Long COVID: New Info on Who Is Most Likely to Get It
Medscape | By Solarina Ho
The COVID-10 pandemic may no longer be a global public health emergency, but millions continue to struggle with the aftermath: Long COVID. New research and clinical anecdotes suggest that certain individuals are more likely to be afflicted by the condition, nearly 4 years after the virus emerged.
People with a history of allergies, anxiety or depression, arthritis, and autoimmune diseases and women are among those who appear more vulnerable to developing long COVID, said doctors who specialize in treating the condition.
Many patients with long COVID struggle with debilitating fatigue, brain fog, and cognitive impairment. The condition is also characterized by a catalog of other symptoms that may be difficult to recognize as long COVID, experts said. That's especially true when patients may not mention seemingly unrelated information, such as underlying health conditions that might make them more vulnerable. This makes screening for certain conditions and investigating every symptom especially important.
The severity of a patient's initial infection is not the only determining factor for developing long COVID, experts said.
"Don't judge the person based on how sick they were initially," said Mark Bayley, MD, medical director of the Toronto Rehabilitation Institute at University Health Network and a professor with the Temerty Faculty of Medicine at the University of Toronto. "You have to evaluate every symptom as best you can to make sure you're not missing anything else."
Someone who only had a bad cough or felt really unwell for just a few days and recovered but started feeling rotten again later — "that's the person that we are seeing for long COVID," said Bayley…
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CDC Urges Nursing Home Vaccinations
The Hill | By Nathaniel Weixel and Joseph Choi
Its’ the height of respiratory virus season, but some of the country’s most vulnerable people remain at risk.
According to the Centers for Disease Control and Prevention (CDC), most nursing home residents haven’t received an updated COVID-19 vaccine or the new respiratory syncytial virus (RSV) vaccine.
COVID-19, influenza and RSV activity are still below levels seen last year at this time, according to the CDC. But only 35 percent of nursing home residents have gotten the updated COVID-19 vaccine, and just 10 percent had received an RSV shot.
RSV can cause severe illness and death in older adults. The Food and Drug Administration estimated that the virus hospitalizes 60,000 to 160,000 people over age 65 each year and causes 6,000 to 10,000 deaths.
This is the first year there’s been a vaccine available to prevent RSV– and there are two on the market. Arexvy, the shot from GlaxoSmithKline, was 94 percent effective against severe illness in older adults. Pfizer’s shot, called Abrysvo, was 86 percent effective against severe illness.
Both shots are fully covered by Medicaid, Medicare Part D prescription drug coverage, and most private insurance plans.
Nursing homes are encouraged to collaborate with state, local and federal public health and long-term care pharmacy partners to address barriers contributing to low vaccination coverage, CDC said.
Vaccine fatigue, inaccurate health information and vaccine hesitancy contribute to lack of vaccine demand, the CDC said.
For the COVID-19 vaccine, lower uptake might be related to challenges to vaccine access, as well as cost and payment barriers associated with the vaccine’s commercialization, the agency said.
Older people are also receiving messaging for multiple seasonal vaccines (in many cases three or four), and it can be overwhelming. The relative newness of the RSV shots may also confuse providers, who then give inaccurate information to their patients.
Another possible barrier is the CDC’s recommendation of “shared decision making.” That means the vaccine was recommended only after a conversation between a patient and their provider, rather than a blanket recommendation like the one for flu shots. |
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SLAPP Back: Colorado Court of Appeals Addresses Protection Against “Vengeful” Online Posts
Littler | By Danielle Van Katwyk and Steve Baumann
On November 30, 2023, the Colorado Court of Appeals in Tender Care v. Barnett tested the limits of Colorado’s anti-SLAPP law in considering whether an individual’s online review of a company could invoke the protections of the anti-SLAPP law. A client of a veterinary clinic had posted six online reviews on her personal Facebook page, the company’s Facebook page, and four different community-based Facebook pages, asserting that the veterinary clinic engaged in “malpractice,” and employs “incompetent” and “dishonest” doctors and staff. The clinic had filed suit for defamation per se, and the individual posting about her experience filed a special motion to dismiss under the anti-SLAPP law.
“SLAPP” stands for Strategic Lawsuit Against Public Participation. While California has had a SLAPP statute in place for quite some time, Colorado only recently enacted an anti-SLAPP statute in 2019, section 13-20-1101, C.R.S. Colorado’s statute. Like California’s statute before it, Colorado’s version is intended to protect the right to free speech and petition, and to prohibit the filing of non-meritorious lawsuits merely aimed to silence critics. Colorado’s anti-SLAPP law allows defendants to file a “special motion to dismiss” based on the right of free speech or petition in connection with a public issue or an issue of public interest. Defendants must file the special motion within 63 days after service of the complaint unless a later filing date is deemed proper by the court, and a hearing will typically be scheduled within 28 days after service of the special motion. Such motions will be granted unless the plaintiff establishes a “reasonable likelihood” of success on the claim, in which case the matter proceeds as normal. In making its determination, the court will consider the pleadings and supporting and opposing affidavits stating the facts upon which the liability or defense is based…
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NAHC President Offers Upbeat Forecast for Home Care in 2024
McKnight’s | By Adam Healy
Though providers weathered hardships from Medicare rate cuts to worker shortages in 2023, developments on the horizon give encouragement for home care’s future, according to William Dombi, president of the National Association for Home Care & Hospice.
“There is no shortage of innovations and reforms ongoing now,” Dombi said in a Thursday webinar hosted by healthcare technology firm Relias. He reassured providers: “You are all in the right place. The challenges will be there, but so will opportunities.”
Many of these innovations came in the form of successful payment or care delivery models that hit their strides during 2023. One of these, the Home Health Value-Based Purchasing Model, expanded on a national scale in January. It represented “one of the very few value-based programs that has been shown to work,” according to Dombi. Other positive developments include the ever-growing hospital-at-home program, advancements in telehealth services and strong Medicaid support for home- and community-based services.
Medicaid HCBS concern
Still home care initiatives such as Medicaid HCBS, one of the largest home care programs in the nation, Dombi noted, are facing challenges. The Medicaid Access Rule, proposed in May, would require 80% of Medicaid payments for homemaker, personal care and respite care services be used on worker compensation.
“If you’re a Medicaid provider, this is something to pay attention to,” Dombi said
Though the rule was designed with noble intentions, including alleviating home care workforce challenges, such stringent payment mandates could give providers cause for concern, he added.
And while shortages may signal increased demand for home care services, staffing remains a top priority across the home care, hospice and healthcare industry at large.
“Demand and interest remains exceptionally high — higher than we have the supply,” Dombi noted. “Currently, the data is showing that more than half of all referrals to home health agencies are being rejected due to workforce shortages.”
Recruitment and retention therefore should remain at the forefront for providers, as losing employees sacrifices time, money and even quality of care. But to reach these workforce goals, “better compensation starts with better payment rates,” Dombi asserted.
Strong congressional support
NAHC and other advocates made strong headway with congressional leaders in 2023, particularly through the introduction of the Preserving Access to Home Health Act of 2023 and the recent House passage of the Elizabeth Dole Home Care Act. In September, home care allies spoke out against erosion of the Medicare home health benefit before the Senate Finance Committee’s Subcommittee on Health Care, winning support from both sides of the aisle.
“We are seeing strong bipartisan support for home health services,” Dombi said. And while political bickering and sticker shock surrounding pricey legislation are eternal barriers to strong, consistent federal support for home care, the reality that older loved ones are in need of care “tends to bring the parties together,” he noted…
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