Who is Most at Risk for Long COVID?

Harvard Medical School | By Jake Miller

A new study of more than 800,000 people has found that in the U.S., COVID "long haulers" were more likely to be older and female, with more chronic conditions than people in a comparison group who—after getting COVID—did not have diagnosed long COVID or any of the symptoms associated with long COVID. The findings are published in the March issue of Health Affairs.

The national study, which focused on people with private insurance or Medicare Advantage coverage, aims to inform public health and clinical care by advancing the understanding of who gets long COVID.

As one of the largest studies of long COVID in the U.S. to date, in terms of the number and diversity of people studied and the length of time symptoms and diagnoses were followed, the study solidifies many previous insights about the demographics and clinical profile of people most likely to get sick.

It also provides new information to consider about the complex interaction of COVID-19 in patients with previously diagnosed chronic illnesses.

"This work in a large population helps to address the question of who is more at risk of long COVID," said Zirui Song, associate professor in the Department of Health Care Policy in the Blavatnik Institute at Harvard Medical School, lead author of the article.

"This may help clinicians and health care organizations screen, monitor, and treat patients more effectively. It may also help individuals, who know their own medical history, better assess their risk of long COVID and the value of protecting against getting COVID-19 in the first place," Song said.

The study's findings also indicate that symptoms of long COVID can appear or persist much longer after initial infection than many previous studies had suggested.

Most earlier work showed a peak of long COVID symptoms and diagnoses within the first six months of a person's initial COVID-19 diagnosis, the authors note, but the new research shows another, smaller peak around one year, which the authors note was significantly longer than the follow-up period of most initial studies.

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FDA Authorizes Pfizer Covid Booster For Kids As Young As 6 Months

Kaiser Health News 

The shot is for children who were previously vaccinated with three doses of the original vaccine. In other covid-related news, operators of an upscale Los Angeles care facility for dementia patients were charged Tuesday with felony elder abuse.

CNBC: FDA Authorizes Pfizer's Covid Omicron Booster As Fourth Shot For Kids Under 5The U.S. Food and Drug Administration on Tuesday authorized Pfizer’s omicron booster shot for kids under five years old who were previously vaccinated with three doses of the company’s original vaccine.  Children six months through four years old who completed their three-dose primary series with Pfizer and BioNTech’s original monovalent shots more than two months ago are now eligible to receive a single booster dose of the updated shot. The new shot is bivalent, meaning it targets the original Covid strain as well as omicron BA.4 and BA.5. (Constantino, 3/14)

HHS Releases Initial Guidance for Historic Medicare Drug Price Negotiation Program for Price Applicability Year 2026

For the first time in history, Medicare will have the ability to negotiate lower prescription drug prices because of the Inflation Reduction Act, President Biden’s historic law which lowers health care and prescription drug costs. Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued initial guidance detailing the requirements and parameters—including requests for public comment— on key elements of the new Medicare Drug Price Negotiation Program for 2026, the first year the negotiated prices will apply. Alongside other provisions in the new drug law, the Medicare Drug Price Negotiation Program will strengthen Medicare’s ability to serve people currently in Medicare and for generations to come.

“For far too long, millions of Americans have had to choose between their prescription drugs and other monthly expenses,” said HHS Secretary Xavier Becerra. “President Biden is leading the fight to lower the cost of prescription drugs – and with the Inflation Reduction Act, we’re making historic progress. Through the Medicare Drug Price Negotiation Program, we will make sure seniors get a fair price on Medicare’s costliest prescription drugs, promote competition in the market, and ensure Medicare is strong for beneficiaries today and into the future.”

“Drug price negotiation is a critical piece of how this historic law improves the Medicare program,” said CMS Administrator Chiquita Brooks-LaSure. “By considering factors such as clinical benefit and unmet medical need, drug price negotiation intends to increase access to innovative treatments for people with Medicare.”…

View a fact sheet - PDF on the Medicare Drug Price Negotiation Program Initial Guidance

Read the Medicare Drug Price Negotiation Program Initial Guidance - PDF

Read the Full Press Release

The Sacred Moment of Death

By Barbara Karnes

The sacred moment of death - that is the goal for those of us who work with end of life. Guiding, supporting and teaching those present what is normal in dying and what is not. What is fixable and what is not. What is painful and what is not. What to do and what not to do. What to say and what to be silent about.

All the work we do leads up to the moment of death. Our goal is to guide and support those present through the moment the last breath occurs.

How do we do that? How do we support and guide? We first give information. We teach the signs of approaching death. Teach what is normal and what is more challenging. We give guidance as to what families or significant others can do while labor is progressing.

Here are my thoughts:

In the hours before death, when the person is not responsive, suggest that each person present spend time alone with the person who is dying. To talk with them, tell them everything they have wanted and need to say, the good, and even the challenging. 

Sit by or on the bed, hold a hand, lay down in the bed, cuddle, whatever your heart guides you to do. This is their gift as well as a gift to the person who is dying. The opportunity to address “loose ends,” to say those things that were never said. 

The person that is dying is processing their life. By sharing innermost thoughts and feelings with them they are giving their special person more pieces to their puzzle of life.

Now is the time to talk with those present as to what is about to occur. Explain how the breathing changes, about the sounds they may hear, the words that won’t make sense, the often strange and unusual facial expressions they may see. All that is part of the labor of dying. 

By guiding them you are showing those present that nothing bad is happening, nothing pathological is happening. This is how people die. Dad or grandmother or friend or husband are expressing the effort to release them from their body.

Once death has occurred  encourage those present to say goodbye to the body again before calling the funeral home. This will be the last private time they will have with their special person, give them that opportunity.

Through this support and guidance you are creating the sacred experience for those present and that experience will become their sacred memory. They will carry that memory with them forever.

This is the work we do. This is the goal, the culmination of our time spent with families and significant others. This is the gift we can give them.