Tag Archives: Elderly

Delayed 2nd Pfizer/BioNTech shot boosts antibodies in elderly; COVID-19 obesity risk higher for men

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Delaying second Pfizer/BioNTech dose boosts antibodies in elderly

Delaying the second dose of the Pfizer/BioNTech COVID-19 vaccine beyond the originally recommended three-week gap used by the companies in clinical trials appears to induce a stronger antibody response in the elderly, UK researchers found. Shortly after the vaccine became available, UK health officials advised that the second dose should be given 12 weeks after the first to allow more people to get protected by a first dose early on. In a new paper seen by Reuters and expected to appear on medRxiv on Friday ahead of peer review, researchers found that among 175 people ages 80 to 99, those who got their second dose at 12 weeks had antibody responses that were 3.5 times higher than those who got it after three weeks. Antibodies are only one part of the immune system, and vaccines also generate T cells that fight infections. The peak T cell responses were higher in the group with a three-week interval between doses, and the authors cautioned against drawing conclusions on how protected individuals were based on which dosing schedule they received.

Impact of obesity on COVID-19 risks may be greater in men

The known increased risk of severe COVID-19 and death linked to obesity may be even more pronounced for men than women, new data suggest. Researchers studied 3,530 hospitalized COVID-19 patients with an average age of 65, including 1,469 who were obese. In men, moderate obesity was associated with a significantly higher risk of developing severe disease, needing mechanical breathing assistance and dying from COVID-19. (The threshold for moderate obesity is a body mass index (BMI) of 35. In an 5-foot, five-inch tall (1.65 m) adult, that would correspond to a weight of 210 pounds (95 kg). In women, however, only a BMI of 40 or higher, indicating severe obesity, was linked with the increased risks. In a report published in European Journal of Clinical Microbiology & Infectious Diseases, the researchers note that while obesity is known to be linked with body-wide inflammation, patients’ levels of inflammatory proteins did not appear to explain the association between obesity and severe illness. For now, they conclude, “particular attention should be paid” to protecting patients with obesity from the coronavirus, “with priority to vaccination access, remote work, telemedicine, and other measures given the higher risk of adverse outcomes once they are diagnosed with COVID-19.”

COVID-19 testing rates low among symptomatic Americans

Sick Americans appear to be passing up opportunities to get tested for coronavirus and thus are likely unknowingly spreading the infection throughout their communities, new research shows. Among 37,000 adults across the United States who participated in a smartphone app survey between March and October 2020, nearly 2,700 reported at least one episode of fever and chills. But according to a report published in JAMA Network Open, only a small fraction reported receiving a COVID-19 test result within seven days of the onset of illness. At first, as tests became more accessible, the numbers improved. In early April 2020, less than 10% of survey participants reporting illness with fever received test results within a week. By late July, that proportion had increased to 24.1%. Throughout the summer and fall, as tests became easier to find, the number of sick participants who reported getting tested remained flat. By late October, only 26% reported receiving a test result within a week of febrile illness. “It’s shocking to me that when people have a fever they’re still not getting tested,” said coauthor Dr. Mark Pletcher of the University of California, San Francisco. “Tests are easy to come by. People might have coronavirus, might be spreading it to their friends and neighbors, and they’re not getting tested.”

(Reporting by Nancy Lapid, Alistair Smout and Ronnie Cohen; Editing by Bill Berkrot)

T cell shortage linked to severe COVID-19 in elderly; antiseptic spray may limit virus spread

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Shortage of ‘naive’ T cells raises COVID-19 risk in elderly

A lower supply of a certain type of immune cell in older people that is critical to fighting foreign invaders may help explain their vulnerability to severe COVID-19, scientists say. When germs enter the body, the initial “innate” immune response generates inflammation not specifically targeted at the bacteria or virus.

Within days, the more precise “adaptive” immune response starts generating antibodies against the invader along with T cells that either assist in antibody production or seek out and attack infected cells.

In a small study published on Wednesday in Cell, COVID-19 patients with milder disease had better adaptive immune responses, and in particular, stronger T-cell responses to the coronavirus.

People over age 65 were much more likely to have poor T cell responses, and a poorly coordinated immune response in general, coauthor Shane Crotty of the La Jolla Institute for Immunology said in a news release.

As we age, our supply of “naive” T cells shrinks, he explained. Put another way, we have fewer “inexperienced” T cells available to be activated to respond to a new invader. “Ageing and scarcity of naive T cells may be linked risk factors for failure to generate a coordinated adaptive immune response, resulting in increased susceptibility to severe COVID-19,” the researchers said.

Antiseptic nasal spray may help limit coronavirus spread

An antiseptic nasal spray containing povidone-iodine may help curb transmission of the new coronavirus, preliminary research suggests.

In test tube experiments, a team of ear, nose and throat doctors found that a povidone-iodine nasal spray inactivated the virus in as little as 15 seconds. The nasal spray they tested is typically used to disinfect the inside of the nose before surgery. Formulations designed for use on skin are not safe in the nose, the researchers note.

They reported on Thursday in JAMA Otolaryngology – Head and Neck Surgery that they now have their patients use the spray before intranasal procedures, to reduce the risk of virus transmission through the air via droplets and aerosol spread.

They also suggest instructing patients to perform nasal decontamination before coming to appointments, to “further decrease intranasal viral load and … prevent spread in waiting areas and other common areas.” They caution, however, that routine use of povidone-iodine would not be safe for some people, including pregnant women and patients with thyroid conditions. Larger clinical trials have not yet proved that viral transmission is curbed by intranasal povidone-iodine solutions, but “these studies are already underway,” the researchers said.

Not all COVID-19 antibody tests are equal

Some COVID-19 antibody tests are much more reliable than others. But even with the best ones, reliability varies among patient subgroups, a new study suggests. Some tests look for IgM or IgA antibodies, the first antibodies produced by the immune system in response to an invader, which do not remain long in the body.

Other tests – the most common kind – look for IgG antibodies, which generally develop within seven to 10 days after symptoms begin and remain in the blood for some time after the patient recovers.

In a study posted on medRxiv on Wednesday in advance of peer review, researchers analyzed data from 11,809 individuals whose COVID-19 had been diagnosed with highly rated tests to see how well the various antibody assays would “recall” that the patient had been infected.

The most commonly used assays, which look for IgG, had a 91.2% recall rate. But the IgA and IgM assays had estimated recall rates of 20.6% and 27.3%, respectively, coauthor Natalie Sheils of UnitedHealth Group told Reuters. “Recall varies significantly across sub-populations and according to timing of the tests, with performance becoming relatively stable after day 14,” she said. “The tests performed better for men versus women, for non-whites versus whites and for individuals above age 45.” More research is needed to understand why these variations occur, Sheils added.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

Japanese researchers build robotic tail to keep elderly upright

An elderly woman prays at a chapel of the San Rafael nursing home in Arecibo, Puerto Rico February 14, 2018. Picture taken February 14, 2018. REUTERS/Alvin Baez

Millions of years after the ancestors of humans evolved to lose their tails, a research team at Japan’s Keio University have built a robotic one they say could help unsteady elderly people keep their balance.

Dubbed Arque, the grey one-meter device mimics tails such as those of cheetahs and other animals used to keep their balance while running and climbing, according to the Keio team.

“The tail keeps balance like a pendulum,” said Junichi Nabeshima, a graduate student and researcher at the university’s Embodied Media Project, displaying the robotic tail attached to his waist with a harness.

“When a human tilts their body one way, the tail moves in the opposite direction.”

As Japan greys it is leading the industrial world in seeking ways to keep its aging population mobile and productive.

While other nations have turned to immigrant workers to replenish a shrinking workforce, less welcoming Japan has focused more on a technological solution.

The robotic tail, which uses four artificial muscles and compressed air to move in eight directions, will remain in the lab for now, however, as researchers look for ways to make it more flexible, Nabeshima said.

Apart from helping the elderly get around, the team are also looking at industrial applications for the artificial appendage, such as a balance aid for warehouse workers carrying heavy loads.

“I think it would be nice to incorporate this further developed prosthetic tail into daily life, when one seeks a little more help balancing,” Nabeshima said.

(Reporting by Megu Jones; Editing by Clarence Fernandez)

Heatwave caused nearly 400 more deaths in Netherlands: stats agency

FILE PHOTO: People cool off underneath a tree during a sunny day in the Vondelpark in Amsterdam, the Netherlands, July 25, 2019. REUTERS/Piroschka van de Wouw

AMSTERDAM (Reuters) – Almost 400 people more died in the Netherlands during Europe’s recent record-breaking heatwave than in a regular summer week, Dutch national statistics agency CBS said on Friday.

In total, 2964 people died in the Netherlands during the week that started on July 22, the CBS said, which was around 15% more than during an average week in the summertime.

Temperature records tumbled across Europe during late July’s heatwave, and for the first time since records began topped 40 degrees Celsius (104 Fahrenheit) in the Netherlands on July 25.

The death toll in the Netherlands during that week was comparable to the rate during two heatwaves in 2006, which were among the longest ever in the country, the researchers said.

About 300 of the additional fatalities were among people aged 80 years and older.

Most of the deaths occurred in the east of the Netherlands, where temperatures were higher and the heatwave lasted longer than in other parts of the country.

The Netherlands has a total population of around 17 million.

The heatwave was the second to hit Europe in a month, and climate specialists warn such bursts of heat may become more common as the planet warms up due to greenhouse gas emissions.

(Reporting by Bart Meijer; editing by Darren Schuettler)

Islamic State pinned in tiny eastern Syria enclave with families, U.S. backed force says

FILE PHOTO: Syrian Democratic Forces (SDF) celebrate the first anniversary of Raqqa province liberation from ISIS, in Raqqa, Syria Ocotber 27, 2018. REUTERS/Aboud Hamam/File Photo

By Rodi Said

QAMISHLI, Syria (Reuters) – Islamic State fighters in eastern Syria are pinned down in a final tiny pocket with their wives and children, forcing a U.S.-backed militia to slow its advance to protect civilians, the militia said on Tuesday.

An aid agency said separately that 10,000 civilians had fled the enclave since last week and were arriving hungry and desperate at a camp.

The Kurdish-led Syrian Democratic Forces, which have been backed by 2,000 U.S. troops and air support, are preparing for a final showdown with Islamic State in eastern Syria after helping to drive the fighters from the towns and cities that once formed the group’s self-proclaimed caliphate.

SDF spokesman Mustafa Bali said Islamic State fighters were now confined to a pocket of just 5-6 square km (around 2 square miles) by the Euphrates River. The presence of their wives and children meant the U.S.-backed militia could not launch an all-out storm of it, and was using slower, more precise tactics instead.

“There are thousands of Daesh families there. They are civilians at the end of the day,” Bali told Reuters, using an acronym for Islamic State. “We cannot storm the area or put any child’s life in danger.”

The SDF had refused an offer from the jihadists via mediators to surrender the territory in return for safe passage out, Bali said.

Clashes had slowed because of the presence of the civilians, and “precise operations” were taking more time. “Calm prevails on the frontlines but there’s a state of caution and waiting.”

The International Rescue Committee (IRC) charity said it was helping tend to a sudden influx of more than 10,000 people, almost all women, children and elderly, who had arrived at a camp in northeast Syria since last week.

Most were exhausted, extremely hungry, and thirsty as they fled Islamic State territory, the global aid agency said. Many arrived barefoot. The United Nations confirmed that 12 young children had died after reaching the al-Hol camp or on the dangerous journey there, the IRC added on Tuesday.

The SDF, spearheaded by the Kurdish YPG militia, has seized much of north and east Syria with U.S. help. It has been battling Islamic State remnants near the Iraqi border for months.

Last month, U.S. President Donald Trump declared that Islamic State had been defeated and announced the abrupt withdrawal of the U.S. troops, over objections of top advisors including Defense Secretary Jim Mattis who quit in protest.

The SDF vowed to escalate its operations against Islamic State this month after a bomb attack killed several people including two U.S. soldiers in northern Syria. SDF officials have warned of an Islamic State revival if Washington withdraws.

Kurdish leaders also fear a U.S. pullout would give Turkey, which sees the YPG as a threat on its border, the chance to mount a new assault. Washington has since said it will make sure its allies are protected when it leaves.

(Reporting by Rodi Said in Syria and Ellen Francis in Beirut; Editing by Peter Graff)

In Puerto Rico, a new hurricane season threatens the elderly

An elderly woman prays at a chapel of the San Rafael nursing home in Arecibo, Puerto Rico February 14, 2018. Picture taken February 14, 2018. REUTERS/Alvin Baez

By Nick Brown, Jessica Resnick-Ault and Ricardo Ortiz

ADJUNTAS, PUERTO RICO (Reuters) – At 84 years old and battling cancer, Israel Gonzalez Maldonado has lived without electricity for the nine months since Hurricanes Irma and Maria devastated Puerto Rico.

His wife, Zoraida Reyes, 77, struggles to keep the house stocked with fresh food without a refrigerator. At night, she fans her husband so he can sleep.

With another hurricane season starting, older Puerto Ricans have little to protect them from another storm on an impoverished island that remains far from fully recovered. Younger and wealthier people have been moving away for years, leaving an older and sicker population in the hands of an underfunded healthcare system. Tens of thousands more have fled since Maria.

“We wish we could move, at least for the time he has left,” Reyes said of her husband.

Senior citizens make up a larger share of the population here than in all but four U.S. states, according to federal Census data. About half are disabled, more than any state.

Forty percent of seniors rely on food stamps, more than three times the percentage in New York state, the second-highest nationally.

Yet the island has just six nursing homes – with a total of 159 beds – that are certified by the U.S. Centers for Medicare and Medicaid (CMS) to provide rehabilitative services.

Puerto Rico relies instead on a patchwork of about 800 nursing homes licensed by the island’s Department of Family. They are typically private businesses or nonprofit organizations that care for small numbers of elderly people with limited services – and limited budgets, strained further since Maria.

A fragile healthcare system is hardly the only problem that leaves the elderly here – and all Puerto Ricans – vulnerable to another catastrophic storm.

About 7,000 houses and businesses still lack power, after Maria leveled a grid that was ill-maintained before the storm. Power utility PREPA has patched together most of the system but remains years away from making the fundamental improvements needed to enable it to withstand another hurricane.

“The grid needs to be rebuilt – not just the lines,” PREPA Chief Executive Walter Higgins said.

Maria also damaged nearly half the island’s levees. Several major water pumps, used to remove floodwater, remain in disrepair.

“God help us, but we definitely can’t handle any more hurricanes,” said Tania Vazquez, the island’s secretary of natural resources.

Governor Ricardo Rossello’s office declined to comment on the island’s hurricane preparedness or on specific efforts to protect the elderly, referring questions to other agencies.

Glorimar Andujar, Secretary of the Department of Family, said officials learned a lot from Maria about how to prepare for the next storm.

“The emergency plans are much better,” Andujar said, “because we now have an experience that no other generation of agency leaders have experienced.”

ELDERLY AT RISK

Rosa Iturrizaga runs Hostal de Amigos, a small eldercare residence in San Juan.

The home barely broke even before Maria, relying on resident fees of between $2,000 and $3,000 a month. Since then, two of 11 residents moved to the mainland, and insurance has so far not paid for about $40,000 in storm damage, Iturrizaga said. The business carries $500,000 in debt, has fallen behind on loan and tax payments and now loses up to $5,000 a month.

“I don’t know what’s kept me going,” Iturrizaga said. “I love doing this, but I’m looking at other things to do with the land.”

Another private home, the nonprofit Asilo San Rafael in Arecibo, theoretically charges residents $1,200 a month; in reality, only three of 27 residents pay full price, and at least nine pay nothing, said board member Lucila Oliver.

Operating costs run about $700,000 annually, with about $110,000 coming from a handful of subsidies from the island’s central government – subsidies she says have declined sharply in recent years as the now-bankrupt Puerto Rican government fell into a fiscal crisis, Oliver said.

The Department of Family’s Andujar disputed that the subsidies have declined, but Oliver provided Reuters with balance sheets showing a drop in department funding to $59,000 this fiscal year from $80,000 last year.

Maria brought new costs: about $1,200 a month to bring in water tanks, and thousands more on diesel for generators. Oliver said San Rafael is “used to living on the edge,” but says the edge has drawn closer since the hurricanes.

Many elderly and disabled here find a way to get by at home, with little care. Some seek help from the Department of Family, applying for a caregiver to come by just a day or two a week, said Andujar.

Many are turned away, she said.

“The funding is very limited,” she said, “and the need is very big.”

PREPARING FOR ANOTHER HIT

This hurricane season, the department is making sure it has accurate locations for all licensed nursing homes after cell phone service disruptions stymied the response to Hurricane Maria. The homes, Andujar said, are now required to have 30 days of food on hand, and the department has also requested they have generators and water tanks.

She added that about 315,000 elderly people currently receive benefits as part of a $1.27 billion federal allocation under the Nutritional Assistance Program.

The U.S. Federal Emergency Management Agency (FEMA) remains on the island and said it has given municipalities money to improve community resilience.

Dr. Carmen Sanchez Salgado, Puerto Rico’s ombudsmen for the elderly, said her staff has been educating elderly people about the emergency supplies they need.

Charities and nonprofits have also helped. The nonprofit PRxPR, created in response to Maria, is funding solar panels for elderly people and community centers.

One such center in Naguabo had no power as recently as four weeks ago, said Carmen Baez, the group’s co-founder.

“Our installation was it,” she said.

(Reporting by Nick Brown, Jessica Resnick-Ault and Ricardo Ortiz; Additional reporting by Robin Respaut; Editing by Daniel Bases and Brian Thevenot)

U.S. flu-related hospitalizations highest in nearly a decade: agency

Emergency room nurse Christine Bauer treats Joshua Lagade of Vista, California, for the flu as his girlfriend Mayra Mora looks on in the emergency room at Palomar Medical Center in Escondido, California, U.S., January 18, 2018.

By Deena Beasley

(Reuters) – Flu activity worsened over the past week as more people headed to doctors’ offices and emergency rooms, with hospitalizations at the highest in nearly 10 years, U.S. health officials said on Friday.

Sixteen children died of the flu in the week ended Jan. 27, bringing total pediatric deaths to 53 for the season, according to the Centers for Disease Control and Prevention’s weekly report.

Out of every 100,000 people in the general population, an estimated 51.4 have been hospitalized for the flu, surpassing the rate in the last severe season of 2014/2015, when 710,000 were hospitalized and 148 children died. Adults aged 65 or older had the most hospitalizations, followed by those aged 50 to 64, and children below 5.

The dominant strain during this flu season is an especially nasty type called influenza A (H3N2) that in seasons past had been linked with severe disease and death, especially in the elderly and young.

“So far this year the cumulative rate of hospitalization is the highest since we began tracking in this way,” Dr. Anne Schuchat, acting director of the Centers for Disease Control and Prevention, told reporters on a conference call. The CDC began its current hospital flu surveillance program during the 2009-2010 H1N1 swine flu pandemic.

Schuchat was named acting CDC director earlier this week after Dr. Brenda Fitzgerald resigned from the post because of financial conflicts of interest, including purchases of tobacco and healthcare stocks while in office.

Flu is widespread in 48 states, down from 49 last week, with Oregon reporting less flu activity, the CDC said.

“We are not out of the woods yet,” Schuchat said, noting that sick people should stay home to avoid transmitting the virus to others, frequently wash hands and cover their mouth while coughing or sneezing.

The CDC official also said it was not too late to get a flu vaccine.

(Reporting by Deena Beasley; Editing by Richard Chang)

Death toll from overheated Florida nursing home rises to 10

FILE PHOTO: The Rehabilitation Center at Hollywood Hills is seen in Hollywood, north of Miami, Florida, U.S., September 13, 2017. REUTERS/Andrew Innerarity/File Photo

(Reuters) – A 10th elderly patient at a Miami-area nursing home has died after she was exposed to sweltering heat in the aftermath of Hurricane Irma, police said on Thursday.

The resident of the Rehabilitation Center at Hollywood Hills died on Wednesday, police in Hollywood, Florida, said in a statement, without giving details.

Police have opened a criminal investigation into the deaths at the center, which city officials have said continued to operate with little or no air conditioning after power was cut off by Irma, which struck the state on Sept. 10.

Julie Allison, a lawyer for the nursing home, did not respond to a request for comment. Calls to the Rehabilitation Center went unanswered.

Florida’s Agency for Health Care Administration suspended the center’s license on Wednesday and terminated its participation in Medicaid, the federal-state healthcare program for the poor, disabled and elderly.

Medical personnel at the home had delayed calling 911 and residents were not quickly transported to an air-conditioned hospital across the street, the agency said in a statement.

Patients taken to the hospital had temperatures ranging from 107 Fahrenheit to 109.9 Fahrenheit (41.7 Celsius to 43.3 Celsius), it said. Average human body temperature is 98.6 Fahrenheit (37 Celsius).

Staff at the center also made many late entries to patients’ medical records that inaccurately depicted what had happened, the agency’s statement said.

One late entry said a patient was resting in bed with even and unlabored breathing, even though the person had already died, the statement said.

Last week, the agency ordered the center not to take new admissions and suspended it from taking part in Medicaid.

Irma was one of the most powerful Atlantic storms on record and killed at least 84 people in its path across the Caribbean and the U.S. mainland.

(Reporting by Ian Simpson in Washington; Editing by Daniel Wallis and Marcy Nicholson)

CDC Declares National Flu Epidemic

The Centers for Disease Control has officially declared a flu epidemic.

The number of states reporting high levels of flu jumped from 13 to 22 last week and the CDC says there are now flu outbreaks in every region of the country.

The CDC also said that 15 children have died as a result of this year’s flu outbreak, 6 of them in Tennessee alone.  East Tennessee Children’s Hospital has reported 442 children with flu already this year.

ABC Chief Medical Editor Dr. Richard Besser said on Good Morning America that about a hundred children a year die from the flu.  He said that children, the elderly and anyone with a compromised immune system are at highest danger for death.

The CDC says the H3N2 subtype is the strain in 90 percent of confirmed flu cases.

Dr. Besser said that the flu season has been striking earlier during the last few years and he called it a “worrying trend.”

He advised anyone in a high risk category to get a flu shot.

Swiss Organization To Allow Suicide For Healthy Elderly People

A Swiss right-to-die and assisted suicide organization has announced they are no longer going to limit their services to people suffering from some kind of terminal illness.

The group, “Exit”, has announced that “suicide due to old age” is now going to be considered a valid reason for use of their assisted suicide techniques.  The group says that older adults who are experiencing psychological or physical problems can now choose to end their life rather than deal with issues like arthritis.

The group also said they will be streamlining the process for elderly patients who do not want to experience the lengthy process for assisted suicide.

Assisted death is legal in Switzerland.

The Swiss Medical Association was quick to issue a condemnation of the group’s actions, saying that their decision could cause significant problems for elderly citizens whose families just don’t want to care for them in later years.  Families could force family members to say they want to die when they really don’t wish to die.