AARP Coronavirus Tele-Town Hall From November 10

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

(Española)

Bill Walsh: AARP, a nonprofit, nonpartisan membership organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of the global coronavirus pandemic, AARP is providing information and resources to help older adults and those caring for them. While the pandemic has been officially declared over, we aren't out of the woods yet from a health standpoint. New COVID cases and hospitalizations have ticked up slightly as we enter fall and winter, and fewer Americans than ever are getting flu shots in the face of what experts say could be a worse-than-normal flu season. Meantime, in our nursing homes where our most vulnerable loved ones live, only half of staff and residents are up to date on their COVID vaccines. As we prepare to gather with friends and family this holiday season, there are some commonsense steps we can all take to stay healthy and safe and make sure our loved ones are protected as well.

Today we're going to hear from an impressive panel of experts about these issues and more. We'll also get an update from Capitol Hill and legislation affecting older Americans. If you've participated in one of our Tele-Town Halls in the past, you know this is similar to a radio talk show and you have the opportunity to ask your questions live. For those of you joining us on the phone, if you'd like to ask a question about the coronavirus pandemic, press *3 on your telephone keypad to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. And if you're joining on Facebook or YouTube, you can post your question in the comments.

We have some outstanding guests joining us today, including an infectious disease specialist, an immunization expert, and a national nursing home advocate. We'll also be joined by my AARP colleague Jesse Salinas, who will help facilitate your calls today. This event is being recorded and you can access the recording at AARP.org/coronavirus 24 hours after we wrap up. ... Now, I'd like to welcome our guests. Céline Gounder, M.D., is a senior fellow and editor-at-large for public health at the Kaiser Family Foundation. Dr. Gounder is also a clinical associate professor of Medicine and Infectious Diseases at NYU's Grossman School of Medicine, and a CBS News medical contributor. Welcome, Dr. Gounder.

Céline Gounder: It's great to be here.

Bill Walsh: All right, it's great to have you. We're also joined by L.J. Tan, M.D., chief strategy officer at the Immunization Action Coalition. Welcome back to the program, Dr. Tan.

L.J. Tan: Oh, thank you so much. Happy to be back.

Bill Walsh: All right, we're happy to have you. And we also have Sam Brooks, who is the director of public policy at the National Consumer Voice for Quality Long-Term Care. Welcome to the program, Sam.

Sam Brooks: Great, thanks. Happy to be here.

Bill Walsh: Let's get to it. Dr. Gounder, are there indications we'll see another fall or a winter COVID surge, do you expect?

Céline Gounder: We anticipate another COVID surge this winter. In 2020 and 2021, we saw big winter surges, and the wonderful thing about the winter holidays is that we get to see family and friends. But those gatherings between Thanksgiving and the New Year have also driven a lot of COVID transmissions. And then on top of that, new COVID variants have emerged again, which means there's less of an immunity wall blocking the spread of the virus, even among people who've been vaccinated or infected in the past.

Bill Walsh: Dr. Gounder, let me ask you about the flu. Now, the flu has hit earlier this year and has been more severe at this early stage of the season at any time since 2009. Yet flu vaccination rates are lower than ever. Why is that? And, and given the low rates, how bad could things get?

Céline Gounder: Unfortunately, I think we've seen some of the resistance to COVID vaccination and the politicization of vaccines have a spillover effect on other vaccines, including flu shots. And the timing here is really terrible. We had the suppression of any number of respiratory viruses in 2020 and 2021 when people were masking and social distancing. And now those viruses, like flu, like RSV, and so on, are coming back with a vengeance. And then on top of that, hospitals are really, really full. We're still dealing with staffing shortages that were caused by the pandemic. So the best thing you can do is try to stay out of the ER, not by avoiding medical care if you need it, but try not to get sick by getting your flu shot, by getting your COVID shots.

Bill Walsh: Yeah, all right, great advice. Dr. Tan, you're an expert in immunization. Let me turn to you for a moment here. You know, this time of year can be really confusing, as Dr. Gounder just said, with an increase in all kinds of respiratory infections. Are there any clear-cut symptoms that distinguish say, a cold from the flu, from COVID? How do people know what they might be experiencing?

L.J. Tan: Yeah. Well, glad to be back here, Bill. Thank you very much again. I think the challenge is that as COVID has continued to evolve, and we have seen all these, you know, what we like to call the Scrabble variants pop up. It has become more and more like a cold or an influenza or flu in terms of symptoms. And I think it's hard to tell the difference now. Obviously, if you go in, these people can test and can help you identify something between flu and COVID, but in terms of you just looking at yourself and feeling sick with your headache and your fever and your chills, it's getting harder and harder to distinguish them. But what I can say is that there is a vaccine against flu, there is a vaccine against COVID and you, if we get vaccinated, we can take those two, at least in terms of severity of symptoms everything that Dr. Gounder talked about, we can take those off the table, right? We may not be able to take the cold off the table, but we can take flu and COVID off the table.

Bill Walsh: Well, let's stay on flu for just a moment. There's been a lot of misinformation out there about the flu, and maybe you can help clear some of that up. I want to take a moment and review some common beliefs about flu and maybe you can just let us know if these are true or false, kind of rapid-fire style. I mean one thing we are hearing all the time is that the flu isn't all that serious. True or false?

L.J. Tan: Oh, absolutely false. Hundreds of thousands of hospitalizations, potentially tens of thousands of deaths every flu season — depending obviously on the strain that's circulating. So false, it's not true.

Bill Walsh: Healthy adults don't need to take the vaccine.

L.J. Tan: Not true at all. Flu does not discriminate between whether you have a high-risk condition or whether you're healthy. It can take you out, if you're lucky, maybe just three to five days out of work. But if you're unlucky, it could be months.

Bill Walsh: Another one we hear a lot is you … can get ill from the flu vaccine.

L.J. Tan: That is a falsehood. It is not possible to get flu from the flu vaccine because the vaccine comprises inactivated or what we like to call killed elements of the virus. So there's no way the vaccine can give you the flu.

Bill Walsh: If you're not vaccinated early, you might as well skip it, is another belief floating around out there.

L.J. Tan: Another piece of misinformation. Definitely not true, and this is very relevant for this season because we actually do have an early start to the flu season. The vaccine comprises four different strains of flu virus, so it provides vaccine protection against more than just the strain that you might have gotten sick with. And so definitely it is worthwhile to keep getting vaccinated throughout the flu season as it continues to provide benefits, as it continues to provide protection against hospitalization and disease throughout the flu season.

Bill Walsh: Here's another common belief: Flu vaccines aren't effective because people still get the flu.

L.J. Tan: Yeah, so many, many reasons for that, why that's not necessarily true. Obviously, flu vaccines protect against the flu, as we've already discussed. There are other diseases that causes similar symptoms that circulate. Those won't get protected by the flu vaccine. So you might get vaccinated against flu and still pick up a cold. Secondly, a lot of people can get flu but what happens is that if you're vaccinated, it will protect you from all the bad side effects from flu like hospitalizations, and, of course, death.

Bill Walsh: And finally another common belief we hear oftentimes about the flu is that flu vaccines side effects are risky.

L.J. Tan: So not true. Flu vaccines are probably one of the safest vaccines we have. Millions, millions and millions and millions and millions of doses of flu vaccine has been given every season and through the last decades. So we know almost everything we need to know with regards to flu vaccine safety. It is an incredibly, incredibly safe vaccine.

Bill Walsh: Hmm, and isn't there a new high-dose flu vaccine for older adults out there?

L.J. Tan: There are actually three vaccines that are now recommended for people over 65. I'm going to use the actual name of the vaccine, but this does not imply an endorsement by me of any of these specific brands. Just have to disclaim that. So there is something called Fluzone High Dose, there's something called Fluad, and then there's something called Flublok. Those three vaccines have been recommended for 65 and older by the CDC because they promote a better immune response in those over 65. So yes.

Bill Walsh: Very good. Thanks for that, Dr. Tan, really helpful. Dr. Gounder, let me turn back to you and let's shift our focus to COVID. Last week, Pfizer said the newest bivalent COVID vaccine produces four times more antibodies for people over 55 than the original vaccine. What does this mean for older adults, and are the newest vaccines more effective at preventing infection?

Céline Gounder: I think we have to be careful about saying that the new boosters are better. They're at least as good as the old ones, but the jury is still out as to whether they're actually more effective in preventing infection. Big picture, they're at least as good, and it's really important, especially if you're 50 and older, that you get your booster before this winter surge.

Bill Walsh: And you heard Dr. Tan urging people to get their flu vaccine, too. What do you say to people about getting multiple vaccines at the same time, Dr. Gounder.

Céline Gounder: You can absolutely get your flu shot and your COVID shot at the same time. That has been shown to be safe. You may have a little bit more in the way of some of those mild fevers or some achiness afterwards, but studies have also been done recently looking at the use of Tylenol, Ibuprofen, those kinds of over-the-counter pain and fever medications —and those can be used safely to reduce those side effects if you get your flu and COVID shots.

Bill Walsh: Okay. Thanks for that, Dr. Gounder. Let's turn to our listeners. It's now time to address your questions about the coronavirus with Dr. Gounder, Dr. Tan, and Sam Brooks. … I'd now like to bring in my AARP colleague Jesse Salinas to help facilitate your calls today. Welcome, Jesse.

Jesse Salinas: So glad to be here, Bill.

Bill Walsh: All right, Jesse, who do we have first on the line?

Jesse Salinas: Our first caller is going to be Shirley from California.

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

Shirley: I'm 81 years old and I wanted, I got all the shots, the Moderna 1, 2, 3, 4, and then I got the booster in April of this year. But just the last couple of days I've had this slight headache, I don't know where it's coming from. Should I go get another shot?

Bill Walsh: Dr. Gounder, can you help Shirley with that?

Celine Gounder: I think first things first. If you have symptoms, you should get yourself tested. You can either go to a local testing site or get one of those at home rapid tests for COVID. You can also try going to an urgent care center for that. If you have COVID, or for that matter, the flu, there are treatments for both of those. And so you have Paxlovid for COVID, you have Tamiflu for the flu, so if you have those infections, you should be treated. If you don't, you can get vaccinated now.

Bill Walsh: Dr. Gounder, Shirley mentioned she was boosted in April. That was quite some time ago. Is she due for another booster at this point, or should she wait some? What is the period of time people should be waiting before they get a booster?

Céline Gounder: About three months or so between doses or after your most recent infection. But that said, if she's currently infected, she should hold off until three months after that. But I think the really important thing for Shirley is, if she's sick with COVID right now, if she's sick with the flu right now, address that first, and then once she's done so, to absolutely get that additional COVID booster.

Bill Walsh: Very good. Thank you for that, Dr. Gounder. Jesse, who is our next caller?

Jesse Salinas: Our next caller is going to be Chris from California.

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

Chris: Hi. My brother is 73. He just tested for COVID. My mother is 95 and she just had surgery. So what I would like to know is how long should we wait before he comes to visit her?

Bill Walsh: Hmm, interesting question. Dr. Gounder, can you field that one?

Céline Gounder: Sure, there's two different ways to approach this. Either you can use those at-home rapid COVID tests to figure out when your brother is no longer infectious. What you want to do is see him test negative two times, twice in a row, at least one to two days apart. If you do not have tests or can't afford tests, you could also count somewhere between 10 to 14 days after he was initially diagnosed. I would err on the longer side, 14 days, if you're able to before he spends time with your mother and other people.

Bill Walsh: All right, and Dr. Gounder, is the federal government still sending free tests to people or is that option still available?

Céline Gounder: Insurance companies, including Medicare, will reimburse you for eight tests per month per individual. But unfortunately, there's no more money left for purchasing more of these at-home tests. So … no, the federal government just can't send those out anymore.

Bill Walsh: All right, Jesse, who is our next caller?

Jesse Salinas: Our next caller is going to be Carl from New York.

Bill Walsh: Hey, Carl, welcome to our program. Go ahead with your question. Hey, Carl, welcome to the program. Do you have a question? Sounds like we may have lost Carl.

Jesse Salinas: Yep. Let's go to another one. We've got a question from Facebook by somebody named PD (inaudible). "If you're planning to have visitors for Thanksgiving, how far in advance should they take a COVID test? Is it advisable to have them stay overnight for their visit?"

Bill Walsh: Hmm, Dr. Tan, do you want to handle that one?

L.J. Tan: Yeah, I'm happy to take that. This is a build-off of Dr. Gounder's response. I think before they show up, they should be testing negative with one of those in-home tests that you can get access to … preferably 24 to 48 hours before arrival with two negative tests. I think one of the things to keep in mind, obviously, is that if anyone's symptomatic … then they should definitely hold off on visiting until they have tested themselves as negative for COVID. I think one of the interesting things that has happened as we've come through this is indeed we say, you know, if you've got symptoms, test negative for COVID, and then you can continue. But I think the point of the matter is that if you have symptoms of any sort, really you should consider taking yourself out of some of these activities because of the fact that you could be, if you're not spreading COVID, you could be spreading flu, RSV, right? So I think it's important to kind of broaden the idea that if you're sick, stay home, and of course get vaccinated. And this way we reduce the likelihood that you'll be unable to attend some of these holiday gatherings that we're all looking forward to.

Bill Walsh: Thank you very much, Dr. Tan. Jesse, who do we have up next?

Jesse Salinas: Our next call is going to be from Mike in Illinois.

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

Mike: Hi. I still have to get my … I have had two shots last in 2021 I think, and I never got the third booster. So now they have the fourth booster. Should I just go ahead and get the fourth booster? And then my question on that also would be, I had Moderna for the first two. Is there any difference in effectiveness between Moderna, Pfizer, or the others for the newest booster shot?

Bill Walsh: All right, Mike. Let's ask the experts. Dr. Gounder, can you weigh in on that? Is it ever too late to get a booster?

Céline Gounder: It is not too late. I wouldn't worry about counting how many doses. If you've gotten at least your first two doses, at this point, we're really just talking about boosting for the season or when there's a new booster available. So absolutely, go out and get your updated booster now and that way you'll be protected for the holidays.

Bill Walsh: OK, and Mike's second question had to do with the effectiveness of one versus the other, Moderna versus Pfizer. … Can he mix and match, and is there any difference in effectiveness?

Céline Gounder: They're pretty comparable. Moderna is a slightly higher dose than Pfizer. There are some slight differences. Some people also report a little bit more in terms of side effects with Moderna, again, related to that slightly higher dose, but I really wouldn't worry too much about which brand, just whichever one you're able to get your hands on. There's also a newer booster that's recently been approved, Novavax, which is a slightly different technology. It's what we call a protein vaccine. It's a technology that we use for a lot of other vaccines, and that's certainly an option as well.

Bill Walsh: And so should people worry about mixing and matching these or should, I think you said they should just take whatever's available to them.

Céline Gounder: Yeah, it's absolutely fine to mix and match. Just whatever is available to you and that you're able to get as soon as possible.

Bill Walsh: OK, very good. … Jesse, let's go back to the lines. Who do we have up next?

Jesse Salinas: We're going to bring in Joan from Indiana.

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

Joan: My question is I've got a daughter who's 53 years old, she's never had a flu shot, but she's never had the flu. And her argument is if she's never had the flu, then she shouldn't have to take it. And she claims she's talked to a physician about this, and as long as she takes her vitamins and her other medications, then she should be OK. What's your response to that?

Bill Walsh: Let's ask Dr. Tan about that. Doctor, what would you say to Joan and her daughter?

L.J. Tan: I think it's a common misperception that if you're healthy and you've never had flu before, you don't need to get protected against the flu. Every single flu season, Joan, is different, and every single flu season that your daughter doesn't get vaccinated, she's essentially gambling with her health because this could be the season where she will actually catch flu — and it could be a really bad flu that she catches that could really hurt her. So I think it's one of those things where I always ask, why are you gambling every season? We have a good, safe, effective vaccine. If you get the vaccine, you can guarantee yourself that you're not going to have severe consequences from flu. And I don't see why people want to gamble. Every single flu season is different, Joan, and just because you didn't catch it last season does not mean … you'll not catch it this season.

Bill Walsh: And Dr. Tan, what are you seeing as it relates to the severity of the flu this season?

L.J. Tan: Yeah, so this flu season is a little scary. I actually — just before this town hall — came out of a meeting with CDC. We have dramatic, we have, as Dr. Gounder has already pointed out, our hospitalization rates are higher this flu season than they've ever been for the last 10 flu seasons. So, we are very concerned about that. And then obviously, we have diseases, the disease is surging in so many parts of the country faster than we've ever seen for the last few seasons as well. So I think … there's a perfect confluence here of disease as well as vaccination rates being lower, that's really concerning the CDC and folks like us, like Dr. Gounder and myself.

Bill Walsh: And how effective is the flu vaccine this year?

L.J. Tan: So we don't have the data right now for this year's flu season, obviously, because we're still going into it. But the great news, again, from this call that I just got off with the CDC, is that the vaccine strain, the virus that's in the vaccine appears to be 92 to a 100 percent matching the strains that are currently circulating. So it looks like we've got a good vaccine this year.

Bill Walsh: Hmm. That's great news. All right, thanks, Dr. Tan, for that. Let's take another call, Jesse.

Jesse Salinas: We're going to bring on Deborah from North Carolina.

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

Deborah: Hi. I just wanted to ask the panel their opinion on the use of Evusheld for immunocompromised patients who are fully vaccinated and have both boosters.

Bill Walsh: Hmm.

Deborah: And it's E-v-u-s-h-e-l-d.

Bill Walsh: OK, Dr. Tan, can you address that?

L.J. Tan: You know, I'm going to punt that to Dr. Gounder in her expertise as an ID doc. This is obviously the monoclonal antibody treatment, and I think we do know that there's some data that suggests that this monoclonal antibody treatment for COVID may be less effective against some of the subvariants that we are seeing with omicron. But Dr. Gounder, I would rather have you take this as your expertise.

Céline Gounder: Sure. And I agree with that. This is one of the concerns that we have about the emerging subvariants that are spreading across the country right now. You may have heard BQ 11, for example. What we … as Dr. Tan referred to as the Scrabble variants with this mix of letters that are hard to decipher. But the problem with these subvariants is that many of them are resistant to all of the monoclonals that we have, all of these treatments — including Evusheld, which is used as a preventative medication for people who are immunocompromised, as Deborah said. And so it makes it all that much more important that people get vaccinated because we have, unfortunately, fewer tools in our arsenal to deal with COVID this winter.

Bill Walsh: Right. And so people have the opportunity to prevent it on the front end because we don't have a lot of tools on the back end to manage it, it sounds like.

Céline Gounder: Exactly.

L.J. Tan: Bill, if I could ...

Bill Walsh: Yeah. Go ahead.

L.J. Tan: If I could also quickly jump in, because I forgot to mention this when Joan was talking about her daughter, and this is obviously true with COVID too. …When I was emphasizing the answer about protecting herself and not gambling, part of the reason to get vaccinated also is that you don't want to be infecting others. And if you get vaccinated, you can also protect the people around you that you care about. And in this situation, obviously someone who's immunocompromised, if you are vaccinated against COVID, you reduce the risk that you transmit something to someone who's immunocompromised.

Bill Walsh: Yeah, it's a great point. And I think people forget that, right? They think of it's about themselves, but they can be carriers too, and they may not even know it. Great point. Let's go back to the lines. Jesse, who's next?

Jesse Salinas: Yeah, I'm going to bring on Nancy from Ohio.

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

Nancy: Hi, there. Thank you for your program. One quick question. I'm concerned about the RSV virus in adults. Is it dangerous for somebody 78 years old to be near a baby that has the RSV virus?

Bill Walsh: Hmm, great question. Dr. Tan, do you want to field that one?

L.J. Tan: Yeah, I'll field that one, and then I will also ask Dr. Gounder to weigh in as well. So RSV has surged and continues to surge in this past month, and I think one of the biggest challenges is that it has dramatically higher impact on young children — in other words, hospitalizing them and potentially also higher rates of death, as well as in adults that are 65 years of age and older. And so, Nancy, that will be right where you are. So indeed, RSV does have more severe impact on older adults, and unfortunately, in older adults, we don't have a treatment for it other than supportive care. In other words, which means taking care of how you feel. So we really would love that if you are taking care of a younger grandchild who has been diagnosed with RSV, we do urge that you have to be especially cautious … and make sure you don't catch it. So that could include yourself wearing a good quality mask, making sure you're sanitizing your hands frequently between touching the child, and obviously, if at all possible, taking some time away when the child is actively in symptoms because that's when they're most infectious. And I understand that's tricky, obviously, because it is the grandchild, you want to be there. So that's kind of what I would advise. Dr. Gounder, do you have anything else to add to that?

Céline Gounder: Yeah, what we see with a lot of respiratory infections, whether it's the flu or COVID or RSV, is that it can cause exacerbation or worsening of other underlying chronic medical conditions. So that could be COPD or emphysema. It could be heart disease where people come in with a heart attack. In fact, we've seen as an example the vaccination against the flu can protect you from having a heart attack that's related to having the flu over the winter. And so there are many reasons for older people to really try to avoid getting RSV. It's not just the infection itself, but the way in which it can make other conditions worse.

Bill Walsh: Hmm, OK. Thanks for that both Dr. Tan and Dr. Gounder. And thank you, our listeners, for all those great questions. We're going to take more of your questions shortly, but before we do, let's get a quick update from Capitol Hill. In addition to sharing information and resources, AARP advocates at the state and national levels for issues that affect you the most. To give a quick update on how AARP is fighting for you, I wanted to bring in Government Affairs Vice President Megan O'Reilly. Welcome, Megan.

Megan O’Reilly: Happy to be here, Bill.

Bill Walsh: All right. Happy to have you. Now, I want to ask about a few important issues, but let's start with some really good news. This past August, a historic prescription drug reforms passed the House and Senate were signed into law. Can you tell us a little bit about what this means for people?

Megan O’Reilly: Yes, the Prescription and Drug Pricing Reform Law is a huge victory for older Americans. After decades of calling on Congress to make prescription drugs more affordable, AARP won the fight to let Medicare negotiate lower drug prices and for other policies that will save seniors money on their medications. For example, the new law will cap the cost of Medicare-covered insulin at $35 a month starting in January, and eliminates out-of-pocket costs for most vaccines under Medicare, such as the shingles vaccine. Starting in 2025, there will be an annual $2,000 limit on how much Medicare Part D beneficiaries pay out-of-pocket for their prescription medications, and drug makers that increase their prices faster than the rate of inflation will be penalized. These are huge wins.

Bill Walsh: Well, that's awesome news. Thanks for that, Megan. Now, in addition to Medicare, Social Security is another top priority for AARP, and there's good news there as well, right?

Megan O’Reilly: Yes, Social Security recently announced an 8.7 percent cost-of-living adjustment – the largest COLA increase in 41 years. AARP has fought long and hard to protect Social Security COLA so seniors can keep up with rising prices. This increase will provide much-needed relief to millions of Americans struggling with higher food, health care, and other costs. We're also urging Congress to work together in a bipartisan way to protect and strengthen Social Security for the long term.

Bill Walsh: OK, Megan, thanks for that update. I want to take a minute to talk about the current state of COVID in America's nursing homes. For those living and working in skilled nursing facilities, this pandemic is far from over, isn't that right?

Megan O’Reilly: Sadly, that's correct, Bill. The AARP Nursing Homes COVID Dashboard shows that transmission in nursing homes remains significantly elevated compared to the rest of the population. One of the most important things people can do is make sure their loved ones are vaccinated and have received the recommended boosters. Nearly half of residents and more than half of staff are not up-to-date with their shots, and this could have deadly consequences as we head into cold and flu season. This is the time to be an advocate for your loved one. Contact your nursing home and ask about vaccination rates and plans to keep residents safe this fall and winter. And if you need help knowing what to ask, go to AARP.org/nursinghomes and see our article, "10 COVID-19 Questions to Ask a Nursing Home."

Bill Walsh: OK, that was AARP.org/nursinghomes. That's a terrific story. The 10 questions to ask a nursing home. It's really helpful, and we're updating it regularly. So take a look at that on AARP.org. Thanks so much for being here today, Megan. If our listeners want to get involved with AARP’s advocacy, how can they do it?

Megan O’Reilly: Sure, we encourage everyone to go online to AARP.org/getinvolved. That's AARP.org/getinvolved, and sign up to be an e-activist. You'll receive email action alerts with easy ways to make your voice heard, whether on COVID, protecting your hard-earned Social Security and Medicare benefits, and more. Once again, that's AARP.org/getinvolved. It's an easy way to make a big difference.

Bill Walsh: All right. Thank you so much, Megan, for that update. Really appreciate your being here today. Let us turn back to our experts. … Dr. Gounder, you recently wrote an article in The Atlantic that said Americans and political leaders lack the moral imagination to solve the COVID crisis, that we needlessly tolerate 150,000 deaths per year, and too often ignore elderly people, people of color, and people with disabilities. Can you share more about your concerns?

Céline Gounder: Sure. We're still seeing between 300 and 500 deaths from COVID per day, which translates to 150,000 additional deaths per year in the United States from COVID. And at the same time, we've also seen deaths from COVID shift older. Ninety percent of deaths from COVID are now occurring among people 65 and older, and 40 percent of COVID deaths are now occurring among people 85 and older. So the demographics have really shifted older since the summer of 2021, when it was about 50/50 deaths among people over and under 65. We also know that people of color and people who are immunocompromised or have disabilities are at higher risk for comp … (dogs barking) Sorry, the dogs ... are higher risk for complications from COVID, and unfortunately the vast majority of the American population thinks the pandemic is over and has stopped taking precautions. To prevent transmission, I think we're thinking too narrowly about what we can do to reduce the risk. So yes, masks and vaccines. Vaccines are important, but there are other highly effective tools, too. For example, improving indoor air quality with ventilation and air filtration. For the holidays you can get yourself some portable HEPA air filtration units for your home, put them in places where the family or friends congregate — kitchen, living room, dining room, for example. We should also make a lot more use of COVID testing and treatment, and again, a reminder that if you do test positive for COVID, you can be treated with Paxlovid, which is highly effective in keeping people out of the hospital. And finally, when the public health emergency does come to an end, some people may be losing their Medicaid coverage. Medicaid covers low-income people. Medicare will stay the same, but some people might lose that Medicaid coverage, which can really create hardship for folks who are already struggling to get by.

Bill Walsh: Thanks for that, Dr. Gounder, but let's talk a little bit more about some of the tools you mentioned there. We've talked a little bit about the newest vaccines. I wonder how effective they are against the subvariants that you and Dr. Tan have talked about; and also at-home COVID tests. Are they effective in detecting these subvariants?

Céline Gounder: The at-home COVID tests still work perfectly well with the new subvariants. Same goes for Paxlovid, the pill that you can take for COVID. Both of those tools still work very well, just as well for the new subvariants. The vaccines may not work as well, and the monoclonal antibodies may not work as well. Where we need to sort of adjust our expectations of vaccines is that the vaccines will keep you out of the hospital. They will prevent you from dying. They may not prevent all infections, and so it's very important that you get vaccinated, but you may still want to be layering other tools like masking, like those HEPA air filtration units, like testing and treatment to further reduce your risk.

Bill Walsh: I like that notion of layering on protection. Makes a lot of sense. Dr. Gounder, great effort is being made to understand what causes and alleviates so-called long COVID. This week, in fact, researchers at the US Department of Veterans Affairs said that the antiviral Paxlovid, which you just mentioned, reduces the chances of certain long-COVID conditions by a quarter. Why do some people continue to experience COVID complications and how dangerous are they?

Céline Gounder: Well, one thing we have seen is that if you have immunity, if you've been vaccinated, your risk of developing long COVID is lower than if you have not been vaccinated. We don't entirely understand what causes long COVID yet. It's probably a cluster of a number of different syndromes, each of which have a slightly different set of symptoms caused slightly differently, but we know that, again, vaccination will reduce your risk and getting treated with Paxlovid if you are infected does seem to be, at least from the early data, does seem to be protective. It's yet another reason, if you have symptoms to get yourself tested for COVID, so you can get treated and so you're less likely to end up with long COVID.

Bill Walsh: OK, very good. Dr. Tan, let me bring you back in. We're beginning to see school closures around the country in response to the flu and the RSV infections. What do grandparents helping care for school-aged grandchildren or great-grandchildren need to know about RSV and flu outbreaks?

L.J. Tan: Yeah, thanks Bill. I think to follow up on some of this conversation from earlier, I think if you're taking care of a child that's younger than school age, the first thing, get the flu vaccine because we can take flu off the table. Again, to echo Dr. Gounder's point, it reduces your risk of hospitalization, reduces your risk of death, reduces your risk of severe disease. It may not entirely protect you from getting infected, but it does have strong benefits — and so get vaccinated against flu. Take that off the table. Now, as we've already talked about RSV, we don't have a vaccine for that yet. And, unfortunately, we do want to keep away from getting infected with RSV because of some of the reasons Dr. Gounder had already mentioned, including this idea that it exacerbates or makes worse some of the chronic conditions that older people tend to have — things like, for example, a heart disease; COPD, which is a chronic obstructive pulmonary disease, lung disease, in other words. Diabetes, for example, is another one that we know flu exacerbates as well or makes worse. So we would urge that in the process of taking care of a school-aged child who might have been exposed to an outbreak, that you keep that in mind and take the precautions of layering on infection control things like masking, frequent sanitizing, washing of hands, making sure that the child covers their cough so that if possible at all, you avoid being infected. And, of course, you know, what I would say is if you can avoid getting in contact with someone who's actually symptomatic, that is something you want to do.

Bill Walsh: Thanks very much for that, Dr. Tan. Now my colleague, Megan O'Reilly, was talking about some concerns in our nation's nursing homes, particularly the low vaccination rates there. To give us more insights on long-term care facilities, I'd like to bring in Sam Brooks to our conversation. Sam is the director of public policy at the National Consumer Voice for Quality Long-Term Care, a national consumer advocacy group. Sam, welcome to the program. I'd like to ask you … you know nearly one half of long-term care facility residents are not up-to-date with COVID vaccines. What are facilities doing to ensure that residents have access to the newest COVID and flu vaccines, and how are they educating residents?

Sam Brooks: Thanks for that question. First, just let me say what a wonderful call this has been and how informative it has been. The statistic that you mentioned is very concerning to us. And it's, unfortunately, not clear just what facilities are doing to ensure that both staff and residents are up- to-date with their boosters. We saw at the beginning when vaccines first became available, there was an all-out effort, really from the government down; there were vaccine clinics, there were partnerships formed with various pharmacies, and you saw a real high uptake of vaccinations in residents. You know, 8 or 9 out of 10 residents had their first primary set of vaccinations. But now you've just seen, not a corresponding effort from the government, when it comes to boosters, and it's very concerning to us. We're hearing from residents — or we're hearing from residents and long-term care ombudsmen, that residents don't understand why they continue to need to get shots. And we really believe, unfortunately, I mean we would hope that most residents could be on a call like this today to see just how important this is. And I know that you know there's 15,000 nursing homes across the United States. Unless we have a concerted effort, really, from the federal government and state governments to say, we need to do some education around this, we're going to see these dismal numbers continue. And going into the fall flu and COVID season, it's very concerning for us.

Bill Walsh: Thanks for that, Sam. Now according to October CDC data, long-term care facilities staff and home health care workers have the lowest COVID vaccination rates, lowest COVID booster rates, and lowest flu vaccination rates among health care professionals. Why is this, and where do you turn if you have concerns or need help working with a long-term care facility?

Sam Brooks: Again, I was looking at the data. Three out of four nursing home direct care staff aren't up-to-date on their vaccines. The federal government, the Centers for Medicare and Medicaid Services, instituted a mandate that staff be vaccinated. And you saw that … about 9 out of 10 staff got their first primary set of vaccinations. But that's just not true with boosters. And we're concerned, again, that there isn't a concerted effort by the government to say, hey, we're going to update our guidance and require staff to be updated with boosters. And I think this makes both residents and families and their loved ones need to be more hypervigilant when making decisions about nursing homes. Nursing homes, if you go to Care Compare … on medicare.gov, you can see the vaccination rates and the booster rates for each nursing home. But those are the types of questions that you need to be asking facilities when you're thinking about the safety of yourself or a loved one. What are the vaccination rates for staff? What are the plans to get your vaccination rates up for staff and residents? Because there's just a lot of things going on right now that are putting residents at risk.

Bill Walsh: Yeah, it sounds like it's really time to be an advocate for your loved ones in those facilities. Thanks so much for that, Sam. We're going to come back with more questions for you shortly. And now it's time to address more of our listener questions. … Jesse, who do we have on the line next?

Jesse Salinas: OK, Bill. We have a lot of questions on YouTube, on Facebook, and even in our queue from people who are asking about their confusion with how many shots they should have taken or need to take or have to take before they can get the new booster. So can your experts maybe talk about that?

Bill Walsh: Dr. Gounder, can you walk us through that?

Céline Gounder: As long as you've had two shots, don't worry about counting shots anymore. Just make sure you get the most up-to-date booster available as they come out. So as long as you've had two shots, at a minimum, you can go out and get the updated bivalent omicron boosters, those new ones that have just come out.

Bill Walsh: Very good. Keep it simple. All right, Jesse, who do we have up next?

Jesse Salinas: This is from Lana in New York.

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

Lana: Hi. I was wondering if it is safe to get the flu vaccine if you have an allergy to eggs, and also if the eggs are contained in the flu vaccine.

Bill Walsh: Dr. Tan, do you want to field that one?

L.J. Tan: Yes, actually there's been a lot of research on this recently and it is absolutely safe to take the flu vaccine now, even if you have an allergy to eggs. That being said, the CDC does advise that if  … you’re known to have a severe allergy to eggs, you should try to get the vaccine in a place where someone can watch you after you get the flu vaccine so that, you know, just in case. There is a vaccine out there … there are several vaccines out there that do not have eggs that you can consider. One is called Flucelvax, and the other one's called Flublok. And Flublok indeed is that same vaccine that's recommended for 65 and older. They do not have egg components that are of concern.

Bill Walsh: Hmm. That's interesting. I know for the COVID vaccine, people are urged to wait 15 minutes or so to see if there's an allergic reaction. Is it the same guidance for the flu vaccine?

L.J. Tan: Yes, it is. And also to do it in a location where there is obviously access to epinephrine in case there is what we call an anaphylaxis reaction.

Bill Walsh: Very good. Thank you so much. Jesse, who do we have up next?

Jesse Salinas: Our next question is going to be from Bob in North Dakota.

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

Bob: Thank you. My question has to do with the flu vaccine. I did receive my flu vaccine earlier in October; however, I was not 65 and so I didn't get the high dose. My wife is immunocompromised, and now I am 65, so I'm wondering if and when I could get the high-dose vaccine later on.

Bill Walsh: OK, Dr. Tan, do you have any advice for Bob?

L.J. Tan: I can give you the official advice, and then I'm going to give you my personal opinion. And I will caveat that. So officially, you've got your flu vaccine, sir. You don't need another flu vaccine. My personal position on this also is that if you turn 65, you just have to realize that if you get a second flu vaccine, it will not be covered by insurance. It will not be covered by Medicare because you are only allowed one flu vaccine in one season. That being said, there is no safety issue with getting two flu vaccines in the same season if they're separated by more than four weeks. And that's just me speaking as an expert. It is not an endorsed position by anybody.

Bill Walsh: Now, you said earlier, Dr. Tan, it seemed that the flu vaccine was pretty effective this season. Does that weigh into this at all since Bob has already gotten that flu vaccine?

L.J. Tan: It is the same flu vaccine in terms of the strains that are covered in the vaccine, so that's not the equation here. I think the good news, as I said — when I said earlier, it's about 92 to 100 percent matching, the vaccine is 92 to 100 percent matching what's circulating. So that's a very good thing. However, as Dr. Gounder has already pointed out, we don't have real data on that. I mean, until the season continues to progress and we see how well the vaccine actually works in people, we don't have actual data in terms of how well it's preventing hospitalizations, preventing disease, preventing deaths.

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

Jesse Salinas: The next caller is going to be Dolores in Nevada.

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

Dolores: Hi, my question is, excuse me ...

Bill Walsh: Are you still with us, Dolores?

Dolores: Yes. I waited so long; I can't remember what it was. (chuckles)

Jesse Salinas: All right, let's move on, Bill.

Bill Walsh: All right. Sorry about that, Dolores.

Jesse Salinas: Frances from Oklahoma.

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

Frances: Yes. I was just asking about the Tylenol and (inaudible), and I think I got my question answered on that. But anyway, I've got a husband in a nursing home, and they are really good about … I've got power of attorney over him, so they send me letters each year for me to sign for him to get his shots. And I always sign them so they don't have to worry about whether they can give it or not.

Bill Walsh: Hmm. Any concern whether you should be signing those or whether those are adequate to make sure that he's getting the shots?

Jesse Salinas: I think that's right, Bill. I think we've lost her.

Bill Walsh: OK. Sam, do you want to take that?

Sam Brooks: Sure, I mean when it comes to getting your vaccinations annually, primarily the facility must … first of all, the facility must make these available to residents. And residents themselves should be able to make those choices. But in instances where residents may not be able to, for instance, because of a cognitive impairment or an inability to communicate for some reason, they need to be talking with guardians or loved ones just to make them aware of what is available. And if you are making those decisions for a loved one that's in a nursing home, you can be proactive. You can call them and ask them, first, when are you offering boosters? What boosters are you offering? And also, what type of treatments are you offering for COVID should my loved one get it? So oftentimes you do have to be a little extra active as we talked about before. I'm glad to hear that this particular facility is sending letters. I imagine that might be true for some, but it's always good; it's never good to assume that that will happen, especially if you're the one making those decisions. But, of course, we always want those decisions to be made by residents themselves when they can —  but it's always good to have as many people advocating for that safety as possible for folks in nursing homes.

Bill Walsh: OK, thanks so much for that, Sam. And Dolores, who had called us earlier, I believe she was going to ask about the cost of boosters. Dr. Gounder, are the boosters still free and will they always be free?

Céline Gounder: The boosters are still free for now. So the federal government has purchased the boosters for this fall and winter season. However, in the future, unless Congress decides to allocate more money, and that's really a decision for Congress to make — Congress allocates funding, and it has the power of the purse string, not the president. So if Congress decides to allocate more funding to purchase more vaccines, we may have free vaccines in the future, but that does not seem to be in the cards right now.

Bill Walsh: OK, thanks very much for that. Sam, you were just talking about nursing homes. Let's dig into that a little bit. Last month, the Centers for Medicare and Medicaid Services relaxed nursing home vaccine requirements as long as good faith efforts are being made to achieve compliance. What does this mean for people with families in long-term care facilities?

Sam Brooks: Yeah, I'm glad you brought that up. We were very, for lack of a better term, disturbed when we heard about this. If you look at the numbers now, they're dismal. And despite this fact in its announcement that it was going to be relaxing enforcement penalties of the vaccine mandate, they called it a success. And when 3 out of 4 staff aren't up-to-date with their boosters and where only 41 percent of residents are, we don't see that as a success. And we do not see this. It's a sign, as Dr. Tan I think indicated, that it's … sending a false sense of security to residents when we're going into a season here that we really need to protect residents. So we're concerned about that. And we should, for families and residents, they need to be talking to their facilities. I mean, a good faith effort isn't enough. We need to see those numbers raised. And if you're in a facility or your loved one is in a facility that has low vaccination rates, you can call that administrator or call that facility and say, what are your plans to get your staff up? And they need to be providing you with that information. And just another thing around this is at the same time, CDC has relaxed masking guidance in health care settings. And we find this particularly troublesome in nursing homes, saying masking only needs to be done or should be done where community transmission levels are high. And we just think it's particularly, and I'm just speaking for nursing homes here, that this is just a very long, a step in the wrong direction. When again, 3 out of 4 staff are not up-to-date with their vaccines, you need to be hypervigilant about whether that facility is requiring health care staff to wear masks. And we're hearing from a lot of residents that they're not. So there's a couple things here going on that we're really concerned about that are coming out just at the wrong time. And really, as you say, you gotta be on your toes to protect your loved ones.

Bill Walsh: Let's, let me dig into that just a little bit. I mean, what kind of rights do families have to advocate on behalf of their loved ones in nursing homes? I know just from past programs people feel it's often opaque. They don't really know what's going on inside the facilities. It kind of depends on facility to facility and management company to management company, but what rights do they have, and do they have any allies on the outside they can turn to for assistance?

Sam Brooks: Sure, that's a great question and I think you're absolutely right. Unfortunately, the way the system operates, it can be two facilities — one across the street from each other — operating at very different levels. I think the most important resources oftentimes to residents and families are the Long-Term Care Ombudsman. The Long-Term Care Ombudsman is an office of advocates for residents, and each nursing home has a designated long-term care ombudsman — that number must be provided and displayed visually someplace in the facility. And you can call and express your concern with the ombudsman, and the ombudsman will go out and speak to the resident and also act as an advocate on behalf of the resident. And, in addition to that, they can also talk about what rights residents have because there's lots of rights that residents are afforded, but they often don't hear about from the facility. And the second option is filing a complaint with a state survey agency or a state regulatory agency. And this information also needs to be readily available to residents. If you have a concern that your loved one is not getting access to vaccines or that a facility is not observing or practicing proper infection-control procedures, you need to file those complaints and get people out there to take a look and make sure that residents are protected. So there are resources. You can also go on the website, go to Consumer Voice, theconsumervoice.org, and we have pages and pages of ways to advocate on behalf of residents in nursing homes.

Bill Walsh: OK. Theconsumervoice.org. And that long-term care ombudsman program is free, is that correct?

Sam Brooks: Oh, of course. Yep, it's free. The numbers, you can access those numbers; if you Google your state and long-term care ombudsman, it should come up. You can also get the information at our website. We have … you can click on the map, and we'll give you all kinds of helpful numbers, and that is a free, confidential service that has nothing to do with the facility. It's not hired by the facilities; they're advocates for you and primarily for residents, and I encourage folks to take advantage of them.

Bill Walsh: Just very quickly, how are nursing homes held accountable if they fail to provide adequate care?

Sam Brooks: Well, I mean, primarily, the primary mechanism, in theory at least, is that states are supposed to go out and enforce the federal regulations. Unfortunately, we're seeing difficulties with that now, attributable to the pandemic. But facilities can face a variety of penalties — including financial penalties and also being excluded from the Medicare and Medicaid programs. And that's really what most facilities want to avoid. However, we — and I think Megan would agree with me — we need to have stronger enforcement from the federal government around these regulations to ensure that the penalties that are in place, facilities do pay to make sure that residents are safe.

Bill Walsh: Sam Brooks, thank you so much, and thanks so much also to Drs. Céline Gounder and L.J. Tan. This has been a really informative discussion. We really appreciate all of our guests for being here and offering their insights 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 a recording of the Q&A event can be found at AARP.org/coronavirus starting Nov. 11. Go there if your question was not addressed, and you'll find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please join us again Dec. 15 for another Tele-Town Hall on COVID-19. Thank you very much and have a great day. This concludes our call.

11/10 Tele-Town Hall Transcript with Timestamps

[00:00:00] Bill Walsh: Hello, I am AARP Vice President Bill Walsh, and I want to welcome you to this important discussion about the coronavirus. Before we begin, if you'd like to hear this Telephone Town Hall in Spanish, press *0 on your telephone keypad now.

[00:00:15] [Española]

[00:00:21] 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. While the pandemic has been officially declared over, we aren't out of the woods yet from a health standpoint. New COVID cases and hospitalizations have ticked up slightly as we enter fall and winter, and fewer Americans than ever are getting flu shots in the face of what experts say could be a worse-than-normal flu season. Meantime, in our nursing homes where our most vulnerable loved ones live, only half of staff and residents are up to date on their COVID vaccines. As we prepare to gather with friends and family this holiday season, there are some commonsense steps we can all take to stay healthy and safe and make sure our loved ones are protected as well.

[00:01:25] Today we're going to hear from an impressive panel of experts about these issues and more. We'll also get an update from Capitol Hill and legislation affecting older Americans. If you've participated in one of our Tele-Town Halls in the past, you know this is similar to a radio talk show and you have the opportunity to ask your questions live. For those of you joining us on the phone, if you'd like to ask a question about the coronavirus pandemic, press *3 on your telephone keypad to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. And if you're joining on Facebook or YouTube, you can post your question in the comments.

[00:02:27] We have some outstanding guests joining us today, including an infectious disease specialist, an immunization expert, and a national nursing home advocate. We'll also be joined by my AARP colleague Jesse Salinas, who will help facilitate your calls today. This event is being recorded and you can access the recording at AARP.org/coronavirus 24 hours after we wrap up. ... Now, I'd like to welcome our guests. Céline Gounder, M.D., is a senior fellow and editor-at-large for public health at the Kaiser Family Foundation. Dr. Gounder is also a clinical associate professor of Medicine and Infectious Diseases at NYU's Grossman School of Medicine, and a CBS News medical contributor. Welcome, Dr. Gounder.

[00:03:32] Céline Gounder: It's great to be here.

[00:03:34] All right, it's great to have you. We're also joined by L.J. Tan, M.D., chief strategy officer at the Immunization Action Coalition. Welcome back to the program, Dr. Tan.

[00:03:47] L.J. Tan: Oh, thank you so much. Happy to be back.

[00:03:49] Bill Walsh: All right, we're happy to have you. And we also have Sam Brooks, who is the director of public policy at the National Consumer Voice for Quality Long-Term Care. Welcome to the program, Sam.

[00:04:01] Sam Brooks: Great, thanks. Happy to be here.

[00:04:16] Bill Walsh: Let's get to it. Dr. Gounder, are there indications we'll see another fall or a winter COVID surge, do you expect?

[00:04:24] Céline Gounder: We anticipate another COVID surge this winter. In 2020 and 2021, we saw big winter surges, and the wonderful thing about the winter holidays is that we get to see family and friends. But those gatherings between Thanksgiving and the New Year have also driven a lot of COVID transmissions. And then on top of that, new COVID variants have emerged again, which means there's less of an immunity wall blocking the spread of the virus, even among people who've been vaccinated or infected in the past.

[00:04:54] Dr. Gounder, let me ask you about the flu. Now, the flu has hit earlier this year and has been more severe at this early stage of the season at any time since 2009. Yet flu vaccination rates are lower than ever. Why is that? And, and given the low rates, how bad could things get?

[00:05:14] Céline Gounder: Unfortunately, I think we've seen some of the resistance to COVID vaccination and the politicization of vaccines have a spillover effect on other vaccines, including flu shots. And the timing here is really terrible. We had the suppression of any number of respiratory viruses in 2020 and 2021 when people were masking and social distancing. And now those viruses, like flu, like RSV, and so on, are coming back with a vengeance. And then on top of that, hospitals are really, really full. We're still dealing with staffing shortages that were caused by the pandemic. So the best thing you can do is try to stay out of the ER, not by avoiding medical care if you need it, but try not to get sick by getting your flu shot, by getting your COVID shots.

[00:06:02] Yeah, all right, great advice. Dr. Tan, you're an expert in immunization. Let me turn to you for a moment here. You know, this time of year can be really confusing, as Dr. Gounder just said, with an increase in all kinds of respiratory infections. Are there any clear-cut symptoms that distinguish say, a cold from the flu, from COVID? How do people know what they might be experiencing?

[00:06:26] L.J. Tan: Yeah. Well, glad to be back here, Bill. Thank you very much again. I think the challenge is that as COVID has continued to evolve, and we have seen all these, you know, what we like to call the Scrabble variants pop up. It has become more and more like a cold or an influenza or flu in terms of symptoms. And I think it's hard to tell the difference now. Obviously, if you go in, these people can test and can help you identify something between flu and COVID, but in terms of you just looking at yourself and feeling sick with your headache and your fever and your chills, it's getting harder and harder to distinguish them. But what I can say is that there is a vaccine against flu, there is a vaccine against COVID and you, if we get vaccinated, we can take those two, at least in terms of severity of symptoms everything that Dr. Gounder talked about, we can take those off the table, right? We may not be able to take the cold off the table, but we can take flu and COVID off the table.

[00:07:20] Bill Walsh: Well, let's stay on flu for just a moment. There's been a lot of misinformation out there about the flu, and maybe you can help clear some of that up. I want to take a moment and review some common beliefs about flu and maybe you can just let us know if these are true or false, kind of rapid-fire style. I mean one thing we are hearing all the time is that the flu isn't all that serious. True or false?

[00:07:41] L.J. Tan: Oh, absolutely false. Hundreds of thousands of hospitalizations, potentially tens of thousands of deaths every flu season — depending obviously on the strain that's circulating. So false, it's not true.

[00:07:51] Bill Walsh: Healthy adults don't need to take the vaccine.

[00:07:56] L.J. Tan: Not true at all. Flu does not discriminate between whether you have a high-risk condition or whether you're healthy. It can take you out, if you're lucky, maybe just three to five days out of work. But if you're unlucky, it could be months.

[00:08:11] Bill Walsh: Another one we hear a lot is you … can get ill from the flu vaccine.

[00:08:17] L.J. Tan: That is a falsehood. It is not possible to get flu from the flu vaccine because the vaccine comprises inactivated or what we like to call killed elements of the virus. So there's no way the vaccine can give you the flu.

[00:08:31] Bill Walsh: If you're not vaccinated early, you might as well skip it, is another belief floating around out there.

[00:08:38] L.J. Tan: Another piece of misinformation. Definitely not true, and this is very relevant for this season because we actually do have an early start to the flu season. The vaccine comprises four different strains of flu virus, so it provides vaccine protection against more than just the strain that you might have gotten sick with. And so definitely it is worthwhile to keep getting vaccinated throughout the flu season as it continues to provide benefits, as it continues to provide protection against hospitalization and disease throughout the flu season.

[00:09:10] Bill Walsh: Here's another common belief: Flu vaccines aren't effective because people still get the flu.

[00:09:16] L.J. Tan: Yeah, so many, many reasons for that, why that's not necessarily true. Obviously, flu vaccines protect against the flu, as we've already discussed. There are other diseases that causes similar symptoms that circulate. Those won't get protected by the flu vaccine. So you might get vaccinated against flu and still pick up a cold. Secondly, a lot of people can get flu but what happens is that if you're vaccinated, it will protect you from all the bad side effects from flu like hospitalizations, and, of course, death.

[00:09:46] Bill Walsh: And finally another common belief we hear oftentimes about the flu is that flu vaccines side effects are risky.

[00:09:56] L.J. Tan: So not true. Flu vaccines are probably one of the safest vaccines we have. Millions, millions and millions and millions and millions of doses of flu vaccine has been given every season and through the last decades. So we know almost everything we need to know with regards to flu vaccine safety. It is an incredibly, incredibly safe vaccine.

[00:10:17] Bill Walsh: Hmm, and isn't there a new high-dose flu vaccine for older adults out there?

[00:10:24] L.J. Tan: There are actually three vaccines that are now recommended for people over 65. I'm going to use the actual name of the vaccine, but this does not imply an endorsement by me of any of these specific brands. Just have to disclaim that. So there is something called Fluzone High Dose, there's something called Fluad, and then there's something called Flublok. Those three vaccines have been recommended for 65 and older by the CDC because they promote a better immune response in those over 65. So yes.

[00:10:54] Bill Walsh: Very good. Thanks for that, Dr. Tan, really helpful. Dr. Gounder, let me turn back to you and let's shift our focus to COVID. Last week, Pfizer said the newest bivalent COVID vaccine produces four times more antibodies for people over 55 than the original vaccine. What does this mean for older adults, and are the newest vaccines more effective at preventing infection?

[00:11:17] Céline Gounder: I think we have to be careful about saying that the new boosters are better. They're at least as good as the old ones, but the jury is still out as to whether they're actually more effective in preventing infection. Big picture, they're at least as good, and it's really important, especially if you're 50 and older, that you get your booster before this winter surge.

[00:11:39] And you heard Dr. Tan urging people to get their flu vaccine, too. What do you say to people about getting multiple vaccines at the same time, Dr. Gounder.

[00:11:48] Céline Gounder: You can absolutely get your flu shot and your COVID shot at the same time. That has been shown to be safe. You may have a little bit more in the way of some of those mild fevers or some achiness afterwards, but studies have also been done recently looking at the use of Tylenol, Ibuprofen, those kinds of over-the-counter pain and fever medications —and those can be used safely to reduce those side effects if you get your flu and COVID shots.

[00:12:17] Okay. Thanks for that, Dr. Gounder. Let's turn to our listeners. It's now time to address your questions about the coronavirus with Dr. Gounder, Dr. Tan, and Sam Brooks. … I'd now like to bring in my AARP colleague Jesse Salinas to help facilitate your calls today. Welcome, Jesse.

[00:12:56] Jesse Salinas: So glad to be here, Bill.

[00:12:57] Bill Walsh: All right, Jesse, who do we have first on the line?

[00:13:01] Jesse Salinas: Our first caller is going to be Shirley from California.

[00:13:04] Bill Walsh: Hey Shirley. Welcome to our program. Go ahead with your question.

[00:13:15] Shirley: I'm 81 years old and I wanted, I got all the shots, the Moderna 1, 2, 3, 4, and then I got the booster in April of this year. But just the last couple of days I've had this slight headache, I don't know where it's coming from. Should I go get another shot?

[00:13:39] Bill Walsh: Dr. Gounder, can you help Shirley with that?

[00:13:41] Celine Gounder: I think first things first. If you have symptoms, you should get yourself tested. You can either go to a local testing site or get one of those at home rapid tests for COVID. You can also try going to an urgent care center for that. If you have COVID, or for that matter, the flu, there are treatments for both of those. And so you have Paxlovid for COVID, you have Tamiflu for the flu, so if you have those infections, you should be treated. If you don't, you can get vaccinated now.

[00:14:14] Bill Walsh: Dr. Gounder, Shirley mentioned she was boosted in April. That was quite some time ago. Is she due for another booster at this point, or should she wait some? What is the period of time people should be waiting before they get a booster?

[00:14:31] Céline Gounder: About three months or so between doses or after your most recent infection. But that said, if she's currently infected, she should hold off until three months after that. But I think the really important thing for Shirley is, if she's sick with COVID right now, if she's sick with the flu right now, address that first, and then once she's done so, to absolutely get that additional COVID booster.

[00:14:59] Very good. Thank you for that, Dr. Gounder. Jesse, who is our next caller?

[00:15:03] Jesse Salinas: Our next caller is going to be Chris from California.

[00:15:06] Bill Walsh: Hey, Chris. Welcome to our program. Go ahead with your question.

[00:15:09] Chris: Hi. My brother is 73. He just tested for COVID. My mother is 95 and she just had surgery. So what I would like to know is how long should we wait before he comes to visit her?

[00:15:28] Bill Walsh: Hmm, interesting question. Dr. Gounder, can you field that one?

[00:15:32] Céline Gounder: Sure, there's two different ways to approach this. Either you can use those at-home rapid COVID tests to figure out when your brother is no longer infectious. What you want to do is see him test negative two times, twice in a row, at least one to two days apart. If you do not have tests or can't afford tests, you could also count somewhere between 10 to 14 days after he was initially diagnosed. I would err on the longer side, 14 days, if you're able to before he spends time with your mother and other people.

[00:16:11] All right, and Dr. Gounder, is the federal government still sending free tests to people or is that option still available?

[00:16:18] Céline Gounder: Insurance companies, including Medicare, will reimburse you for eight tests per month per individual. But unfortunately, there's no more money left for purchasing more of these at-home tests. So … no, the federal government just can't send those out anymore.

[00:16:39] All right, Jesse, who is our next caller?

[00:16:43] Jesse Salinas: Our next caller is going to be Carl from New York.

[00:16:47] Bill Walsh: Hey, Carl, welcome to our program. Go ahead with your question. Hey, Carl, welcome to the program. Do you have a question? Sounds like we may have lost Carl.

[00:17:04] Jesse Salinas: Yep. Let's go to another one. We've got a question from Facebook by somebody named PD [inaudible]. "If you're planning to have visitors for Thanksgiving, how far in advance should they take a COVID test? Is it advisable to have them stay overnight for their visit?"

[00:17:16] Bill Walsh: Hmm, Dr. Tan, do you want to handle that one?

[00:17:19] L.J. Tan: Yeah, I'm happy to take that. This is a build-off of Dr. Gounder's response. I think before they show up, they should be testing negative with one of those in-home tests that you can get access to … preferably 24 to 48 hours before arrival with two negative tests. I think one of the things to keep in mind, obviously, is that if anyone's symptomatic … then they should definitely hold off on visiting until they have tested themselves as negative for COVID. I think one of the interesting things that has happened as we've come through this is indeed we say, you know, if you've got symptoms, test negative for COVID, and then you can continue. But I think the point of the matter is that if you have symptoms of any sort, really you should consider taking yourself out of some of these activities because of the fact that you could be, if you're not spreading COVID, you could be spreading flu, RSV, right? So I think it's important to kind of broaden the idea that if you're sick, stay home, and of course get vaccinated. And this way we reduce the likelihood that you'll be unable to attend some of these holiday gatherings that we're all looking forward to.

[00:18:22] Bill Walsh: Thank you very much, Dr. Tan. Jesse, who do we have up next?

[00:18:26] Jesse Salinas: Our next call is going to be from Mike in Illinois.

[00:18:30] Bill Walsh: Hey, Mike, welcome to the program. Go ahead with your question.

[00:18:34] Mike: Hi. I still have to get my … I have had two shots last in 2021 I think, and I never got the third booster. So now they have the fourth booster. Should I just go ahead and get the fourth booster? And then my question on that also would be, I had Moderna for the first two. Is there any difference in effectiveness between Moderna, Pfizer, or the others for the newest booster shot?

[00:19:09] Bill Walsh: All right, Mike. Let's ask the experts. Dr. Gounder, can you weigh in on that? Is it ever too late to get a booster?

[00:19:15] Céline Gounder: It is not too late. I wouldn't worry about counting how many doses. If you've gotten at least your first two doses, at this point, we're really just talking about boosting for the season or when there's a new booster available. So absolutely, go out and get your updated booster now and that way you'll be protected for the holidays.

[00:19:37] OK, and Mike's second question had to do with the effectiveness of one versus the other, Moderna versus Pfizer. … Can he mix and match, and is there any difference in effectiveness?

[00:19:47] Céline Gounder: They're pretty comparable. Moderna is a slightly higher dose than Pfizer. There are some slight differences. Some people also report a little bit more in terms of side effects with Moderna, again, related to that slightly higher dose, but I really wouldn't worry too much about which brand, just whichever one you're able to get your hands on. There's also a newer booster that's recently been approved, Novavax, which is a slightly different technology. It's what we call a protein vaccine. It's a technology that we use for a lot of other vaccines, and that's certainly an option as well.

[00:20:27] And so should people worry about mixing and matching these or should, I think you said they should just take whatever's available to them.

[00:20:34] Céline Gounder: Yeah, it's absolutely fine to mix and match. Just whatever is available to you and that you're able to get as soon as possible.

[00:20:41] OK, very good. … Jesse, let's go back to the lines. Who do we have up next?

[00:20:55] Jesse Salinas: We're going to bring in Joan from Indiana.

[00:20:57] Bill Walsh: Hey, Joan, welcome to our program. Go ahead with your question.

[00:21:01] Joan: My question is I've got a daughter who's 53 years old, she's never had a flu shot, but she's never had the flu. And her argument is if she's never had the flu, then she shouldn't have to take it. And she claims she's talked to a physician about this, and as long as she takes her vitamins and her other medications, then she should be OK. What's your response to that?

[00:21:27] Bill Walsh: Let's ask Dr. Tan about that. Doctor, what would you say to Joan and her daughter?

[00:21:32] L.J. Tan: I think it's a common misperception that if you're healthy and you've never had flu before, you don't need to get protected against the flu. Every single flu season, Joan, is different, and every single flu season that your daughter doesn't get vaccinated, she's essentially gambling with her health because this could be the season where she will actually catch flu — and it could be a really bad flu that she catches that could really hurt her. So I think it's one of those things where I always ask, why are you gambling every season? We have a good, safe, effective vaccine. If you get the vaccine, you can guarantee yourself that you're not going to have severe consequences from flu. And I don't see why people want to gamble. Every single flu season is different, Joan, and just because you didn't catch it last season does not mean … you'll not catch it this season.

[00:22:22] Bill Walsh: And Dr. Tan, what are you seeing as it relates to the severity of the flu this season?

[00:22:29] L.J. Tan: Yeah, so this flu season is a little scary. I actually — just before this town hall — came out of a meeting with CDC. We have dramatic, we have, as Dr. Gounder has already pointed out, our hospitalization rates are higher this flu season than they've ever been for the last 10 flu seasons. So, we are very concerned about that. And then obviously, we have diseases, the disease is surging in so many parts of the country faster than we've ever seen for the last few seasons as well. So I think … there's a perfect confluence here of disease as well as vaccination rates being lower, that's really concerning the CDC and folks like us, like Dr. Gounder and myself.

[00:23:11] Bill Walsh: And how effective is the flu vaccine this year?

[00:23:14] L.J. Tan: So we don't have the data right now for this year's flu season, obviously, because we're still going into it. But the great news, again, from this call that I just got off with the CDC, is that the vaccine strain, the virus that's in the vaccine appears to be 92 to a 100 percent matching the strains that are currently circulating. So it looks like we've got a good vaccine this year.

[00:23:37] Bill Walsh: Hmm. That's great news. All right, thanks, Dr. Tan, for that. Let's take another call, Jesse.

[00:23:43] Jesse Salinas: We're going to bring on Deborah from North Carolina.

[00:23:46] Bill Walsh: Hey, Deborah. Welcome to our program. Go ahead with your question.

[00:23:50] Deborah: Hi. I just wanted to ask the panel their opinion on the use of Evusheld for immunocompromised patients who are fully vaccinated and have both boosters.

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

[00:24:02] Deborah: And it's E-v-u-s-h-e-l-d.

[00:24:07] Bill Walsh: OK, Dr. Tan, can you address that?

[00:24:10] L.J. Tan: You know, I'm going to punt that to Dr. Gounder in her expertise as an ID doc. This is obviously the monoclonal antibody treatment, and I think we do know that there's some data that suggests that this monoclonal antibody treatment for COVID may be less effective against some of the subvariants that we are seeing with omicron. But Dr. Gounder, I would rather have you take this as your expertise.

[00:24:31] Céline Gounder: Sure. And I agree with that. This is one of the concerns that we have about the emerging subvariants that are spreading across the country right now. You may have heard BQ 11, for example. What we … as Dr. Tan referred to as the Scrabble variants with this mix of letters that are hard to decipher. But the problem with these subvariants is that many of them are resistant to all of the monoclonals that we have, all of these treatments — including Evusheld, which is used as a preventative medication for people who are immunocompromised, as Deborah said. And so it makes it all that much more important that people get vaccinated because we have, unfortunately, fewer tools in our arsenal to deal with COVID this winter.

[00:25:21] Bill Walsh: Right. And so people have the opportunity to prevent it on the front end because we don't have a lot of tools on the back end to manage it, it sounds like.

[00:25:28] Céline Gounder: Exactly.

[00:25:29] L.J. Tan: Bill, if I could ...

[00:25:30] Bill Walsh: Yeah. Go ahead.

[00:25:30] L.J. Tan: If I could also quickly jump in, because I forgot to mention this when Joan was talking about her daughter, and this is obviously true with COVID too. …When I was emphasizing the answer about protecting herself and not gambling, part of the reason to get vaccinated also is that you don't want to be infecting others. And if you get vaccinated, you can also protect the people around you that you care about. And in this situation, obviously someone who's immunocompromised, if you are vaccinated against COVID, you reduce the risk that you transmit something to someone who's immunocompromised.

[00:25:58] Bill Walsh: Yeah, it's a great point. And I think people forget that, right? They think of it's about themselves, but they can be carriers too, and they may not even know it. Great point. Let's go back to the lines. Jesse, who's next?

[00:26:09] Jesse Salinas: Yeah, I'm going to bring on Nancy from Ohio.

[00:26:12] Bill Walsh: Hey, Nancy, welcome to our program. Go ahead with your question.

[00:26:15] Nancy: Hi, there. Thank you for your program. One quick question. I'm concerned about the RSV virus in adults. Is it dangerous for somebody 78 years old to be near a baby that has the RSV virus?

[00:26:28] Bill Walsh: Hmm, great question. Dr. Tan, do you want to field that one?

[00:26:32] L.J. Tan: Yeah, I'll field that one, and then I will also ask Dr. Gounder to weigh in as well. So RSV has surged and continues to surge in this past month, and I think one of the biggest challenges is that it has dramatically higher impact on young children — in other words, hospitalizing them and potentially also higher rates of death, as well as in adults that are 65 years of age and older. And so, Nancy, that will be right where you are. So indeed, RSV does have more severe impact on older adults, and unfortunately, in older adults, we don't have a treatment for it other than supportive care. In other words, which means taking care of how you feel. So we really would love that if you are taking care of a younger grandchild who has been diagnosed with RSV, we do urge that you have to be especially cautious … and make sure you don't catch it. So that could include yourself wearing a good quality mask, making sure you're sanitizing your hands frequently between touching the child, and obviously, if at all possible, taking some time away when the child is actively in symptoms because that's when they're most infectious. And I understand that's tricky, obviously, because it is the grandchild, you want to be there. So that's kind of what I would advise. Dr. Gounder, do you have anything else to add to that?

[00:27:45] Céline Gounder: Yeah, what we see with a lot of respiratory infections, whether it's the flu or COVID or RSV, is that it can cause exacerbation or worsening of other underlying chronic medical conditions. So that could be COPD or emphysema. It could be heart disease where people come in with a heart attack. In fact, we've seen as an example the vaccination against the flu can protect you from having a heart attack that's related to having the flu over the winter. And so there are many reasons for older people to really try to avoid getting RSV. It's not just the infection itself, but the way in which it can make other conditions worse.

[00:28:27] Bill Walsh: Hmm, OK. Thanks for that both Dr. Tan and Dr. Gounder. And thank you, our listeners, for all those great questions. We're going to take more of your questions shortly, but before we do, let's get a quick update from Capitol Hill. In addition to sharing information and resources, AARP advocates at the state and national levels for issues that affect you the most. To give a quick update on how AARP is fighting for you, I wanted to bring in Government Affairs Vice President Megan O'Reilly. Welcome, Megan.

[00:28:59] Megan O’Reilly: Happy to be here, Bill.

[00:29:00] All right. Happy to have you. Now, I want to ask about a few important issues, but let's start with some really good news. This past August, a historic prescription drug reforms passed the House and Senate were signed into law. Can you tell us a little bit about what this means for people?

[00:29:16] Megan O’Reilly: Yes, the Prescription and Drug Pricing Reform Law is a huge victory for older Americans. After decades of calling on Congress to make prescription drugs more affordable, AARP won the fight to let Medicare negotiate lower drug prices and for other policies that will save seniors money on their medications. For example, the new law will cap the cost of Medicare-covered insulin at $35 a month starting in January, and eliminates out-of-pocket costs for most vaccines under Medicare, such as the shingles vaccine. Starting in 2025, there will be an annual $2,000 limit on how much Medicare Part D beneficiaries pay out-of-pocket for their prescription medications, and drug makers that increase their prices faster than the rate of inflation will be penalized. These are huge wins.

[00:30:06] Well, that's awesome news. Thanks for that, Megan. Now, in addition to Medicare, Social Security is another top priority for AARP, and there's good news there as well, right?

[00:30:15] Megan O’Reilly: Yes, Social Security recently announced an 8.7 percent cost-of-living adjustment – the largest COLA increase in 41 years. AARP has fought long and hard to protect Social Security COLA so seniors can keep up with rising prices. This increase will provide much-needed relief to millions of Americans struggling with higher food, health care, and other costs. We're also urging Congress to work together in a bipartisan way to protect and strengthen Social Security for the long term.

[00:30:47] OK, Megan, thanks for that update. I want to take a minute to talk about the current state of COVID in America's nursing homes. For those living and working in skilled nursing facilities, this pandemic is far from over, isn't that right?

[00:31:01] Megan O’Reilly: Sadly, that's correct, Bill. The AARP Nursing Homes COVID Dashboard shows that transmission in nursing homes remains significantly elevated compared to the rest of the population. One of the most important things people can do is make sure their loved ones are vaccinated and have received the recommended boosters. Nearly half of residents and more than half of staff are not up-to-date with their shots, and this could have deadly consequences as we head into cold and flu season. This is the time to be an advocate for your loved one. Contact your nursing home and ask about vaccination rates and plans to keep residents safe this fall and winter. And if you need help knowing what to ask, go to AARP.org/nursinghomes and see our article, "10 COVID-19 Questions to Ask a Nursing Home."

[00:31:53] OK, that was AARP.org/nursinghomes. That's a terrific story. The 10 questions to ask a nursing home. It's really helpful, and we're updating it regularly. So take a look at that on AARP.org. Thanks so much for being here today, Megan. If our listeners want to get involved with AARP’s advocacy, how can they do it?

[00:32:20] Megan O’Reilly: Sure, we encourage everyone to go online to AARP.org/getinvolved. That's AARP.org/getinvolved, and sign up to be an e-activist. You'll receive email action alerts with easy ways to make your voice heard, whether on COVID, protecting your hard-earned Social Security and Medicare benefits, and more. Once again, that's AARP.org/getinvolved. It's an easy way to make a big difference.

[00:32:54] All right. Thank you so much, Megan, for that update. Really appreciate your being here today. Let us turn back to our experts. … Dr. Gounder, you recently wrote an article in The Atlantic that said Americans and political leaders lack the moral imagination to solve the COVID crisis, that we needlessly tolerate 150,000 deaths per year, and too often ignore elderly people, people of color, and people with disabilities. Can you share more about your concerns?

[00:33:34] Céline Gounder: Sure. We're still seeing between 300 and 500 deaths from COVID per day, which translates to 150,000 additional deaths per year in the United States from COVID. And at the same time, we've also seen deaths from COVID shift older. Ninety percent of deaths from COVID are now occurring among people 65 and older, and 40 percent of COVID deaths are now occurring among people 85 and older. So the demographics have really shifted older since the summer of 2021, when it was about 50/50 deaths among people over and under 65. We also know that people of color and people who are immunocompromised or have disabilities are at higher risk for comp … [dogs barking] Sorry, the dogs ... are higher risk for complications from COVID, and unfortunately the vast majority of the American population thinks the pandemic is over and has stopped taking precautions. To prevent transmission, I think we're thinking too narrowly about what we can do to reduce the risk. So yes, masks and vaccines. Vaccines are important, but there are other highly effective tools, too. For example, improving indoor air quality with ventilation and air filtration. For the holidays you can get yourself some portable HEPA air filtration units for your home, put them in places where the family or friends congregate — kitchen, living room, dining room, for example. We should also make a lot more use of COVID testing and treatment, and again, a reminder that if you do test positive for COVID, you can be treated with Paxlovid, which is highly effective in keeping people out of the hospital. And finally, when the public health emergency does come to an end, some people may be losing their Medicaid coverage. Medicaid covers low-income people. Medicare will stay the same, but some people might lose that Medicaid coverage, which can really create hardship for folks who are already struggling to get by.

[00:35:39] Thanks for that, Dr. Gounder, but let's talk a little bit more about some of the tools you mentioned there. We've talked a little bit about the newest vaccines. I wonder how effective they are against the subvariants that you and Dr. Tan have talked about; and also at-home COVID tests. Are they effective in detecting these subvariants?

[00:35:59] Céline Gounder: The at-home COVID tests still work perfectly well with the new subvariants. Same goes for Paxlovid, the pill that you can take for COVID. Both of those tools still work very well, just as well for the new subvariants. The vaccines may not work as well, and the monoclonal antibodies may not work as well. Where we need to sort of adjust our expectations of vaccines is that the vaccines will keep you out of the hospital. They will prevent you from dying. They may not prevent all infections, and so it's very important that you get vaccinated, but you may still want to be layering other tools like masking, like those HEPA air filtration units, like testing and treatment to further reduce your risk.

[00:36:48] I like that notion of layering on protection. Makes a lot of sense. Dr. Gounder, great effort is being made to understand what causes and alleviates so-called long COVID. This week, in fact, researchers at the US Department of Veterans Affairs said that the antiviral Paxlovid, which you just mentioned, reduces the chances of certain long-COVID conditions by a quarter. Why do some people continue to experience COVID complications and how dangerous are they?

[00:37:17] Céline Gounder: Well, one thing we have seen is that if you have immunity, if you've been vaccinated, your risk of developing long COVID is lower than if you have not been vaccinated. We don't entirely understand what causes long COVID yet. It's probably a cluster of a number of different syndromes, each of which have a slightly different set of symptoms caused slightly differently, but we know that, again, vaccination will reduce your risk and getting treated with Paxlovid if you are infected does seem to be, at least from the early data, does seem to be protective. It's yet another reason, if you have symptoms to get yourself tested for COVID, so you can get treated and so you're less likely to end up with long COVID.

[00:38:04] OK, very good. Dr. Tan, let me bring you back in. We're beginning to see school closures around the country in response to the flu and the RSV infections. What do grandparents helping care for school-aged grandchildren or great-grandchildren need to know about RSV and flu outbreaks?

[00:38:24] L.J. Tan: Yeah, thanks Bill. I think to follow up on some of this conversation from earlier, I think if you're taking care of a child that's younger than school age, the first thing, get the flu vaccine because we can take flu off the table. Again, to echo Dr. Gounder's point, it reduces your risk of hospitalization, reduces your risk of death, reduces your risk of severe disease. It may not entirely protect you from getting infected, but it does have strong benefits — and so get vaccinated against flu. Take that off the table. Now, as we've already talked about RSV, we don't have a vaccine for that yet. And, unfortunately, we do want to keep away from getting infected with RSV because of some of the reasons Dr. Gounder had already mentioned, including this idea that it exacerbates or makes worse some of the chronic conditions that older people tend to have — things like, for example, a heart disease; COPD, which is a chronic obstructive pulmonary disease, lung disease, in other words. Diabetes, for example, is another one that we know flu exacerbates as well or makes worse. So we would urge that in the process of taking care of a school-aged child who might have been exposed to an outbreak, that you keep that in mind and take the precautions of layering on infection control things like masking, frequent sanitizing, washing of hands, making sure that the child covers their cough so that if possible at all, you avoid being infected. And, of course, you know, what I would say is if you can avoid getting in contact with someone who's actually symptomatic, that is something you want to do.

[00:39:55] Bill Walsh: Thanks very much for that, Dr. Tan. Now my colleague, Megan O'Reilly, was talking about some concerns in our nation's nursing homes, particularly the low vaccination rates there. To give us more insights on long-term care facilities, I'd like to bring in Sam Brooks to our conversation. Sam is the director of public policy at the National Consumer Voice for Quality Long-Term Care, a national consumer advocacy group. Sam, welcome to the program. I'd like to ask you … you know nearly one half of long-term care facility residents are not up-to-date with COVID vaccines. What are facilities doing to ensure that residents have access to the newest COVID and flu vaccines, and how are they educating residents?

[00:40:44] Sam Brooks: Thanks for that question. First, just let me say what a wonderful call this has been and how informative it has been. The statistic that you mentioned is very concerning to us. And it's, unfortunately, not clear just what facilities are doing to ensure that both staff and residents are up- to-date with their boosters. We saw at the beginning when vaccines first became available, there was an all-out effort, really from the government down; there were vaccine clinics, there were partnerships formed with various pharmacies, and you saw a real high uptake of vaccinations in residents. You know, 8 or 9 out of 10 residents had their first primary set of vaccinations. But now you've just seen, not a corresponding effort from the government, when it comes to boosters, and it's very concerning to us. We're hearing from residents — or we're hearing from residents and long-term care ombudsmen, that residents don't understand why they continue to need to get shots. And we really believe, unfortunately, I mean we would hope that most residents could be on a call like this today to see just how important this is. And I know that you know there's 15,000 nursing homes across the United States. Unless we have a concerted effort, really, from the federal government and state governments to say, we need to do some education around this, we're going to see these dismal numbers continue. And going into the fall flu and COVID season, it's very concerning for us.

[00:42:24] Bill Walsh: Thanks for that, Sam. Now according to October CDC data, long-term care facilities staff and home health care workers have the lowest COVID vaccination rates, lowest COVID booster rates, and lowest flu vaccination rates among health care professionals. Why is this, and where do you turn if you have concerns or need help working with a long-term care facility?

[00:42:52] Sam Brooks: Again, I was looking at the data. Three out of four nursing home direct care staff aren't up-to-date on their vaccines. The federal government, the Centers for Medicare and Medicaid Services, instituted a mandate that staff be vaccinated. And you saw that … about 9 out of 10 staff got their first primary set of vaccinations. But that's just not true with boosters. And we're concerned, again, that there isn't a concerted effort by the government to say, hey, we're going to update our guidance and require staff to be updated with boosters. And I think this makes both residents and families and their loved ones need to be more hypervigilant when making decisions about nursing homes. Nursing homes, if you go to Care Compare … on medicare.gov, you can see the vaccination rates and the booster rates for each nursing home. But those are the types of questions that you need to be asking facilities when you're thinking about the safety of yourself or a loved one. What are the vaccination rates for staff? What are the plans to get your vaccination rates up for staff and residents? Because there's just a lot of things going on right now that are putting residents at risk.

[00:44:11] Bill Walsh: Yeah, it sounds like it's really time to be an advocate for your loved ones in those facilities. Thanks so much for that, Sam. We're going to come back with more questions for you shortly. And now it's time to address more of our listener questions. … Jesse, who do we have on the line next?

[00:44:37] Jesse Salinas: OK, Bill. We have a lot of questions on YouTube, on Facebook, and even in our queue from people who are asking about their confusion with how many shots they should have taken or need to take or have to take before they can get the new booster. So can your experts maybe talk about that?

[00:44:52] Bill Walsh: Dr. Gounder, can you walk us through that?

[00:44:54] Céline Gounder: As long as you've had two shots, don't worry about counting shots anymore. Just make sure you get the most up-to-date booster available as they come out. So as long as you've had two shots, at a minimum, you can go out and get the updated bivalent omicron boosters, those new ones that have just come out.

[00:45:16] Very good. Keep it simple. All right, Jesse, who do we have up next?

[00:45:21] Jesse Salinas: This is from Lana in New York.

[00:45:23] Bill Walsh: Hey, Lana. welcome to our program. Go ahead with your question.

[00:45:28] Lana: Hi. I was wondering if it is safe to get the flu vaccine if you have an allergy to eggs, and also if the eggs are contained in the flu vaccine.

[00:45:40] Bill Walsh: Dr. Tan, do you want to field that one?

[00:45:42] L.J. Tan: Yes, actually there's been a lot of research on this recently and it is absolutely safe to take the flu vaccine now, even if you have an allergy to eggs. That being said, the CDC does advise that if … you’re known to have a severe allergy to eggs, you should try to get the vaccine in a place where someone can watch you after you get the flu vaccine so that, you know, just in case. There is a vaccine out there … there are several vaccines out there that do not have eggs that you can consider. One is called Flucelvax, and the other one's called Flublok. And Flublok indeed is that same vaccine that's recommended for 65 and older. They do not have egg components that are of concern.

[00:46:21] Bill Walsh: Hmm. That's interesting. I know for the COVID vaccine, people are urged to wait 15 minutes or so to see if there's an allergic reaction. Is it the same guidance for the flu vaccine?

[00:46:31] L.J. Tan: Yes, it is. And also to do it in a location where there is obviously access to epinephrine in case there is what we call an anaphylaxis reaction.

[00:46:44] Bill Walsh: Very good. Thank you so much. Jesse, who do we have up next?

[00:46:48] Jesse Salinas: Our next question is going to be from Bob in North Dakota.

[00:46:52] Bill Walsh: Hey Bob, welcome to the program. Go ahead with your question.

[00:46:56] Bob: Thank you. My question has to do with the flu vaccine. I did receive my flu vaccine earlier in October; however, I was not 65 and so I didn't get the high dose. My wife is immunocompromised, and now I am 65, so I'm wondering if and when I could get the high-dose vaccine later on.

[00:47:22] Bill Walsh: OK, Dr. Tan, do you have any advice for Bob?

[00:47:26] L.J. Tan: I can give you the official advice, and then I'm going to give you my personal opinion. And I will caveat that. So officially, you've got your flu vaccine, sir. You don't need another flu vaccine. My personal position on this also is that if you turn 65, you just have to realize that if you get a second flu vaccine, it will not be covered by insurance. It will not be covered by Medicare because you are only allowed one flu vaccine in one season. That being said, there is no safety issue with getting two flu vaccines in the same season if they're separated by more than four weeks. And that's just me speaking as an expert. It is not an endorsed position by anybody.

[00:48:09] Bill Walsh: Now, you said earlier, Dr. Tan, it seemed that the flu vaccine was pretty effective this season. Does that weigh into this at all since Bob has already gotten that flu vaccine?

[00:48:24] L.J. Tan: It is the same flu vaccine in terms of the strains that are covered in the vaccine, so that's not the equation here. I think the good news, as I said — when I said earlier, it's about 92 to 100 percent matching, the vaccine is 92 to 100 percent matching what's circulating. So that's a very good thing. However, as Dr. Gounder has already pointed out, we don't have real data on that. I mean, until the season continues to progress and we see how well the vaccine actually works in people, we don't have actual data in terms of how well it's preventing hospitalizations, preventing disease, preventing deaths.

[00:49:04] Bill Walsh: Got it. OK. Thanks very much for that. Jesse, who do we have up next?

[00:49:08] Jesse Salinas: The next caller is going to be Dolores in Nevada.

[00:49:11] Bill Walsh: Hey Dolores, welcome to our program. Go ahead with your question.

[00:49:15] Dolores: Hi, my question is, excuse me ...

[00:49:18] Bill Walsh: Are you still with us, Dolores?

[00:49:25] Dolores: Yes. I waited so long; I can't remember what it was. [chuckles]

[00:49:35] Jesse Salinas: All right, let's move on, Bill.

[00:49:37] Bill Walsh: All right. Sorry about that, Dolores.

[00:49:40] Jesse Salinas: Frances from Oklahoma.

[00:49:42] Bill Walsh: Hey Frances. Welcome to our program. Go ahead with your question.

[00:49:45] Frances: Yes. I was just asking about the Tylenol and [inaudible], and I think I got my question answered on that. But anyway, I've got a husband in a nursing home, and they are really good about … I've got power of attorney over him, so they send me letters each year for me to sign for him to get his shots. And I always sign them so they don't have to worry about whether they can give it or not.

[00:50:21] Bill Walsh: Hmm. Any concern whether you should be signing those or whether those are adequate to make sure that he's getting the shots?

[00:50:30] Jesse Salinas: I think that's right, Bill. I think we've lost her.

[00:50:32] Bill Walsh: OK. Sam, do you want to take that?

[00:50:35] Sam Brooks: Sure, I mean when it comes to getting your vaccinations annually, primarily the facility must … first of all, the facility must make these available to residents. And residents themselves should be able to make those choices. But in instances where residents may not be able to, for instance, because of a cognitive impairment or an inability to communicate for some reason, they need to be talking with guardians or loved ones just to make them aware of what is available. And if you are making those decisions for a loved one that's in a nursing home, you can be proactive. You can call them and ask them, first, when are you offering boosters? What boosters are you offering? And also, what type of treatments are you offering for COVID should my loved one get it? So oftentimes you do have to be a little extra active as we talked about before. I'm glad to hear that this particular facility is sending letters. I imagine that might be true for some, but it's always good; it's never good to assume that that will happen, especially if you're the one making those decisions. But, of course, we always want those decisions to be made by residents themselves when they can — but it's always good to have as many people advocating for that safety as possible for folks in nursing homes.

[00:52:04] Bill Walsh: OK, thanks so much for that, Sam. And Dolores, who had called us earlier, I believe she was going to ask about the cost of boosters. Dr. Gounder, are the boosters still free and will they always be free?

[00:52:17] Céline Gounder: The boosters are still free for now. So the federal government has purchased the boosters for this fall and winter season. However, in the future, unless Congress decides to allocate more money, and that's really a decision for Congress to make — Congress allocates funding, and it has the power of the purse string, not the president. So if Congress decides to allocate more funding to purchase more vaccines, we may have free vaccines in the future, but that does not seem to be in the cards right now.

[00:52:51] OK, thanks very much for that. Sam, you were just talking about nursing homes. Let's dig into that a little bit. Last month, the Centers for Medicare and Medicaid Services relaxed nursing home vaccine requirements as long as good faith efforts are being made to achieve compliance. What does this mean for people with families in long-term care facilities?

[00:53:16] Sam Brooks: Yeah, I'm glad you brought that up. We were very, for lack of a better term, disturbed when we heard about this. If you look at the numbers now, they're dismal. And despite this fact in its announcement that it was going to be relaxing enforcement penalties of the vaccine mandate, they called it a success. And when 3 out of 4 staff aren't up-to-date with their boosters and where only 41 percent of residents are, we don't see that as a success. And we do not see this. It's a sign, as Dr. Tan I think indicated, that it's … sending a false sense of security to residents when we're going into a season here that we really need to protect residents. So we're concerned about that. And we should, for families and residents, they need to be talking to their facilities. I mean, a good faith effort isn't enough. We need to see those numbers raised. And if you're in a facility or your loved one is in a facility that has low vaccination rates, you can call that administrator or call that facility and say, what are your plans to get your staff up? And they need to be providing you with that information. And just another thing around this is at the same time, CDC has relaxed masking guidance in health care settings. And we find this particularly troublesome in nursing homes, saying masking only needs to be done or should be done where community transmission levels are high. And we just think it's particularly, and I'm just speaking for nursing homes here, that this is just a very long, a step in the wrong direction. When again, 3 out of 4 staff are not up-to-date with their vaccines, you need to be hypervigilant about whether that facility is requiring health care staff to wear masks. And we're hearing from a lot of residents that they're not. So there's a couple things here going on that we're really concerned about that are coming out just at the wrong time. And really, as you say, you gotta be on your toes to protect your loved ones.

[00:55:36] Bill Walsh: Let's, let me dig into that just a little bit. I mean, what kind of rights do families have to advocate on behalf of their loved ones in nursing homes? I know just from past programs people feel it's often opaque. They don't really know what's going on inside the facilities. It kind of depends on facility to facility and management company to management company, but what rights do they have, and do they have any allies on the outside they can turn to for assistance?

[00:56:03] Sam Brooks: Sure, that's a great question and I think you're absolutely right. Unfortunately, the way the system operates, it can be two facilities — one across the street from each other — operating at very different levels. I think the most important resources oftentimes to residents and families are the Long-Term Care Ombudsman. The Long-Term Care Ombudsman is an office of advocates for residents, and each nursing home has a designated long-term care ombudsman — that number must be provided and displayed visually someplace in the facility. And you can call and express your concern with the ombudsman, and the ombudsman will go out and speak to the resident and also act as an advocate on behalf of the resident. And, in addition to that, they can also talk about what rights residents have because there's lots of rights that residents are afforded, but they often don't hear about from the facility. And the second option is filing a complaint with a state survey agency or a state regulatory agency. And this information also needs to be readily available to residents. If you have a concern that your loved one is not getting access to vaccines or that a facility is not observing or practicing proper infection-control procedures, you need to file those complaints and get people out there to take a look and make sure that residents are protected. So there are resources. You can also go on the website, go to Consumer Voice, theconsumervoice.org, and we have pages and pages of ways to advocate on behalf of residents in nursing homes.

[00:57:43] Bill Walsh: OK. Theconsumervoice.org. And that long-term care ombudsman program is free, is that correct?

[00:57:51] Sam Brooks: Oh, of course. Yep, it's free. The numbers, you can access those numbers; if you Google your state and long-term care ombudsman, it should come up. You can also get the information at our website. We have … you can click on the map, and we'll give you all kinds of helpful numbers, and that is a free, confidential service that has nothing to do with the facility. It's not hired by the facilities; they're advocates for you and primarily for residents, and I encourage folks to take advantage of them.

[00:58:24] Bill Walsh: Just very quickly, how are nursing homes held accountable if they fail to provide adequate care?

[00:58:30] Sam Brooks: Well, I mean, primarily, the primary mechanism, in theory at least, is that states are supposed to go out and enforce the federal regulations. Unfortunately, we're seeing difficulties with that now, attributable to the pandemic. But facilities can face a variety of penalties — including financial penalties and also being excluded from the Medicare and Medicaid programs. And that's really what most facilities want to avoid. However, we — and I think Megan would agree with me — we need to have stronger enforcement from the federal government around these regulations to ensure that the penalties that are in place, facilities do pay to make sure that residents are safe.

[00:59:24] Bill Walsh: Sam Brooks, thank you so much, and thanks so much also to Drs. Céline Gounder and L.J. Tan. This has been a really informative discussion. We really appreciate all of our guests for being here and offering their insights 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 a recording of the Q&A event can be found at AARP.org/coronavirus starting Nov. 11. Go there if your question was not addressed, and you'll find the latest updates as well as information created specifically for older adults and family caregivers. We hope you learned something that can help keep you and your loved ones healthy. Please join us again Dec. 15 for another Tele-Town Hall on COVID-19. Thank you very much and have a great day. This concludes our call.

Teleasamblea de AARP: vacunas de refuerzo contra la COVID-19,

la temporada de gripe y el impacto en los hogares de ancianos

 

 

Participan:

 

Céline Gounder, M.D.: miembro sénior y editora general de Salud Pública en Kaiser Family Foundation

 

L.J. Tan, M.D.: director de Estrategia de Immunization Action Coalition

 

Sam Brooks: director de Políticas Públicas de National Consumer Voice for Quality Long-Term Care

 

Megan O'Reilly: invitada especial, vicepresidenta, AARP

 

Jesse Salinas: organizador, vicepresidente, AARP

 

Bill Walsh: moderador, vicepresidente, AARP

 

 

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

 

[En español]

 

Bill Walsh: AARP, una organización de membresía sin afiliación política y sin fines de lucro, ha estado trabajando para promover la salud y el bienestar de los adultos mayores durante más de 60 años. Ante la pandemia mundial del coronavirus, AARP brinda información y recursos para ayudar a los adultos mayores y a quienes los cuidan. Si bien la pandemia se ha declarado oficialmente terminada, aún no estamos fuera de peligro desde el punto de vista de la salud. Los nuevos casos de COVID-19 y las hospitalizaciones han aumentado ligeramente a medida que entramos en otoño e invierno, y menos personas que nunca se vacunan contra la gripe en Estados Unidos frente a lo que los expertos dicen que podría ser una temporada de gripe peor de lo normal. Mientras tanto, en nuestros hogares de ancianos, donde viven nuestros seres queridos más vulnerables, solo la mitad del personal y los residentes están al día con sus vacunas contra la COVID-19. Mientras nos preparamos para reunirnos con amigos y familiares en esta temporada navideña, hay algunos pasos de sentido común que todos podemos tomar para mantenernos saludables y protegidos, y asegurarnos de que nuestros seres queridos también lo estén.

 

Hoy, vamos a escuchar 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. Si ya han participado en alguna de nuestras teleasambleas en el pasado, 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 nos acompañan por teléfono, si desean hacer una pregunta sobre la pandemia del coronavirus, presionen *3 en el teclado de su teléfono para conectarse con un miembro del personal de AARP, quien anotará su nombre y su pregunta y lo ubicará en turno para hacer esa pregunta en vivo. Y si participan por medio de Facebook o YouTube, pueden publicar su pregunta en los comentarios.

 

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

 

Hoy nos acompañan invitados destacados, incluidos una especialista en enfermedades infecciosas y un experto en inmunización, y un defensor de los hogares de ancianos a nivel nacional. También nos acompañará mi colega de AARP, Jesse Salinas, quien ayudará a facilitar sus llamadas de hoy. Este evento está siendo grabado 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 por medio de Facebook o YouTube, dejen su pregunta en la sección de comentarios. Ahora me gustaría dar la bienvenida a nuestra invitada, La doctora Céline Gounder, es miembro sénior y editora general de Salud Pública en la Kaiser Family Foundation. La Dra. Gounder también es profesora clínica adjunta de Medicina y Enfermedades Infecciosas de la Facultad de Medicina Grossman de New York University y colaboradora médica de CBS News. Bienvenida, Dra. Gounder.

 

Céline Gounder: Me alegro de estar aquí.

 

Bill Walsh: Nos alegramos de tenerla. También nos acompaña L.J. Tan, M.D., director de Estrategia de la Immunization Action Coalition. Bienvenido de nuevo al programa, Dr. Tan.

 

L.J. Tan: Oh, muchas gracias. Feliz de estar de vuelta.

 

Bill Walsh: Muy bien. Estamos felices de tenerlo. Y también tenemos a Sam Brooks, que es el director de Políticas Públicas de la National Consumer Voice for Quality Long-Term Care. Bienvenido al programa, Sam.

 

Sam Brooks: Gracias. Feliz de estar aquí.

 

Bill Walsh: Muy bien. Y solo un recordatorio para todos nuestros oyentes, para hacer una pregunta, presionen *3 en el teclado de su teléfono o colóquenla en la sección de comentarios en Facebook o YouTube. Comencemos. Dra. Gounder, ¿Hay indicios de que veremos nuevamente un aumento repentino de COVID-19 en otoño o en invierno? ¿Qué se espera?

 

Céline Gounder: Anticipamos otro aumento de COVID-19 este invierno. En el 2020 y el 2021, vimos grandes aumentos durante el invierno, y lo maravilloso de las vacaciones de invierno es que podemos ver a familiares y amigos, pero esas reuniones entre el Día de Acción de Gracias y el Año Nuevo también han generado una gran cantidad de transmisión de COVID-19. Y además de eso, han vuelto a surgir nuevas variantes de COVID-19, lo que significa que hay menos barrera inmunitaria que bloquee la propagación del virus, incluso entre las personas que han sido vacunadas o infectadas en el pasado.

 

Bill Walsh: Dra. Gounder, déjeme preguntarle sobre la gripe. Ahora, la gripe llegó a principios de este año y ha sido más grave en esta etapa temprana de la temporada que en cualquier otro momento desde el 2009. Sin embargo, los índices de vacunación contra la gripe son más bajos que nunca. ¿Por qué es eso? Y dados los bajos índices, ¿qué tan mal podrían ponerse las cosas?

 

Céline Gounder: Desafortunadamente, creo que hemos visto que parte de la resistencia a la vacunación contra la COVID-19 y la politización de las vacunas tienen efectos indirectos en otras vacunas, incluidas las vacunas contra la gripe, y el momento aquí es realmente terrible. Vivimos la supresión de una gran cantidad de virus respiratorios en el 2020 y el 2021, cuando las personas usaban mascarillas y se distanciaban socialmente, y ahora esos virus como la gripe, el RSV, etc., están regresando con mucha vehemencia. Y además de eso, los hospitales están muy, muy llenos. Todavía estamos lidiando con la escasez de personal causada por la pandemia. Entonces, lo mejor que uno puede hacer es tratar de mantenerse fuera de la sala de emergencias, no evitando la atención médica si la necesita, sino tratando de no enfermarse vacunándose contra la gripe y vacunándose contra la COVID-19.

 

Bill Walsh: Sí. Buen consejo. Dr. Tan, usted es un experto en inmunización. Permítame preguntarle algo. Esta época del año puede ser realmente confusa, como acaba de decir la Dra. Gounder, con un aumento en todo tipo de infecciones respiratorias. ¿Hay algún síntoma claro que diferencie un resfriado de la gripe, de COVID-19? ¿Cómo saben las personas lo que podrían estar experimentando?

 

L.J. Tan: Sí, bueno, me alegro de estar de vuelta aquí, Bill. Muchas gracias otra vez. Creo que el desafío es que a medida que la COVID-19 ha seguido evolucionando, y hemos visto aparecer todas estas, lo que nos gusta llamar 'variantes de Scrabble', se ha vuelto cada vez más como un resfriado o influenza o gripe en términos de síntomas, y creo que es difícil notar la diferencia ahora. Obviamente, la gente puede hacerse la prueba y ayudar a distinguir la gripe de la COVID-19. Pero en términos de que si solo se mira a sí mismo y se siente mal, con dolor de cabeza, fiebre y escalofríos, cada vez es más difícil distinguirlos. Pero lo que puedo decir es que hay una vacuna contra la gripe, hay una vacuna contra la COVID-19, y si nos vacunamos, podemos vencer esas dos, al menos en cuanto a la gravedad de los síntomas, todo lo que ha dicho la Dra. Gounder, podemos quitarlos de la mesa, ¿verdad? Es posible que no podamos quitar el resfriado de la mesa, pero podemos quitar la gripe y la COVID-19 de la mesa.

 

Bill Walsh: Bien, bueno, sigamos con la gripe por un momento. Ha habido mucha información errónea sobre la gripe, y tal vez pueda ayudarnos a aclarar algo de eso. Quiero tomarme un momento y repasar algunas creencias comunes sobre la gripe, y tal vez solo decirnos si son verdaderas o falsas. Quiero decir, una cosa que escuchamos todo el tiempo es que la gripe no es tan grave, ¿verdadero o falso?

 

L.J. Tan: Oh, absolutamente falso. Cientos de miles de hospitalizaciones, potencialmente decenas de miles de muertes cada temporada de gripe, dependiendo, obviamente, de la cepa que esté circulando. Es falso. No es verdad.

 

Bill Walsh: Está bien. Los adultos sanos no necesitan vacunarse.

 

L.J. Tan: No es cierto en absoluto. La gripe no discrimina si tiene un trastorno de alto riesgo o si está sano, se puede contagiar. Si tiene suerte, tal vez solo de tres a cinco días sin trabajar, pero si no tiene suerte, podrían ser meses.

 

Bill Walsh: Está bien. Otra cosa que escuchamos mucho es que se puede enfermar por la vacuna contra la gripe.

 

L.J. Tan: Eso es una falsedad. No es posible contraer gripe a partir de la vacuna contra la gripe porque la vacuna contiene elementos inactivos o lo que nos gusta llamar elementos muertos del virus, por lo que no hay forma de que la vacuna le contagie la gripe.

 

Bill Walsh: Está bien, está bien. Si no se vacuna temprano, entonces no se vacune, es otra creencia que circula por ahí.

 

L.J. Tan: Otra información errónea. Definitivamente no es cierto. Y esto es muy pertinente para esta temporada, porque en realidad tenemos un comienzo temprano de la temporada de gripe. La vacuna comprende cuatro cepas diferentes del virus de la gripe, por lo que brinda protección contra más de una cepa con la que uno podría haberse enfermado. Y definitivamente, vale la pena seguir vacunándose durante la temporada de gripe, ya que continúa brindando beneficios, así como continúa brindando protección contra la hospitalización y la enfermedad durante la temporada de gripe.

 

Bill Walsh: Bien, aquí hay otra creencia común, las vacunas contra la gripe no son eficaces porque las personas aún contraen la gripe.

 

L.J. Tan: Sí, hay muchas, muchas razones por las que eso no es necesariamente cierto. Obviamente, las vacunas contra la gripe protegen contra la gripe, como ya hemos comentado. También circulan otras enfermedades que causan síntomas similares, y esas no serán protegidas por la vacuna contra la gripe. Así que es posible que lo vacunen contra la gripe y aun así se resfríe. En segundo lugar, muchas personas pueden contraer la gripe, pero lo que sucede es que, si está vacunado, lo protegerá de todos los efectos secundarios negativos de la gripe, como las hospitalizaciones y, por supuesto, la muerte.

 

Bill Walsh: Bueno, y finalmente, otra creencia común que escuchamos a menudo sobre la gripe es que los efectos secundarios de la vacuna contra la gripe son riesgosos.

 

L.J. Tan: Para nada cierto. Las vacunas contra la gripe son probablemente una de las más seguras que tenemos. Se han administrado millones, y miles de millones de dosis de vacunas contra la gripe cada temporada y durante la última década. Así que sabemos casi todo lo que necesitamos saber con respecto a la seguridad de la vacuna contra la gripe. Es una vacuna increíblemente segura.

 

Bill Walsh: ¿Y no existe una nueva vacuna contra la gripe de dosis alta para adultos mayores?

 

L.J. Tan: Sí, en realidad hay tres vacunas que ahora se recomiendan para personas mayores de 65 años. Usaré el nombre real de la vacuna, pero esto no implica mi respaldo a ninguna de estas marcas específicas, solo tengo que especificar eso. Hay algo que se llama Fluzone High-Dose, hay algo que se llama FLUAD, y luego hay algo que se llama Flublok. Esas tres vacunas han sido recomendadas para personas mayores de 65 años por los CDC, porque estimulan una mejor respuesta inmunitaria en personas mayores de 65 años. Entonces, sí.

 

Bill Walsh: Está bien. Muy bien. Gracias por eso, Dr. Tan, realmente útil. Dra. Gounder, permítame volver a usted y cambiemos nuestro enfoque a la COVID-19. La semana pasada, Pfizer dijo que la vacuna bivalente más nueva contra la COVID-19 produce cuatro veces más anticuerpos para personas mayores de 55 años que la vacuna original. ¿Qué significa esto para los adultos mayores? ¿Las vacunas más nuevas son más eficaces para prevenir infecciones?

 

Céline Gounder: Creo que debemos tener cuidado al decir que los nuevos refuerzos son mejores. Son al menos tan buenos como los anteriores, pero aún no se sabe si son realmente más eficaces para prevenir infecciones. En el panorama general, son al menos igual de buenos. Y es muy importante, especialmente si uno tiene 50 años o más, que reciba su refuerzo antes de este aumento invernal.

 

Bill Walsh: Bien, y escuchó al Dr. Tan que recomendó a las personas a que también se vacunen contra la influenza, ¿qué les dice a las personas acerca de recibir varias vacunas al mismo tiempo, Dra. Gounder?

 

Céline Gounder: Absolutamente, pueden vacunarse contra la gripe y darse la vacuna contra la COVID-19 al mismo tiempo, eso ha demostrado ser seguro. Es posible que tengan un poco más de algunas de esas fiebres leves o algo de dolor después, pero también se han realizado estudios recientemente que analizan el uso de Tylenol, ibuprofeno, ese tipo de analgésicos de venta libre y medicamentos para la fiebre, y esos se pueden usar de manera segura para reducir los efectos secundarios si uno recibe sus vacunas contra la gripe y la COVID-19.

 

Bill Walsh: Bien, gracias, Dra. Gounder. Dirijámonos a nuestros oyentes. Ahora es el momento de abordar sus preguntas sobre el coronavirus con la Dra. Gounder, el Dr. Tan y Sam Brooks. 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 este programa en español, presionen *0 en el teclado de su teléfono ahora.

 

[En español]

 

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

 

Jesse Salinas: Un placer estar aquí, Bill.

 

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

 

Jesse Salinas: Nuestra primera llamada será Shirley, de California.

 

Bill Walsh: Hola, Shirley, bienvenida a nuestro programa. Adelante con su pregunta. Hola, Shirley, siga adelante con su pregunta.

 

Shirley: Oh, bueno, tengo 81 años y recibí todas las inyecciones, la Moderna una, dos, tres, cuatro y luego recibí el refuerzo en abril de este año. Pero solo en los últimos días, he tenido un ligero dolor de cabeza, no sé de dónde viene. ¿Debería ir a recibir otra inyección?

 

Bill Walsh: Bien, Dra. Gounder, ¿puede ayudar a Shirley con eso?

 

Céline Gounder: Bueno, creo que lo primero es lo primero, si tiene síntomas, debe hacerse la prueba. Puede ir a un lugar de pruebas local o hacerse una de esas pruebas rápidas para COVID-19 en el hogar, también puede intentar ir a un centro de atención de urgencia para eso. Si tiene COVID-19, o gripe, existen tratamientos para ambos. Tiene Paxlovid para COVID-19, tiene Tamiflu para la gripe. Entonces, si tiene esas infecciones, debe recibir tratamiento. Si no lo hace, puede vacunarse ahora.

 

Bill Walsh: Dra. Gounder, Shirley mencionó que recibió un refuerzo en abril, eso fue hace bastante tiempo. ¿Debería recibir otro refuerzo en este momento, o debería esperar un poco? ¿Cuánto tiempo deberían esperar las personas antes de recibir un refuerzo?

 

Céline Gounder: Aproximadamente tres meses entre dosis o después de su infección más reciente. Pero dicho esto, si actualmente está infectada, debería esperar hasta tres, seis o tres meses después de eso. Pero creo que lo realmente importante para Shirley es, ¿está enferma de COVID-19 en este momento, está enferma de gripe en este momento? Que resuelva eso primero, y luego, una vez que lo haya hecho, absolutamente que vaya reciba ese refuerzo adicional contra la COVID-19.

 

Bill Walsh: Está bien. Gracias, Dra. Gounder. Jesse, ¿de quién es nuestra próxima llamada?

 

Jesse Salinas: La próxima llamada será Chris, de California.

 

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

 

Chris: Hola, mi hermano tiene 73 años, acaba de hacerse la prueba de COVID-19. Mi madre tiene 95 años y acaba de operarse. Entonces, lo que me gustaría saber es cuánto tiempo debemos esperar para que él venga a visitarla.

 

Bill Walsh: Pregunta interesante. Dra. Gounder, ¿puede responder?

 

Céline Gounder: Claro. Hay dos formas diferentes de abordar esto, pueden usar la prueba rápida de COVID-19 en el hogar para averiguar cuándo su hermano ya no es infeccioso. Lo que debe buscar es que dé negativo dos veces, dos veces seguidas, con al menos uno o dos días de diferencia. Si no tiene pruebas o no puede pagarlas, también podrías contar entre 10 y 14 días después del diagnóstico inicial. Lo mejor sería 14 días si puede, antes de que él pase tiempo con su madre y otras personas.

 

Bill Walsh: Muy bien. Y, Dra. Gounder, ¿el Gobierno federal sigue enviando pruebas gratuitas a las personas? ¿Esa opción todavía está disponible?

 

Céline Gounder: Las compañías de seguros, incluido Medicare, reembolsarán ocho pruebas al mes por persona. Pero desafortunadamente, no queda más dinero para comprar más de estas pruebas caseras, así que no, el Gobierno federal simplemente ya no puede enviarlas.

 

Bill Walsh: Está bien. Muy bien, Jesse, ¿quién es nuestra próxima llamada?

 

Jesse Salinas: Sí, nuestra próxima llamada será de Carl, de Nueva York.

 

Bill Walsh: Hola, Carl, bienvenido a nuestro programa. Adelante con su pregunta. Hola, Carl, bienvenido al programa. ¿Tiene una pregunta? Parece que hemos perdido a Carl.

 

Jesse Salinas: Sí, busquemos otro. Tenemos una pregunta de Facebook de alguien llamado P.D. Eczar. Si uno planea recibir visitas para el Día de Acción de Gracias, ¿con cuánta anticipación deben hacerse una prueba de COVID-19? ¿Es recomendable que pasen la noche durante su visita?

 

Bill Walsh: Dr. Tan, ¿quiere responder eso?

 

L.J. Tan: Sí, con gusto. Esta es una continuación de la respuesta de la Dra. Gounder, creo que antes de que aparezcan, deberían dar negativo con una de esas pruebas caseras a las que se puede acceder, preferiblemente de 24 a 48 horas antes de la llegada, con dos pruebas negativas. Creo que una de las cosas que deben tener en cuenta, obviamente, es si alguien tiene síntomas, ¿no? Entonces definitivamente deberían abstenerse de visitar hasta que hayan dado negativo en la prueba de COVID-19. Creo que una de las cosas más interesantes que ha sucedido a medida que avanzamos en esto es que, de hecho, decimos, si tiene síntomas, que le dé negativa la prueba de COVID-19 y luego puede continuar. Pero creo que el punto es que si uno tiene síntomas de cualquier tipo, en realidad, debería considerar retirarse de algunas de estas actividades, por el hecho de que podría estar, si no lo está ya, propagando COVID-19, podría estar propagando la gripe, RSV, ¿verdad? Así que creo que es importante difundir la idea de que, si está enfermo, se quede en casa. Y por supuesto, vacunarse. Y de esta manera, reducimos la probabilidad de que no pueda asistir a algunas de estas reuniones navideñas que todos esperamos con ansias.

 

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

 

Jesse Salinas: Sí. Nuestra próxima llamada será de Mike, en Illinois.

 

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

 

Mike: Hola, todavía tengo que conseguir... Creo que recibí las dos últimas inyecciones en el 2021 y nunca recibí el tercer refuerzo. Y ahora tienen el cuarto refuerzo. ¿Debería recibir el cuarto refuerzo directamente? Y luego mi pregunta sobre eso también sería que recibí Moderna para los dos primeros, ¿hay alguna diferencia en la eficacia entre Moderna, Pfizer o el otro, o la dosis de refuerzo más nueva?

 

Bill Walsh: Muy bien, Mike, preguntemos a los expertos. Dra. Gounder, ¿puede opinar al respecto? ¿Puede volverse demasiado tarde para conseguir un refuerzo?

 

Céline Gounder: No es demasiado tarde. No me preocuparía por contar cuántas dosis, si uno ha recibido al menos las dos primeras dosis, a esta altura, en realidad solo estamos hablando de refuerzo para la temporada, o cuando haya un nuevo refuerzo disponible. Así que definitivamente, que vaya y reciba su refuerzo actualizado ahora, y de esa manera estará protegido para las fiestas.

 

Bill Walsh: Bien, y la segunda pregunta de Mike tenía que ver con la eficacia de una frente a la otra, Moderna frente a Pfizer. ¿Se pueden mezclar y combinar? Y, ¿hay alguna diferencia en la eficacia?

 

Céline Gounder: Son bastante comparables. Moderna es una dosis ligeramente más alta que Pfizer, hay algunas pequeñas diferencias. Algunas personas también informan un poco más de efectos secundarios con Moderna, nuevamente, relacionados con esa dosis ligeramente más alta. Pero realmente no me preocuparía demasiado sobre la marca, solo cualquiera que pueda conseguir. También hay un refuerzo más nuevo que se aprobó recientemente, Nova Vax, que es una tecnología ligeramente diferente, es lo que llamamos una vacuna de proteína. Es tecnología que usamos para muchas otras vacunas, y ciertamente también es una opción.

 

Bill Walsh: Y ¿debería la gente preocuparse por mezclar y combinarlas o debería, —creo que dijo—, que deberían simplemente recibir lo que esté disponible?

 

Céline Gounder: Sí, absolutamente está bien mezclar y combinar, lo que sea que esté disponible para uno y que pueda obtener lo antes posible.

 

Bill Walsh: Está bien, muy bien. Como recordatorio para nuestros oyentes, si desean esperar su turno para hacer su pregunta en vivo, presionen *3 en cualquier momento en el teclado de su teléfono. Jesse, volvamos a las líneas. ¿A quién tenemos ahora?

 

Jesse Salinas: Vamos a traer a Joan, de Indiana.

 

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

 

Joan: Mi pregunta es: tengo una hija que tiene 53 años, nunca se ha vacunado contra la gripe, pero nunca ha tenido gripe. Y su argumento es que si nunca ha tenido gripe, entonces no debería tener que vacunarse. Y afirma que ha hablado con un médico sobre esto, y le ha dicho que mientras tome sus vitaminas y sus otros medicamentos, entonces debería estar bien. ¿Cuál es su respuesta a eso?

 

Bill Walsh: Preguntémosle al Dr. Tan sobre eso. Doctor, ¿qué les diría a Joan y a su hija?

 

L.J. Tan: Sí, creo que es un error común pensar que si uno está sano y nunca ha tenido gripe, no necesita protegerse contra la gripe. Cada temporada de gripe, Joan, es diferente. Y cada temporada de gripe en la que su hija no se vacuna, esencialmente está jugando con su salud, porque esta podría ser la temporada en la que realmente se contagie de gripe, y podría ser una gripe muy grave que se contagie y realmente hacerle daño. Así que creo que es una de esas cosas en las que siempre pregunto: "¿Por qué se arriesga todas las temporadas? Tenemos una vacuna buena, segura y eficaz. Si se vacuna, se puede garantizar que no va a tener graves consecuencias de la gripe". Y no veo por qué la gente quiere arriesgarse. Cada temporada de gripe es diferente, Joan. Y solo porque uno no se contagió la temporada pasada, no significa que no suceda esta temporada.

 

Bill Walsh: Y Dr. Tan, ¿qué se está viendo en relación con la gravedad de la gripe esta temporada?

 

L.J. Tan: Sí, esta temporada de gripe da un poco de miedo. De hecho, justo antes de esta teleasamblea, salía de una reunión con los CDC. Como ya lo señaló la Dra. Gounder, nuestros índices de hospitalización son más altos en esta temporada de gripe que en las últimas diez temporadas de gripe. Así que estamos muy preocupados por eso. Y luego, obviamente, tenemos enfermedades. La enfermedad también está aumentando en muchas partes del país más rápido de lo que hemos visto en las últimas temporadas. Así que creo que aquí hay una confluencia perfecta de enfermedades, además de que los índices de vacunación son más bajos, eso es realmente preocupante para los CDC y la gente como nosotros, como la Dra. Gounder y yo.

 

Bill Walsh: ¿Y qué tan eficaz es la vacuna contra la gripe este año?

 

L.J. Tan: No tenemos los datos en este momento para la temporada de gripe de este año, obviamente, porque todavía estamos investigando. Pero la buena noticia, de nuevo, de esta llamada que acabo de recibir de los CDC es que la cepa de la vacuna, el virus que está en la vacuna, parece coincidir en un 92 a 100% con las cepas que circulan actualmente. Así que parece que tenemos una buena vacuna este año.

 

Bill Walsh: Esa es una gran noticia. Está bien. Gracias, Dr. Tan, por eso. Tomemos otra llamada, Jesse.

 

Jesse Salinas: Sí, traeremos a Deborah, de Carolina del Norte.

 

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

 

Deborah: Hola, solo quería pedirle al panel su opinión sobre el uso de Evusheld para pacientes inmunocomprometidos que están completamente vacunados y tienen ambos refuerzos. Y es E V U S H E L D.

 

Bill Walsh: Bien, Dr. Tan, ¿puede responder eso?

 

L.J. Tan: Sabe, se lo voy a dejar a la Dra. Gounder en su experiencia como médica. Obviamente, este es el tratamiento con anticuerpos monoclonales, y creo que sabemos que hay algunos datos que sugieren que este tratamiento con anticuerpos monoclonales para COVID-19 puede ser menos eficaz contra algunas de las subvariantes que estamos viendo con ómicron. Pero, Dra. Gounder, preferiría que responda esto debido a su experiencia.

 

Céline Gounder: Sí, claro, y estoy de acuerdo con eso. Esta es una de las preocupaciones que tenemos sobre las subvariantes emergentes que se están extendiendo por todo el país en este momento. Es posible que hayan escuchado Sobre BQ11, por ejemplo, a lo que nosotros, como el Dr. Tan, nos referimos como las variantes de ‘Scrabble’, simplemente mezclamos letras que son difíciles de descifrar. Pero el problema con estas subvariantes es que muchas de ellas son resistentes a todos los monoclonales que tenemos, a todos estos tratamientos, incluido Evusheld, que se usa como medicamento preventivo para las personas inmunodeprimidas, como dijo Deborah. Por eso, es mucho más importante que las personas se vacunen porque, lamentablemente, tenemos menos herramientas en nuestro arsenal para lidiar con la COVID-19 este invierno.

 

Bill Walsh: Correcto. La gente tiene la oportunidad de prevenirlo desde el principio, porque no tenemos muchas herramientas en reserva para gestionarlo.

 

Céline Gounder: Exactamente.

 

Bill Walsh: Sí, adelante.

 

L.J. Tan: Si puedo comentar algo rápidamente.

 

Bill Walsh: Sí, por favor.

 

L.J. Tan: Porque olvidé mencionar esto cuando Joan estaba hablando de su hija. Y esto obviamente también se aplica a la COVID-19… Cuando enfaticé en la respuesta sobre protegerse y no apostar, parte de la razón para vacunarse también es no infectar a otros. Y si uno se vacuna, también puede proteger a las personas que te rodean y que aprecias. Y en esta situación, obviamente, alguien que está inmunocomprometido, si uno está vacunado contra la COVID-19, reduce el riesgo de que le transmita algo a alguien que está inmunocomprometido.

 

Bill Walsh: Sí, es un gran punto, y creo que la gente lo olvida, ¿verdad? Piensan que se trata de ellos mismos, pero también pueden ser portadores y es posible que ni siquiera lo sepan. Gran punto. Volvamos a las líneas. Jesse, ¿quién sigue?

 

Jesse Salinas: Sí, traeré a Nancy, de Ohio.

 

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

 

Nancy: Hola. Gracias por su programa. Una pregunta rápida, me preocupa el virus RSV en adultos. ¿Es peligroso para alguien de 78 años estar cerca de un bebé que tiene el virus RSV?

 

Bill Walsh: Buena pregunta. Dr. Tan, ¿quiere contestarla?

 

L.J. Tan: Sí, contestaré y luego también le pediré a la Dra. Gounder que intervenga. RSV ha aumentado y continuará aumentando en el último mes. Y creo que uno de los mayores desafíos es que tiene un impacto dramáticamente mayor en los niños pequeños, en otras palabras, con hospitalizaciones y posiblemente también índices más altos de muerte, así como en adultos de 65 años o más. Y entonces, Nancy, eso sucede. De hecho, RSV tiene un impacto más grave en los adultos mayores. Y, lamentablemente, en los adultos mayores, no tenemos otro tratamiento que no sea la atención de apoyo. En otras palabras, solo nos ocupamos de cómo se siente. Por lo tanto, nos encantaría que si está cuidando a un nieto más pequeño al que se le ha diagnosticado RSV, le instamos a que sea especialmente cautelosa y se asegure de no contraerlo. Eso podría incluir usar una mascarilla de buena calidad, asegurarse de desinfectarse las manos con frecuencia entre tocar al niño y, obviamente, si es posible, tomarse un tiempo alejado cuando el niño tenga síntomas activos, porque ahí es cuando es más infeccioso. Entiendo que es complicado, obviamente, porque es el nieto, quiere estar allí. Así que eso es un poco lo que yo aconsejaría. Dra. Gounder, ¿tiene algo más que agregar a eso?

 

Céline Gounder: Sí, lo que vemos con muchas infecciones respiratorias, ya sea la gripe, la COVID-19 o el RSV, es que puede causar la exacerbación o el empeoramiento de otras afecciones médicas crónicas subyacentes. Entonces eso podría tratarse de EPOC o enfisema, podría ser una enfermedad cardíaca, donde las personas ingresan con un ataque cardíaco. De hecho, hemos visto, a modo de ejemplo, que la vacunación contra la gripe puede protegerse de sufrir un infarto relacionado con haber tenido gripe durante el invierno. Y entones, hay muchas razones para que las personas mayores realmente intenten evitar contraer el RSV. No es solo la infección en sí, sino la forma en que puede empeorar a otras enfermedades.

 

Bill Walsh: Está bien. Gracias, tanto al Dr. Tan como a la Dra. Gounder. Y gracias a nuestros oyentes, por todas esas excelentes preguntas. Responderemos más de sus preguntas en breve, pero antes de hacerlo, vamos a recibir una actualización rápida del Capitolio. Además de compartir información y recursos, AARP aboga a nivel estatal y nacional por los problemas que más los afectan. Para brindar una actualización rápida sobre cómo AARP está luchando por ustedes, quería traer a la vicepresidenta de Asuntos Gubernamentales, Megan O'Reilly. Bienvenida, Megan.

 

Megan O’Reilly: Feliz de estar aquí, Bill.

 

Bill Walsh: Muy bien. Feliz de tenerla. Ahora quiero preguntarle sobre algunos temas importantes, pero comencemos con algunas noticias realmente buenas. En agosto pasado, una histórica reforma de medicamentos recetados aprobada por la Cámara y el Senado se convirtió en ley. ¿Puede contarnos un poco sobre lo que esto significa para las personas?

 

Megan O’Reilly: Sí, la Ley de Reforma de Precios de Medicamentos Recetados es una gran victoria para los adultos mayores del país. Después de décadas de pedirle al Congreso que haga que los medicamentos recetados sean más asequibles, AARP ganó la lucha para permitir que Medicare negocie precios de medicamentos más bajos y otras políticas que ahorrarán dinero a las personas mayores en sus medicamentos. Por ejemplo, la nueva ley limitará el costo de la insulina cubierta por Medicare a $35 por mes a partir de enero y eliminará los costos de bolsillo para la mayoría de las vacunas con Medicare, como la vacuna contra la culebrilla. A partir del 2025, habrá un límite anual de $2,000 en la cantidad que paga de su bolsillo al beneficiario de la Parte D de Medicare por sus medicamentos recetados. Y los fabricantes de medicamentos que aumenten sus precios más allá de la tasa de inflación serán penalizados. Estas son grandes victorias.

 

Bill Walsh: Bueno, esa es una noticia increíble. Gracias por eso, Megan. Ahora, además de Medicare, el Seguro Social es otra prioridad principal para AARP. Y también hay buenas noticias, ¿verdad?

 

Megan O’Reilly: Sí, el Seguro Social anunció recientemente un ajuste del costo de vida del 8.7%, el mayor aumento de COLA en 41 años. AARP ha luchado durante mucho tiempo para proteger el COLA del Seguro Social, para que las personas mayores puedan mantenerse al día con los precios en aumento. Este aumento brindará un alivio muy necesario a millones de personas en Estados Unidos que luchan con mayores costos de alimentos, atención médica y otros. También instamos al Congreso a trabajar juntos de manera bipartidista para proteger y fortalecer el Seguro Social a largo plazo.

 

Bill Walsh: Está bien, Megan. Gracias por esa actualización. Quiero tomarme un minuto para hablar sobre el estado actual de la COVID-19 en los hogares de ancianos de Estados Unidos, para quienes viven y trabajan en centros de enfermería especializada. Esta pandemia está lejos de terminar, ¿no es así?

 

Megan O’Reilly: Lamentablemente, eso es correcto. Los datos de AARP sobre la COVID-19 en los hogares de ancianos demuestran que la transmisión en los hogares de ancianos sigue siendo significativamente elevada en comparación con el resto de la población. Una de las cosas más importantes que la gente puede hacer es asegurarse de que sus seres queridos estén vacunados y hayan recibido los refuerzos recomendados. Casi la mitad de los residentes y más de la mitad del personal no están al día con sus vacunas. Esto podría tener consecuencias mortales a medida que nos acercamos a la temporada de resfriados y gripe. Este es el momento de ser un defensor de su ser querido. De comunicarse con el hogar de ancianos y preguntar sobre los índices de vacunación y los planes para mantener seguros a los residentes este otoño e invierno. Y si necesitan ayuda para saber qué preguntar, vayan a aarp.org\nursinghomes y vean nuestro artículo, 10 preguntas sobre la COVID-19 para hacer en un hogar de ancianos.

 

Bill Walsh: Bien, eso fue aarp.org\nursinghomes. Esa es una excelente historia, las 10 preguntas para hacer en un hogar de ancianos. Es realmente útil y lo estamos actualizando periódicamente. Así que echen un vistazo a eso en aarp.org. Muchas gracias por estar aquí hoy, Megan. Si nuestros oyentes quieren participar en la defensa de derechos que lleva a cabo AARP, ¿cómo pueden hacerlo?

 

Megan O’Reilly: Claro, alentamos a todos a conectarse en línea a aarp.org\getinvolved. Repito, aarp.org\getinvolved, e inscribirse para ser un activista. Recibirá alertas de acción por correo electrónico con formas fáciles de hacer que se escuche su voz, ya sea sobre COVID-19, la protección de los beneficios del Seguro Social y de Medicare que tanto costó ganar, y mucho más. Una vez más, eso es aarp.org\getinvolved. Es una manera fácil de lograr importantes cambios.

 

Bill Walsh: Muy bien. Muchas gracias, Megan, por esa actualización. Realmente aprecio que haya estado aquí hoy. Volvamos a nuestros expertos. Y como recordatorio para nuestros oyentes, en breve responderemos más de sus preguntas en vivo. Si desean hacer una pregunta, presionen *3 en el teclado de su teléfono en cualquier momento. Dra. Gounder, recientemente escribió un artículo en The Atlantic que decía que las personas y los líderes políticos carecen de la imaginación moral para resolver la crisis de COVID-19, que toleramos innecesariamente 150,000 muertes por año y que con demasiada frecuencia ignoramos a las personas mayores, a las personas de color y las personas con discapacidades. ¿Puede compartir más sobre sus preocupaciones?

 

Céline Gounder: Claro. Todavía estamos viendo entre 300 y 500 muertes por COVID-19 por día, lo que se traduce en 150,000 muertes adicionales por año en Estados Unidos por COVID-19. Y al mismo tiempo, también hemos visto que las muertes por COVID-19 afectan por edad, el 90% de las muertes por COVID-19 ahora ocurren entre personas de 65 años o más, y el 40% de las muertes por COVID-19 ahora ocurren entre personas de 85 años o más. Por lo tanto, la demografía realmente ha evolucionado hacia una mayor edad desde el verano del 2021, cuando hubo alrededor de igualdad de muertes entre personas mayores y menores de 65 años. También sabemos que las personas de color y las personas inmunocomprometidas o con discapacidades tienen un mayor riesgo de... Lo siento, [el perro]. Tienen mayor riesgo de sufrir complicaciones por COVID-19. Y, lamentablemente, la gran mayoría de la población del país cree que la pandemia ha terminado y ha dejado de tomar precauciones que evitan la transmisión. Y creo que estamos pensando demasiado acerca de lo que podemos hacer para reducir el riesgo. Entonces sí, mascarillas y vacunas, las vacunas son importantes. Pero también hay otras herramientas muy eficaces. Por ejemplo, mejorar la calidad del aire interior con ventilación y filtración de aire. Entonces, para las vacaciones, pueden obtener algunas unidades portátiles de filtración de aire HEPA para su hogar, y colocarlas en lugares donde se reúnen la familia o los amigos. Entonces, en la cocina, la sala, el comedor, por ejemplo, también deberíamos hacer mucho más uso de las pruebas y el tratamiento de COVID-19. Y nuevamente, un recordatorio de que si uno da positivo en una prueba de COVID-19, puede recibir tratamiento con Paxlovid, que es altamente eficaz para mantener a las personas fuera del hospital. Y finalmente, cuando la emergencia de salud pública llegue a su fin, es posible que algunas personas pierdan su cobertura de Medicaid. Medicaid cubre a las personas de bajos ingresos, Medicare permanecerá igual, pero algunas personas podrían perder la cobertura de Medicaid, lo que realmente puede crear dificultades para las personas que ya están luchando para sobrevivir.

 

Bill Walsh: Bueno, bueno, gracias por eso. Dra. Gounder. Hablemos un poco más sobre algunas de las herramientas que ha mencionado. Hemos hablado un poco sobre las vacunas más nuevas, me pregunto qué tan eficaces son contra las subvariantes de las que hablaron usted y el Dr. Tan. Y también las pruebas caseras de COVID-19, ¿son eficaces para detectar estas subvariantes?

 

Céline Gounder: Bueno, las pruebas de COVID-19 en el hogar todavía funcionan perfectamente bien con las nuevas subvariantes, lo mismo ocurre con Paxlovid, la píldora que se puede tomar para la COVID-19. Ambas herramientas siguen funcionando muy bien, igual de bien para las nuevas subvariantes. Es posible que las vacunas no funcionen tan bien y que los anticuerpos monoclonales no funcionen tan bien. Donde necesitamos ajustar nuestras expectativas de las vacunas, es que las vacunas nos mantendrán fuera del hospital, evitarán la muerte. Es posible que no prevengan todas las infecciones, por lo que es muy importante vacunarse, pero es posible que deseen combinar otras herramientas, como usar mascarillas, como esas unidades de filtración de aire HEPA, como pruebas y tratamiento para reducir aún más su riesgo.

 

Bill Walsh: Me gusta esa noción de capas de protección, tiene mucho sentido. Dra. Gounder, se está haciendo un gran esfuerzo para comprender qué causa y qué alivia la llamada COVID-19 prolongada. Esta semana, de hecho, los investigadores del Departamento de Asuntos de Veteranos de EE.UU. dijeron que el antiviral Paxlovid, que acaba de mencionar, reduce en una cuarta parte las probabilidades de que se produzcan ciertos problemas por COVID-19. ¿Por qué algunas personas continúan experimentando complicaciones por COVID-19 y qué tan peligrosas son?

 

Céline Gounder: Bueno, una cosa que hemos visto es que si uno tiene inmunidad, es decir, si ha sido vacunado, el riesgo de tener COVID-19 prolongada es menor que si no ha sido vacunado. No entendemos completamente qué causa la COVID-19 prolongada; sin embargo, es probable que sea un grupo de varios síndromes diferentes, cada uno de los cuales tiene un conjunto de síntomas ligeramente diferente causado de manera ligeramente diferente, pero sabemos que, nuevamente, la vacunación reducirá el riesgo y recibir tratamiento con Paxlovid, si uno ya está infectado, parece ser al menos, según los primeros datos, parece brindar protección. Por lo tanto, es otra razón más si tiene síntomas, para hacerse la prueba de COVID-19, puede recibir tratamiento y, por lo tanto, es menos probable que termine con COVID-19 prolongada.

 

Bill Walsh: Está bien, muy bien. Dr. Tan, permítame traerlo nuevamente. Estamos comenzando a ver cierres de escuelas en todo el país en respuesta a la gripe y las infecciones por RSV. ¿Qué necesitan saber los abuelos que ayudan a cuidar a sus nietos o bisnietos en edad escolar sobre el RSV y los brotes de gripe?

 

L.J. Tan: Sí, gracias, Bill. Creo que, para dar seguimiento a una parte de esta conversación de antes, es que creo que si uno está cuidando a un niño que es más pequeño en edad escolar, lo primero que debe hacer es vacunarse contra la gripe porque podemos eliminar la posibilidad de contraerla. Nuevamente, para repetir el punto de la Dra. Gounder, ya sabe, reduce el riesgo de hospitalización, reduce el riesgo de muerte, reduce el riesgo de enfermedad grave. Puede que no lo proteja por completo de infectarse, pero tiene grandes beneficios. Y entonces, vacunarse contra la gripe, quitar la posibilidad de la mesa. Ahora, como ya hemos hablado sobre el RSV, todavía no tenemos una vacuna para eso y, lamentablemente, queremos evitar infectarnos con el RSV debido a algunas de las razones que la Dra. Gounder ya mencionó, que incluyen esta idea de que exacerba o empeora algunas de las enfermedades crónicas que las personas mayores suelen tener. Cosas como, por ejemplo, una enfermedad del corazón, EPOC, que es enfermedad pulmonar obstructiva crónica, en otras palabras, enfermedad pulmonar. La diabetes, por ejemplo, es otra que sabemos que la gripe también exacerba o empeora. Por lo tanto, instamos a que en el proceso de cuidar a un niño en edad escolar que podría haber estado expuesto a un brote, tenga eso en cuenta y tome la precaución de superponer elementos de control de infecciones como mascarillas, desinfección frecuente, lavado de manos, asegurarse de que el niño se cubra la boca cuando tose para que, en lo posible, evite que se infecte. Y, por supuesto, lo que diría es que si uno puede evitar ponerse en contacto con alguien que tiene síntomas, eso es algo importante de hacer.

 

Bill Walsh: Muy bien, muchas gracias por eso, Dr. Tan. Ahora, mi colega Megan O'Reilly estaba hablando de algunas preocupaciones en los hogares de ancianos de nuestra nación, particularmente los bajos índices de vacunación allí. Y para darnos más información sobre los centros de atención a largo plazo, me gustaría traer a Sam Brooks a nuestra conversación. Sam es el director de Políticas Públicas de National Consumer Voice for Quality Long-Term Care en National Consumer Advocacy Group. Sam, bienvenido al programa. Me gustaría preguntarle, casi la mitad de los residentes de centros de atención a largo plazo no están al día con las vacunas contra la COVID-19. ¿Qué están haciendo estos establecimientos para garantizar que los residentes tengan acceso a las vacunas contra la gripe y la COVID-19 más recientes, y cómo están educando a los residentes?

 

Sam Brooks: Gracias por esa pregunta. Y primero, permítanme decir qué maravillosa llamada ha sido esta y cuán informativa ha sido. Y la estadística que mencionó es muy preocupante para nosotros. Y, desafortunadamente, no está claro qué están haciendo los establecimientos para garantizar que tanto el personal como los residentes estén al día con sus refuerzos. Vimos al principio, cuando las vacunas estuvieron disponibles por primera vez, hubo un esfuerzo total, realmente desde el Gobierno hacia abajo. Hubo clínicas de vacunas, se formaron asociaciones con varias farmacias y se observó una gran aceptación de las vacunas entre los residentes. Y, ya sabe, ocho o nueve de cada diez residentes recibieron su primer conjunto de vacunas primarias. Pero ahora no se ha visto un esfuerzo correspondiente por parte del Gobierno en lo que respecta a los refuerzos, y es muy preocupante para nosotros. Nos dicen los residentes y los defensores del pueblo de los cuidados a largo plazo, que los residentes no entienden por qué siguen necesitando vacunas. Y realmente creemos, desafortunadamente, que esperamos que la mayoría de los residentes puedan estar en una llamada como esta hoy para ver cuán importante es esto. Y sé que, ya sabe, hay 15,000 hogares de ancianos en Estados Unidos. Y a menos que hagamos un esfuerzo concertado, realmente del Gobierno federal y los Gobiernos estatales deben decir, necesitamos educar un poco sobre esto, o vamos a ver que estos números sombríos continúan. Y entrar en la temporada de gripe de otoño y COVID-19, es muy preocupante para nosotros.

 

Bill Walsh: Gracias por eso, Sam. Ahora, según los datos de octubre de los CDC, el personal de los centros de atención a largo plazo y los trabajadores de atención médica domiciliaria tienen los índices más bajos de vacunación contra la COVID-19, los índices más bajos de refuerzos contra la COVID-19 y los índices más bajos de vacunación contra la influenza entre los profesionales de la salud. ¿Por qué es esto? ¿Y a dónde acude uno si tiene inquietudes o necesita ayuda para trabajar con un centro de atención a largo plazo?

 

Sam Brooks: Sí, de nuevo, estaba mirando los datos, tres de cada cuatro miembros del personal de atención directa de hogares de ancianos no están al día con sus vacunas. El Gobierno federal, los Centros de Servicios de Medicare y Medicaid, instituyeron un mandato para que el personal sea vacunado, y se vio que nueve de cada diez empleados recibieron su primer conjunto de vacunas primarias, pero eso no sucede con los refuerzos. Y nuevamente nos preocupa que no haya un esfuerzo concertado por parte del Gobierno para decir: "Bueno, vamos a actualizar nuestra guía y exigiremos que el personal se actualice con refuerzos". Y creo que esto hace que tanto los residentes, las familias y sus seres queridos deban estar más atentos, ya sabe, al tomar decisiones sobre los hogares de ancianos. Hogares de ancianos, si van a Care Compare con Medicare en medicare.gov, pueden ver los índices de vacunación y los índices de refuerzo para cada hogar de ancianos. Pero ese es el tipo de preguntas que uno debe hacer a los establecimientos cuando piensa en su seguridad o la de un ser querido: ¿cuáles son los índices de vacunación del personal? ¿Cuáles son los planes para aumentar sus índices de vacunación para el personal y los residentes? Porque están sucediendo muchas cosas en este momento que están poniendo en riesgo a los residentes.

 

Bill Walsh: Sí, parece que realmente es hora de ser un defensor de sus seres queridos en esos establecimientos. Muchas gracias por eso, Sam. Vamos a volver con más preguntas en breve. Y ahora es el momento de abordar más preguntas de nuestros oyentes. Nuevamente, como recordatorio, presionen *3 en cualquier momento en el teclado de su teléfono para conectarse con un miembro del personal de AARP y ponerse en la fila para hacer su pregunta en vivo. Jesse, ¿a quién tenemos ahora en la línea?

 

Jesse Salinas: Bill, tenemos muchas preguntas en YouTube y Facebook e incluso en nuestra cola de personas que preguntan sobre su confusión con la cantidad de inyecciones que deberían haber recibido, o deben recibir, o tienen que recibir antes de que puedan obtener el nuevo refuerzo. Entonces, ¿pueden sus expertos hablar sobre eso?

 

Bill Walsh: Dra. Gounder, ¿puede explicarnos eso?

 

Céline Gounder: Siempre que uno haya recibido dos vacunas, no se preocupen más por contar las vacunas. Solo asegúrense de recibir el refuerzo más actualizado disponible a medida que salgan. Entonces, siempre que se hayan dado dos inyecciones, como mínimo, pueden salir y recibir los refuerzos bivalentes contra ómicron actualizados, esos nuevos que acaban de salir.

 

Bill Walsh: Está bien, muy bien. Simple. Muy bien, Jesse, ¿a quién tenemos ahora?

 

Jesse Salinas: La siguiente es Lana, en Nueva York.

 

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

 

Lana: Hola, me preguntaba si es seguro vacunarse contra la gripe si uno es alérgico a los huevos, y también si la vacuna contra la gripe contiene huevo.

 

Bill Walsh: Bien, Dr. Tan, ¿quiere responder?

 

L.J. Tan: Sí, en realidad, ha habido mucha investigación sobre esto recientemente y es absolutamente seguro. Se puede recibir la vacuna contra la gripe ahora, incluso si se tiene alergia a los huevos. Dicho esto, los CDC aconsejan que si se sabe que se tiene una alergia grave a los huevos, debe tratar de vacunarse en un lugar donde alguien pueda vigilarlo después de recibir la vacuna contra la gripe, ya sabe, simplemente por si caso. Existen varias vacunas que no tienen huevos, que se pueden considerar. Una se llama Flucelvax y la otra se llama Flublok. Y Flublok, de hecho, es la misma vacuna que se recomienda para los mayores de 65 años, no tiene componentes de huevo que sean motivo de preocupación.

 

Bill Walsh: Eso es interesante. Sé que para la vacuna contra la COVID-19, se insta a las personas a esperar 15 minutos más o menos para ver si hay una reacción alérgica. ¿Es la misma orientación para la vacuna contra la gripe?

 

L.J. Tan: Sí, lo es. Y también hacerlo en un lugar donde obviamente haya acceso a la epinefrina en caso de que haya lo que llamamos una reacción de anafilaxia.

 

Bill Walsh: Muy bien. Muchas gracias. Jesse, ¿a quién tenemos ahora?

 

Jesse Salinas: Nuestra próxima pregunta será de Bob, en Dakota del Norte.

 

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

 

Bob: Gracias. Mi pregunta tiene que ver con la vacuna contra la gripe. Recibí mi vacuna contra la gripe a principios de octubre. Sin embargo, no tenía 65 años, por lo que no recibí la dosis alta. Mi esposa está inmunocomprometida y ahora tengo 65 años. Así que me pregunto si podría recibir la vacuna de dosis alta más adelante y cuándo.

 

Bill Walsh: Bien, Dr. Tan, ¿tiene algún consejo para Bob?

 

L.J. Tan: Puedo darle el consejo oficial y luego le daré mi opinión personal. Y lo advertiré. Oficialmente, tiene su vacuna contra la gripe, por lo que no necesita otra. Mi posición personal sobre esto también es que si cumple 65 años, solo tiene que darse cuenta de que si recibe una segunda vacuna contra la gripe, no estará cubierta por el seguro, no estará cubierta por Medicare, porque solo se le permite una vacuna contra la gripe por temporada. Dicho esto, no hay problemas de seguridad respecto a recibir dos vacunas contra la gripe en la misma temporada cuando están separadas por más de cuatro semanas. Y solo soy yo hablando como experto, no es una posición respaldada por nadie.

 

Bill Walsh: Usted dijo antes, Dr. Tan, que parecía que la vacuna contra la gripe fue bastante eficaz esta temporada. ¿Eso aporta en algo ya que Bob ya recibió la vacuna contra la gripe?

 

L.J. Tan: Es la misma vacuna contra la gripe en términos de las cepas que están cubiertas en la vacuna, así que esa no es la ecuación aquí. Creo que la buena noticia es que, como dije antes, se trata de un 92 a un 100% de compatibilidad de la vacuna con la cepa que está circulando, así que eso es algo muy bueno. Sin embargo, como ya ha señalado la Dra. Gounder, no tenemos datos reales al respecto. Quiero decir, hasta que la temporada continúe progresando y veamos qué tan bien funciona la vacuna en las personas, no tenemos datos reales en términos de qué tan bien previene hospitalizaciones, enfermedades, muertes.

 

Bill Walsh: De acuerdo. Bueno. Muchas gracias por eso. Jesse, ¿a quién tenemos ahora?

 

Jesse Salinas: La próxima llamada será Dolores, en Nevada.

 

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

 

Dolores: Hola, mi pregunta es. Perdóneme.

 

Bill Walsh: ¿Sigue con nosotros, Dolores?

 

Dolores: Sí. Esperé mucho. No puedo recordar lo que era.

 

Jesse Salinas: Muy bien, continuemos, Bill.

 

Bill Walsh: Muy bien. Lo siento, Dolores.

 

Jesse Salinas: Francis, de Oklahoma.

 

Bill Walsh: Hola, Francis. Bienvenido a nuestro programa. Adelante con su pregunta.

 

Francis: Sí, solo quería preguntar sobre Tylenol y NSAID, y creo que obtuve respuesta a mi pregunta sobre eso. Pero de todos modos, tengo a mi marido en un hogar de ancianos, y son muy buenos con el poder notarial. Entonces me envían cartas, me animan para que les firme para que reciba sus vacunas. Y siempre encuentro que no tengo que preocuparme de si lo vacunan o no.

 

Bill Walsh: ¿Y le preocupa si debería firmarlos o si son adecuados para asegurarse de que reciba las vacunas?

 

Jesse Salinas: Creo que eso es correcto, Bill. Creo que la hemos perdido.

 

Bill Walsh: Bien, Sam, ¿quiere responder?

 

Sam Brooks: Claro. Cuando se trata de vacunarse anualmente, principalmente, el establecimiento debe, en primer lugar, deben ponerlas a disposición de los residentes. Y los propios residentes deberían poder tomar esas decisiones. Pero en los casos en que los residentes no puedan hacerlo, por ejemplo, debido a un deterioro cognitivo o una incapacidad para comunicarse por algún motivo, deben hablar con los tutores o seres queridos, solo para informarles sobre lo que está disponible. Y si está tomando esas decisiones por un ser querido que está en un hogar de ancianos, puede ser proactivo. Puede llamarlos y preguntarles: "Primero, ¿cuándo ofrecen refuerzos? ¿Qué refuerzos ofrecen? ¿Y qué tipo de tratamientos ofrecen para la COVID-19? ¿Debería recibirlo mi ser querido?". Entonces, a menudo, tiene que ser un poco más activo, como hablamos antes, me alegra saber que este establecimiento en particular está enviando cartas, imagino que puede ser así para algunos, pero nunca es bueno suponer que eso sucederá, especialmente si es usted quien toma esas decisiones. Pero, por supuesto, siempre queremos que esas decisiones las tomen los propios residentes cuando puedan, pero siempre es bueno tener tantas personas abogando por esa seguridad, tanto como sea posible, para las personas en hogares de ancianos.

 

Bill Walsh: Bien, muchas gracias por eso, Sam. Y, Dolores, que nos había llamado antes, creo que iba a preguntar sobre el costo de los refuerzos. Dra. Gounder, ¿los refuerzos siguen siendo gratuitos y siempre lo serán?

 

Céline Gounder: Los refuerzos siguen siendo gratuitos por ahora. El Gobierno federal ha comprado los refuerzos para esta temporada de otoño e invierno. Sin embargo, en el futuro, a menos que el Congreso decida asignar más dinero, y esa es realmente una decisión que debe tomar el Congreso, el Congreso asigna los fondos y tiene el poder del presupuesto, no el presidente. Entonces, si el Congreso decide asignar más fondos para comprar más vacunas, es posible que tengamos vacunas gratuitas en el futuro, pero eso no parece estar en las cartas en este momento.

 

Bill Walsh: Bien, muchas gracias por eso. Sam, estaba hablando de hogares de ancianos. Profundicemos un poco en eso. El mes pasado, los Centros de Servicios de Medicare y Medicaid relajaron los requisitos de vacunas para hogares de ancianos siempre que se hagan esfuerzos de buena fe para lograr el cumplimiento. ¿Qué significa esto para las personas con familias en centros de atención a largo plazo?

 

Sam Brooks: Sí, me alegro de que haya mencionado eso. Estábamos muy, a falta de un término mejor, perturbados, cuando nos enteramos de esto. Si mira los números ahora, son pésimos. Y a pesar de ello, al anuncio de que se iban a relajar las penas de aplicación de la vacuna exigida, lo calificaron de éxito. Y cuando tres de cada cuatro empleados no están al día con sus refuerzos, y donde los residentes, solo el 41 % de los residentes lo están, no lo vemos como un éxito. Y no vimos esto. Es una señal de que el Dr. Tan, creo, indicó que se está financiando una falsa sensación de seguridad para los residentes cuando estamos entrando en una temporada aquí en la que realmente necesitamos proteger a los residentes. Así que estamos preocupados por eso. Y deberíamos, por las familias y los residentes, deben hablar con los establecimientos. Quiero decir, un esfuerzo de buena fe no es suficiente. Necesitamos ver esos números elevarse. Y si uno o su ser querido está en un establecimiento que tiene bajos índices de vacunación, se puede llamar al administrador o llamar a ese establecimiento y decir: "¿Cuáles son sus planes para que su personal aumente los números?" Y tienen que proporcionarle esa información. Y otra cosa sobre esto es que, al mismo tiempo, los CDC han relajado la orientación sobre el uso de mascarillas en los entornos de atención médica. Y encontramos esto particularmente problemático en los hogares de ancianos, haciendo, diciendo, que solo deben usar mascarilla o deben usarse donde los niveles de transmisión comunitaria son altos. Y pensamos que es particularmente, y solo estoy hablando de los hogares de ancianos, que esto es muy incorrecto, un paso en la dirección equivocada. Cuando nuevamente, tres de cada cuatro empleados no están al día con sus vacunas, uno debe estar muy atento a si ese establecimiento requiere que el personal de atención médica use mascarillas, y muchos residentes nos dicen que no las usan. Así que hay un par de cosas aquí que nos preocupan mucho y que están saliendo en el momento equivocado. Y realmente, como dice, tiene que estar alerta para proteger a su ser querido.

 

Bill Walsh: Sí, bueno, déjeme profundizar un poco en eso. ¿Qué tipo de derechos tienen las familias para defender a sus seres queridos en los hogares de ancianos? Lo sé solo por programas anteriores, la gente siente que a menudo es poco transparente. Realmente no saben lo que sucede dentro de los establecimientos, depende del establecimiento y la empresa administradora, pero qué derechos tienen y si tienen aliados en el exterior a los que puedan acudir en busca de ayuda.

 

Sam Brooks: Claro, esa es una gran pregunta. Creo que tiene toda la razón. Desafortunadamente, por la forma en que opera el sistema, pueden ser dos establecimientos, una al otro lado de la calle, que pueden estar operando a niveles muy diferentes. Creo que, a menudo, los recursos más importantes para los residentes y las familias son el defensor del pueblo de atención a largo plazo. El Defensor del Pueblo de Atención a Largo Plazo es una oficina de defensores de los residentes. Y cada hogar de ancianos tiene un defensor del pueblo designado para cuidados a largo plazo, ese número debe proporcionarse y exhibirse visualmente en algún lugar del establecimiento y puede llamar y expresar su preocupación con el defensor del pueblo, quien saldrá y hablará con el residente y también actuará como abogado en nombre del residente. Y además de eso, también pueden hablar sobre los derechos que tienen los residentes, porque hay muchos derechos que se otorgan a los residentes, pero a menudo no se enteran por el centro. Y la segunda opción es presentar una queja ante la agencia estatal de encuestas o la agencia reguladora estatal. Y esta información también debe estar fácilmente disponible para los residentes. Si a uno le preocupa que su ser querido no tenga acceso a las vacunas o que un establecimiento no esté observando o practicando los procedimientos adecuados de control de infecciones, debe presentar quejas y hacer que la gente lo vea y se asegure de que los residentes estén protegidos. Entonces hay recursos. También pueden ir al sitio web, ir a theconsumervoice.org, y tenemos páginas y páginas de formas de abogar en nombre de los residentes en hogares de ancianos.

 

Bill Walsh: Bien, theconsumervoice.org. Y ese programa de Defensor del Pueblo de Atención a Largo Plazo es gratuito, ¿es correcto?

 

Sam Brooks: Oh, por supuesto. Sí, es gratis. Los números, pueden encontrar esos números si buscan en Google su estado y Defensor del pueblo de atención a largo plazo, debería aparecer. Y también pueden obtener la información en el sitio web que tenemos. Pueden hacer clic en el mapa y les dará todo tipo de números útiles. Es un servicio gratuito y confidencial que no tiene nada que ver con el establecimiento. No lo contratan los establecimientos ni los defensores, es para ustedes y principalmente para los residentes. Y animo a la gente a aprovecharlos.

 

Bill Walsh: Bueno, muy rápido, ¿cómo se responsabiliza a los hogares de ancianos si no brindan la atención adecuada?

 

Sam Brooks: Bueno, quiero decir que, principalmente, el mecanismo principal, al menos en teoría, es que los estados deben encargarse de hacer cumplir la normativa federal. Desafortunadamente, estamos viendo dificultades con eso, ahora atribuible a la pandemia, pero los establecimientos pueden enfrentar una variedad de sanciones, incluidas sanciones financieras, y también ser excluidos de los programas de Medicare y Medicaid. Y eso es realmente lo que la mayoría de los establecimientos quieren evitar. Sin embargo, y creo que Megan estaría de acuerdo conmigo, necesitamos una aplicación más estricta por parte del Gobierno federal en torno a estas regulaciones para garantizar que los establecimientos se enfrenten a las sanciones vigentes para garantizar que los residentes estén seguros.

 

Bill Walsh: Está bien. Sam Brooks, muchas gracias. Y muchas gracias también a los doctores Céline Gounder y L.J. Tan. Esta ha sido una discusión muy informativa. Realmente apreciamos a todos nuestros invitados por estar aquí y ofrecer sus ideas 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 durante más de 60 años. Ante esta crisis, brindamos información y recursos para ayudar a los adultos mayores y a quienes los cuidan a protegerse del virus y prevenir su propagación a otros mientras se cuidan a sí mismos. Todos los recursos a los que se hizo referencia hoy, incluida la grabación del evento de preguntas y respuestas, se podrán encontrar en aarp.org/coronavirus a partir de mañana, 11 de noviembre. Vayan allí si su pregunta no fue respondida y encontrarán las últimas actualizaciones, así como la información creada específicamente para adultos mayores y cuidadores familiares. Esperamos que hayan aprendido algo que pueda ayudarlos a ustedes y a sus seres queridos a mantenerse saludables. Acompáñennos nuevamente el 15 de diciembre para participar en otra teleasamblea sobre la COVID-19. Muchas gracias y que tengan un gran día. Esto concluye nuestra llamada.