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COVID-19 Vaccine Rollout: Where We Are So Far

from Moderna and Pfizer and they’ve shown significant efficacy in Phase 3 clinical trials. The incoming Biden administration will take on distribution and has established a COVID-19 Task Force. A limited number of doses may become available as early as December.

The Interim Playbook

This document from the Center for Disease Control and Prevention (CDC) is the roadmap for state, territorial, tribal, and local public health programs and their partners. It focuses on how to plan and operationalize a vaccine response to the pandemic within their jurisdictions. It’s quite comprehensive and is a good reference for the coming months.

Phased Approach

In the Interim Playbook, the CDC has given states a set of planning assumptions by which they can develop their distribution plans and explains how the vaccine will likely be administered in phases.

  • Phase 1 – there is an initial limited supply of vaccine doses that will be prioritized for certain groups. The distribution will be more tightly controlled and a limited number of providers will be administering the vaccine.
  • Phase 2 – supply would increase and access will be expanded to include a broader set of the population, with more providers involved.
  • Phase 3 – there would likely be sufficient supply to meet demand and distribution would be integrated into routine vaccination programs.

Common Themes and Concerns from State Plans

The Kaiser Family Foundation (KFF), a non-profit organization focusing on national health issues, sought to collect plans from all 50 states and DC. As of Nov. 13, they’ve reviewed 47 of these plans and have singled out key areas contained within each plan.

  • Identifying priority populations for vaccination. Each state will determine who will be first in line, initially; however, every plan highlights the following categories as being the priority during Phase 1: healthcare workers, essential workers, and those at high risk (older people and those with pre-disposing health risk factors). A majority of states (25 of 47, or 53 percent) have at least one mention of incorporating racial and/or ethnic minorities or health equity considerations in their targeting of priority populations. 
  • Identifying the network of providers in their state will be responsible for administering vaccines. Even though states are at different points in the process, providers will likely include hospitals and doctors’ offices, pharmacies, health departments, federally qualified health centers, and other clinics that play a role in administering vaccines today. Given the need to quickly vaccinate most residents, additional partners will be needed, such as long-term care facilities, and will (potentially) set up public locations like schools and community centers for mass vaccinations.
  • Developing the data collection and reporting systems needed to track the vaccine distribution progress. Many states are relying on (and often expanding) existing state-level immunization registries, while other states are developing new systems or using those provided by the federal government. To sum it up, each state is at a different stage in this process.
  • Laying out a communications strategy for the period before and during vaccination. The CDC has asked states to design plans that anticipate and respond to different populations and include the need to address misinformation and vaccine hesitancy. Not surprisingly, some of these states’ plans are detailed while some are not.

All of these things are high-level summations of what is planned so far. For a more detailed explanation, check out the Interim Playbook from the CDC. The COVID-19 situation is ever-changing, but the most important takeaway is that steps are being put in place to help protect us all. Stay safe.

Sources

States Are Getting Ready to Distribute COVID-19 Vaccines. What Do Their Plans Tell Us So Far?

https://www.nytimes.com/2020/11/16/health/Covid-moderna-vaccine.html?action=click&module=Top%20Stories&pgtype=Homepage

https://www.newsweek.com/fauci-optimistic-about-covid-19-vaccine-says-high-risk-could-get-it-december-1546384

https://www.cdc.gov/vaccines/imz-managers/downloads/COVID-19-Vaccination-Program-Interim_Playbook.pdf

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A Realistic Picture: Will You Be Able to Afford In-Home Elder Care?

Cost of Care Survey that examines the cost of various types of long-term care. However, when you break down the assumptions, you might find the survey’s cost estimations are lower than what many people actually pay.

For example, the average fee for homemaker services (household chores, prepare meals, run errands, accompany to appointments) is $22.50 an hour. For a home health aide (help with bathing, dressing, toileting and simple first aid) the average hourly wage is $23. Depending on your location, you could pay more for a company that employs home workers or pay less for independent caregivers. Be aware that if you choose the independent route, you’ll have to vet abilities, trustworthiness and schedule your own back-up resources if they don’t show up for some reason.

However, according to the Genworth report, the average daily rate for a homemaker is only $141, or $4,290 a month. That breaks down to about six hours a day. What happens when you reach a point where it’s unsafe for you to mill about the house by yourself because you might leave the stove on, or you might fall and there’s no one to help. If you pay a caregiver to stay with you 16 waking hours a day, that would cost you $360 per diem, or about $11,000 a month.

If you don’t sleep well and tend to have to use the restroom at night, you might need to pay for a night shift caregiver just to make sure you get around OK. That means 24-hour care will run you more than $16,000 a month, or $195,000 a year – and that’s in today’s dollars.

If you’re planning on in-home care 10 to 15 years from now, those rates will probably be higher.

There are a couple of other issues to note. First, you don’t need to be completely incapacitated to require 24-hour care. It could be as simple as mild but gradual progressive dementia; a mobility issue; or fear of living alone after a spouse dies. Also, if a couple is living comfortably at home with 24-hour care, that expense probably won’t go away if one spouse dies – but household income will probably decrease.

There are alternative ways you might consider that would allow you to stay home throughout your elder years, and the earlier you plan for them the better they will work out. First of all, be nice to your grown children. Not only might you prefer to move in with them or they move in with you, but if things don’t work out, they will likely be the ones to determine where you live out your golden years.

Second, consider your housing situation and if you can negotiate room and board to one or more caregivers in exchange for their help. You might also consider cohabitating with an elderly friend or family member to help share caregiver fees, and perhaps eliminate the need for excess hours a day. Better yet, consider moving in together with several friends to help spread out the costs and improve your chances that some seniors will be less informed than others.

Since 2010, on average more than 10,000 Baby Boomers turned age 65 per day and by the year 2030, all Baby Boomers will be 65 or older. Among them, 52 percent will require long-term care in their lifetime. If you want to remain at home but worry about the cost of caregiving, you’ll have plenty of housemates from which to choose.