Tag: LongTerm

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Health

Youngsters With Covid Get better Quick, however a Few Have Lengthy-Time period Signs

Kids With Covid Recover Fast, but a Few Have Long-Term Symptoms

Although most children with Covid-19 recover within a week, a small percentage of more than 1,700 UK children will experience long-term symptoms, according to a new study of more than 1,700 UK children. The researchers found that 4.4 percent of children have symptoms that last four weeks or more, while 1.8 percent have symptoms that last eight weeks or more.

The results suggest that what has sometimes been referred to as “long covid” is less common in children than adults. In a previous study, some of the same researchers found that 13.3 percent of adults with Covid-19 had symptoms that lasted for at least four weeks and 4.5 percent had symptoms that lasted for at least eight weeks.

“It is comforting that the number of children with long-term symptoms of Covid-19 is low,” said Dr. Emma Duncan, King’s College London endocrinologist and lead author on the study, in a statement. “Even so, some children suffer from long-term illness with Covid-19, and our study confirms the experiences of these children and their families.”

The study, published Tuesday in The Lancet Child & Adolescent Health, is based on an analysis of data collected by the smartphone app Covid Symptom Study. The paper focuses on 1,734 children between the ages of 5 and 17 who tested positive for the virus and developed symptoms between September 1 and January 24. Parents or carers reported the children’s symptoms in the app.

In most cases the illness was mild and brief. The children were sick for an average of six days and had an average of three symptoms. The most common symptoms were headache and fatigue.

But a small subset of children had persistent symptoms such as fatigue, headaches, and loss of smell. Children between the ages of 12 and 17 were sicker longer than younger children and were more likely to have symptoms that lasted for at least four weeks.

“We hope that our results will be useful and up-to-date for doctors, parents and schools who are caring for these children – and of course the children themselves,” said Dr. Duncan.

The researchers also compared children who tested positive for the coronavirus with those who reported symptoms in the app but tested negative for the virus. Children who tested negative – and possibly had other illnesses like colds or flu – recovered faster and were less likely to have persistent symptoms than those with Covid. They were sick for an average of three days, and only 0.9 percent of the children had symptoms that lasted for at least four weeks.

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New Covid research hints at long-term lack of mind tissue, Dr. Scott Gottlieb warns

U.S. potentially facing ‘perpetual infection’ of Covid, says Gottlieb

Dr. Scott Gottlieb warned on Thursday of the potential for long-term brain loss related to Covid, citing a new study from the UK.

“In short, the study suggests that there could be long-term loss of brain tissue from Covid, and that would have some long-term consequences,” said the former FDA chief and CNBC employee.

“You could compensate for that over time, so the symptoms of it may go away, but you will never get the tissue back if the virus actually destroys it,” said Gottlieb, serving on the board of Covid vaccine maker Pfizer.

The UK study looked at brain imaging before and after coronavirus infection, specifically looking at the potential effects on the nervous system.

Gottlieb told CNBC’s “The News with Shepard Smith” that the destruction of brain tissue could explain why Covid patients have lost their sense of smell.

“The decrease in the amount of cortical tissue happened by chance in regions of the brain that are near the places responsible for the odor,” he said. “What it suggests is that the odor, the loss of smell, is just an effect of a more primary process that is going on, and that process is actually the shrinking of the cortical tissue.”

Disclosure: Scott Gottlieb is a CNBC employee and a member of the board of directors of Pfizer, genetic testing startup Tempus, health technology company Aetion Inc., and biotechnology company Illumina.

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Health

Biden Takes On Sagging Security Web With Plan to Repair Lengthy-Time period Care

Biden Takes On Sagging Safety Net With Plan to Fix Long-Term Care

President Biden’s $ 400 billion proposal to improve long-term care for older adults and people with disabilities was received either as a long overdue addition to the social security net or as an example of a misguided government transgression.

Republicans ridiculed the inclusion of elderly care in an infrastructure program. Others ridiculed it as a gift to the Service Employees International Union, which aims to organize caregivers. It was also blamed for omitting childcare.

For Ai-jen Poo, co-director of Caring Across Generations, a coalition of stakeholders working to strengthen the long-term care system, this was an answer to years of hard work.

“Although I’ve been fighting for it for years,” she said, “if you’d told me 10 years ago that the President of the United States would give a speech in which $ 400 billion would be allocated to improve access to these services and to strengthen this work. ” Kraft, I didn’t think it would happen. “

What has failed the debate on the President’s proposal is that, despite the large number, its ambitions remain uniquely narrow compared to the enormous and growing demands of an aging population.

Mr Biden’s proposal, which is part of his US $ 2 trillion employment plan, is only aimed at empowering Medicaid, which pays just over half the cost of long-term care in the country. And it is aimed only at home care and outpatient care in facilities such as day care centers for adults – not at nursing homes, which make up just over 40 percent of the Medicaid care budget.

Even so, the money would be used up very quickly.

Consider an important goal: increasing caregiver wages. In 2019, the typical wage for the 3.5 million household and personal care workers was $ 12.15 an hour. They earn less as janitors and telemarketers, less as workers in food processing plants or on farms. Many – usually women of color, often immigrants – live in poverty.

The helpers are employed by care facilities that bill Medicaid for their hours worked in the beneficiaries’ homes. The agencies regularly report labor shortages, which may not be surprising given the low pay.

Increasing wages can be essential to meet booming demand. The Department of Labor estimates that these occupations will require 1.6 million additional workers over 10 years.

It won’t be cheap, however. An increase in the hourly wages of the aides to $ 20 – still below the average wage in the country – would more than consume the eight-year effort of $ 400 billion. That would leave little money for other priorities, such as meeting the demand for care – 820,000 people were on the states’ waiting lists in 2018 with an average waiting time of more than three years – or the provision of more comprehensive services.

The battle for resources is likely to strain the coalition of unions and groups that advance the interests of elderly and disabled Americans who have worked together to advocate Mr. Biden’s plan. Even before nursing homes complain that they are being left out.

The president “needs to strike the right balance between reducing the waiting list and increasing wages,” said Paul Osterman, professor at the Massachusetts Institute of Technology’s Sloan School of Management who has written about the country’s care structures. “There is tension.”

Care for the elderly has long been at the center of political struggles over social security. President Lyndon B. Johnson considered bringing the benefits of establishing Medicare in the 1960s, said Howard Gleckman, an expert in long-term care at the Urban Institute. However, House Ways and Means Committee chair Wilbur Mills cautioned how expensive this approach would be when baby boomers retired. Better, he argued, make it part of Medicaid and let states shoulder a lot of the burden.

That compromise resulted in a patchwork of services that has abandoned millions of seniors and their families and yet consumes around a third of Medicaid spending – about $ 197 billion in 2018, according to the Kaiser Family Foundation. According to Kaiser’s calculations, Medicaid pays about half of the long-term care services. Payouts and private insurance together make up just over a quarter of the tab. (Other sources, like veteran programs, cover the rest.)

Unlike institutional care, which requires government Medicaid programs, home and community care services are optional. That explains the waiting lists. This also means that the quality of the services and the rules for using the services are very different.

Although the federal government pays at least half of the state’s Medicaid budgets, the states have plenty of leeway in how the program runs. In Pennsylvania, Medicaid pays an average of $ 50,300 per year per recipient of home or outpatient care. In New York it pays $ 65,600. In contrast, Medicaid pays $ 15,500 per recipient in Mississippi and $ 21,300 in Iowa.

This regulation has also left the middle class in the lurch. The private insurance market is shrinking and can no longer handle the high cost of end-of-life care: it’s too expensive for most Americans and too risky for most insurers.

As a result, middle-class Americans in need of long-term care either resort to relatives – usually daughters who throw millions of women out of work – or use up their resources until they qualify for Medicaid.

Regardless of the boundaries of the Biden proposal, proponents of its main constituencies – those in need of care and those who provide it – stand firm behind it. After all, this would be the largest expansion in long-term care support since the 1960s.

“The two big issues of waiting lists and labor are related,” said Nicole Jorwic, senior director of public policy at Arc, which promotes the interests of people with disabilities. “We are confident that we can do this in such a way that we can overcome the conflicts that have stopped progress in the past.”

And yet the dispute over resources could reopen the conflicts of the past. For example, when President Barack Obama proposed extending the Fair Labor Standards Act of 1938 to include domestic carers, who would cover them with minimum wage and overtime rules, attorneys for beneficiaries and their families opposed fearing that states with budgetary pressure would cut off -Service around 40 hours a week.

“We have a long way to go to get this into law and get it done,” said Haeyoung Yoon, senior policy director of the National Domestic Workers Alliance, of the Biden proposal. On the way, she said, the supporters have to stick together.

Given the scale of the need, some wonder if there could be a better approach to supporting long-term care than spending more money on Medicaid. The program is constantly being asked for resources that are forced to compete with education and other priorities in state budgets. And Republicans have repeatedly tried to narrow their scope.

“It’s hard to imagine that Medicaid is the right funding tool,” said Robert Espinoza, vice president of policy at PHI, a nonprofit research group that monitors the home care sector.

Some experts have instead proposed the creation of a new line of social insurance, possibly financed by payroll taxes, to provide a minimum of services to all.

A few years ago, the Long-Term Care Financing Collaborative, a group that was formed to ponder how to pay for long-term care for the elderly, reported that half of adults typically have “high levels of personal support at some point “Would need for two years at an average cost of $ 140,000. Today around six million people require these types of services, a number the group expects to grow to 16 million in less than 50 years.

In 2019, the National Social Insurance Academy published a report proposing nationwide insurance programs paid by a special tax to cover a range of services from early childhood care to family vacations to long-term care and support for older adults and the disabled.

This can be structured in a number of ways. One option for seniors, a disaster insurance plan that covers expenses up to $ 110 per day (in 2014, after a waiting period determined by the beneficiary’s income) could be funded by a one percentage point increase in Medicare tax.

Mr. Biden’s plan is not very detailed. Mr Gleckman of the Urban Institute notes that it has become vague since Mr Biden suggested it on the campaign – perhaps because he realized the tensions that would arise from it. In either case, a major overhaul of the system may be required.

“This is a significant historic investment,” said Espinoza. “But when you consider the extent of the crisis ahead of us, it is clear that this is only a first step.”

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Frustrations Boil at Tempo of Vaccinations at Lengthy-Time period Care Amenities

Frustrations Boil at Pace of Vaccinations at Long-Term Care Facilities

In mid-December, a top Trump administration official floated an enticing possibility: All nursing home residents in the United States could be vaccinated against the coronavirus by Christmas. “It’s really a remarkable, remarkable prospect,” Alex M. Azar II, the secretary of health and human services, declared.

It turned out to be a fantasy.

A month later, vaccinations of some of the country’s most vulnerable citizens are going more slowly than many state officials, industry executives and families expected. Their hopes had been buoyed when government officials said long-term care facilities would be at the front of the line for vaccines.

CVS and Walgreens, which are largely responsible for vaccinating residents and workers in long-term care facilities, are on track to make at least initial vaccination visits to nearly all nursing homes they are working with by Jan. 25. The two pharmacy chains have already given out more than 1.7 million vaccine doses at long-term care facilities.

But the progress is uneven across the country and not nearly as comprehensive for different types of long-term care. For example, thousands of assisted living facilities — for older people who need less care than those in nursing homes — do not yet even have an appointment for their first visit from the pharmacy teams, in large part because states have given such facilities lower priority in their vaccine-distribution plans.

“I’ve had facilities call me, and I’ve had people cry, I’ve had people curse, because this was the first sign of hope that they’ve had in many, many months,” said Betsy Johnson, who leads a group that represents Kentucky’s nursing homes and assisted living facilities.

“It’s just human nature to think, ‘OK, but I was supposed to be first — and I don’t even know when my clinic is going to happen,’” Ms. Johnson said.

In Pennsylvania, teams from CVS or Walgreens are not scheduled to visit some nursing homes until February, and the vast majority of the state’s assisted living facilities have not yet been scheduled for a first visit, said Zach Shamberg, president of the Pennsylvania Health Care Association.

“There’s a great deal of frustration, there’s a great deal of apprehension, as to when or if this vaccine will come,” Mr. Shamberg said.

The pace of the vaccination program has taken on greater urgency as the rapidly spreading virus continues to decimate nursing homes and similar facilities. The virus’s surge since November has killed about 30,000 long-term care staff and residents, raising the total of virus-related deaths in these facilities to at least 136,000, according to a New York Times tracker. Since the pandemic began, long-term care facilities have accounted for just 5 percent of coronavirus cases but 36 percent of virus-related deaths.

Even as the vaccination campaign accelerates, the suffering is unlikely to wane. The coming months could be “the deadliest of the pandemic” for people living and working in long-term care, according to an analysis released on Thursday by the Kaiser Family Foundation.

The Trump administration announced in October that it had teamed up with CVS and Walgreens to lead a federal effort to vaccinate residents and workers at long-term care facilities, among the first eligible groups.

On Friday, CVS said it had given out just over one million doses in more than 12,000 initial visits to long-term care facilities. Nearly 8,000 visits are scheduled for the coming week. Walgreens said it had given out nearly 750,000 doses in nearly 9,000 visits to facilities, mostly nursing homes. The number of visits that Walgreens has scheduled with assisted living facilities “continues to accelerate,” a company spokeswoman, Rebekah Pajak, said.

The vaccinations by CVS and Walgreens were always expected to take several months because of the need to visit tens of thousands of facilities three times. The first two visits are for most residents and staff to get the two doses of the vaccine, with the third visit as a backup for people who missed the first clinic.

Covid-19 Vaccines ›

Answers to Your Vaccine Questions

If I live in the U.S., when can I get the vaccine?

While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.

When can I return to normal life after being vaccinated?

Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.

If I’ve been vaccinated, do I still need to wear a mask?

Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.

Will it hurt? What are the side effects?

The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.

Will mRNA vaccines change my genes?

No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

The idea that all nursing home residents could get their first doses by Christmas was not a realistic prospect even when Mr. Azar, the health secretary, floated it 12 days before the holiday. By that point, some states had told the Centers for Disease Control and Prevention that they would not activate the federal program to vaccinate their nursing homes until Dec. 28. The logistics would have been challenging even if states had put a priority on getting their first doses to nursing homes.

Michael Pratt, a spokesman for the Health and Human Services Department, said Mr. Azar had been speaking only aspirationally about what states were capable of doing, since they had enough vaccine doses to cover all nursing home residents by Christmas. But that would have required that states place less of a priority on vaccinating high-risk groups like heath care workers.

T.J. Crawford, a spokesman for CVS, said the chain was making first visits to all facilities within four weeks of each state’s activating its vaccination program for nursing homes or assisted living facilities.

“This isn’t a drive-through or stadium vaccination effort,” Mr. Crawford said. “We’re visiting more than 40,000 facilities with an average of less than 100 residents, in some cases going room to room.” He said CVS was “on track and delivering on goals established and communicated early in the process.”

But a growing number of governors and state health officials have voiced frustration with CVS’s and Walgreens’ speed.

In Mississippi, some long-term facilities won’t get their first visit until Feb. 11, the state health officer, Dr. Thomas Dobbs, said this month. “We’re clearly disappointed with the progress in the long-term care program,” he said.

Some states and cities are exploring ways to hasten the inoculations.

Seattle is using its Fire Department to vaccinate nearly 1,000 residents and staff at adult family homes, a type of long-term care, by the end of January. Florida hired an emergency services company, CDR Maguire, to give out doses at 1,900 assisted living facilities that had not been scheduled for visits by CVS and Walgreens teams before Jan. 24.

In Michigan, officials have asked the federal government to let them work with other pharmacies, such as the supermarket chains Meijer and Kroger, to speed up the vaccination effort in long-term care facilities, said Bobby Leddy, a spokesman for Gov. Gretchen Whitmer.

West Virginia is the only state that has not activated the federal program involving CVS and Walgreens, though Walgreens is separately working with West Virginia to vaccinate 32 of its long-term care facilities. Relying mostly on local independent pharmacies, the state said on Dec. 30 that it had wrapped up the first round at its 214 long-term care facilities.

Some of the initially feared problems that could slow down the vaccine rollout in nursing homes have not emerged as serious obstacles, at least so far, according to facility operators and industry researchers.

Despite widespread worries that the vaccines’ side effects — which can include fevers, chills and fatigue — would cause staff to miss work and residents to need more care, that has not happened to any significant degree. And while there was early confusion about how nursing homes should get consent from residents or their families, that process has largely gone smoothly.

But other things are slowing the campaign. A significant number of long-term care workers have balked at receiving the vaccine. The virus’s spread is also delaying the process. People should not be vaccinated while they still have Covid-19 symptoms or are isolating, according to the C.D.C.

Outbreaks and cases of Covid-19 in some long-term care communities have led Walgreens to delay scheduling initial visits or to reschedule them, said Rick Gates, an executive leading the company’s long-term care vaccinations.

CVS has encountered the same issue, though it has not been widespread. The company has left the decision about whether to proceed with visits in such cases to local clinic team leaders and officials at the facilities, Mr. Crawford said.

Another factor is that some states did not quickly activate their programs to vaccinate people at assisted living facilities and similar communities. In some cases, they waited until weeks after they began vaccinations at nursing homes.

But many long-term care facilities include both nursing homes and assisted living. In those cases, pharmacy teams have been able to vaccinate only a subset of residents.

In Prairie du Chien, Wis., for example, a team from Walgreens on Thursday made its first visit to the local nursing home, Prairie Maison, to inject nearly all of its roughly 50 residents with the Moderna vaccine.

But Prairie Maison is part of a larger senior community, which includes about 50 assisted living residents. Because Wisconsin did not activate its vaccination program for assisted living until Friday, those residents weren’t offered the vaccine — even though they are in the same building as the nursing home residents.

“Vaccinating one group and not the other doesn’t make a lot of sense,” said Dr. Mark Grunwald, the chairman of Prairie Maison’s board.

Abby Goodnough contributed reporting.