AARP Coronavirus Tele-Town Halls

Coronavirus TTH – 12-15-22

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 has been providing information and resources to help older adults as well as those caring for them. While COVID cases and deaths are nowhere near what they were a year ago, both have been trending upward as winter approaches and 2022 comes to a close. As families gather for the holidays, we face an unusual triple threat of respiratory illnesses with the spread of flu, RSV and COVID resulting in a scarcity of hospital beds around the country. If you're wondering how best to stay safe and healthy during the holiday season, or to cut through the online misinformation, you're in luck. Today we're talking to the U.S. surgeon general[CL(1] , and he'll be taking your questions. We'll also get a timely update from Capitol Hill on legislation affecting older Americans as Congress prepares to recess for the year.

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, press *3 on your telephone to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. If you're joining on Facebook or YouTube, you can post your question in the comments.

Hello, if you're just joining, I'm Bill Walsh with AARP, and I want to welcome you to this important discussion about the changing COVID landscape, vaccines and the epidemic of health misinformation. We're talking with the U.S. surgeon general today and taking your questions live. To ask your question, please press *3 on your telephone keypad, and if you're joining on Facebook or YouTube, you can drop your question into the comments section. 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 that recording at aarp.org/coronavirus 24 hours after we wrap up. Again, to ask your question, please press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you're joining us on Facebook or YouTube, place your question into the comments.

Now I'd like to welcome our guests. Vice Admiral Vivek H. Murthy is the U.S. surgeon general, M.D. and MBA. Dr. Murthy is the 19th and 21st surgeon general of the United States. His mission as the nation's doctor is to restore trust by relying on the best scientific information available, providing clear, consistent guidance and resources for the public, and ensuring that we reach our most vulnerable communities. Welcome back to our program, Dr. Murthy.

Vivek Murthy: Well, thank you so much for having me back.

Bill Walsh: All right, we're delighted to have you. And a little bit later in the program, we'll be joined by Alex Mahadevan from MediaWise to discuss misinformation. Just a reminder, to ask your question, please press *3 on your telephone keypad or drop it into the comments section on Facebook or YouTube.

Thank you again for returning to the program, Dr. Murthy. We really appreciate your time. Let's get right to the questions. COVID just does not seem to want to go away. What can you tell us about the recent COVID-19 variants, and are they more severe or transmissible than what we've seen in the past?

Vivek Murthy: Well, thanks for asking, and we certainly have been through quite a lot these last almost three years dealing with COVID-19, and it's gone through many phases. But the good news is that overall we are in a much different and better place than we were in March of 2000, or 2020 rather, when much of this started in the United States. And so that is good news. And it didn't happen by accident. It happened because scientists around the world, because government, because organizations and communities and so many people on this call took it upon themselves to get the facts and figure out what was going to help them to prevent infection and protect against the worst outcomes of COVID, against COVID. And that included by taking vaccines. And so we had the vast majority of seniors in our country began the vaccination process the last couple years, and I think that's why, according to a recent Commonwealth Fund survey, we have likely saved around 3 million lives in the United States because of the vaccinations alone. So, that is very good news. But the viruses constantly change, and they mutate over time, and we've certainly seen that with COVID as well. Now, sometimes these new mutations will cause variants of the virus that are consequential. They may be more transmissible, in particular, and we've certainly seen that. When the omicron variant hit around this time last year, that's what we saw: a variant that was much more transmissible and even evaded some of our immune defenses compared to prior variants. Right now we know that the virus is continuing to evolve, and there are a couple of variants in particular called BQ.1 and BQ.1.1. You don’t have to remember those, so don’t worry about that, but those two are the dominant variants right now. What's less important than remembering the actual variant is just to remember this: That with all of the experience we have over the last couple of years, it's taught us that regardless of the variant that's come our way, that when people are up to date with their vaccines, their likelihood of ending up seriously ill because of COVID is dramatically lower. And that up-to-date part matters because right now there are a lot of people who got their original two shots, what we call the primary series, but they may not have gotten their booster or they got their booster a really long time ago, and they may not be up to date. And we have seen that that makes a difference. If you just got your first two shots but you haven't gotten your updated COVID vaccine, then you don't do as well as people who went ahead and did get that updated vaccine. And so what I want to make sure I share with everyone here is that there is an updated vaccine available. It is something that for most people right now is free. It is easy to get. You can just go to vaccines.gov to find a location around you where you can get that updated shot, and this is really important because when we look at who’s being hospitalized right now for COVID, predominantly people who are older. And when we look at who is dying from COVID, it’s predominantly people who are 7 years of age and up. But when we look at the people who are in that category, they include very few people who are actually up to date with their vaccines, and even fewer who have reached for medications like Paxlovid when they've gotten ill. So, again, bottom line is be up to date with your vaccines, reach for medicine like Paxlovid if you get seriously ill, and that means talk to your doctor about it. Go to covid.gov to find locations where you can get Paxlovid, and that should save you from the worst outcomes of this virus.

Bill Walsh: OK. Now, of course, travel and family gatherings are going to be increasing over the next couple of weeks with more close contact, family meals, time indoors around the holidays, etc. If someone hasn't received an updated flu or COVID vaccine, is it too late?

Vivek Murthy: It's never too late. Even if you've gotten vaccinated or boosted, even if you've gotten sick with COVID earlier in the year, getting this updated vaccine as soon as you can will put you in the best position to be in good shape ahead of the holidays. In addition to COVID-19, we know that there is also flu that's circulating. In fact, there is a lot of flu out there right now, some of the highest levels that we've seen in a long time, and that's why I would also advise people, whether you're traveling or not, to go ahead and get your flu shot as well. You can get the COVID-19 shot and the flu shot at the same time. In fact, that's what I did, and that's what my wife did as well. So, that can save you some time and give you protection. But in addition to the vaccine, I also just want to remind people that if you do get your vaccines but you end up having what's called a breakthrough case of COVID, it’s good to know that there are medications available that can help you, like Paxlovid, and we want people to be able to reach for those because those further reduce your chances of ending up in the hospital and dying. And finally, remember this: There are some behavioral modifications we can make, some steps we can take to also reduce the chances that we may get sick in the first place. So, for example, if you are getting together with other people and you are sick, staying home is a good idea, but also avoiding contact with people who may be sick themselves is also helpful because we know that through contact you can actually more easily transmit the virus. We also know that wearing masks in crowded public places can also be a good way to help protect yourself, not just against COVID-19, but against the spread of flu and other viruses that are circulating. And finally, testing. We know that testing can be an important strategy to help reduce the chances that a gathering may end up being a super-spreader event. So, if you're going to get together with family, and especially if you're at higher risk or somebody in your family's at higher risk, testing before you gather is a good strategy as well. And just today — in fact this week, rather — the administration announced that they are reopening the program where they are delivering free tests to your house. So, you can go again to covid.gov and you can request for up to four tests to be delivered to you free of charge. And again, that's one more strategy you can take to make sure that you enjoy the holidays safely.

Bill Walsh: Well, that's great to hear. I know some people were concerned that there were no more free tests, and those tests aren’t cheap to buy. So, it's great to hear that the administration's going to be providing additional ones. Do you know how long that is going to last?

Vivek Murthy: Well, we're hoping to run it as long as we can, but I would urge people to go as quickly as possible to the site and get it. I should also remind people that in addition to getting the free tests from the government directly to your home, you are also eligible to get eight tests per month covered by your insurance. And that's important for you to know about because it's another strategy to which you can get tests free of charge.

Bill Walsh: Great, thanks so much for that information. Let's go to the phones now. It's now time to address our listener questions about COVID and vaccines with U.S. Surgeon General Dr. Vivek Murthy. As a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member and share your question. And if you'd like to listen in Spanish, press *0 on your telephone keypad now.

(instructions in Spanish)

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

Jesse Salinas: So good to be here today, Bill.

Bill Walsh: All right. Who do we have up first?

Jesse Salinas: We're going to start with Sylvia in Illinois.

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

Sylvia: Yes, hi. Thank you. I have a bit of a confusion about boosters, so I just want to let you know that I've had my first two doses in 2021. That was fine. Then I believe I had a booster in October of 2021, then a second booster in August of 2022. So, am I now due for another booster?

Bill Walsh: OK.

Sylvia: For that variant?

Bill Walsh: Right, the new one. Let's ask Dr. Murthy. Dr. Murthy, can you address Sylvia's question? This comes up a lot. I think there's just a little bit of confusion out there about how much people need.

Vivek Murthy: Well, I am so glad you asked that question, Sylvia. Thank you for that. And I could understand with all the information out there that gets updated, sometimes it can get pretty confusing. So, here's what you need to know. With the updated vaccine that's now available for COVID, you are eligible to get it if you are more than two months out from your last shot, and if you're more than three months out from your most recent COVID infection. So, in your case, if you got your last shot in August of 2022, that would be more than two months ago. And so this would be the right time for you to get your updated COVID shot. And I'm presuming, because this new updated shot was not available in August of this year, you likely had the original vaccine booster that was made available earlier in 2022. So, this would be the right time for you to get your updated shot.

Bill Walsh: OK, very good. Thanks so much, Doctor. Jesse, let's take the next question.

Jesse Salinas: I think this one's similar, but I'm going to bring it anyway. It's Brenda from Pennsylvania.

Bill Walsh: Hey, Brenda. Welcome to our program. Go ahead with your question for the surgeon general.

Brenda: Yes, I'm 80 years old now, and I had my booster; the last one I had was November. I had the flu shot; I had the one in November. Now, after that the most recent booster, right?

Bill Walsh: I heard you say you had your booster in November, and I think the question was, do you need to get the new vaccine?

Jesse Salinas: That's what it sounded like, Bill.

Bill Walsh: Yeah. Doctor, can you address that?

Vivek Murthy: Yes. So, Brenda, if you had your most recent COVID shot in November, that was likely the updated COVID shot. So, you are all set in terms of COVID shots. You do not need another one right now.

Bill Walsh: OK. Well, let me ask about that. How long of … what kind of protection does that new shot offer to people? Are they good for a year, six months?

Vivek Murthy: Well, a really good question. So, here's what we know. We know that the updated shot will likely initially protect you pretty well against getting COVID at all, but then that protection against mild infections may wane over time, over several months. But what seems to have stayed for a much longer period of time, for around the order of six months or more, is the protection against serious illness. And that's what we want to prevent. The most important job of the vaccine is to keep us out of the hospital and to save our life. And it seems, based on the studies that — experience we've had with the earlier versions of vaccine, that that protection does typically last on the order of six months or so. And what we're anticipating going forward is that for most people, they will likely need an annual COVID shot, just like you get an annual flu vaccine. For some people at higher risk, including those who are older, you may require more than one shot a year, more likely two shots a year. So, that is what we're anticipating right now. But if you got your COVID shot in November like Brenda did, then you should be good for a while.

Bill Walsh: OK, thanks so much for that. Jesse, let's take another call.

Jesse Salinas: Our next caller is going to be Maryanne. I can't tell where she's from, but Maryanne.

Bill Walsh: Hey, Maryanne. Welcome to our program. Go ahead with your question for the surgeon general.

Maryanne: Yes. I'd like to know if there are statistics that say which manufacturer of the vaccine has low and high tolerance for second, let's say getting the COVID or whatever.

Bill Walsh: Hmm, Doctor, are there any? We've done so much study of these vaccines. What is it telling us about the ones made by the various companies, the effectiveness?

Vivek Murthy: Yeah, it's a very good question. I mean, the two major companies that most people have been utilizing for their vaccines are Moderna and Pfizer. And I would say that the protection is comparable between the two of them. They are different dosages, and so some people find that they may have slightly greater incidence of fever or arm soreness potentially with the vaccine that has a higher dose, that's the Moderna vaccine, but on the whole they're both quite effective. So, what I would say is that if you go out to get a shot and only one of them is available, I would rather get one of those rather than waiting to go somewhere else and another day try to get the other shot. Because, again, both give you very strong protection against the worst outcomes of COVID, which are hospitalization and death.

Bill Walsh: OK. Thanks so much, Doctor. Let's go back to our phone lines. Jesse, who's up next?

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

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

Alicia: Hi, I'm Alicia from North Carolina. I have a grandson who has not been vaccinated, not for COVID or flu, fully vaccinated flu, COVID and booster. What can I do to protect myself if I want to spend time with him during the holiday?

Bill Walsh: Oh, that's a great question. Dr. Murthy, can you offer any guidance on that?

Vivek Murthy: Well, I'm so glad you asked that question because a lot of us may have family members who have made different decisions around getting vaccines and different decisions around taking precautions, as well, against infection, and that can be tricky when it comes time for the holiday. But if you think that there are people who will be gathering around you who may not have protection, may bring the virus in, there are a couple of steps that you can take. One is you can ask your grandson to test before he comes to see you. That's pretty quick. It's easy. As I mentioned now, there are free ways to get tests either through your insurance covering them to eight tests a month, or directly ordering them from the government and having them delivered to your home for free through covid.gov. So, I would ask your grandson to test before you got together with him. I would also suggest that you wear masks whenever possible when you're indoors together because that can also be helpful if wearing a high-quality mask can help to reduce the spread of COVID, if indeed he ends up being infected. So, these are two strategies that may help. And the third I'd mention is just to ask him if he's feeling OK before he comes over, and if he's having any symptoms like a runny nose, a fever, a sore throat, congestion, then he should really consider staying back because sometimes it takes a day or two from when you have COVID to get infected with it, to when your test actually turns positive. And so if someone's having symptoms, it's a good idea for them to avoid exposing you, because that could put you at risk.

Bill Walsh: OK. Thanks very much. Jesse, who's up next?

Jesse Salinas: The next question is going to be Barbara from California.

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

Barbara: I'm wondering — there's expiration dates on these tests. I've never heard anybody talk about them, but they're definitely on there. Should we be throwing these tests away after the expiration date and ordering more?

Bill Walsh: Hmm. Dr. Murthy?

Vivek Murthy: Oh, Barbara, that's a great question. I would say that if your tests have expired, then yes, I would go ahead and order some new ones again, either online or you can, as I mentioned, covid.gov or through buying it on retail and having your insurance cover it, which they should cover up to eight tests per month. So, that is what I would do. There have been some certain circumstances, Barbara, with some manufacturers where they have extended the expiration date, but again, if you're not sure about that, I would go with the marking that you see on the box.

Bill Walsh: OK. Thanks so much for that, and thank you for all those questions. We're going to be taking more of your questions soon and continue our discussion with Surgeon General Dr. Vivek Murthy. But right now, let's get an update from Capitol Hill. In addition to sharing trustworthy information, AARP advocates for issues that affect you the most. To give a quick update on how AARP is fighting for you, I want to bring in AARP Government Affairs Vice President Megan O'Reilly. Welcome, Megan.

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

Bill Walsh: All right. Well, now, we're coming to the end of 2022. It was a big year on the advocacy front, and AARP led many successful fights to help older Americans stay healthier and financially secure. What were you most excited about?

Megan O'Reilly: The biggest victory is really the historic prescription drug reform that was signed into law in August. 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, beginning in January, just next month, the new law caps out-of-pocket costs of Medicare-covered insulin at just $35 a month, and it eliminates out-of-pocket costs for most recommended vaccines under Medicare, such as shingles vaccines. More benefits are on the horizon. In 2025, there will also be a limit on how much seniors with Medicare Part B have to pay out of pocket for their prescriptions. This is initially set at $2,000 a year, and right now drugmakers will be penalized if they increase prices faster than the rate of inflation. This is something AARP has fought for for years and will save Medicare seniors and taxpayers billions of dollars.

Bill Walsh: OK, that's tremendous progress for consumers. What other advocacy highlights can you talk to us about?

Megan O'Reilly: Sure. Social Security is another top AARP priority. The administration recently announced an 8.7 percent cost of living adjustment, the largest COLA increase in 41 years. We have fought long and hard to protect Social Security COLA so that seniors can keep up with rising prices. We're also fighting to improve Social Security's customer service, which is falling further behind as the number of seniors has been increasing. In addition, we advocated to increase support for family caregivers, fight age discrimination and empower older workers, protect and improve pensions and savings, improve nursing home conditions and protect older Americans from fraud. In addition to prescription drug reforms, we have championed other important improvements to Medicare, including simplifying the enrollment process, holding providers accountable for the quality of care they deliver, and making sure seniors have access to at-home COVID tests and the latest treatments at no cost. Also, something exciting that just came about this fall is for people with mild to moderate hearing loss: They can now buy more affordable hearing aids over the counter without a prescription. This is all great news.

Bill Walsh: All right, Megan. Well, thanks so much for that update. And before I let you go, many of our listeners have loved ones in nursing homes. For those who live and work in long-term care facilities, the pandemic is far from over. What can you share that might enlighten or help them feel empowered?

Megan O'Reilly: One of the most important things people can do is to make sure their loved ones are vaccinated and have received the recommended boosters. AARP's Nursing Home COVID Dashboard shows that vaccine and booster rates have declined even though transmission in nursing homes remains elevated compared to the rest of the population. It's important that families advocate for their loved ones. Contact the nursing home and ask about vaccination rates and plans to keep residents safe this winter. And if you need help knowing what to ask, go to aarp.org/nursinghomes. See our article "10 COVID-19 Questions to Ask a Nursing Home."

Bill Walsh: OK. So, that's aarp.org/nursing homes. Thanks so much for being here today, Megan. If our listeners want to get involved with AARP'S advocacy efforts, what can they do to help?

Megan O'Reilly: We'd encourage everyone to go online to aarp.org/getinvolved and sign up for the AARP Advocate. This is a free monthly e-newsletter, and you'll also receive email alerts and the latest advocacy news. Again, that's aarp.org/getinvolved. This is an easy way to make a big difference. Thanks for having me, and I wish everyone a happy and safe holiday season.

Bill Walsh: OK, Megan, thanks so much for the update and you as well. We are going to return to more of your live questions in just a moment. Before we do, I just wanted to give our listeners some information on getting COVID tests. They can get free COVID tests at covid.gov/tests or call a toll-free number: 1-800-232-0233. That's 800-232-0233. And if you'd like to pose a question to the U.S. surgeon general, Dr. Vivek Murthy, go ahead and press *3 on your telephone keypad at any time. But for the moment, Dr. Murthy, I wanted to ask you a few questions about vaccines and some important developments. We were talking earlier about the new vaccines, not so new anymore, but it's called the bivalent vaccine. I wonder if you can talk to our listeners about how it differs from previous vaccines and why it's so important.

Vivek Murthy: Well, thanks for asking that question. The new bivalent booster, and also sometimes called the updated COVID vaccine, this is the most recent version of the COVID-19 vaccine, and it contains both the original vaccine strain of the virus and a strain that's derived from the omicron variant, which you may remember first arrived in the United States around this time last year. And this updated vaccine is now approved for people age 6 months and older. And it's really our most effective way to maximize protection against the worst outcomes of COVID, including hospitalization and death. So, that's why we're encouraging people who receive their initial vaccine, and even if they got a booster dose, if it was more than two months ago, to go ahead and get that bivalent vaccine, that updated vaccine, because that will give you the most protection that you need going into this winter. About 42 million Americans or so above the age of 5 have already gotten the updated vaccine, but we need everyone to step up in the next few weeks to get that vaccine to ensure that we've got maximum protection over the holidays.

Bill Walsh: OK. Now, the first vaccines were rolled out two years ago this week, and while we've seen the benefits of these vaccines, as you were just discussing, a smaller number of older adults are getting the successive boosters. Why does someone need boosters if they've had the initial COVID vaccine?

Vivek Murthy: Well, that's a good question. If you think about other vaccines that you may have gotten, including the tetanus shot or the flu vaccine, you know that even though these vaccines work, sometimes you need to get an update or a booster, if you will. And that's because even if a vaccine is effective in generating protection, sometimes that protection can wane over time. And that's why with a number of vaccines we're asked to come back and get an additional shot. When it comes to COVID, what's happened is that, one, there has been both strong response to the vaccine but some reduction in protection over time, but also the virus itself is continuing to evolve and to mutate. And what we've then thought to do is to make sure that our response is also evolving, that we keep up with it and as much as we can, stay ahead of the virus. And so that is why people have been asked in the past to both get their primary series, those first two shots, but then to get a booster on top of that. This new updated vaccine that we have is, which is called a bivalent vaccine, this combines the original strain and the omicron strain. And so this is what we feel will give you the best possible protection going forward as we go into the winter, because we're seeing different variants of omicron that are cropping up. But we feel pretty good that the vaccine will give people good protection against the worst outcomes of COVID.

Bill Walsh: OK. Now, the highest number of those hospitalized and dying from COVID remain older adults, especially those over the age of 65. Why do you suppose we're experiencing vaccine hesitation among those who received the initial shot and really are the ones who are most at risk?

Vivek Murthy: Well, that's a very important question because we know that the more people that we get vaccinated, especially those over age 65, the more we'll be able to lower the death rate from COVID. Keep in mind that each day we're losing somewhere in the neighborhood of 400 Americans to COVID-19. That's an extraordinary toll every day. It's much better than where we were in the worst of the pandemic, where we were losing thousands of people a day. And, again, we've come a long way since then, but we want to get that number as low as possible, and we can do that if we get more folks up to date with their vaccine and more people treated with medications like Paxlovid. So, why haven't we had, what's preventing people, if you will, from getting vaccinated? I would say when it comes to older people, I don't think it's so much hesitancy in the sense that they don't believe in the vaccine, because we know that somewhere around 90 percent plus of seniors actually got an initial shot of their COVID vaccine. But I do think that part of what one of the challenges that we're dealing with is that some people are just frankly fatigued with COVID. And I can understand that. I mean, we've been at this pandemic for almost three years now and, a lot of people are just [fed up] with it. I think another thing is that many people may not be listening at this time. A lot of folks moved on from reading about COVID, listening to COVID, and they wanted to understandably get back to their lives. But that means that they're not, may not be hearing the recommendations or know that the updated shot is out there, that it's important for them to get it. And third, we know that there's some group of people who, even if they know it's available and should be taken, aren't sure how urgent it is. They might figure, “well, yeah, it's good to do, but maybe I'll get it later, when it's convenient.” And that's where we wanted to remind people that time does matter, because we've already started to see in the last few weeks an increase in COVID cases and in hospitalizations. And now we're starting to see death threat rates creep up a little bit as well. And so, the time is really now to get that updated shot as these numbers will probably continue to increase at least for some weeks. And last year we saw that January was when we … around late January is when we really hit the peak of the of the COVID surge. So, all the good news about all of these factors I just listed that may be preventing people from taking the vaccine is they can be addressed. We can get information to people, we can remind people about how urgent this is, we can up this knowledge of people's fatigue, but hopefully, encourage them to do what they need to do to have a protected and healthy holiday. And this isn't just doctors who can do this. The good news is all of us who are on the phone today can play that role in helping to protect the people around us by letting them know that we got our updated shot and asking them if they've had a chance to go out and get theirs. And if they're not sure where to get it, just remember you can send them to vaccines.gov. And the vast majority of people in America live within a few miles of a pharmacy that has the updated vaccine. So, it's easier to get than ever.

Bill Walsh: All right. Very good. All great points. Thank you for that, Dr. Murthy. Let's go back to the phone lines. It's time now to address more of your questions with U.S. Surgeon General Dr. Vivek Murthy. As a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member and get into the line to ask your question live. Jesse, who do we have up next?

Jesse Salinas: Yeah, our next question is going to come from YouTube. It's from Sandie Frus, and she asks, "Why is COVID more of an issue than standard cold if the symptoms are becoming more identical?"

Bill Walsh: Hmm, Dr. Murthy.

Vivek Murthy: Well, that's a very good question, and you are right that the symptoms are really similar. You can have a runny nose, you can have a fever, you can have a cough and congestion with a cold and with COVID. But here's the difference. We've noticed that when you look at the actual impact on severe illness, on which virus is actually landing up people in the hospital and actually costing us lives, COVID turns out to be far worse than the common cold. So, even though they may look different, I mean look similar on the surface, when you have a mild case, more people are having severe cases of illness with COVID than with the common cold. And that is why we're taking COVID so seriously. We've lost well over 1 million people during this pandemic to COVID-19. I will tell you that the death toll from flu or from the cold has been nowhere near that. And so we're seeing in the numbers itself that this is a much more severe illness, and it seems to be most severe in people who are older, those who are 65 years of age and up, which is why it's so important that if you're in that age group, that you make sure you're up to date with your vaccine.

Bill Walsh: OK, thanks so much for that. Jesse, who do we have up next?

Jesse Salinas: We're going to take another one from Facebook. This is from Kim Reed. She says, "If someone loses their COVID vaccine card, how do they get another, and is it required for getting your boosters?"

Bill Walsh: Hmm, that's a practical concern. Dr. Murthy.

Vivek Murthy: Oh, Kim, that's a, a really good logistical question. And the good news is, even if you lost your card, don't worry, you can still go and get your updated shot. They won't send you back just because you don't have your card. And, in fact, what you can tell them is that you need a new card, and they'll fill one out for you there indicating that you got your updated shot, and you should be OK.

Bill Walsh: OK, great. Jesse, who do we have up next?

Jesse Salinas: Our next caller is Doug from New Mexico.

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

Doug: Thanks a lot. I'm 66 and up until about a month ago I was pretty religious about wearing a mask. But I've kind of, since Thanksgiving roughly, I've kind of let down my guard a bit and have not been wearing a mask in some definitely crowded situations, for example. What I was wondering as far as like the KN95s go, are there any, for example, or N95, are there any negative impacts of wearing a mask to protect myself from RSV, the flu, COVID, etc.?

Bill Walsh: Dr. Murthy, can you address that question from Doug and other questions people might have about whether or not to be wearing a mask these days?

Vivek Murthy: Well, Doug, thanks for that question. And I'm glad to hear that you've been so vigilant about protecting your health and about preventing folks around you from being exposed. And you specifically were asking are there any negative effects to wearing masks like a high-quality mask, particularly the KN95s or the N95 masks. And the answer is no. I know there has been some misinformation circulating that maybe masks could have harmful effects on your breathing or on your metabolism. And that does not seem to be the case at all. That's not to say that masks are always comfortable. Some people don't feel necessarily comfortable in masks for long periods of time. And sometimes you have to try a few different masks to find one that works and works well for you. But with that said, there's no adverse health impact to wearing the mask and especially with winter here, with rising COVID numbers, if you are going to be in crowded indoor spaces and, again, if you're at higher risk or someone you live with is at higher risk, it makes sense to go ahead and wear that mask because it'll give you an additional layer of protection.

Bill Walsh: OK, and Dr. Murthy mentioned earlier the availability of a free COVID test. I just want to repeat the phone number where people can get those. That number is 1-800-232-0233. That's 800-232-0233, or go to covid.gov/tests. Jesse, let's go back to the lines and take another call.

Jesse Salinas: Yeah, this next one is also from Facebook. This is from Karen. Karen says, “I've read that Paxlovid will not be covered by Medicare after the current emergency use authorization expires in 2023. Is this information accurate, and if so, is anything being done to resolve this issue?"

Bill Walsh: Doctor, maybe you can give our listeners a little update on Paxlovid, which has really been a remarkable drug. But she, Karen, is also asking about the availability of it for free.

Vivek Murthy: Yeah. Well, Karen, thank you for that question. And for those out there who may not be familiar with Paxlovid, this is an oral medication that can be taken by people who are at higher risk for bad outcomes with COVID. That includes people who are older. And it's a medication you take, you want to take early on in your illness course. So, if you test positive, you want to reach for Paxlovid and take it within the first few days, even if you only have mild symptoms. It's still worth taking because sometimes your symptoms can get worse later on. And what we have found is that when people do take Paxlovid, when they get ill, it significantly reduces their chances of ending up in the hospital or dying from COVID-19. So, a very important medication to take. You know, as Karen mentioned, this medication is currently available to people, and the cost is covered, and we are certainly in the process with vaccines and with other parts of the COVID response of moving these to a phase where the private insurance, these sort of programs will support these and will cover them as well. So, for the time being, Paxlovid is covered, and our goal is to make sure it continues to be covered through both public and private insurance even after the emergency ends.

Bill Walsh: OK. I wonder if there are any folks for whom Paxlovid is not appropriate.

Vivek Murthy: Yeah, so thanks for asking that question. Paxlovid does have some interactions with other medications that you have to be mindful of. Now, it doesn't mean you cannot take Paxlovid if you're on those medications. It just may mean that they need to be held or the dose has to be adjusted. So, I'll give you an example. Certain cholesterol medications, like statin medications, have an interaction with Paxlovid. So, holding your statin for your duration of Paxlovid therapy is the appropriate thing to do, and that's something your doctor can advise you on. But also it's something that generally is not harmful for people to hold their statin cholesterol medication for a few days. There's a certain blood thinner, one called Eliquis, for example, which some people may be on, which also interacts with Paxlovid. But there's circumstances where you can reduce the dose of it instead of holding it entirely, and that can allow you to take the medicine and be safe. So, what I wouldn't want people to do is to say, “Gosh there's some medication interactions. I'm just not eligible to take Paxlovid.” That's not the case. It turns out that the medication interactions can be managed, and what's really important is to make sure you're getting the medication you need to give you the greatest chance of making it through COVID without severe complications.

Bill Walsh: OK. Thanks so much for that. Jesse, let's take another call.

Jesse Salinas: Our next caller is going to be Vincent from Louisiana.

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

Vincent: I'm just wondering what studies are being done for long-term effects from taking the COVID virus, or are there any studies being done taking the COVID vaccines, I'm sorry, and the booster?

Bill Walsh: OK, Dr. Murthy, what about that? It's still relatively early days, but we're almost three years in. What about Vincent's question about long-term studies related to taking the COVID vaccines?

Vivek Murthy: Well, that's a really good question, Vincent. Thanks for asking. One of the things that the government does in partnership with industry is to make sure that even after a medication is authorized or approved, and this applies to vaccines as well, that they continue to be studied after they're made available, just so that if there is any sort of signal that may have, [that reactions] may be taking place even at rare levels, that we detect it, and that we understand what that impact is. And so the vaccines have continued to be studied even after they initially rolled out in December of 2020. And the good news so far is that two things have remained clear from this continued study: One is that the vaccines have remained remarkably effective at preventing the worst outcomes from COVID, and those are hospitalization and death, but they've also been able to do so with a remarkably strong safety profile. You may have heard some stories early on about some people who may have had allergic reactions to the vaccine. Thankfully, those were rare cases, and that happens, unfortunately, with many types of medications or vaccines. You've probably heard of friends or colleagues who have had allergic reactions to other medicines. But thankfully that is rare, and it's been manageable, actually, that you can give people medications to deal with that allergic response. So, the bottom line is that overall, when looking at the safety of the vaccine, the safety profile has remained remarkably strong. And what the CDC does is it collects data that's submitted from the public for medical professionals, from public health agencies at local and state level, and they track that closely to understand whether or not there are any problems that they're being observed with the vaccines that are being taken. I raise this only because sometimes you may hear stories that somebody had a medication or took a vaccine, and then a month later they had a health complication. That what the CDC tries to do, and what scientific organizations in general try to do, is try to understand were those two events actually related to one another, because sometimes they're not. You know, like, I may have started a medication today and then I may have gotten sick tomorrow with a cold because my child came and had a cold, and infected me at home. That doesn't necessarily mean that the medication caused the cold. So, when they've parsed that data and looked at it carefully, what they have found is, again, that the safety profile of these vaccines is really strong. But I'm glad you raised the question, Vincent. This is something that they will continue to study to make sure that the safety profile remains good, and that the benefits continue to outweigh any risks.

Bill Walsh: OK. Thanks for that. Jesse, let's take another caller.

Jesse Salinas: Our next caller is going to be from Robert in Michigan.

Bill Walsh: Hey, Robert. Welcome to our program. Go ahead with your question. Hey, Robert, how are you?

Robert: Good. How are you doing today?

Bill Walsh: Good. Go ahead with your question.

Robert: OK, my big question is I live here in Michigan in a very desirable area, which is in northern Michigan here, and my concern is that there's so much disinformation coming … here. We have people in my neighborhood who travel a lot back and forth from Florida to Michigan. And they're listening to bad advice. And my wife and I know many people that refuse to be vaccinated, and we just don't understand why so many people have decided to listen to the wrong information about all of this going on. And it's very confusing to us. We just don't understand why we, we kind of live in an area where a lot of people have just, they, they are just against all of it — vaccines and all of it regarding their health. And we just don't understand that. And we can no longer be around those people and that's a big concern to us.

Jesse Salinas: Oh, looks like we lost him, Bill. I'm sorry.

Bill Walsh: Ah, OK. Well, Robert, thanks for that question. And I assure you the misinformation isn't just in Michigan. And we are actually going to turn to a segment on misinformation. But before we do, Dr. Murthy, I was wondering if you could address Robert's concern. I think a lot of our listeners know people or are hearing about people who don't believe in the efficacy of the vaccine or the virus. What do you say to them?

Vivek Murthy: Well, I really empathize with Robert's question because like Robert, I also have seen how frequently misinformation has spread and how it's led people to often make decisions that are counter to their health interests. And that's been very sad to see. And I know many of us have likely seen that in our own families. I think, unfortunately, what happened in the COVID response is, unfortunately, things became polarized very quickly and as misinformation spread, it found a particular home for spreading online. And that, I think, really hurt us, and many people, as things evolved in this pandemic — because again, things did evolve, right? We were learning about this new virus, and as we learned more, recommendations evolved, but as those recommendations evolved and changed, it was also confusing to people. And sometimes they weren't quite sure who to believe, who was telling the truth. And so this to me is, this is one of the reasons why in July of 2021, I issued a Surgeon General's Advisory on health misinformation because we'd recognized just what a profound impact this is having on our health. I think misinformation was literally costing people their lives. As a doctor, I believe that people have the right to make their own decisions about their health. I also think they have the right to get accurate information so they can make those decisions in a way that's consistent with their own interests. And so one of the things I would just remind folks of is when we think about misinformation, just remember there's a lot of it out there. It's not always easy to tell what's accurate and what's not. So, make sure you're getting your information from a trusted source like your doctor, your local health department, the CDC or another trusted scientific body. The second thing I would say is if you encounter information that seems like it's worrisome and you think, Gosh, I gotta let people know about this. Again, if you're not sure about this source, then I would not share it online because this is, unfortunately, how misinformation spreads despite the best of our intentions. And finally, if you've got somebody in your family who may have absorbed some misinformation and may have questions or be confused about whether it's medications around COVID or whether COVID itself is even serious or around the vaccine, and if you want to have a conversation with them, just remember it's important always just to start with listening first. Nobody likes to have a conversation when they, if they're feeling the other person's goal is to change your mind. But if you can have a conversation with somebody and listen to them and understand their point of view, and then share your own perspective, that can often be a more productive pathway to having a conversation with somebody who may have a different point of view.

Bill Walsh: Well, that's a great tip as people are preparing to gather for the holidays and maybe having some of those very discussions. Let me bring in our other guest, Alex Mahadevan, the director at MediaWise. Alex is an expert on online misinformation and disinformation. MediaWise is a nonprofit organization that helps older Americans learn how to sort fact from fiction online. Thanks for returning to our program, Alex.

Alex Mahadevan: Yeah, happy to be here.

Bill Walsh: You heard the doctor just say that so much of this misinformation is spread online, and of course, social media is a powerful tool to connect people, but also a consistent source of false and misleading information. What should social media companies be doing to combat false and outlandish public health claims? And how can people protect themselves and build up their digital literacy?

Alex Mahadevan: Well, that's a great question. So, for the first part, I think social media companies should be doing everything they can to prioritize and surface legitimate important information. So, for example, we should, on Facebook or wherever, see the messages from the surgeon general about free COVID-19 tests much more prominently than posts from, like, John Boy 6767. Posts from the CDC should outweigh your crazy aunt on your newsfeed. Secondly, they should be limiting the reach and attaching fact checks to harmful misinformation, especially harmful health misinformation.

Alex Mahadevan: Now, Facebook and Instagram, they do a relatively good job at flagging posts like this. You might have seen warnings if you spend any time on social media about COVID-19 or election misinformation. But really, social media firms should be working with fact-checkers. But you really can be your own fact-checker, you know? So, as far as building resiliency to misinformation, the first thing I would say — and Dr. Murthy had some great, great tips — but first and foremost, stay in tune with your feelings when you see the email or a video on Facebook. If it makes you angry, anxious, upset, or even happy or overjoyed, there's a chance it could be misinformation. See, when we get emotional, we let our guard down, and that's really where bad actors pounce. So, just be on the lookout for these false posts claiming that celebrities have "died suddenly from the vaccine." Now, they may pop into your timeline and really freak you out, but you gotta stay in tune with those emotions. And I just, I have to direct you to, MediaWise has worked with AARP on some great content that can help teach you to be a fact-checker. If you follow the link poy.nu/aarp, you can take a free course that we have worked on together.

Bill Walsh: All right, that was poy.nu/aarp. Thanks for that, Alex. Dr. Murthy, you had said a moment ago that misinformation has literally cost people their lives. How has misinformation undermined care and treatment? Can you say a little bit more about that?

Vivek Murthy: Sure. So, we rely on accurate information to help people make health decisions. And when lifesaving treatments and vaccines are available, we want people to know about them so they can protect themselves and their families. When people don't have access to that information because they're misled by misinformation, then that can lead them to make decisions that may, in fact, have them turn down lifesaving treatments or lifesaving vaccines or that may lead them to deny or even lead them to not take precautions to protect themselves from getting COVID in the first place because they're misled to think that COVID is no worse than the common cold. And so that is one tangible way. Sadly, we've seen again and again and again misinformation lead to bad health outcomes. But we've also seen something else, which is that misinformation has taken a toll on our health care workers, our nurses and doctors and others in our hospitals. I've spent a lot of time with health care workers from around the country, and what they used to tell me time and time again was that they were battling COVID in the hospital during the day, and then they were coming home at night and battling COVID online trying to convince their patients and their family members that the misinformation that they were encountering online was not true. And it was truly exhausting for health care providers who've already been overtaxed and who have burned out at incredibly high rates during this pandemic. So, the bottom line is misinformation harms people, but it also makes the job of health care workers much, much harder. And it, in many cases, has made the conversations and engagements between health care providers and their patients more difficult as well. We know that according to surveys from the Kaiser Family Foundation, that around [nearly 8 in 10] of people on their surveys either believe some piece of misinformation about COVID or think that misinformation might be true. That's an incredibly high number, and so one of the great challenges we're going to have, not just in addressing this pandemic going forward but in public health more broadly, is figuring out how to address the rapid growth of misinformation online so that people know that they can get accurate, reliable information to help them make decisions for themselves and their families.

Bill Walsh: All right, thanks for that. Well, Alex, let's talk about one of the most prominent social media platforms, and that's Twitter. And of course there's been big news with the shake-up at Twitter in recent months. But the fact is that less than one quarter of adults in the U.S. use Twitter according to Pew Research Center. So, what is Twitter's real influence? Do false and misleading informational tweets really matter?

Alex Mahadevan: So true. Fewer people use Twitter. That is true, but a majority of the people who do use it, they use it to follow the news. People don't use Facebook, Instagram or TikTok in the same way. So, at its core, Twitter has just become the place to follow breaking news. And it's also a platform that is really dominated by journalists and policymakers and all sorts of movers and shakers and influencers who are following and reporting the news. So, what happens on Twitter gets reported in big news outlets. We've seen this, like you mentioned the shake-up, it gets splashed across TV screens and where we see the most misinformation, the absolute most, posted on other social media platforms. You see tweets, misleading tweets that are posted on Facebook or Instagram or elsewhere. So, that's a media literacy tip right there. If you see a tweet that's posted on another platform, check it out because it might be chock-full of falsehoods. And as far as where it matters, misinformation anywhere matters. Misinformation anywhere online has those real-world effects that Dr. Murthy just mentioned. And on Twitter, misleading information about COVID-19 vaccines, whether it's falsely claiming a celebrity death as a result of the shot or something, they create vaccine hesitancy in the real world. It causes real conflict that can play out at holiday dinner tables. And it obviously makes someone like Dr. Murthy's job a lot harder. It's just ,a false post online can create this massive ripple effect that harms you, your family, your community.

Bill Walsh: Well, Alex, maybe you can tell us where older adults can turn for reliable information.

Alex Mahadevan: Well, I think, again, Dr. Murthy summed it up really well: When you go to official sources of information — that might be the CDC, the WHO, your local doctor — if you go to a general practitioner, please ask her all these questions that came up today. I would also add, your local news outlet knows your area, your region, your local health department. So, really look to the experts, look to the reporters to get your information. And, as a longtime user, I would say, don't even go on Twitter.

Bill Walsh: OK. Dr. Murthy, I'll give you the last word. Where should people go for reliable health information?

Vivek Murthy: Well, I think, Alex summed it up well. Think about the people who have credentials and credibility to give you information on health. I love my grandmother dearly, but I don't get my health information from her because that's not her area of expertise. But your doctor, the nurses who may be involved in your care, your local health department, the CDC: These are all places that you want to go to. And if you encounter information online, if somebody sends you, say, a piece of information by text or email, make sure you look at the source, and if you can't find a source, you should pause before you act on that or before you share it with other people. But overall, I just want to say also, I know we spent a lot of time today talking about different aspects of COVID. I know this has been a really tough pandemic for so many of us. It's been three years. Many of us may have lost family members — I know I have — to COVID-19. Many of us may have had our lives disrupted in other ways, losing the chance to be together for the holidays in the first couple of years of COVID, or in some cases maybe worrying about jobs or worrying about your grandkids in school or about safety. And these are all real tolls, if you will, of the pandemic. And while there's the physical toll that we hear about and read about in the papers, I also want to acknowledge the mental health toll of this pandemic. It's something that we should be mindful of. And if you're having trouble sleeping, as I was early in the pandemic, if you're finding that you're more irritable, that you're more stressed in general, this is a time where you're not alone. A lot of people are feeling that way, and it's in part because of the upheaval that we've experienced over the last three years. So, all that to say just give yourself some grace. Be patient with yourself. If you're feeling that way, just know that you're not alone. And this is a time where I think we also have to give each other a bit of grace and realize that the impatience or the challenges we may find in our encounters with other people maybe could be they, too, might be having a hard time dealing with this pandemic. But I'm optimistic going forward because I have seen how far we have come. We have tools now to address COVID that we just did not have at the beginning of this pandemic. I remember March 2020 very clearly. And I only wish that we had had vaccines and treatments and tests and high-quality masks widely available. I think we could have saved even more lives. We do have those now. I want people to know about them so they can use them to protect themselves and their families, and so that ultimately we can get back to the things that we love in our life, our family, our friends, our work, our hobbies and just being together.

Bill Walsh: Well, that's a great end-of-year message. Thank you so much, Dr. Murthy and Alex Mahadevan. Terrific insights and information today. I also want to thank our AARP members, volunteers and listeners for participating in the discussion today. AARP, a nonprofit, nonpartisan membership organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we're providing information and resources to help older adults and those caring for them protect themselves from the virus, prevent its spread to others while taking care of themselves. All of the resources referenced today, including a recording of the Q&A event, can be found at aarp.org/coronavirus beginning tomorrow, December 16th. 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'll return in 2023 with more informational and helpful programs, and we hope you'll join us then. In the meantime, we hope your holiday celebrations are safe and healthy. Thank you and have a good day. This concludes our call.

Coronavirus TTH-2022-12-15-MP3

[00:00:00] Coronavirus TTH – 12-15-22

[00:00:01] 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 has been providing information and resources to help older adults as well as those caring for them. While COVID cases and deaths are nowhere near what they were a year ago, both have been trending upward as winter approaches and 2022 comes to a close. As families gather for the holidays, we face an unusual triple threat of respiratory illnesses with the spread of flu, RSV and COVID resulting in a scarcity of hospital beds around the country. If you're wondering how best to stay safe and healthy during the holiday season, or to cut through the online misinformation, you're in luck. Today we're talking to the U.S. surgeon general , and he'll be taking your questions. We'll also get a timely update from Capitol [00:01:00] Hill on legislation affecting older Americans as Congress prepares to recess for the year.

[00:01:06] Bill Walsh: 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, press *3 on your telephone to be connected with an AARP staff member who will note your name and question and place you in a queue to ask that question live. If you're joining on Facebook or YouTube, you can post your question in the comments.

[00:01:36] Bill Walsh: Hello, if you're just joining, I'm Bill Walsh with AARP, and I want to welcome you to this important discussion about the changing COVID landscape, vaccines and the epidemic of health misinformation. We're talking with the U.S. surgeon general today and taking your questions live. To ask your question, please press *3 on your telephone keypad, and if you're joining on Facebook [00:02:00] or YouTube, you can drop your question into the comments section. 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 that recording at aarp.org/coronavirus 24 hours after we wrap up. Again, to ask your question, please press *3 at any time on your telephone keypad to be connected with an AARP staff member, or if you're joining us on Facebook or YouTube, place your question into the comments.

[00:02:37] Bill Walsh: Now I'd like to welcome our guests. Vice Admiral Vivek H. Murthy is the U.S. surgeon general, M.D. and MBA. Dr. Murthy is the 19th and 21st surgeon general of the United States. His mission as the nation's doctor is to restore trust by relying on the best scientific information available, providing clear, consistent guidance and resources for the public, [00:03:00] and ensuring that we reach our most vulnerable communities. Welcome back to our program, Dr. Murthy.

[00:03:06] Vivek Murthy: Well, thank you so much for having me back.

[00:03:08] Bill Walsh: All right, we're delighted to have you. And a little bit later in the program, we'll be joined by Alex Mahadevan from MediaWise to discuss misinformation. Just a reminder, to ask your question, please press *3 on your telephone keypad or drop it into the comments section on Facebook or YouTube.

[00:03:28] Bill Walsh: Thank you again for returning to the program, Dr. Murthy. We really appreciate your time. Let's get right to the questions. COVID just does not seem to want to go away. What can you tell us about the recent COVID-19 variants, and are they more severe or transmissible than what we've seen in the past?

[00:03:49] Vivek Murthy: Well, thanks for asking, and we certainly have been through quite a lot these last almost three years dealing with COVID-19, and it's gone through many phases. But the good [00:04:00] news is that overall we are in a much different and better place than we were in March of 2000, or 2020 rather, when much of this started in the United States. And so that is good news. And it didn't happen by accident. It happened because scientists around the world, because government, because organizations and communities and so many people on this call took it upon themselves to get the facts and figure out what was going to help them to prevent infection and protect against the worst outcomes of COVID, against COVID. And that included by taking vaccines. And so we had the vast majority of seniors in our country began the vaccination process the last couple years, and I think that's why, according to a recent Commonwealth Fund survey, we have likely saved around 3 million lives in the United States because of the vaccinations alone. So, that is very good news. But the viruses constantly change, and [00:05:00] they mutate over time, and we've certainly seen that with COVID as well. Now, sometimes these new mutations will cause variants of the virus that are consequential. They may be more transmissible, in particular, and we've certainly seen that. When the omicron variant hit around this time last year, that's what we saw: a variant that was much more transmissible and even evaded some of our immune defenses compared to prior variants. Right now we know that the virus is continuing to evolve, and there are a couple of variants in particular called BQ.1 and BQ.1.1. You don’t have to remember those, so don’t worry about that, but those two are the dominant variants right now. What's less important than remembering the actual variant is just to remember this: That with all of the experience we have over the last couple of years, it's taught us that regardless of the variant that's come our way, that when people are up to date with their [00:06:00] vaccines, their likelihood of ending up seriously ill because of COVID is dramatically lower. And that up-to-date part matters because right now there are a lot of people who got their original two shots, what we call the primary series, but they may not have gotten their booster or they got their booster a really long time ago, and they may not be up to date. And we have seen that that makes a difference. If you just got your first two shots but you haven't gotten your updated COVID vaccine, then you don't do as well as people who went ahead and did get that updated vaccine. And so what I want to make sure I share with everyone here is that there is an updated vaccine available. It is something that for most people right now is free. It is easy to get. You can just go to vaccines.gov to find a location around you where you can get that updated shot, and this is really important because when we look at who’s being hospitalized right now for COVID, [00:07:00] predominantly people who are older. And when we look at who is dying from COVID, it’s predominantly people who are 7 years of age and up. But when we look at the people who are in that category, they include very few people who are actually up to date with their vaccines, and even fewer who have reached for medications like Paxlovid when they've gotten ill. So, again, bottom line is be up to date with your vaccines, reach for medicine like Paxlovid if you get seriously ill, and that means talk to your doctor about it. Go to covid.gov to find locations where you can get Paxlovid, and that should save you from the worst outcomes of this virus.

[00:07:37] Bill Walsh: OK. Now, of course, travel and family gatherings are going to be increasing over the next couple of weeks with more close contact, family meals, time indoors around the holidays, etc. If someone hasn't received an updated flu or COVID vaccine, is it too late?

[00:07:55] Vivek Murthy: It's never too late. Even if you've gotten vaccinated or boosted, [00:08:00] even if you've gotten sick with COVID earlier in the year, getting this updated vaccine as soon as you can will put you in the best position to be in good shape ahead of the holidays. In addition to COVID-19, we know that there is also flu that's circulating. In fact, there is a lot of flu out there right now, some of the highest levels that we've seen in a long time, and that's why I would also advise people, whether you're traveling or not, to go ahead and get your flu shot as well. You can get the COVID-19 shot and the flu shot at the same time. In fact, that's what I did, and that's what my wife did as well. So, that can save you some time and give you protection. But in addition to the vaccine, I also just want to remind people that if you do get your vaccines but you end up having what's called a breakthrough case of COVID, it’s good to know that there are medications available that can help you, like Paxlovid, and we want people to be able to reach for those because those further reduce your chances of ending up in the hospital and dying. And finally, [00:09:00] remember this: There are some behavioral modifications we can make, some steps we can take to also reduce the chances that we may get sick in the first place. So, for example, if you are getting together with other people and you are sick, staying home is a good idea, but also avoiding contact with people who may be sick themselves is also helpful because we know that through contact you can actually more easily transmit the virus. We also know that wearing masks in crowded public places can also be a good way to help protect yourself, not just against COVID-19, but against the spread of flu and other viruses that are circulating. And finally, testing. We know that testing can be an important strategy to help reduce the chances that a gathering may end up being a super-spreader event. So, if you're going to get together with family, and especially if you're at higher risk or somebody in your family's at higher risk, testing before you gather is a good strategy as well. And just today — in fact this week, [00:10:00] rather — the administration announced that they are reopening the program where they are delivering free tests to your house. So, you can go again to covid.gov and you can request for up to four tests to be delivered to you free of charge. And again, that's one more strategy you can take to make sure that you enjoy the holidays safely.

[00:10:22] Bill Walsh: Well, that's great to hear. I know some people were concerned that there were no more free tests, and those tests aren’t cheap to buy. So, it's great to hear that the administration's going to be providing additional ones. Do you know how long that is going to last?

[00:10:38] Vivek Murthy: Well, we're hoping to run it as long as we can, but I would urge people to go as quickly as possible to the site and get it. I should also remind people that in addition to getting the free tests from the government directly to your home, you are also eligible to get eight tests per month covered by your insurance. And [00:11:00] that's important for you to know about because it's another strategy to which you can get tests free of charge.

[00:11:06] Bill Walsh: Great, thanks so much for that information. Let's go to the phones now. It's now time to address our listener questions about COVID and vaccines with U.S. Surgeon General Dr. Vivek Murthy. As a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member and share your question. And if you'd like to listen in Spanish, press *0 on your telephone keypad now.

[00:11:38] Bill Walsh: [instructions in Spanish]

[00:11:39] Bill Walsh: OK. I'd like to now bring in my AARP colleague Jesse Salinas to help facilitate your calls today. Welcome, Jesse.

[00:11:46] Jesse Salinas: So good to be here today, Bill.

[00:11:47] Bill Walsh: All right. Who do we have up first?

[00:11:49] Jesse Salinas: We're going to start with sylvia in Illinois.

[00:11:52] Bill Walsh: Hey, Sylvia, welcome to our program. Go ahead with your question.

[00:11:55] Sylvia: Yes, hi. Thank you. I have a bit of a confusion about [00:12:00] boosters, so I just want to let you know that I've had my first two doses in 2021. That was fine. Then I believe I had a booster in October of 2021, then a second booster in August of 2022. So, am I now due for another booster?

[00:12:21] Bill Walsh: OK.

[00:12:22] Sylvia: For that variant?

[00:12:23] Bill Walsh: Right, the new one. Let's ask Dr. Murthy. Dr. Murthy, can you address Sylvia's question? This comes up a lot. I think there's just a little bit of confusion out there about how much people need.

[00:12:35] Vivek Murthy: Well, I am so glad you asked that question, Sylvia. Thank you for that. And I could understand with all the information out there that gets updated, sometimes it can get pretty confusing. So, here's what you need to know. With the updated vaccine that's now available for COVID, you are eligible to get it if you are more than two months out from your last shot, and if you're more than three months out from your [00:13:00] most recent COVID infection. So, in your case, if you got your last shot in August of 2022, that would be more than two months ago. And so this would be the right time for you to get your updated COVID shot. And I'm presuming, because this new updated shot was not available in August of this year, you likely had the original vaccine booster that was made available earlier in 2022. So, this would be the right time for you to get your updated shot.

[00:13:34] Bill Walsh: OK, very good. Thanks so much, Doctor. Jesse, let's take the next question.

[00:13:38] Jesse Salinas: I think this one's similar, but I'm going to bring it anyway. It's Brenda from Pennsylvania.

[00:13:42] Bill Walsh: Hey, Brenda. Welcome to our program. Go ahead with your question for the surgeon general.

[00:13:47] Brenda: Yes, I'm 80 years old now, and I had my booster; the last one I had was November. I had the flu shot; I had the one in November. Now, [00:14:00] after that the most recent booster, right?

[00:14:08] Bill Walsh: I heard you say you had your booster in November, and I think the question was, do you need to get the new vaccine?

[00:14:15] Vivek Murthy: That's what it sounded like, Bill.

[00:14:16] Bill Walsh (Moderator): Yeah. Doctor, can you address that?

[00:14:19] Vivek Murthy: Yes. So, Brenda, if you had your most recent COVID shot in November, that was likely the updated COVID shot. So, you are all set in terms of COVID shots. You do not need another one right now.

[00:14:32] Bill Walsh: OK. Well, let me ask about that. How long of … what kind of protection does that new shot offer to people? Are they good for a year, six months?

[00:14:42] Vivek Murthy: Well, a really good question. So, here's what we know. We know that the updated shot will likely initially protect you pretty well against getting COVID at all, but then that protection against mild infections may wane over time, over several months. But what [00:15:00] seems to have stayed for a much longer period of time, for around the order of six months or more, is the protection against serious illness. And that's what we want to prevent. The most important job of the vaccine is to keep us out of the hospital and to save our life. And it seems, based on the studies that — experience we've had with the earlier versions of vaccine, that that protection does typically last on the order of six months or so. And what we're anticipating going forward is that for most people, they will likely need an annual COVID shot, just like you get an annual flu vaccine. For some people at higher risk, including those who are older, you may require more than one shot a year, more likely two shots a year. So, that is what we're anticipating right now. But if you got your COVID shot in November like Brenda did, then you should be good for a while.

[00:15:53] Bill Walsh: OK, thanks so much for that. Jesse, let's take another call.

[00:15:57] Jesse Salinas: Our next caller is going to be Maryanne. I can't tell where [00:16:00] she's from, but Maryanne.

[00:16:01] Bill Walsh: Hey, Maryanne. Welcome to our program. Go ahead with your question for the surgeon general.

[00:16:06] Maryanne: Yes. I'd like to know if there are statistics that say which manufacturer of the vaccine has low and high tolerance for second, let's say getting the COVID or whatever.

[00:16:25] Bill Walsh: Hmm, doctor, are there any? We've done so much study of these vaccines. What is it telling us about the ones made by the various companies, the effectiveness?

[00:16:37] Vivek Murthy: Yeah, it's a very good question. I mean, the two major companies that most people have been utilizing for their vaccines are Moderna and Pfizer. And I would say that the protection is comparable between the two of them. They are different dosages, and so some people find that they may have [00:17:00] slightly greater incidence of fever or arm soreness potentially with the vaccine that has a higher dose, that's the Moderna vaccine, but on the whole they're both quite effective. So, what I would say is that if you go out to get a shot and only one of them is available, I would rather get one of those rather than waiting to go somewhere else and another day try to get the other shot. Because, again, both give you very strong protection against the worst outcomes of COVID, which are hospitalization and death.

[00:17:35] Bill Walsh: OK. Thanks so much, Doctor. Let's go back to our phone lines. Jesse, who's up next?

[00:17:40] Jesse Salinas: We're going to bring Alicia from North Carolina.

[00:17:43] Bill Walsh: Hey, Alicia, welcome to our program. Go ahead with your question.

[00:17:48] Alicia: Hi, I'm Alicia from North Carolina. I have a grandson who has not been vaccinated, not for COVID or flu, fully vaccinated [00:18:00] flu, COVID and booster. What can I do to protect myself if I want to spend time with him during the holiday?

[00:18:10] Bill Walsh: Oh, that's a great question. Dr. Murthy, can you offer any guidance on that?

[00:18:16] Vivek Murthy: Well, I'm so glad you asked that question because a lot of us may have family members who have made different decisions around getting vaccines and different decisions around taking precautions, as well, against infection, and that can be tricky when it comes time for the holiday. But if you think that there are people who will be gathering around you who may not have protection, may bring the virus in, there are a couple of steps that you can take. One is you can ask your grandson to test before he comes to see you. That's pretty quick. It's easy. As I mentioned now, there are free ways to get tests either through your insurance covering them to eight tests a month, or directly ordering them from the government and having them [00:19:00] delivered to your home for free through covid.gov. So, I would ask your grandson to test before you got together with him. I would also suggest that you wear masks whenever possible when you're indoors together because that can also be helpful if wearing a high-quality mask can help to reduce the spread of COVID, if indeed he ends up being infected. So, these are two strategies that may help. And the third I'd mention is just to ask him if he's feeling OK before he comes over, and if he's having any symptoms like a runny nose, a fever, a sore throat, congestion, then he should really consider staying back because sometimes it takes a day or two from when you have COVID to get infected with it, to when your test actually turns positive. And so if someone's having symptoms, it's a good idea for them to avoid exposing you, because that could put you at risk.

[00:19:55] Bill Walsh: OK. Thanks very much. Jesse, who's up next?

[00:19:58] Vivek Murthy: The next question is going to be [00:20:00] Barbara from California.

[00:20:01] Bill Walsh: Hey, Barbara, welcome to our program. Go ahead with your question.

[00:20:06] Barbara: I'm wondering — there's expiration dates on these tests. I've never heard anybody talk about them, but they're definitely on there. Should we be throwing these tests away after the expiration date and ordering more?

[00:20:19] Bill Walsh: Hmm. Dr. Murthy?

[00:20:22] Vivek Murthy: Oh, Barbara, that's a great question. I would say that if your tests have expired, then yes, I would go ahead and order some new ones again, either online or you can, as I mentioned, covid.gov or through buying it on retail and having your insurance cover it, which they should cover up to eight tests per month. So, that is what I would do. There have been some certain circumstances, Barbara, with some manufacturers where they have extended the expiration date, but again, if you're not sure about that, I would go with the marking that you see on the box.

[00:20:54] Bill Walsh: OK. Thanks so much for that, and thank you for all those questions. We're going to be taking more of your questions [00:21:00] soon and continue our discussion with Surgeon General Dr. Vivek Murthy. But right now, let's get an update from Capitol Hill. In addition to sharing trustworthy information, AARP advocates for issues that affect you the most. To give a quick update on how AARP is fighting for you, I want to bring in Government Affairs Vice President Megan O'Reilly. Welcome, Megan.

[00:21:24] Megan O'Reilly: Happy to be here, Bill.

[00:21:25] Bill Walsh: All right. Well, now, we're coming to the end of 2022. It was a big year on the advocacy front, and AARP led many successful fights to help older Americans stay healthier and financially secure. What were you most excited about?

[00:21:40] Megan O'Reilly: The biggest victory is really the historic prescription drug reform that was signed into law in August. 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, [00:22:00] beginning in January, just next month, the new law caps out-of-pocket costs of Medicare-covered insulin at just $35 a month, and it eliminates out-of-pocket costs for most recommended vaccines under Medicare, such as shingles vaccines. More benefits are on the horizon. In 2025, there will also be a limit on how much seniors with Medicare Part B have to pay out of pocket for their prescriptions. This is initially set at $2,000 a year, and right now drugmakers will be penalized if they increase prices faster than the rate of inflation. This is something AARP has fought for for years and will save Medicare seniors and taxpayers billions of dollars. OK, that's tremendous progress for consumers. What other advocacy highlights can you talk to us about?

[00:22:46] Bill Walsh: Sure.

[00:22:47] Megan O'Reilly: Social Security is another top AARP priority. The administration recently announced an 8.7 percent cost of living adjustment, the largest COLA increase in 41 years. We have [00:23:00] fought long and hard to protect Social Security COLA so that seniors can keep up with rising prices. We're also fighting to improve Social Security's customer service, which is falling further behind as the number of seniors has been increasing. In addition, we advocated to increase support for family caregivers, fight age discrimination and empower older workers, protect and improve pensions and savings, improve nursing home conditions and protect older Americans from fraud. In addition to prescription drug reforms, we have championed other important improvements to Medicare, including simplifying the enrollment process, holding providers accountable for the quality of care they deliver, and making sure seniors have access to at-home COVID tests and the latest treatments at no cost. Also, something exciting that just came about this fall is for people with mild to moderate hearing loss: They can now buy more affordable hearing aids over the counter without a prescription. [00:24:00] This is all great news.

[00:24:00] Bill Walsh: All right, Megan. Well, thanks so much for that update. And before I let you go, many of our listeners have loved ones in nursing homes. For those who live and work in long-term care facilities, the pandemic is far from over. What can you share that might enlighten or help them feel empowered?

[00:24:17] Megan O'Reilly: One of the most important things people can do is to make sure their loved ones are vaccinated and have received the recommended boosters. AARP's Nursing Home COVID Dashboard shows that vaccine and booster rates have declined even though transmission in nursing homes remains elevated compared to the rest of the population. It's important that families advocate for their loved ones. Contact the nursing home and ask about vaccination rates and plans to keep residents safe this winter. And if you need help knowing what to ask, go to aarp.org/nursinghomes. See our article "10 COVID-19 Questions to Ask a Nursing Home."

[00:24:58] Bill Walsh: OK. So, that's [00:25:00] aarp.org/nursing homes. Thanks so much for being here today, Megan. If our listeners want to get involved with AARP'S advocacy efforts, what can they do to help?

[00:25:13] Megan O'Reilly: We'd encourage everyone to go online to aarp.org/getinvolved and sign up for the AARP Advocate. This is a free monthly e-newsletter, and you'll also receive email alerts and the latest advocacy news. Again, that's aarp.org/getinvolved. This is an easy way to make a big difference. Thanks for having me, and I wish everyone a happy and safe holiday season.

[00:25:40] Bill Walsh: OK, Megan, thanks so much for the update and you as well. We are going to return to more of your live questions in just a moment. Before we do, I just wanted to give our listeners some information on getting COVID tests. They can get free COVID tests at [00:26:00] covid.gov/tests or call a toll-free number: 1-800-232-0233. That's 800-232-0233. And if you'd like to pose a question to the U.S. surgeon general, Dr. Vivek Murthy, go ahead and press *3 on your telephone keypad at any time. But for the moment, Dr. Murthy, I wanted to ask you a few questions about vaccines and some important developments. We were talking earlier about the new vaccines, not so new anymore, but it's called the bivalent vaccine. I wonder if you can talk to our listeners about how it differs from previous vaccines and why it's so important.

[00:26:49] Vivek Murthy: Well, thanks for asking that question. The new bivalent booster, and also sometimes called the updated COVID vaccine, this is the most recent version of the COVID-19 [00:27:00] vaccine, and it contains both the original vaccine strain of the virus and a strain that's derived from the omicron variant, which you may remember first arrived in the United States around this time last year. And this updated vaccine is now approved for people age 6 months and older. And it's really our most effective way to maximize protection against the worst outcomes of COVID, including hospitalization and death. So, that's why we're encouraging people who receive their initial vaccine, and even if they got a booster dose, if it was more than two months ago, to go ahead and get that bivalent vaccine, that updated vaccine, because that will give you the most protection that you need going into this winter. About 42 million Americans or so above the age of 5 have already gotten the updated vaccine, but we need everyone to step up in the next few weeks to get that vaccine to ensure that we've got maximum protection over the holidays.

[00:27:59] Bill Walsh (Moderator): [00:28:00] OK. Now, the first vaccines were rolled out two years ago this week, and while we've seen the benefits of these vaccines, as you were just discussing, a smaller number of older adults are getting the successive boosters. Why does someone need boosters if they've had the initial COVID vaccine?

[00:28:19] Vivek Murthy: Well, that's a good question. If you think about other vaccines that you may have gotten, including the tetanus shot or the flu vaccine, you know that even though these vaccines work, sometimes you need to get an update or a booster, if you will. And that's because even if a vaccine is effective in generating protection, sometimes that protection can wane over time. And that's why with a number of vaccines we're asked to come back and get an additional shot. When it comes to COVID, what's happened is that, one, there has been both strong response to the vaccine but some reduction in protection over time, but also the virus itself [00:29:00] is continuing to evolve and to mutate. And what we've then thought to do is to make sure that our response is also evolving, that we keep up with it and as much as we can, stay ahead of the virus. And so that is why people have been asked in the past to both get their primary series, those first two shots, but then to get a booster on top of that. This new updated vaccine that we have is, which is called a bivalent vaccine, this combines the original strain and the omicron strain. And so this is what we feel will give you the best possible protection going forward as we go into the winter, because we're seeing different variants of omicron that are cropping up. But we feel pretty good that the vaccine will give people good protection against the worst outcomes of COVID.

[00:29:49] Bill Walsh: OK. Now, the highest number of those hospitalized and dying from COVID remain older adults, especially those over the age of [00:30:00] 65. Why do you suppose we're experiencing vaccine hesitation among those who received the initial shot and really are the ones who are most at risk?

[00:30:12] Vivek Murthy: Well, that's a very important question because we know that the more people that we get vaccinated, especially those over age 65, the more we'll be able to lower the death rate from COVID. Keep in mind that each day we're losing somewhere in the neighborhood of 400 Americans to COVID-19. That's an extraordinary toll every day. It's much better than where we were in the worst of the pandemic, where we were losing thousands of people a day. And, again, we've come a long way since then, but we want to get that number as low as possible, and we can do that if we get more folks up to date with their vaccine and more people treated with medications like Paxlovid. So, why haven't we had, what's preventing people, if you will, from [00:31:00] getting vaccinated? I would say when it comes to older people, I don't think it's so much hesitancy in the sense that they don't believe in the vaccine, because we know that somewhere around 90 percent plus of seniors actually got an initial shot of their COVID vaccine. But I do think that part of what one of the challenges that we're dealing with is that some people are just frankly fatigued with COVID. And I can understand that. I mean, we've been at this pandemic for almost three years now and, a lot of people are just [fed up] with it. I think another thing is that many people may not be listening at this time. A lot of folks moved on from reading about COVID, listening to COVID, and they wanted to understandably get back to their lives. But that means that they're not, may not be hearing the recommendations or know that the updated shot is out there, that it's important for them to get it. And third, we know that there's some group of people who, even if they know it's available and should be taken, aren't sure how urgent it is. They might [00:32:00] figure, “well, yeah, it's good to do, but maybe I'll get it later, when it's convenient.” And that's where we wanted to remind people that time does matter, because we've already started to see in the last few weeks an increase in COVID cases and in hospitalizations. And now we're starting to see death threat rates creep up a little bit as well. And so, the time is really now to get that updated shot as these numbers will probably continue to increase at least for some weeks. And last year we saw that January was when we … around late January is when we really hit the peak of the of the COVID surge. So, all the good news about all of these factors I just listed that may be preventing people from taking the vaccine is they can be addressed. We can get information to people, we can remind people about how urgent this is, we can up this knowledge of people's fatigue, but hopefully, encourage them to do what they need to do to have a protected and healthy holiday. And this isn't [00:33:00] just doctors who can do this. The good news is all of us who are on the phone today can play that role in helping to protect the people around us by letting them know that we got our updated shot and asking them if they've had a chance to go out and get theirs. And if they're not sure where to get it, just remember you can send them to vaccines.gov. And the vast majority of people in America live within a few miles of a pharmacy that has the updated vaccine. So, it's easier to get than ever.

[00:33:26] Bill Walsh: All right. Very good. All great points. Thank you for that, Dr. Murthy. Let's go back to the phone lines. It's time now to address more of your questions with U.S. Surgeon General Dr. Vivek Murthy. As a reminder, press *3 at any time on your telephone keypad to be connected with an AARP staff member and get into the line to ask your question live. Jesse, who do we have up next?

[00:33:50] Jesse Salinas: Yeah, our next question is going to come from YouTube. It's from Sandie Frus, and she asks, "Why is COVID more of an issue than standard cold if the symptoms are becoming more [00:34:00] identical?"

[00:34:00] Bill Walsh: Dr. Murthy.

[00:34:03] Vivek Murthy: Well, that's a very good question, and you are right that the symptoms are really similar. You can have a runny nose, you can have a fever, you can have a cough and congestion with a cold and with COVID. But here's the difference. We've noticed that when you look at the actual impact on severe illness, on which virus is actually landing up people in the hospital and actually costing us lives, COVID turns out to be far worse than the common cold. So, even though they may look different, I mean look similar on the surface, when you have a mild case, more people are having severe cases of illness with COVID than with the common cold. And that is why we're taking COVID so seriously. We've lost well over 1 million people during this pandemic to COVID-19. I will tell you that the death toll from flu or from the cold has been nowhere near that. And so we're seeing in the numbers itself [00:35:00] that this is a much more severe illness, and it seems to be most severe in people who are older, those who are 65 years of age and up, which is why it's so important that if you're in that age group, that you make sure you're up to date with your vaccine.

[00:35:15] Bill Walsh: OK, thanks so much for that. Jesse, who do we have up next?

[00:35:20] Jesse Salinas: We're going to take another one from Facebook. This is from Kim Reed. She says, "If someone loses their COVID vaccine card, how do they get another, and is it required for getting your boosters?"

[00:35:29] Bill Walsh: Hmm, that's a practical concern. Dr. Murthy.

[00:35:33] Vivek Murthy: Oh, Kim, that's a, a really good logistical question. And the good news is, even if you lost your card, don't worry, you can still go and get your updated shot. They won't send you back just because you don't have your card. And, in fact, what you can tell them is that you need a new card, and they'll fill one out for you there indicating that you got your updated shot, and you should be OK.

[00:35:55] Bill Walsh: OK, great. Jesse, who do we have up next?

[00:36:00] Jesse Salinas: [00:36:00] Our next caller is Doug from New Mexico.

[00:36:02] Bill Walsh: Hey, Doug, welcome to the program. Go ahead with your question.

[00:36:07] Doug: Thanks a lot. I'm 66 and up until about a month ago I was pretty religious about wearing a mask. But I've kind of, since Thanksgiving roughly, I've kind of let down my guard a bit and have not been wearing a mask in some definitely crowded situations, for example. What I was wondering as far as like the KN95s go, are there any, for example, or N95, are there any negative impacts of wearing a mask to protect myself from RSV, the flu, COVID, etc.?

[00:36:41] Bill Walsh: Dr. Murthy, can you address that question from Doug and other questions people might have about whether or not to be wearing a mask these days?

[00:36:49] Vivek Murthy: Well, Doug, thanks for that question. And I'm glad to hear that you've been so vigilant about protecting your health and about preventing folks around you from being exposed. And [00:37:00] you specifically were asking are there any negative effects to wearing masks like a high-quality mask, particularly the KN95s or the N95 masks. And the answer is no. I know there has been some misinformation circulating that maybe masks could have harmful effects on your breathing or on your metabolism. And that does not seem to be the case at all. That's not to say that masks are always comfortable. Some people don't feel necessarily comfortable in masks for long periods of time. And sometimes you have to try a few different masks to find one that works and works well for you. But with that said, there's no adverse health impact to wearing the mask and especially with winter here, with rising COVID numbers, if you are going to be in crowded indoor spaces and, again, if you're at higher risk or someone you live with is at higher risk, it makes sense to go ahead and wear that mask because it'll give you an additional layer of protection.

[00:37:56] Bill Walsh: OK, and Dr. Murthy mentioned earlier the [00:38:00] availability of a free COVID test. I just want to repeat the phone number where people can get those. That number is 1-800-232-0233. That's 800-232-0233, or go to covid.gov/tests. Jesse, let's go back to the lines and take another call.

[00:38:25] Jesse Salinas: Yeah, this next one is also from Facebook. This is from Karen. Karen says, “I've read that Paxlovid will not be covered by Medicare after the current emergency use authorization expires in 2023. Is this information accurate, and if so, is anything being done to resolve this issue?"

[00:38:41] Bill Walsh: Doctor, you can give our listeners a little update on Paxlovid, which has really been a remarkable drug. But she, Karen, is also asking about the availability of it for free.

[00:38:56] Vivek Murthy: Yeah. Well, Karen, thank you for that question. And for those [00:39:00] out there who may not be familiar with Paxlovid, this is an oral medication that can be taken by people who are at higher risk for bad outcomes with COVID. That includes people who are older. And it's a medication you take, you want to take early on in your illness course. So, if you test positive, you want to reach for Paxlovid and take it within the first few days, even if you only have mild symptoms. It's still worth taking because sometimes your symptoms can get worse later on. And what we have found is that when people do take Paxlovid, when they get ill, it significantly reduces their chances of ending up in the hospital or dying from COVID-19. So, a very important medication to take. You know, as Karen mentioned, this medication is currently available to people, and the cost is covered, and we are certainly in the process with vaccines and with other parts of the COVID response of moving these to a phase where the private [00:40:00] insurance, these sort of programs will support these and will cover them as well. So, for the time being, Paxlovid is covered, and our goal is to make sure it continues to be covered through both public and private insurance even after the emergency ends.

[00:40:18] Bill Walsh: OK. I wonder if there are any folks for whom Paxlovid is not appropriate.

[00:40:25] Vivek Murthy: Yeah, so thanks for asking that question. Paxlovid does have some interactions with other medications that you have to be mindful of. Now, it doesn't mean you cannot take Paxlovid if you're on those medications. It just may mean that they need to be held or the dose has to be adjusted. So, I'll give you an example. Certain cholesterol medications, like statin medications, have an interaction with Paxlovid. So, holding your statin for your duration of Paxlovid therapy is the appropriate thing to do, and that's something your doctor can advise you on. But also it's something that [00:41:00] generally is not harmful for people to hold their statin cholesterol medication for a few days. There's a certain blood thinner, one called Eliquis, for example, which some people may be on, which also interacts with Paxlovid. But there's circumstances where you can reduce the dose of it instead of holding it entirely, and that can allow you to take the medicine and be safe. So, what I wouldn't want people to do is to say, “Gosh there's some medication interactions. I'm just not eligible to take Paxlovid.” That's not the case. It turns out that the medication interactions can be managed, and what's really important is to make sure you're getting the medication you need to give you the greatest chance of making it through COVID without severe complications.

[00:41:46] Bill Walsh: OK. Thanks so much for that. Jesse, let's take another call.

[00:41:50] Jesse Salinas: Our next caller is going to be Vincent from Louisiana.

[00:41:53] Bill Walsh: Hey, Vincent, welcome to the program. Go ahead with your question.

[00:41:58] Vincent: I'm just wondering what [00:42:00] studies are being done for long-term effects from taking the COVID virus, or are there any studies being done taking the COVID vaccines, I'm sorry, and the booster?

[00:42:12] Bill Walsh: OK, Dr. Murthy, what about that? It's still relatively early days, but we're almost three years in. What about Vincent's question about long-term studies related to taking the COVID vaccines?

[00:42:27] Vivek Murthy: Well, that's a really good question, Vincent. Thanks for asking. One of the things that the government does in partnership with industry is to make sure that even after a medication is authorized or approved, and this applies to vaccines as well, that they continue to be studied after they're made available, just so that if there is any sort of signal that may have, [that reactions] may be taking place even at rare levels, that we detect it, and that we understand what that impact is. And so the vaccines have [00:43:00] continued to be studied even after they initially rolled out in December of 2020. And the good news so far is that two things have remained clear from this continued study: One is that the vaccines have remained remarkably effective at preventing the worst outcomes from COVID, and those are hospitalization and death, but they've also been able to do so with a remarkably strong safety profile. You may have heard some stories early on about some people who may have had allergic reactions to the vaccine. Thankfully, those were rare cases, and that happens, unfortunately, with many types of medications or vaccines. You've probably heard of friends or colleagues who have had allergic reactions to other medicines. But thankfully that is rare, and it's been manageable, actually, that you can give people medications to deal with that allergic response. So, the bottom line is that overall, when looking at the [00:44:00] safety of the vaccine, the safety profile has remained remarkably strong. And what the CDC does is it collects data that's submitted from the public for medical professionals, from public health agencies at local and state level, and they track that closely to understand whether or not there are any problems that they're being observed with the vaccines that are being taken. I raise this only because sometimes you may hear stories that somebody had a medication or took a vaccine, and then a month later they had a health complication. That what the CDC tries to do, and what scientific organizations in general try to do, is try to understand were those two events actually related to one another, because sometimes they're not. You know, like, I may have started a medication today and then I may have gotten sick tomorrow with a cold because my child came and had a cold, and infected me [00:45:00] at home. That doesn't necessarily mean that the medication caused the cold. So, when they've parsed that data and looked at it carefully, what they have found is, again, that the safety profile of these vaccines is really strong. But I'm glad you raised the question, Vincent. This is something that they will continue to study to make sure that the safety profile remains good, and that the benefits continue to outweigh any risks.

[00:45:22] Bill Walsh: OK. Thanks for that. Jesse, let's take another caller.

[00:45:26] Jesse Salinas: Our next caller is going to be from Robert in Michigan.

[00:45:29] Bill Walsh: Hey, Robert. Welcome to our program. Go ahead with your question. Hey, Robert, how are you?

[00:45:44] Robert: Good. How are you doing today?

[00:45:46] Bill Walsh: Good. Go ahead with your question.

[00:45:48] Robert: OK, my big question is I live here in Michigan in a very desirable area, which is in northern Michigan here, and my concern [00:46:00] is that there's so much disinformation coming … here. We have people in my neighborhood who travel a lot back and forth from Florida to Michigan. And they're listening to bad advice. And my wife and I know many people that refuse to be vaccinated, and we just don't understand why so many people have decided to listen to the wrong information about all of this going on. And it's very confusing to us. We just don't understand why we, we kind of live in an area where a lot of people have just, they, they are just against all of it — vaccines and all of it regarding their [00:47:00] health. And we just don't understand that. And we can no longer be around those people and that's a big concern to us.

[00:47:11] Jesse Salinas: Oh, looks like we lost him, Bill. I'm sorry.

[00:47:12] Bill Walsh: Ah, OK. Well, Robert, thanks for that question. And I assure you the misinformation isn't just in Michigan. And we are actually going to turn to a segment on misinformation. But before we do, Dr. Murthy, I was wondering if you could address Robert's concern. I think a lot of our listeners know people or are hearing about people who don't believe in the efficacy of the vaccine or the virus. What do you say to them?

[00:47:44] Vivek Murthy: Well, I really empathize with Robert's question because like Robert, I also have seen how frequently misinformation has spread and how it's led people to often [00:48:00] make decisions that are counter to their health interests. And that's been very sad to see. And I know many of us have likely seen that in our own families. I think, unfortunately, what happened in the COVID response is, unfortunately, things became polarized very quickly and as misinformation spread, it found a particular home for spreading online. And that, I think, really hurt us, and many people, as things evolved in this pandemic — because again, things did evolve, right? We were learning about this new virus, and as we learned more, recommendations evolved, but as those recommendations evolved and changed, it was also confusing to people. And sometimes they weren't quite sure who to believe, who was telling the truth. And so this to me is, this is one of the reasons why in July of 2021, I issued a Surgeon General's Advisory on health misinformation because we'd recognized just what a profound impact this is having [00:49:00] on our health. I think misinformation was literally costing people their lives. As a doctor, I believe that people have the right to make their own decisions about their health. I also think they have the right to get accurate information so they can make those decisions in a way that's consistent with their own interests. And so one of the things I would just remind folks of is when we think about misinformation, just remember there's a lot of it out there. It's not always easy to tell what's accurate and what's not. So, make sure you're getting your information from a trusted source like your doctor, your local health department, the CDC or another trusted scientific body. The second thing I would say is if you encounter information that seems like it's worrisome and you think, Gosh, I gotta let people know about this. Again, if you're not sure about this source, then I would not share it online because this is, unfortunately, how misinformation spreads despite the best of our intentions. And finally, if you've got somebody in your [00:50:00] family who may have absorbed some misinformation and may have questions or be confused about whether it's medications around COVID or whether COVID itself is even serious or around the vaccine, and if you want to have a conversation with them, just remember it's important always just to start with listening first. Nobody likes to have a conversation when they, if they're feeling the other person's goal is to change your mind. But if you can have a conversation with somebody and listen to them and understand their point of view, and then share your own perspective, that can often be a more productive pathway to having a conversation with somebody who may have a different point of view.

[00:50:37] Bill Walsh: Well, that's a great tip as people are preparing to gather for the holidays and maybe having some of those very discussions. Let me bring in our other guest, Alex Mahadevan, the director at MediaWise. Alex is an expert on online misinformation and disinformation. MediaWise is a nonprofit organization that helps older Americans learn how to sort fact from [00:51:00] fiction online. Thanks for returning to our program, Alex.

[00:51:04] Alex Mahadevan: Yeah, happy to be here.

[00:51:05] Bill Walsh: You heard the doctor just say that so much of this misinformation is spread online, and of course, social media is a powerful tool to connect people, but also a consistent source of false and misleading information. What should social media companies be doing to combat false and outlandish public health claims? And how can people protect themselves and build up their digital literacy?

[00:51:31] Alex Mahadevan: Well, that's a great question. So, for the first part, I think social media companies should be doing everything they can to prioritize and surface legitimate important information. So, for example, we should, on Facebook or wherever, see the messages from the surgeon general about free COVID-19 tests much more prominently than posts from, like, John Boy 6767. Posts from the CDC should outweigh your crazy aunt on your newsfeed. [00:52:00] Secondly, they should be limiting the reach and attaching fact checks to harmful misinformation, especially harmful health misinformation.

[00:52:07] Alex Mahadevan: Now, Facebook and Instagram, they do a relatively good job at flagging posts like this. You might have seen warnings if you spend any time on social media about COVID-19 or election misinformation. But really, social media firms should be working with fact-checkers. But you really can be your own fact-checker, you know? So, as far as building resiliency to misinformation, the first thing I would say — and Dr. Murthy had some great, great tips — but first and foremost, stay in tune with your feelings when you see the email or a video on Facebook. If it makes you angry, anxious, upset, or even happy or overjoyed, there's a chance it could be misinformation. See, when we get emotional, we let our guard down, and that's really where bad actors pounce. So, just be on the lookout for these false posts claiming that celebrities have "died [00:53:00] suddenly from the vaccine." Now, they may pop into your timeline and really freak you out, but you gotta stay in tune with those emotions. And I just, I have to direct you to, MediaWise has worked with AARP on some great content that can help teach you to be a fact-checker. If you follow the link poy.nu/aarp, you can take a free course that we have worked on together.

[00:53:26] Bill Walsh: All right, that was poy.nu/aarp. Thanks for that, Alex. Dr. Murthy, you had said a moment ago that misinformation has literally cost people their lives. How has misinformation undermined care and treatment? Can you say a little bit more about that?

[00:53:48] Vivek Murthy: Sure. So, we rely on accurate information to help people make health decisions. And when lifesaving treatments and vaccines are available, we want people to know [00:54:00] about them so they can protect themselves and their families. When people don't have access to that information because they're misled by misinformation, then that can lead them to make decisions that may, in fact, have them turn down lifesaving treatments or lifesaving vaccines or that may lead them to deny or even lead them to not take precautions to protect themselves from getting COVID in the first place because they're misled to think that COVID is no worse than the common cold. And so that is one tangible way. Sadly, we've seen again and again and again misinformation lead to bad health outcomes. But we've also seen something else, which is that misinformation has taken a toll on our health care workers, our nurses and doctors and others in our hospitals. I've spent a lot of time with health care workers from around the country, and what they used to tell me time and time again was that they were battling COVID in the hospital during the day, and then they were [00:55:00] coming home at night and battling COVID online trying to convince their patients and their family members that the misinformation that they were encountering online was not true. And it was truly exhausting for health care providers who've already been overtaxed and who have burned out at incredibly high rates during this pandemic. So, the bottom line is misinformation harms people, but it also makes the job of health care workers much, much harder. And it, in many cases, has made the conversations and engagements between health care providers and their patients more difficult as well. We know that according to surveys from the Kaiser Family Foundation, that around [nearly 8 in 10] of people on their surveys either believe some piece of misinformation about COVID or think that misinformation might be true. That's an incredibly high number, and so one of the great challenges we're going to have, not just in addressing this pandemic going forward but in public [00:56:00] health more broadly, is figuring out how to address the rapid growth of misinformation online so that people know that they can get accurate, reliable information to help them make decisions for themselves and their families.

[00:56:14] Bill Walsh: All right, thanks for that. Well, Alex, let's talk about one of the most prominent social media platforms, and that's Twitter. And of course there's been big news with the shake-up at Twitter in recent months. But the fact is that less than one quarter of adults in the U.S. use Twitter according to Pew Research Center. So, what is Twitter's real influence? Do false and misleading informational tweets really matter?

[00:56:40] Alex Mahadevan: So true. Fewer people use Twitter. That is true, but a majority of the people who do use it, they use it to follow the news. People don't use Facebook, Instagram or TikTok in the same way. So, at its core, Twitter has just become the place [00:57:00] to follow breaking news. And it's also a platform that is really dominated by journalists and policymakers and all sorts of movers and shakers and influencers who are following and reporting the news. So, what happens on Twitter gets reported in big news outlets. We've seen this, like you mentioned the shake-up, it gets splashed across TV screens and where we see the most misinformation, the absolute most, posted on other social media platforms. You see tweets, misleading tweets that are posted on Facebook or Instagram or elsewhere. So, that's a media literacy tip right there. If you see a tweet that's posted on another platform, check it out because it might be chock-full of falsehoods. And as far as where it matters, misinformation anywhere matters. Misinformation anywhere online has those real-world effects that Dr. Murthy just mentioned. And on Twitter, misleading information about COVID-19 vaccines, whether it's falsely claiming [00:58:00] a celebrity death as a result of the shot or something, they create vaccine hesitancy in the real world. It causes real conflict that can play out at holiday dinner tables. And it obviously makes someone like Dr. Murthy's job a lot harder. It's just ,a false post online can create this massive ripple effect that harms you, your family, your community.

[00:58:23] Bill Walsh: Well, Alex, maybe you can tell us where older adults can turn for reliable information.

[00:58:28] Alex Mahadevan: Well, I think, again, Dr. Murthy summed it up really well: When you go to official sources of information — that might be the CDC, the WHO, your local doctor — if you go to a general practitioner, please ask her all these questions that came up today. I would also add, your local news outlet knows your area, your region, your local health department. So, really look to the experts, look to the reporters to [00:59:00] get your information. And, as a longtime user, I would say, don't even go on Twitter.

[00:59:06] Bill Walsh: OK. Dr. Murthy, I'll give you the last word. Where should people go for reliable health information?

[00:59:15] Vivek Murthy: Well, I think, Alex summed it up well. Think about the people who have credentials and credibility to give you information on health. I love my grandmother dearly, but I don't get my health information from her because that's not her area of expertise. But your doctor, the nurses who may be involved in your care, your local health department, the CDC: These are all places that you want to go to. And if you encounter information online, if somebody sends you, say, a piece of information by text or email, make sure you look at the source, and if you can't find a source, you should pause before you act on that or before you share it with other people. But overall, I just want to say also, I know we [01:00:00] spent a lot of time today talking about different aspects of COVID. I know this has been a really tough pandemic for so many of us. It's been three years. Many of us may have lost family members — I know I have — to COVID-19. Many of us may have had our lives disrupted in other ways, losing the chance to be together for the holidays in the first couple of years of COVID, or in some cases maybe worrying about jobs or worrying about your grandkids in school or about safety. And these are all real tolls, if you will, of the pandemic. And while there's the physical toll that we hear about and read about in the papers, I also want to acknowledge the mental health toll of this pandemic. It's something that we should be mindful of. And if you're having trouble sleeping, as I was early in the pandemic, if you're finding that you're more irritable, that you're more stressed in general, this is a time where you're not alone. A lot of people are feeling that way, and it's in [01:01:00] part because of the upheaval that we've experienced over the last three years. So, all that to say just give yourself some grace. Be patient with yourself. If you're feeling that way, just know that you're not alone. And this is a time where I think we also have to give each other a bit of grace and realize that the impatience or the challenges we may find in our encounters with other people maybe could be they, too, might be having a hard time dealing with this pandemic. But I'm optimistic going forward because I have seen how far we have come. We have tools now to address COVID that we just did not have at the beginning of this pandemic. I remember March 2020 very clearly. And I only wish that we had had vaccines and treatments and tests and high-quality masks widely available. I think we could have saved even more lives. We do have those now. I want people to know about them so they can use them to protect themselves and their families, and so that ultimately we can get back to the [01:02:00] things that we love in our life, our family, our friends, our work, our hobbies and just being together.

[01:02:06] Bill Walsh: Well, that's a great end-of-year message. Thank you so much, Dr. Murthy and Alex Mahadevan. Terrific insights and information today. I also want to thank our AARP members, volunteers and listeners for participating in the discussion today. AARP, a nonprofit, nonpartisan membership organization has been working to promote the health and well-being of older Americans for more than 60 years. In the face of this crisis, we're providing information and resources to help older adults and those caring for them protect themselves from the virus, prevent its spread to others while taking care of themselves. All of the resources referenced today, including a recording of the Q&A event, can be found at aarp.org/coronavirus beginning tomorrow, December 16th. Go there if your question was not addressed, and you'll find the [01:03:00] latest updates as well as information created specifically for older adults and family caregivers. We'll return in 2023 with more informational and helpful programs, and we hope you'll join us then. In the meantime, we hope your holiday celebrations are safe and healthy. Thank you and have a good day. This concludes our call.