The most recent COVID-19 recommendations for older adults

The CDC modified its recommendations (again) for people who test positive for COVID-19 in late December. For most people, that means a shorter quarantine or isolation time if they have been vaccinated, boosted and are asymptomatic or only experiencing mild symptoms. While Omicron appears to be more transmissible, according to experts on a recent AHCJ webcast, it may also be less severe.

However, older adults should still take extra precautions. Even if they have done everything right — getting vaccinated and boosted, masking, and social distancing, they are still statistically at higher risk of more severe disease or complications from the virus than younger people.

While these changing recommendations are confusing, they also present another opportunity for journalists to educate their audiences with evidence and facts, and to dispel some of the myths and misconceptions that still prompt some to spurn the vaccine or push back against mask requirements. It’s especially important for older people to understand and follow the latest recommendations since their risk of serious consequences is so high.

Important CDC stats

More than 81% of COVID-19 deaths occur in people over age 65.
The number of deaths among people over age 65 is 80 times higher than among people age 18-29.
Older unvaccinated adults are more likely to be hospitalized or die.
The risk increases as people age — those 85 and older are the most likely to get very sick and require hospitalization.
COVID-19 data show that Black/African American, Hispanic/Latino, American Indian and Alaska Native persons in the United States experience higher rates of COVID-19-related hospitalization and death compared with non-Hispanic White populations. These disparities persist even when accounting for other demographic and socioeconomic factors.
Vaccination is key: People 65 and older who received both doses of either Pfizer or Moderna vaccines showed a 94% reduced risk of COVID-19-related hospitalization, according to the CDC.

Symptoms of COVID-19 may appear differently in older adults. Normal body temperatures in elders can be lower than in younger adults, so fever temperatures can also be lower. In those over 65, a single temperature reading of 100°F (37.8°C), multiple readings above 99°F (37.2°C), or a rise in temperature greater than 2°F (1.1°C) above the person’s normal (baseline) temperature may be a sign of infection.

Many older people also have underlying chronic medical conditions, such as hypertension or diabetes, putting them at greater risk of more serious complications if they contract COVID-19.

The good news: vaccination rates are generally high for older people. The CDC’s latest data show that as of Dec. 26, 89.8% of community-dwelling adults 65-74 and 84.4% of those 75 and older are fully vaccinated. However, only 57.6% of that group have received their booster dose. The proportion varies by state and county, according to the Kaiser Family Foundation.

Data show cases are also rising for those in long-term care facilities. The greatest rise in cases is among the unvaccinated, followed by people who have not received a booster dose. Cases among those who have received both the primary series and booster dose remain relatively low, particularly in comparison with the other two groups.

Why we still have to talk about COVID-19

I bring all this up now for several reasons: experts expect a post-holiday surge in January, so journalists should emphasize the importance of keeping a close eye on older adults for signs or symptoms of potential infection. Rapid at-home test kits are in short supply — kits I ordered from Walmart in early December arrived in three days. These same kits — actually all test kits — are now out of stock on their website. Amazon has some kits available, but their delivery estimate is currently about 18-21 days. Local pharmacies are completely sold out.

And while the government plans to send a test kit to every household in the U.S., that won’t happen for at least several more weeks. Meanwhile, despite my 71-year old husband and I taking every possible precaution, his rapid antigen test just came up positive. It’s actually not that surprising, since we’ve been been around our young grandchildren, who also tested positive last week. [I’ve now tested negative twice with the antigen test, but if I develop any symptoms I’ll schedule a PCR test too, just to be sure.] It just reinforces that even when you’re super-careful about taking precautions, you can still become infected.

Fortunately, my husband’s symptoms are very mild, even with an underlying condition. We are also following the latest CDC guidelines (with some helpful clarification from infectious disease/COVID-19 core topic leader Bara Vaida). It’s stressful, but so far we’ve managed to dodge the worst of it.

However, other elders who have multiple and/or more serious co-morbid conditions may not fare as well. Reporting on these latest recommendations and the extra precautions both family members and older adults must continue to take will help increase the odds of avoiding or minimizing infection and the subsequent need for additional medical care.

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