Is the COVID-19 Test-to-Treat program testing your patience?
The news is good, bad and downright stupid when it comes to the COVID-19 Test-to-Treat Program that was launched in March.
Good: antiviral medications. Pfizer’s Paxlovid and Merck’s Lagevrio, when taken within five days of developing your first COVID-19 symptoms, can prevent severe illness, hospitalizations and deaths, especially among chronically ill (diabetes, heart disease, etc.), disabled and older Americans.
Good: All qualified heath care providers (that’s your doc) can prescribe these antivirals. And now, the Department of Health and Human Services is distributing oral antiviral pills directly to participating Test-to-Treat pharmacy-based clinics and long-term care pharmacies. You can get tested and prescribed antivirals all in one visit. An online national map shows locations that are offering the service: https://covid-19-test-to-treat-locator-dhhs.hub.arcgis.com.
Bad — and stupid: According to a survey of the Test-to-Treat system by Kaiser Health News, many locales have no nearby clinics that can offer such services. Where there are clinics, there are online glitches, and for the non-tech savvy, things get especially tricky. In addition, some places charge up to $100 for in-person and telehealth Test-to-Treat visits. People without insurance, whose health plans don’t cover visits to the clinics or who have high-deductible plans must shoulder the full costs.
Solutions: Talk to your primary care physician about Test-to-Treat at his/her office — before you need it, so you’re prepared. Order free at-home test kits ahead of time from www.covid.gov/tests. And Kaiser Health News says Truepill offers online COVID-19 assessments and meds through its website findcovidcare.com. Truepill, available in all 50 states and Washington, D.C., costs $25 to $55.
The week’s roundup: bone scam, bariatric surgery, medical debts
In the late 1990s, National Geographic fell for a big bone scam. A fossil they declared was a missing link between dinosaurs and birds turned out to be a glued-together combo of bone bits from various species. The use of QCT (quantitative computed tomography) for bone scans, instead of dual-energy X-ray absorptiometry (DXA) screening technology, may be another bone scam. MedPage Today reports that although QCT is increasingly used these days, it delivers 1,000 to 3,000 times more radiation than DXA and exaggerates fracture risks. Find out what technology your scan center uses and opt for DXA.
A study that looked at over 94,000 severely obese Medicare patients who got bariatric surgery found that the procedure slashed their risk for new-onset heart failure, heart attack, stroke and all-cause death significantly. So don’t let age dissuade you from discussing this option with your doc.
Are you saddled with medical debt? It’s an economic burden for one-third of American adults and a health issue since it keeps folks from seeking additional — and needed — medical attention. Now the government is expanding its “No Surprises Act” mandate to make sure that debt collectors follow the law and providers’ billing practices are legit. All important steps, because, as I point out in the “Great Age Reboot,” economic inequality is a public health issue, and regulations that foster economic equality will improve the health of the nation.
Bottom line: By assuming responsibility for your own health and establishing policies that improve everyone’s health care, we can all live younger, longer.
Exercise your right to smile
“You’re only one workout away from a good mood.” That may sound like a T-shirt slogan, but a new study confirms what we have long suspected: Regular physical activity is a great way to reduce the risk of depression and to improve your mood if you are feeling down. A study in JAMA Psychiatry looked at 15 studies with more than 190,000 participants to determine the association between physical activity and depression. The researchers found that compared to sedentary adults, those who got just half of the recommended amount of physical activity (equivalent to 2.5 hours a week of brisk walking) had an 18 percent lower risk of depression, and those getting the full recommended dose (way less than I think is sufficient) saw a 25 percent reduction.
Just imagine how you might feel if you went for 10,000 steps a day plus two strength-building sessions weekly.
Depression isn’t the only mood-atude that benefits from exercise. Regular exercise dispels stress, anger and mental fatigue, gives you a sense of accomplishment, helps regulate your blood sugar (that affects mood big time) and helps you with focus and motivation in your work (which makes it more enjoyable and successful).
I am currently very enthused about combining walking 10,000 steps a day (do interval training) with jumping jacks (they increase bone and muscle strength, improve balance and coordination) and strength training using your own body weight (planks, wall sits, wall pushups, squats). For a full rundown of these workouts, check out health.clevelandclinic.org; search for “exercise.”
The power of a glass of water
“Once I drink the water, I feel it immediately,” says Cameron Diaz. “I go from being a wilted plant to one that has been rejuvenated by the rain.” Cindy Crawford agrees: “Your body is so happy when you drink water.” Well, your cardiologist is happy, too!
Researchers from the Laboratory of Vascular and Matrix Genetics at the National Heart Lung and Blood Institute recently published a study in the European Heart Journal. It shows that drinking enough water to maintain properly diluted levels of sodium in your blood might reduce your risk of heart failure. Looking at data on around 16,000 adults, they found that if you’ve got blood sodium levels above 142 mEq/L when you’re age 45 to 66, you are more likely to develop left ventricular hypertrophy — that’s a thickening of the wall of the heart’s main pumping chamber — and heart failure during the next 25 years of your life. In fact, you are 39 percent more likely — that’s a huge bump in your risk. And every 1 mEq/L increase in your blood sodium levels from within the normal range of 135-146 mEq/L increases the likelihood of you developing heart failure by 5 percent.
So how much water do you need? Let your thirst be a guide, and that definitely changes depending on your activity level. Sweat more, drink more. But the minimum is around 6-8 cups a day for women and 8-12 cups for men. Remember: Avoid artificially sweetened and sugar/syrup-added beverages. Stick with water flavored with natural citrus and sugar-free electrolyte-restoring tablets.
What happens if you stop smelling the roses
In 1974, when Mac Davis sang “Stop and Smell the Roses,” he crooned: “There’s a whole lot more to life than work and worry,” and he was right. But half of folks age 65 to 80 and 80 percent of those over 80 can’t smell the roses or much of anything else. That turns out to stink.
Loss of sense of smell is associated with neurogenerative conditions like Alzheimer’s and Parkinson’s, even before symptoms are evident, as well as cardiovascular disease, nutritional deficiencies such as iron anemia (what you can’t smell, you don’t eat) and immune disorders.
A study in JAMA Otolaryngology — Head & Neck Surgery looked at 11 studies from around the globe and found that being unable to identify even two of 12 odors was a sign that a health problem, including diabetes and kidney disease, may be developing or worsening — to a lethal degree. Note: COVID-19’s association with loss of smell was not studied in this mix.
Loss of smell is not only associated with disease risks. If you can’t smell a gas leak, a fire or spoiled food, that, too, threatens your well-being. So if you find that smells from flowers, food or a passing truck have faded or disappeared from your everyday experiences, tell your doctor. Get a physical and cognitive checkup to ID signs of impending health issues. Many can be slowed or reversed if you take aggressive action early. Tip: Try this smell acuity booster. Practice smelling four aromas daily: coffee, onions, lemon and lavender.
Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic.