COVID-19 can damage your heart, even when the virus doesn’t directly infect cardiac tissue. That’s the latest from a recent study supported by the National Institutes of Health.

Published in the journal Circulation, the study observed the damaged hearts of patients with acute respiratory distress syndrome associated with the virus and determined that COVID-19 patients suffering from severe lung infections were at risk of heart damage. The findings may prove to be relevant to organs other than the heart and to viruses other than COVID-19, as well.

COVID-19 increases a person’s risk of heart attack and stroke. In fact, more than 50% of COVID-19 patients experience some inflammation or damage to the heart, according to imaging research.

But does the virus damage the heart because it directly infects heart tissue or because of systemic inflammation? The answer might save lives.

“This was a critical question and finding the answer opens up a whole new understanding of the link between this serious lung injury and the kind of inflammation that can lead to cardiovascular complications,” Michelle Olive, Ph.D., told the NIH. “The research also suggests that suppressing the inflammation through treatments might help minimize these complications.” Olive is associate director of the Basic and Early Translational Research Program at the National Heart, Lung, and Blood Institute.

To answer the question, researchers studied mice subjected to biological signals that mimicked lung inflammation.

©2024 The Atlanta Journal-Constitution. Visit at ajc.com. Distributed by Tribune Content Agency, LLC.

Four years after hospitals in New York City overflowed with COVID-19 patients, emergency physician Sonya Stokes remains shaken by how unprepared and misguided the American health system was.

Hospital leadership instructed health workers to forgo protective N95 masks in the early months of 2020, as COVID cases mounted. “We were watching patients die,” Stokes said, “and being told we didn’t need a high level of protection from people who were not taking these risks.”

Droves of front-line workers fell sick as they tried to save lives without proper face masks and other protective measures. More than 3,600 died in the first year. “Nurses were going home to their elderly parents, transmitting COVID to their families,” Stokes recalled. “It was awful.”

Across the country, hospital leadership cited advice from the Centers for Disease Control and Prevention on the limits of airborne transmission. The agency’s early statements backed employers’ insistence that N95 masks, or respirators, were needed only during certain medical procedures conducted at extremely close distances.

Such policies were at odds with doctors’ observations, and they conflicted with advice from scientists who study airborne viral transmission. Their research suggested that people could get COVID after inhaling SARS-CoV-2 viruses suspended in teeny-tiny droplets in the air as infected patients breathed.

But this research was inconvenient at a time when N95s were in short supply and expensive.

Now, Stokes and many others worry that the CDC is repeating past mistakes as it develops a crucial set of guidelines that hospitals, nursing homes, prisons, and other facilities that provide health care will apply to control the spread of infectious diseases. The guidelines update those established nearly two decades ago. They will be used to establish protocols and procedures for years to come.

“This is the foundational document,” said Peg Seminario, an occupational health expert and a former director at the American Federation of Labor and Congress of Industrial Organizations, which represents some 12 million active and retired workers. “It becomes gospel for dealing with infectious pathogens.”

Late last year, the committee advising the CDC on the guidelines pushed forward its final draft for the agency’s consideration. Unions, aerosol scientists, and workplace safety experts warned it left room for employers to make unsafe decisions on protection against airborne infections.

“If we applied these draft guidelines at the start of this pandemic, there would have been even less protection than there is now — and it’s pretty bad now,” Seminario said.

In an unusual move in January, the CDC acknowledged the outcry and returned the controversial draft to its committee so that it could clarify points on airborne transmission. The director of the CDC’s National Institute for Occupational Safety and Health asked the group to “make sure that a draft set of recommendations cannot be misread to suggest equivalency between facemasks and NIOSH Approved respirators, which is not scientifically correct.”

The CDC also announced it would expand the range of experts informing their process. Critics had complained that most members of last year’s Healthcare Infection Control Practices Advisory Committee represent large hospital systems. And about a third of them had published editorials arguing against masks in various circumstances. For example, committee member Erica Shenoy, the infection control director at Massachusetts General Hospital, wrote in May 2020, “We know that wearing a mask outside health care facilities offers little, if any, protection from infection.”

Although critics are glad to see last year’s draft reconsidered, they remain concerned. “The CDC needs to make sure that this guidance doesn’t give employers leeway to prioritize profits over protection,” said Jane Thomason, the lead industrial hygienist at the union National Nurses United.

She’s part of a growing coalition of experts from unions, the American Public Health Association, and other organizations putting together an outside statement on elements that ought to be included in the CDC’s guidelines, such as the importance of air filtration and N95 masks.

But that input may not be taken into consideration.

A key point of contention in the draft guidance is that it recommends different approaches for airborne viruses that “spread predominantly over short distances” versus those that “spread efficiently over long distances.” In 2020, this logic allowed employers to withhold protective gear from many workers.

For example, medical assistants at a large hospital system in California, Sutter Health, weren’t given N95 masks when they accompanied patients who appeared to have COVID through clinics. After receiving a citation from California’s occupational safety and health agency, Sutter appealed by pointing to the CDC’s statements suggesting that the virus spreads mainly over short distances.

A distinction based on distance reflects a lack of scientific understanding, explained Don Milton, a University of Maryland researcher who specializes in the aerobiology of respiratory viruses. In general, people may be infected by viruses contained in someone’s saliva, snot, or sweat — within droplets too heavy to go far. But people can also inhale viruses riding on teeny-tiny, lighter droplets that travel farther through the air. What matters is which route most often infects people, the concentration of virus-laden droplets, and the consequences of getting exposed to them, Milton said. “By focusing on distance, the CDC will obscure what is known and make bad decisions.”

Front-line workers were acutely aware they were being exposed to high levels of the coronavirus in hospitals and nursing homes. Some have since filed lawsuits, alleging that employers caused illness, distress, and death by failing to provide personal protective equipment.

One class-action suit brought by staff was against Soldiers’ Home, a state-owned veterans’ center in Holyoke, Massachusetts, where at least 76 veterans died from COVID and 83 employees were sickened by the coronavirus in early 2020.

“Even at the end of March, when the Home was averaging five deaths a day, the Soldiers’ Home Defendants were still discouraging employees from wearing PPE,” according to the complaint.

It details the experiences of staff members, including a nursing assistant who said six veterans died in her arms. “She remembers that during this time in late March, she always smelled like death. When she went home, she would vomit continuously.”

Researchers have repeatedly criticized the CDC for its reluctance to address airborne transmission during the pandemic. According to a new analysis, “The CDC has only used the words ‘COVID’ and ‘airborne’ together in one tweet, in October 2020, which mentioned the potential for airborne spread.’”

It’s unclear why infection control specialists on the CDC’s committee take a less cautious position on airborne transmission than other experts, industrial hygienist Deborah Gold said. “I think these may be honest beliefs,” she suggested, “reinforced by the fact that respirators triple in price whenever they’re needed.”

Critics fear that if the final guidelines don’t clearly state a need for N95 masks, hospitals won’t adequately stockpile them, paving the way for shortages in a future health emergency. And if the document isn’t revised to emphasize ventilation and air filtration, health facilities won’t invest in upgrades.

“If the CDC doesn’t prioritize the safety of health providers, health systems will err on the side of doing less, especially in an economic downturn,” Stokes said. “The people in charge of these decisions should be the ones forced to take those risks.”

(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Evangelical minister Eddie Hyatt believes in the healing power of prayer but “also the medical approach.” So on a February evening a week before scheduled prostate surgery, he had his sore throat checked out at an emergency room near his home in Grapevine, Texas.

A doctor confirmed that Hyatt had COVID-19 and sent him to CVS with a prescription for the antiviral drug Paxlovid, the generally recommended medicine to fight COVID. Hyatt handed the pharmacist the script, but then, he said, “She kept avoiding me.”

She finally looked up from her computer and said, “It’s $1,600.”

The generally healthy 76-year-old went out to the car to consult his wife about their credit card limits. “I don’t think I’ve ever spent more than $20 on a prescription,” the astonished Hyatt recalled.

That kind of sticker shock has stunned thousands of sick Americans since late December, as Pfizer shifted to commercial sales of Paxlovid. Before then, the federal government covered the cost of the drug.

The price is one reason Paxlovid is not reaching those who need it most. And patients who qualify for free doses, which Pfizer offers under an agreement with the federal government, often don’t realize it or know how to get them.

“If you want to create a barrier to people getting a treatment, making it cost a lot is the way to do it,” said William Schaffner, a professor at Vanderbilt University School of Medicine and spokesperson for the National Foundation for Infectious Diseases.

Public and medical awareness of Paxlovid’s benefits is low, and putting people through an application process to get the drug when they’re sick is a non-starter, Schaffner said. Pfizer says it takes only five minutes online.

It’s not an easy drug to use. Doctors are wary about prescribing it because of dangerous interactions with common drugs that treat cholesterol, blood clots, and other conditions. It must be taken within five days of the first symptoms. It leaves a foul taste in the mouth. In one study, 1 in 5 patients reported “rebound” COVID symptoms a few days after finishing the medicine — though rebound can also occur without Paxlovid.

A recent JAMA Network study found that sick people 85 and older were less likely than younger Medicare patients to get COVID therapies like Paxlovid. The drug might have prevented up to 27,000 deaths in 2022 if it had been allocated based on which patients were at highest risk from COVID. Nursing home patients, who account for around 1 in 6 U.S. COVID deaths, were about two-thirds as likely as other older adults to get the drug.

Shrunken confidence in government health programs is one reason the drug isn’t reaching those who need it. In senior living facilities, “a lack of clear information and misinformation” are “causing residents and their families to be reluctant to take the necessary steps to reduce COVID risks,” said David Gifford, chief medical officer for an association representing 14,000 health care providers, many in senior care.

The anti-vaxxers spreading falsehoods about vaccines have targeted Paxlovid as well. Some call themselves anti-paxxers.

“Proactive and health-literate people get the drug. Those who are receiving information more passively have no idea whether it’s important or harmful,” said Michael Barnett, a primary care physician at Brigham and Women’s Hospital and an associate professor at Harvard, who led the JAMA Network study.

In fact, the drug is still free for those who are uninsured or enrolled in Medicare, Medicaid, or other federal health programs, including those for veterans.

That’s what rescued Hyatt, whose Department of Veterans Affairs health plan doesn’t normally cover outpatient drugs. While he searched on his phone for a solution, the pharmacist’s assistant suddenly appeared from the store. “It won’t cost you anything!” she said.

As Hyatt’s case suggests, it helps to know to ask for free Paxlovid, although federal officials say they’ve educated clinicians and pharmacists — like the one who helped Hyatt — about the program.

“There is still a heaven!” Hyatt replied. After he had been on Paxlovid for a few days his symptoms were gone and his surgery was rescheduled.

About That $1,390 List Price

Pfizer sold the U.S. government 23.7 million five-day courses of Paxlovid, produced under an FDA emergency authorization, in 2021 and 2022, at a price of around $530 each.

Under the new agreement, Pfizer commits to provide the drug for the beneficiaries of the government insurance programs. Meanwhile, Pfizer bills insurers for some portion of the $1,390 list price. Some patients say pharmacies have quoted them prices of $1,600 or more.

How exactly Pfizer arrived at that price isn’t clear. Pfizer won’t say. A Harvard study last year estimated the cost of producing generic Paxlovid at about $15 per treatment course, including manufacturing expenses, a 10% profit markup, and 27% in taxes.

Pfizer reported $12.5 billion in Paxlovid and COVID vaccine sales in 2023, after a $57 billion peak in 2022. The company’s 2024 Super Bowl ad, which cost an estimated $14 million to place, focused on Pfizer’s cancer drug pipeline, newly reinforced with its $43 billion purchase of biotech company Seagen. Unlike some other recent oft-aired Pfizer ads (“If it’s COVID, Paxlovid”), it didn’t mention COVID products.

Connecting With Patients

The other problem is getting the drug where it is needed. “We negotiated really hard with Pfizer to make sure that Paxlovid would be available to Americans the way they were accustomed to,” Department of Health and Human Services Secretary Xavier Becerra told reporters in February. “If you have private insurance, it should not cost you much money, certainly not more than $100.”

Yet in nursing homes, getting Paxlovid is particularly cumbersome, said Chad Worz, CEO of the American Society of Consultant Pharmacists, specialists who provide medicines to care homes.

If someone in long-term care tests positive for COVID, the nurse tells the physician, who orders the drug from a pharmacist, who may report back that the patient is on several drugs that interact with Paxlovid, Worz said. Figuring out which drugs to stop temporarily requires further consultations while the time for efficacious use of Paxlovid dwindles, he said.

His group tried to get the FDA to approve a shortcut similar to the standing orders that enable pharmacists to deliver anti-influenza medications when there are flu outbreaks in nursing homes, Worz said. “We were close,” he said, but “it just never came to fruition.” “The FDA is unable to comment,” spokesperson Chanapa Tantibanchachai said.

Los Angeles County requires nursing homes to offer any COVID-positive patient an antiviral, but the Centers for Medicare & Medicaid Services, which oversees nursing homes nationwide, has not issued similar guidance. “And this is a mistake,” said Karl Steinberg, chief medical officer for two nursing home chains with facilities in San Diego County, which also has no such mandate. A requirement would ensure the patient “isn’t going to fall through the cracks,” he said.

While it hasn’t ordered doctors to prescribe Paxlovid, CMS on Jan. 4 issued detailed instructions to health insurers urging swift approval of Paxlovid prescriptions, given the five-day window for the drug’s efficacy. It also “encourages” plans to make sure pharmacists know about the free Paxlovid arrangement.

Current COVID strains appear less virulent than those that circulated earlier in the pandemic, and years of vaccination and COVID infection have left fewer people at risk of grave outcomes. But risk remains, particularly among older seniors, who account for most COVID deaths, which number more than 13,500 so far this year in the U.S.

Steinberg, who sees patients in 15 residences, said he orders Paxlovid even for COVID-positive patients without symptoms. None of the 30 to 40 patients whom he prescribed the drug in the past year needed hospitalization, he said; two stopped taking it because of nausea or the foul taste, a pertinent concern in older people whose appetites already have ebbed.

Steinberg said he knew of two patients who died of COVID in his companies’ facilities this year. Neither was on Paxlovid. He can’t be sure the drug would have made a difference, but he’s not taking any chances. The benefits, he said, outweigh the risks.

Reporter Colleen DeGuzman contributed to this report.

(KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Four years after the U.S. went into lockdown, the worst of the pandemic has passed. But for people with long COVID, the illness remains a daily misery.

The new research suggests why: The virus is not always fully cleared after the initial infection, so remains deeply embedded, even though people are no longer contagious.

It is not yet known if these small viral proteins, called antigens, are causing long COVID. But, based on the new discovery, the UCSF team is conducting clinical trials of potential therapies that could attack the hidden pathogen.

“This can be a persistent infection for some people,” said Dr. Timothy Henrich, professor of medicine at UCSF who co-authored the research, presented at last week’s Conference on Retroviruses and Opportunistic Infections in Denver. “We’re concerned that this could be leading to, at least in part, some of the long COVID symptoms that people have been experiencing.”

While COVID remains much more serious than the usual seasonal flu, safe and highly effective vaccines have caused a dramatic decline in infections and deaths.

There is a desperate need for a diagnostic test and treatment for long COVID, which affects an estimated 7% of American adults. Currently, doctors are only treating the symptoms, rather than offering a cure. Experts predict that the disorder will place continuing demands on our healthcare system.

“Long COVID patients deserve swift, accurate diagnosis and timely, effective treatment,” said Jaime Seltzer, scientific director at the nonprofit MEAction, which advocates for patients with long COVID and myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS.

Is the clandestine virus constantly provoking the immune system, causing symptoms? That’s one leading theory. Another possibility is that COVID triggers an autoimmune response when the body mistakenly attacks itself. Or perhaps, long after it fends off infection, the immune system fails to turn off.

Using an ultra-sensitive test of blood from 171 people who had been infected with COVID, the UCSF scientists found pieces of the viral “spike” protein that persisted up to 14 months after infection.

Viral proteins were identified in 7% to 14% of the patients.

The likelihood of detecting the protein was about twice as high in people who had been severely ill, requiring hospitalization, than those who were not, according to the team. Detection was also higher in the blood of people who reported being very sick, but were not hospitalized.

In a second study involving tissue samples, traces of the virus were found up to two years after infection. It hid in connective tissue where immune cells are located. The work was conducted at UCSF’s Long COVID Tissue Bank, the world’s first tissue bank with samples donated by patients with long COVID.

Patients are not infectious because the virus is not living in the respiratory tract, where it could be spread by coughing or sneezing, said UCSF’s Henrich. Instead, “there seems to ‘seeding’ of deeper tissue after the initial infection, that may persist over a long period of time.”

The team is now designing studies to target the persistent virus. Hopes are pinned on a monoclonal antibody – a lab-made protein that effectively attacks viruses – and an antiviral therapy that blocks viral replication.

“There is a lot more work to be done, but I feel like we are making progress in really understanding the long-term consequences of this infection,” according to infectious disease expert Dr. Michael Peluso, who led the UCSF study.

This is worrisome because these persistent active infections may act as viral “reservoirs” that lead to new and highly genetically divergent lineages, seeding a future outbreak.

That study found that the risk of long Covid was 55% higher in people with persistent infection.

“We’re making considerable headway on understanding what drives long Covid,”  wrote Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla.

“Clearly finding effective and safe treatments is an urgent matter and not enough is being done to pursue that yet, despite a long list of potential alluring interventions based on mechanistic insights,” he said. “Hopefully that will get going now — it cannot happen soon enough.”

PHILADELPHIA — Trust in public health agencies declined during the COVID-19 pandemic, as misinformation about vaccines and the virus proliferated on social media. But did the public health agencies themselves also play a role in the decline of their credibility?

Paul Offit had a front-row seat to federal public health agencies’ pandemic response. A pediatrician and vaccine developer from the Children’s Hospital of Philadelphia, Offit is a member of the FDA’s vaccine advisory committee, which played a critical role in reviewing COVID vaccine research and advising the FDA on vaccine safety.

In his new book, “Tell Me When It’s Over: An Insider’s Guide to Deciphering Covid Myths and Navigating Our Post-Pandemic World,” Offit chronicles the first years of the pandemic, explains the science of COVID, and traces the rise of anti-vaccine movement and misinformation. He also blames those charged with protecting the nation’s health of taking action against evidence — and in doing so undermining public trust.

He says public health agencies made mistakes in key moments, such as when the FDA fast tracked in 2020 the authorization of an antimalaria drug with risk of fatal heart side effects that didn’t work against COVID. At the time, President Donald Trump called the medication a “game changer” and promoted it as a COVID treatment. The FDA revoked the authorization a few months later.

“People lost faith in the FDA,” Offit said. “People saw that you could twist the FDA’s arm.”

The Inquirer spoke to Offit about his new book, and what steps public health agencies can take to reclaim the public’s trust.

Best of times, worst of times

The pandemic saw significant scientific advancement. Scientists were able to produce a safe and effective vaccine to protect against a new virus within a year — a feat that can take more than 10 years. Offit called the vaccine “the greatest” medical achievement in his lifetime.

At the same time, more people grew suspicious of vaccines, and their mistrust continued to grow through last fall, according to surveys by the Annenberg Public Policy Center at the University of Pennsylvania. In the center’s most recent survey, 71% agreed that vaccines approved in the U.S. are safe, down from 77% in April 2021.

The way public health agencies and elected officials communicated also contributed to the public’s loss of faith, Offit said.

He criticized the response to a July 4, 2021, celebration in Provincetown, Mass. After thousands of people attended the event, nearly 350 fully vaccinated men were among those who developed COVID. Only four of those vaccinated were hospitalized, and the rest developed mild or no symptoms.

Offit saw a success: the vaccines were working.

But the Centers for Disease Control and Prevention used the term “breakthrough infection” to describe the incident, a phrasing choice that Offit said implied failure to offer protection.

Another mixed message came in August 2021: President Joe Biden promoted booster shots for American adults even though boosters had not been approved by the FDA yet.

A month later, the FDA advisory committee overwhelmingly voted against the recommendation to offer boosters to people under age 65, because there wasn’t enough evidence at the time that an extra dose would improve protection to people of all ages.

The conflicting messages added to public distrust, Offit said.

The FDA began expanding the eligibility for boosters in Nov. 2021, and currently recommends that everyone over a ge 6 months receive an extra shoot.

Neither the FDA nor the CDC responded to request for comment about Offit’s criticism. A spokesperson for the FDA shared a statement saying the agency stands by the safety and effectiveness of the COVID vaccines.

Admitting mistakes and going on offense

Rebuilding trust in public health agencies won’t be easy, Offit said. But he has some ideas for how to move forward.

Science and knowledge are always evolving, which means the best advice experts can offer may change. Public health agencies shouldn’t shy away from that fact and should do more to explain the scientific process, Offit said.

“You have to trust the American public to at least tell them the truth,” he said. “It’s OK to make your best guess and get it wrong, but say that.”

Offit also wants to see public health agencies more aggressively responding to anti-vaccination claims and other misinformation. When misinformation is spread, public health agencies should spend resources on campaigns disputing the claims with science.

People who advocate against vaccines “harm children,” he said, pointing to the recent measles outbreaks in the U.S, and he wants public health agencies to portray them as such.

“Hammer back,” Offit said.

©2024 The Philadelphia Inquirer, LLC. Visit at inquirer.com. Distributed by Tribune Content Agency, LLC.

The research, published earlier this month in Frontiers in Pediatrics, analyzed the post-hospital quality of life for children previously diagnosed with COVID-19 or multisystem inflammatory syndrome in children — a rare condition associated with COVID where body parts like the heart, lungs, kidneys, brain, skin and eyes become inflamed.

Researchers found that 30% of the families participating in the study reported that their child had not fully recovered from COVID or the syndrome also known by its initials as MIS-C.

Of the children who hadn’t recovered following their hospital discharge, the majority — 87% — had neurological symptoms, the Kennedy Krieger Institute in Baltimore said in a news release this week. About three in five children continued to struggle with headaches and just under half experienced weakness.

These numbers “speak volumes” about the lasting effects that COVID has on some children, said Dr. Beth Slomine, co-director at Kennedy Krieger’s Brain Injury Clinical Research Center and one of the study’s co-authors.

“Our findings highlight the urgent need for better monitoring systems and care strategies to address the long-term effects that the pandemic made on pediatric health,” said Slomine, who is also Kennedy Krieger’s assistant vice president of psychology.

The study included 79 children from 12 medical centers across the country and lasted from January 2020 to July 2021 during the coronavirus pandemic. It is part of a global research effort to better understand how often people hospitalized with COVID experience neurological problems once they are released.

Other important findings from the study included that of the children who had not recovered from COVID, 40% had at least one return emergency visit and 24% were readmitted to the hospital. These children also had increased signs of inflammation when they were admitted to the hospital, compared to those whose parents reported them being recovered.

“More research is needed to better understand the relationship between pandemic-related social stress and prolonged symptoms,” Slomine said in the news release.

Also in the news release, Dr. Ericka Fink — lead author of the study and a critical care pediatrician at the UPMC Children’s Hospital of Pittsburgh – said the next step for researchers is to dig deeper into understanding factors that could help predict which patients are at risk for persistent symptoms.

In the future, she said, scientists may be able to develop a screening tool to help doctors identify those children more likely to require longitudinal, multidisciplinary care.

Most children diagnosed with COVID and long COVID — a collection of ongoing, returning or new symptoms experienced after an initial COVID infection — don’t require hospitalization, according to Kennedy Krieger’s news release. However, Slomine emphasized the importance of equipping families with information about the risks associated with the illness so they can make the best decisions for their children.

“As we continue to learn about COVID-19, education and awareness remains at the forefront at Kennedy Krieger and around the world,” Dr. Slomine said. “Collaborative endeavors such as these are pivotal in guiding our research and ensuring the best care possible for children affected by the virus.”

The COVID-19 pandemic would be a wake-up call for America, advocates for the elderly predicted: incontrovertible proof that the nation wasn’t doing enough to care for vulnerable older adults.

The death toll was shocking, as were reports of chaos in nursing homes and seniors suffering from isolation, depression, untreated illness, and neglect. Around 900,000 older adults have died of COVID-19 to date, accounting for 3 of every 4 Americans who have perished in the pandemic.

But decisive actions that advocates had hoped for haven’t materialized. Today, most people — and government officials — appear to accept COVID as a part of ordinary life. Many seniors at high risk aren’t getting antiviral therapies for COVID, and most older adults in nursing homes aren’t getting updated vaccines. Efforts to strengthen care quality in nursing homes and assisted living centers have stalled amid debate over costs and the availability of staff. And only a small percentage of people are masking or taking other precautions in public despite a new wave of COVID, flu, and respiratory syncytial virus infections hospitalizing and killing seniors.

In the last week of 2023 and the first two weeks of 2024 alone, 4,810 people 65 and older lost their lives to COVID — a group that would fill more than 10 large airliners — according to data provided by the CDC. But the alarm that would attend plane crashes is notably absent. (During the same period, the flu killed an additional 1,201 seniors, and RSV killed 126.)

“It boggles my mind that there isn’t more outrage,” said Alice Bonner, 66, senior adviser for aging at the Institute for Healthcare Improvement. “I’m at the point where I want to say, ‘What the heck? Why aren’t people responding and doing more for older adults?’”

It’s a good question. Do we simply not care?

I put this big-picture question, which rarely gets asked amid debates over budgets and policies, to health care professionals, researchers, and policymakers who are older themselves and have spent many years working in the aging field. Here are some of their responses.

The pandemic made things worse. Prejudice against older adults is nothing new, but “it feels more intense, more hostile” now than previously, said Karl Pillemer, 69, a professor of psychology and gerontology at Cornell University.

“I think the pandemic helped reinforce images of older people as sick, frail, and isolated — as people who aren’t like the rest of us,” he said. “And human nature being what it is, we tend to like people who are similar to us and be less well disposed to ‘the others.’”

“A lot of us felt isolated and threatened during the pandemic. It made us sit there and think, ‘What I really care about is protecting myself, my wife, my brother, my kids, and screw everybody else,’” said W. Andrew Achenbaum, 76, the author of nine books on aging and a professor emeritus at Texas Medical Center in Houston.

Although COVID continues to circulate, disproportionately affecting older adults, “people now think the crisis is over, and we have a deep desire to return to normal,” said Edwin Walker, 67, who leads the Administration on Aging at the Department of Health and Human Services. He spoke as an individual, not a government representative.

The upshot is “we didn’t learn the lessons we should have,” and the ageism that surfaced during the pandemic hasn’t abated, he observed.

Ageism is pervasive. “Everyone loves their own parents. But as a society, we don’t value older adults or the people who care for them,” said Robert Kramer, 74, co-founder and strategic adviser at the National Investment Center for Seniors Housing & Care.

Kramer thinks boomers are reaping what they have sown. “We have chased youth and glorified youth. When you spend billions of dollars trying to stay young, look young, act young, you build in an automatic fear and prejudice of the opposite.”

Combine the fear of diminishment, decline, and death that can accompany growing older with the trauma and fear that arose during the pandemic, and “I think COVID has pushed us back in whatever progress we were making in addressing the needs of our rapidly aging society. It has further stigmatized aging,” said John Rowe, 79, professor of health policy and aging at Columbia University’s Mailman School of Public Health.

“The message to older adults is: ‘Your time has passed, give up your seat at the table, stop consuming resources, fall in line,’” said Anne Montgomery, 65, a health policy expert at the National Committee to Preserve Social Security and Medicare. She believes, however, that baby boomers can “rewrite and flip that script if we want to and if we work to change systems that embody the values of a deeply ageist society.”

Integration, not separation, is needed. The best way to overcome stigma is “to get to know the people you are stigmatizing,” said G. Allen Power, 70, a geriatrician and the chair in aging and dementia innovation at the Schlegel-University of Waterloo Research Institute for Aging in Canada. “But we separate ourselves from older people so we don’t have to think about our own aging and our own mortality.”

The solution: “We have to find ways to better integrate older adults in the community as opposed to moving them to campuses where they are apart from the rest of us,” Power said. “We need to stop seeing older people only through the lens of what services they might need and think instead of all they have to offer society.”

That point is a core precept of the National Academy of Medicine’s 2022 report Global Roadmap for Healthy Longevity. Older people are a “natural resource” who “make substantial contributions to their families and communities,” the report’s authors write in introducing their findings.

Those contributions include financial support to families, caregiving assistance, volunteering, and ongoing participation in the workforce, among other things.

“When older people thrive, all people thrive,” the report concludes.

Future generations will get their turn. That’s a message Kramer conveys in classes he teaches at the University of Southern California, Cornell, and other institutions. “You have far more at stake in changing the way we approach aging than I do,” he tells his students. “You are far more likely, statistically, to live past 100 than I am. If you don’t change society’s attitudes about aging, you will be condemned to lead the last third of your life in social, economic, and cultural irrelevance.”

As for himself and the baby boom generation, Kramer thinks it’s “too late” to effect the meaningful changes he hopes the future will bring.

“I suspect things for people in my generation could get a lot worse in the years ahead,” Pillemer said. “People are greatly underestimating what the cost of caring for the older population is going to be over the next 10 to 20 years, and I think that’s going to cause increased conflict.”

(KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Vaccines that protect against severe illness, death and lingering long COVID symptoms from a coronavirus infection were linked to small increases in neurological, blood, and heart-related conditions in the largest global vaccine safety study to date.

The rare events — identified early in the pandemic — included a higher risk of heart-related inflammation from mRNA shots made by Pfizer Inc., BioNTech SE, and Moderna Inc., and an increased risk of a type of blood clot in the brain after immunization with viral-vector vaccines such as the one developed by the University of Oxford and made by AstraZeneca Plc.

The viral-vector jabs were also tied to an increased risk of Guillain-Barre syndrome, a neurological disorder in which the immune system mistakenly attacks the peripheral nervous system.

More than 13.5 billion doses of COVID vaccines have been administered globally over the past three years, saving over 1 million lives in Europe alone. Still, a small proportion of people immunized were injured by the shots, stoking debate about their benefits versus harms.

The new research, by the Global Vaccine Data Network, was published in the journal Vaccine last week, with the data made available via interactive dashboards to show methodology and specific findings.

The research looked for 13 medical conditions that the group considered “adverse events of special interest” among 99 million vaccinated individuals in eight countries, aiming to identify higher-than-expected cases after a COVID shot. The use of aggregated data increased the possibility of identifying rare safety signals that might have been missed when looking only at smaller populations.

Myocarditis, or inflammation of the heart muscle, was consistently identified following a first, second and third dose of mRNA vaccines, the study found. The highest increase in the observed-to-expected ratio was seen after a second jab with the Moderna shot. A first and fourth dose of the same vaccine was also tied to an increase in pericarditis, or inflammation of the thin sac covering the heart.

Safety Signals

Researchers found a statistically significant increase in cases of Guillain-Barre syndrome within 42 days of an initial Oxford-developed ChAdOx1 or “Vaxzevria” shot that wasn’t observed with mRNA vaccines. Based on the background incidence of the condition, 66 cases were expected — but 190 events were observed.

ChAdOx1 was linked to a threefold increase in cerebral venous sinus thrombosis, a type of blood clot in the brain, identified in 69 events, compared with an expected 21. The small risk led to the vaccine’s withdrawal or restriction in Denmark and multiple other countries. Myocarditis was also linked to a third dose of ChAdOx1 in some, but not all, populations studied.

Seven cases of acute disseminated encephalomyelitis after vaccination with the Pfizer-BioNTech vaccine were observed, versus an expectation of two.

The adverse events of special interest were selected based on pre-established associations with immunization, what was already known about immune-related conditions and pre-clinical research. The study didn’t monitor for postural orthostatic tachycardia syndrome, or POTS, that some research has linked with COVID vaccines.

Exercise intolerance, excessive fatigue, numbness and “brain fog” were among common symptoms identified in more than 240 adults experiencing chronic post-vaccination syndrome in a separate study conducted by the Yale School of Medicine. The cause of the syndrome isn’t yet known, and it has no diagnostic tests or proven remedies.

The Yale research aims to understand the condition to relieve the suffering of those affected and improve the safety of vaccines, said Harlan Krumholz, a principal investigator of the study, and director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation.

“Both things can be true,” Krumholz said in an interview. “They can save millions of lives, and there can be a small number of people who’ve been adversely affected.”

©2024 Bloomberg L.P. Visit bloomberg.com. Distributed by Tribune Content Agency, LLC.

Researchers in Vietnam have discovered a connection between COVID-19 cases and trouble sleeping in patients.

“One third of participants reported worse sleep quality, shorter sleep duration, and harder to fall asleep, half reported more awaken nights after COVID-19 infection,” the researchers reported. “Participants with depressive … or anxiety … had significantly higher odds of developing insomnia.”

According to Marc Sala, co-director of the Comprehensive COVID Center at Northwestern Medicine, the study’s findings are largely in sync with what doctors treating COVID-19 patients have been seeing.

“So after SARS-CoV-2 infection, there’s certainly a lot of neurocognitive issues that come about,” he told NBC Chicago. “So specifically, people tend to have symptoms of what we call brain fog, or issues with memory and their attention span, and a lot of these are linked to primary neurological brain issues and ailments from whatever COVID has done to their body in terms of inflammation, or other biological patterns to it.

“And so it’s not really surprising that actually, given that your brain also manages your circadian rhythms, that people might have issues with either sleep disordered breathing on the aspect of insomnia, fractured sleep, or even sleep apnea in many individuals,” he added.

The study’s researchers concluded that even COVID-19 patients experiencing mild enough symptoms to not require hospitalization are facing a “substantial burden” of insomnia. They also said there is a significant association of depression and anxiety concerning insomnia connected to COVID-19.

To conduct the study, researchers measured the insomnia severity among 1,068 patients within the Vietnam general population. Participants were COVID-19 survivors of at least 18 years of age who had recovered from the virus within the past six months without hospitalization. Participants with prior medical histories of sleep disorders were excluded.

©2024 The Atlanta Journal-Constitution. Visit at ajc.com. Distributed by Tribune Content Agency, LLC.

In the study, which involved nearly 1,000 patients seen at the Baltimore Convention Center Field Hospital during a five-month period in 2022, researchers found that self-administered COVID tests rivaled those administered by clinicians in their ability to determine accurate positive and negative results.

Self-administered tests were 83.9% accurate in determining positive results — compared to 88.2% for clinician-administered tests — and 99.8% accurate in determining negative results, compared to 99.6%.

“We believe this is an important finding because it suggests physicians can feel confident prescribing treatment based on patient-reported, self-administered tests with positive results,” study senior author Dr. Zishan Siddiqui said in a Johns Hopkins news release on Tuesday. Siddiqui is an assistant professor of medicine at the Johns Hopkins University School of Medicine.

The study was posted online Tuesday in the American Society for Microbiology journal Microbiology Spectrum.

While polymerase chase reaction, or PCR, COVID tests are more accurate that rapid antigen tests, they must be administered by a skilled laboratory technician, require special equipment and take up to an hour or more to process.

Testing on a massive scale can only be done at a large, centralized testing facility, whereas rapid tests can be administered at home by anyone and provide results in about 15 minutes.

For the study, Johns Hopkins researchers worked with researchers at the University of Maryland School of Medicine and five other organizations. Together, they enrolled 953 participants between Feb. 12 and July 15, 2022, at the State Center complex in Midtown Baltimore.

The temporary testing site closed last year after opening in April 2020 to treat COVID patients during the pandemic and help relieve an expected surge that could overwhelm area hospitals. It also offered free COVID tests and, eventually, vaccinations.

Researchers conducted both a rapid and PCR test on study participants, and had them give themselves a rapid test and report their own results. The participant pool was 60.6% female, 58.6% white and 98.2% English-speaking, and their median age was 34, according to the Hopkins news release.

In an earlier Hopkins-led study at the Baltimore Convention Center Field Hospital, researchers demonstrated that rapid COVID tests had comparable accuracy to PCR tests.

“The first study suggested that a health care system can provide an equitable response to COVID-19, with [rapid antigen tests] making it possible to test all socioeconomic levels of a large population quickly and repeatedly,” Siddiqui said in the release.

“The new study bolsters that belief by showing comparable accuracy between self- and physician-performed [rapid antigen tests] and, therefore, helping build clinician confidence in patient-reported results from at-home tests.”

The rapid antigen test used in the study was the BinaxNOW COVID test manufactured by Abbott and supplied at no cost by the Maryland Department of Health.

Future studies “should look at an array of brands across a broader demographic spectrum so that our results can hopefully be confirmed and amplified,” said Mary Jane Vaeth, the study’s lead author, in the Hopkins news release. Vaeth was a clinical assistant at the now-closed field hospital.