuevamente, mi suposición es que no estuvo en un hospital, no estuvo muy enferma.

Entonces, sí, a veces se dan coincidencias, y puede haber sido que estaba en riesgo y esto es lo que sucedió en el ínterin. Creo que la lección para todos nosotros es que la COVID-19, como mencioné al comienzo de la transmisión, parece que puede aumentar el riesgo de episodios cardiovasculares de diferentes tipos. Y lo más importante es hacer lo que acaba de hacer, que es ir a su médico y cuidar su salud, cuidar esos factores de riesgo como la hipertensión y la diabetes, y el colesterol. Y las cosas se resolverán solas.

Bill Walsh: Permítanme seguir con eso. Debbie había comenzado preguntando sobre un período en el que podrían aparecer tales síntomas. E imagino que puede haber muchos oyentes preguntándose: "Bueno, tuve COVID-19, ¿voy a comenzar a tener algunos síntomas de enfermedad cardíaca o hipertensión o algo así?" ¿Los estudios nos han demostrado que hay un período particular en el que suelen aparecer este tipo de síntomas?

Ralph Levy: No. Y en ese estudio en particular fue a un año. Mi apuesta es que vamos a seguir viendo esa señal de daño en los próximos años. Hay, creo, 17 millones de pacientes que tuvieron COVID-19 en Estados Unidos hasta ahora. Pero no hay un aspecto específico que nos diga eso.

Creo que el paciente que debe preocuparse en que realmente necesita acudir al médico, es el paciente que ya tiene una enfermedad cardíaca o que está en riesgo de tener una enfermedad cardíaca, y que tiene los problemas que acabo de mencionar, la presión arterial, la diabetes, cualquiera que sea obeso o, ya sabe, con sobrepeso, como acabo de mencionar, pacientes que tienen afecciones concomitantes como enfermedad pulmonar avanzada, enfermedad renal avanzada, esos son los pacientes que me preocuparán especialmente que tengan un mayor riesgo, pero nada en términos de tiempo hasta ahora.

Tenemos que recordar, Bill, que esta es una enfermedad joven, solo dos años y medio, y todavía estamos tratando de resolverla. Es como si apareciera en este momento y me dijera: "Tenemos esta afección llamada cáncer, resuélvelo". Y, ya sabe, no es tan fácil. Toma un poco de tiempo.

Bill Walsh: Muy bien. Gracias, Dr. Levy y Dra. Passaretti también. Y gracias por todas sus preguntas. Vamos a tomar más de sus preguntas en breve. Y recuerden, si desean tener un turno para hacer su pregunta en vivo, presionen *3, o si están en Facebook o YouTube, dejen su pregunta en la sección de comentarios.

Me gustaría volver a nuestros expertos. Mientras tanto, Dra. Passaretti, los estados y las comunidades eliminarán los requisitos de uso de mascarillas en espacios cerrados, como ya mencionamos, y para fines de marzo, todos los estados, excepto Hawái, habrán terminado los mandatos de uso de mascarilla. ¿Podría hablar un poco sobre las circunstancias en las que las personas deberían seguir usando mascarilla?

Katie Passaretti: Absolutamente. Y, hasta cierto punto, independientemente de si los mandatos de uso de mascarilla han estado vigentes, sé que puedo hablar al menos de Carolina del Norte, mi área geográfica, el cumplimiento del mandato de uso de mascarilla ha sido variable durante bastante tiempo, ya saben, salen y hay mucha gente que no las usa, ya sea que haya un mandato de uso de mascarilla o no.

Así que creo que como hablamos con los oyentes, muy buenas preguntas, seguimos estando y quizás aún más entrando en una fase en la que es individual, analizando el riesgo, el riesgo personal de contraer una enfermedad grave. Así que, de nuevo, las personas que corren el riesgo de padecer una enfermedad grave son las que no están vacunadas, las de edad muy avanzada, las que tienen un sistema inmunitario comprometido y múltiples problemas médicos.

Esos grupos deben analizar a dónde van, cuál es el riesgo en ese lugar, si es un lugar cerrado, repleto de gente y los casos aumentan en su comunidad, ciertamente recomendaría ser precavido y usar mascarilla, o si voy a casa de alguien que es muy susceptible e incluso si tengo una enfermedad leve, sé que quiero proteger a esa persona. Esas son las personas que tienen que analizar su situación particular y hacer una especie de análisis de riesgo-beneficio sobre el uso de la mascarilla.

Estamos en ese tipo de etapa de la pandemia en la que tenemos una cantidad de protección comunitaria razonable debido a las vacunas, los refuerzos y, hasta cierto punto, a una infección previa. Entonces, lo más importante es que las personas que corren el mayor riesgo o están en contacto cercano con el mayor riesgo sean un poco más cautelosas al desechar su mascarilla, todas sus mascarillas a la basura.

Bill Walsh: Muy bien. Déjame hacer una pregunta de seguimiento. La semana pasada, un funcionario de la Casa Blanca dijo que nos acercamos a una fase de COVID-19 en la que se convertirá en un riesgo tratable. ¿Qué significa eso para las personas en términos prácticos?

Katie Passaretti: Sí, muy buena pregunta. Y muy importante, ¿verdad? Hemos visto durante los últimos dos años que la pandemia nos afecta tremendamente, ¿verdad? No solo en mi mundo, las personas con infección, sino por todos los riesgos asociados con la COVID-19, ya sea la carga de la enfermedad de salud mental que aumentó considerablemente en los últimos dos años, o por los retrasos en el tratamiento para todos los otros problemas médicos que no dejan de producirse solo porque hay una pandemia, que, ya sabe, hay compensaciones en algunas de las medidas de mitigación, como quedarse en casa, o que los hospitales tengan que posponer operaciones electivas.

Estamos llegando a un punto en el que suficientes personas han sido vacunadas o previamente infectadas que, ya sabe, la carga abrumadora es un poco menor. Y además de eso, tenemos cosas que pueden protegernos, como vacunas y refuerzos, y los medicamentos de los que hablamos hace un rato que pueden ayudar a mitigar cuando hay personas de alto riesgo que se infectan. Entonces, estamos llegando a ese punto en el que los riesgos generales de la pandemia, no solo los relacionados con la infección, y las medidas de mitigación deben equilibrarse, y comenzamos a acercarnos a este tipo de nueva normalidad para la pandemia.

Bill Walsh: Muy bien, muchas gracias, Dra. Passaretti. Dr. Levy. Dra. Passaretti, estaba haciendo referencia recién a una de las consecuencias de la COVID-19, que es que las personas retrasan el tratamiento médico y de salud en curso. Y, ya sabe, una preocupación adicional durante la pandemia es un aumento significativo de la hipertensión no controlada. ¿Qué tan extendido está esto? ¿Y qué tan serios son los riesgos? ¿Y hay grupos particulares más afectados que otros?

Ralph Levy: Sí, hubo un artículo reciente publicado en la revista de la American Heart Association y (inaudible) la circulación, y fue bastante interesante. Demostró que en un grupo amplio de pacientes que estaban cuidando su salud en un sistema en particular tuvieron un aumento leve en la presión arterial. Fue de solo como dos milímetros en la sistólica, ese es el número alto, y alrededor de medio milímetro y una diastólica, ese es el número bajo. Sin embargo, no creemos que estos números puedan ser significativos.

Vemos aumentos concomitantes en el número de ataques cardíacos, accidentes cerebrovasculares y enfermedades renales, que son las consecuencias de la presión arterial alta. Entonces, ya sabe, esto puede ser un problema. Para contextualizar, nuevamente, recuerdo que cuando comenzó la pandemia, hubo dos tipos de respuestas con mis pacientes. Hubo algunos que dijeron: "Bueno, voy a tratar de estar más saludable. Voy a tratar de hacer ejercicio, más cosas". Y ahora los pacientes decían: "El mundo se está acabando, mejor hago lo que quiera, como lo que quiera, solo quiero sentarme en una silla y mirar televisión las 24 horas del día".

Así que sospecho que pasa un poco eso aquí, pacientes que decidieron: "Sabe, esto es una locura, estoy deprimido porque estoy solo en casa todo el tiempo. Ya no me importa nada. Así que no voy a hacer ejercicio. Y tal vez no voy a tomar mis medicamentos o voy a comer lo que quiera comer". Y creo que eso refleja un poco lo que ha pasado. Además, probablemente hay un poco de retraso en la atención, pacientes que tenían miedo de venir al consultorio.

Así que decidieron que pueden mantenerse alejados del médico. Y a veces no reponen sus recetas, o suben de peso. Durante la pandemia, hablamos sobre COVID-19, COVID-30 y el COVID-50 en términos de cuánto peso han subido las personas. Y esos son todos factores de riesgo. Entonces, para la audiencia, diría que si uno ha subido una cantidad significativa de peso durante la pandemia, si se ha vuelto más inactivo, es hora de cambiar de marcha y volver a la vida.

Bill Walsh: Está bien, bueno, estamos hablando de volver a la vida, Dr. Levy. Hemos oído hablar de complicaciones moderadas o leves posteriores a la COVID-19. Es decir, personas que sufren síntomas mucho después de haber tenido la infección, en algunos casos, dificultad para respirar o poca energía. ¿Es cuestión de tiempo que desaparezcan este tipo de síntomas?

Ralph Levy: Sí, estos síntomas vienen con la COVID-19. Es una de esas cosas que estamos escribiendo mientras hablamos porque estamos obteniendo la experiencia en este momento. Claramente, hay un grupo de pacientes que se ven afectados por COVID-19 a largo plazo. Y algunas de esas consecuencias, como describimos antes, pueden ser problemas cardíacos. Pero también hay temas como la confusión mental, que probablemente la audiencia ha escuchado hablar sobre la fatiga crónica, estar cansado todo el tiempo, estar, ya sabe, deprimido.

Hay pacientes que tienen una enfermedad pulmonar importante durante la COVID-19 de la que no se van a recuperar. Los pulmones están completamente cicatrizados. Y hay algunos pacientes que sufren daño al corazón porque tuvieron ataques al corazón. Así que esto va a ser un problema en los próximos años. Va a ser una gran carga para nuestro sistema de salud. Recuerden, 70 millones de pacientes hasta ahora en Estados Unidos. Algunos de esos pacientes —no todos, la mayoría de las personas sanarán — pero algunos pacientes tendrán el síndrome y tenemos que cuidarlos.

Bill Walsh: Muy bien, muchas gracias, Dr. Levy. Ahora, la información errónea continúa socavando los esfuerzos de salud pública para poner fin a la pandemia. Con la pandemia entrando ahora en su tercer año, vamos a abordar la información errónea durante los próximos minutos en un segmento que llamamos “verificación de cuatro minutos”. Les pediremos a nuestros expertos que nos ayuden a desacreditar afirmaciones engañosas y comprender por qué la información errónea es tan problemática.

Dr. Levy, empecemos por usted. Ha resurgido la desinformación acerca de los episodios cardíacos generalizados entre los atletas profesionales. Publicaciones ampliamente compartidas en las redes sociales dicen que cientos de atletas profesionales colapsaron y murieron después de recibir una vacuna contra la COVID-19 en los últimos meses. ¿Hay algo de verdad en estos informes? ¿Es la vacuna un mayor riesgo para los atletas profesionales? ¿Y por qué cree que se siguen difundiendo estos rumores?

Ralph Levy: Bueno, este es uno de esos temas que realmente me vuelve loco porque no tengo ni idea de dónde salió. Es absolutamente falso. Simplemente no hay datos que demuestren que eso es cierto. Piénselo. Soy un gran aficionado a los deportes, y miro hockey, golf, fútbol y baloncesto. Y si hubiera una verdadera señal de daño en estos atletas, nos habríamos enterado, ¿verdad? Quiero decir, todos estos muchachos que practican deportes, miles de ellos, y todavía están vivos, pateando y haciéndolo bien y ganando su merecido dinero. Así que esto es completamente falso.

Ahora, al comienzo de la pandemia, hubo problemas por ese estudio alemán que muestra cierto daño en el corazón después de tener COVID-19. Y hubo muchos sistemas deportivos en el país que cancelaron temporadas, como en el fútbol americano, por ejemplo, el fútbol americano universitario y cosas por el estilo. Y luego descubrimos que simplemente no era cierto. Estos atletas que están muy en forma y tuvieron COVID-19, estuvieron bien.

Sabe, tenemos protocolos para asegurarnos de que estén bien, hacemos un electrocardiograma, hacemos algunos análisis de sangre, hacemos una ecografía del corazón, pero si esas cosas están bien, estos pacientes van a tener grandes carreras, y les irá muy bien. Entonces, este rumor en particular ha sido completamente desacreditado y hay que tener cuidado con cosas como esta.

Bill Walsh: Bien, gracias por dejar las cosas claras. Dra. Passaretti, permítame hablar con usted. Esperaba que pudiera abordar algunos de los titulares engañosos de las redes sociales que continuaron persistiendo después de dos años. Así que permítanme remarcar algunos de ellos. Y tal vez pueda abordar cada uno. ¿Alguno de los siguientes es cierto? El primero es que el Gobierno está exagerando u ocultando el número de muertes por COVID-19 ¿verdadero o falso?

Katie Passaretti: Diría falso, seguro. Este es uno que nos persiguió durante la pandemia. Y hay muchas personas que de repente se han convertido en expertos en epidemiología en los últimos años. La medicina tiene muchas áreas grises. Y hemos estado hablando durante la última hora…

Uno puede enfermarse gravemente por el virus en sí, la infección por COVID-19 y, ciertamente, como alguien que atiende pacientes en el hospital, ciertamente he visto una buena cantidad de pacientes que fallecieron directamente debido a la infección por COVID-19. También hay muchos pacientes que están enfermos de COVID-19 y tienen complicaciones en el camino, el estrés de la infección, como hemos estado hablando puede afectar a otros.

Bill Walsh: Entonces, ¿los datos son claros?

Katie Passaretti: No. ¿Alguna vez son perfectamente claros los datos de atención médica? La realidad y la verdad es que hemos visto una tremenda cantidad de muertes debido a la COVID-19. Y el exceso de mortalidad debido a la COVID-19 durante los últimos dos años ha tenido un tremendo impacto en nuestra sociedad.

Bill Walsh: Muy bien, déjeme decirle otro que seguimos viendo particularmente en las redes sociales: las mujeres embarazadas no deben recibir la vacuna contra la COVID-19. ¿Qué dice sobre eso?

Katie Passaretti: Falso, falso, falso. Este es uno en el que las redes sociales han hecho mucho daño. Cada vez hay más datos de que la vacunación en mujeres embarazadas protege a esa mujer y protege al bebé. Y estamos obteniendo más y más datos con el tiempo que continúan reforzando que las vacunas contra la COVID-19 son seguras en esta población.

Por lo tanto, recomiendo encarecidamente a todas las mujeres embarazadas que se vacunen por sí mismas y por su futuro bebé. Tengo muy en claro que la vacuna protege a esta población y también hemos visto el tremendo impacto de la infección por COVID-19, que causa un aumento de las muertes en mujeres jóvenes embarazadas, por lo demás sanas, y

el impacto en el parto prematuro y el impacto en el bebé.

Bill Walsh: Bueno, déjeme mencionar uno más. Seguimos viendo que se ha demostrado que las vacunas contra la COVID-19 causan infertilidad y reducen la función sexual ¿verdadero o falso?

Katie Passaretti: También, falso. Lo que sí hemos visto son datos que sugieren que la infección por COVID-19 puede afectar la fertilidad tanto masculina como femenina, pero no hemos tenido ningún dato de que las vacunas en sí mismas causen infertilidad, reduzcan la función sexual, tengan algún impacto en eso. Así que eso también es un tipo de desinformación de las redes sociales.

Bill Walsh: Bien, muchas gracias a ambos, Dr. Levy y Dra. Passaretti, por eso. Ahora es el momento de abordar más preguntas con la Dra. Katie Passaretti y el Dr. Ralph Levy. Opriman *3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP. Jesse, ¿a quién tenemos en la lista?

Jesse Salinas: Nuestra próxima llamada será de Mark de Ohio.

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

Mark: Sí, tengo fibrilación auricular en el bloqueo del eje cerebral derecho. Y mi corazón no está latiendo como debería. Estoy bajo cuidado cardiaco. Me preguntaba si debería pedir una cuarta inyección de refuerzo.

Bill Walsh: Dr. Levy, ¿puede responder la pregunta de Mark?

Ralph Levy: Sí. Gracias, Mark. La respuesta a eso es todavía no. De hecho, lo consulté con mi jefe de enfermedades infecciosas esta mañana porque sabía que esta pregunta surgiría. Así que las recomendaciones actuales fueron pacientes inmunocomprometidos: los pacientes que, por ejemplo, toman medicamentos llamados esteroides en dosis altas o que tienen ciertos tipos de neoplasias hematológicas malignas como linfomas y leucemias, por lo que se sometieron a algo llamado trasplante de células madre, o que tienen una infección por VIH no controlada, problemas que producen una disminución de la inmunidad. Usted no está en esa categoría. Así que yo diría que espere por ahora.

Bill Walsh: Muchas gracias, Dr. Levy. Jesse, ¿a quién tenemos ahora?

Jesse Salinas: Nuestra próxima pregunta es de Facebook, y esta es Laura. Y pregunta: "Para las personas con diabetes tipo 1, ¿hay alguna evidencia de que la diabetes tipo 1 por sí sola ponga a las personas en mayor riesgo de contraer una COVID-19 grave?"

Bill Walsh: Dra. Passaretti.

Katie Passaretti: Sí. La diabetes es uno de los trastornos médicos que se ha asociado con una enfermedad más grave debido a la COVID-19. También es una de las enfermedades que se ha asociado con las personas que son más propensas a la COVID-19 prolongada o a la COVID-19 posaguda. Entonces, a menudo la diabetes, la obesidad, han sido factores de riesgo persistentes para una enfermedad más grave una vez que se infecta con COVID-19.

Bill Walsh: Está bien. Muchas gracias. Dra. Passaretti. Jesse, ¿a quién tenemos ahora en línea?

Jesse Salinas: Nuestra próxima llamada es William.

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

William: Sí, tengo una amiga que tiene COVID-19. Tiene 62 años y tiene una válvula cardíaca. Y no tenía idea de que la COVID-19 podría provocar algún tipo de enfermedad cardíaca.

Bill Walsh: Está bien. Dr. Levy, me pregunto si podría responder a William. Hable sobre la incidencia de afecciones cardíacas entre las personas que contrajeron la infección por COVID-19.

Ralph Levy: Una vez más, volveré a las cosas que mencioné antes. Creo que entendí que mencionó algo sobre una válvula cardíaca tal vez. Entonces, las válvulas son las cosas que tenemos en nuestros corazones que dirigen la sangre de una cámara a otra. Y esas válvulas pueden tener dos tipos de problemas. A veces son muy cerradas. A veces pueden tener muchas fugas o se supone que permiten que la sangre fluya en una dirección, y a veces permiten que la sangre entre, vuelva a la cámara de donde vino. Entonces, los pacientes que tienen una enfermedad valvular muy grave y contraen COVID-19, la COVID-19 puede perjudicarlos solo porque tienen una afección cardíaca preexistente. Entonces eso es una cosa.

Lo segundo es que no estaba seguro de que fuera un problema de válvula porque no podía entenderlo bien, pero en términos de afecciones cardíacas, como mencioné antes. Si tiene una enfermedad preexistente, como hipertensión, diabetes o una enfermedad cardíaca previa, como una insuficiencia cardíaca o un ataque al corazón, seguro que corre el riesgo de sufrir complicaciones en el próximo año, como acabamos de ver en ese estudio del hospital del VA. Y esos pacientes tienen que estar especialmente atentos para ponerse en contacto con sus médicos y asegurarse de que siguen una terapia médica óptima para tratar de prevenir esas complicaciones

Bill Walsh: Muy bien, muchas gracias por eso, Dr. Levy. Jesse, ¿a quién tenemos ahora?

Jesse Salinas: Nuestra próxima pregunta será de Vicki en Massachusetts.

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

Vicki: Hola, esta es realmente una pregunta personal. Fui vacunada con la Johnson & Johnson en marzo del 2021, y ocho meses después, cuando me lo permitieron, recibí la mitad de la dosis de Moderna. Y quiero saber si estoy suficientemente vacunada.

Bill Walsh: Dra. Passaretti, ¿puede responder esa pregunta?

Katie Passaretti: Sí. Mientras no se considere inmunocomprometida, no tenga ningún problema médico subyacente que debilite significativamente su sistema inmunitario, se considerará que está al día con la vacuna. Así que recibió la dosis Johnson & Johnson inicial, la Moderna actuó como su refuerzo. Si está inmunocomprometida, es decir, para las poblaciones inmunocomprometidas, dado que se necesita más estímulo para obtener la misma cantidad de respuesta de anticuerpos con la vacuna, la serie primaria para personas inmunocomprometidas incluye una dosis adicional.

Entonces, si uno recibió la Johnson & Johnson y está inmunocomprometida, idealmente debería recibir una ARNm. Entonces, la Pfizer o la Moderna son una especie de refuerzo de la segunda dosis después de la dosis inicial. Y luego se recomendaría un refuerzo dos meses después de eso para las personas inmunocomprometidas. Así que hay una ligera diferencia basada en los factores de riesgo de su sistema inmunitario. Pero si no tiene problemas de inmunidad, comorbilidades médicas regulares, entonces se consideraría que está completamente vacunada en este momento.

Bill Walsh: Está bien, muy bien. Jesse, tomemos otra llamada.

Jesse Salinas: Nuestra siguiente pregunta es de Lisa en Virginia, quien pregunta: "La gente con problemas cardiovasculares, ¿qué hacemos para manejar el regreso al trabajo? Y ¿deberíamos usar mascarilla? ¿O cómo deberíamos manejar nuestra enfermedad cardíaca junto con la posible exposición a la COVID-19?"

Bill Walsh: Dr. Levy, ¿quiere contestar?

Ralph Levy: Sí, absolutamente. Esta es una pregunta muy interesante porque no tenemos respuestas claras. Puedo decirle lo que hago, porque tengo algunos pacientes, por ejemplo, que son diabéticos delicados, tienen enfermedades cardíacas conocidas. Así que trato de protegerlos. Creo que tendrán un riesgo increíblemente alto de complicaciones si contraen COVID-19. Entonces, de hecho, escribo cartas a sus empleadores y les digo: "Escuchen, este paciente tiene que estar trabajando desde casa porque corre un riesgo demasiado alto". Y la mayoría de la gente escucha y hacen adaptaciones para el paciente.

Entonces, si uno se encuentra en una categoría de riesgo en particular, diría que sí, las adaptaciones deben continuar. Ahora, es un trabajo en progreso, a medida que la COVID-19 se vuelve menos peligrosa, digámoslo de esa manera, esperamos que siga evolucionando de esa manera, tal vez el riesgo no sea tan alto y podamos permitir que esos pacientes puedan integrarse y vuelvan a trabajar. Pero mientras tanto trato de aislar a aquellos pacientes que considero de alto riesgo.

Bill Walsh: Está bien, gracias. Muchas gracias, Dr. Levy. Esta ha sido una discusión muy informativa, y gracias a nuestros dos panelistas expertos por responder nuestras preguntas hoy. Y gracias a nuestros socios de AARP, voluntarios y oyentes por participar en esta discusión. AARP, una organización de membresía no partidista y sin fines de lucro, ha estado trabajando para promover la salud y el bienestar de los adultos mayores de Estados Unidos 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 y prevenir la propagación a otros mientras se cuidan. Todos los recursos a los que se hizo referencia hoy, incluida una grabación del evento de preguntas y respuestas, se pueden encontrar en aarp.org/coronavirus a partir de mañana 25 de febrero. Vayan allí si su pregunta no fue respondida y encontrarán las últimas actualizaciones, así como información creada específicamente para adultos mayores y cuidadores familiares. Y si necesitan asistencia de Medicare durante la COVID-19, visiten el siguiente sitio web shiphelp.org/covid-19, eso es shiphelp.org/covid-19.

Esperamos que hayan aprendido algo hoy que puedan ayudarlos a ustedes y a sus seres queridos a mantenerse saludables. Regresen el 10 de marzo para participar en un evento especial de preguntas y respuestas en vivo sobre el coronavirus que marca dos años desde de la pandemia de COVID-19. Esperamos que puedan participar con nosotros en ese momento. Mientras tanto, gracias y que tengan un buen día. Esto concluye nuestra llamada.

Coronavirus: Current State, What to Expect, and Heart Health

Listen to a replay of the event above.

New coronavirus cases have declined, and deaths are showing a downturn, but many questions remain around boosters, subvariants, and guidelines. New studies are also showing an increase in heart disease directly tied to COVID. This Q&A event addresses the latest updates on the virus, heart health, and the impact of misinformation.

The experts:

Katie Passaretti, M.D.
Vice President, Enterprise Chief Epidemiologist, Atrium Health

Ralph Levy, M.D.
Chief, Adult Cardiac Medical Services, Memorial Cardiac & Vascular Institute


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