Seniors and COVID

Ok, I am a senior, and I am a physician. We seniors have and continue to make up the substantial majority of those who become seriously ill. We seniors overwhelm the healthcare system; we suffer greatly, and we die, leaving our lives incomplete and our families grieving our loss. What is best for folks my age regarding COVID now? What has changed? What is understood and what remains, well, muddled and confusing?
   
Seniors have access to vaccines and boosters. Should they take them? I have spent many hours discussing this with patients. Some patients are unwilling to take even the initial series of vaccine, citing personal preference, or thinking that they are protected because they have already had COVID. Vaccines can offer added protection to people who have had COVID-19, including protection against being hospitalized from a new infection, especially as variants continue to emerge.
   
Some have already had the initial series plus a booster. Why get the new (bivalent) booster? If your primary vaccination series was more than five months ago, especially if you are an older adult, your neutralizing antibodies have largely waned, and a booster, as with other vaccines for measles and tetanus, will restore immunity and should prevent breakthrough infection. An updated (bivalent) booster helps our bodies make neutralizing antibodies to the currently dominant and highly infectious Omicron BA.5 subvariant, as well as to the original virus.
   
These vaccines have been thoroughly researched and monitored. Vaccines do have side effects, usually short-term. The benefits of COVID-19 vaccination far outweigh the known and feared risks. As with any vaccination, some people have short-term side effects such as headache, fatigue, muscle pain, and soreness at the injection site. Serious side effects are rare.
 
 Paxlovid, and to a lesser extent molnupiravir, remdesivir, and the monoclonals, do allow us to treat most patients who come to our attention early in the course of the disease; most recover in a few days. Treated patients sometimes, but not often, worsen to the point of needing emergency room or hospital care.
   
Our local hospital system reports having a moderate number of COVID cases; many of those in hospitals are there for other reasons and happen to have the virus. COVID cases burden healthcare personnel, and there remain limits on access for some medical procedures. Unless the newer variants take a turn for the worse, we have a path toward more normal living.
   
We have much more information now:
• New variants occur quite often, quickly taking the place of the former ones
• The newest variants are simultaneously less dangerous to the individual with COVID, yet more folks contract the illness from those who are not all that ill
• The best public health precautions have helped keep hospitals from being overburdened
• Divisions between people cause much harm – at a time when unity of purpose would be so much wiser
• Vaccines sharply lessen the risk of having a hospital-level illness or death
• “Long-COVID” is common and includes a wide range of health problems that can last weeks, months, or longer
• We have sufficiently accurate tests to diagnose COVID early and limit its spread
• There are enough high-quality masks that when used appropriately can lessen the risk of getting infected.
   
Seniors remain at much higher risk for serious COVID. As we age our immune systems are less robust in identifying and destroying offending infection of all kinds – COVID is no exception. Many of us have other health risks – particularly heart and vascular disease; diabetes; liver or kidney diseases; cancer; obesity – or take medicines that decrease our immune function. As seniors, we more often than our younger family and friends, are impaired sufficiently that managing a problem like COVID adds to the limitations we already have.
   
So, my fellow seniors – please get the protection afforded by the COVID booster injections; obtain high quality masks and use them when indoors in an area of risk; and stock up on COVID test kits and learn how and when to use them.
   
Non-senior friends and family, you can protect us best by carefully managing your own risk.
 
 Jesus taught what I believe would be in line with other faith groups when He said, “Thou shalt love thy neighbor as thyself.” By caring for each other, we can find a better path to living with COVID.

Jim Redka, MD, is a board-certified family physician practicing with FPC Cornerstone and past president of the Lycoming County Medical Society.
Published: 9/17/22

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