PLEASE NOTE: THE OFFICE WILL BE CLOSED NOVEMBER 27-29TH TO ALLOW US TO TRAVEL TO AND FROM THANKSGIVING GATHERINGS. AS ALWAYS, DRS. THORNTON AND WALLACE WILL BE AVAILABLE BY EMAIL, TEXT OR CELL FOR URGENT ISSUES.
We are about to gather for Thanksgiving and the downside is that many of us will be traveling on public transportation and gathering with family and friends. That gives us the opportunity to share more than fellowship. Calls on respiratory illnesses will start on Monday, December the 2nd. Here are a couple of articles that deal with this. There are new home tests that can check for Flu A/B and Covid. Recently, one was added that includes RSV as well. After that is an infectious disease expert’s prediction of the fall and winter respiratory season. Finally, there is an article on the pros and cons of Medicare Advantage plans from The Houston Chronicle. The bottom line is that the less the plan costs, the more restrictive it is. Some of them require us to make referrals for patients to see specialist and that can be challenging in a small practice. WellMed, in particular, is very restrictive. United Healthcare Medicare Advantage plans which are paid through WellMed will not allow us to make referrals after March 31, 2025. You can call the office and we can tell you if your plan is paid through WellMed. There is not a problem with PPOs. Caveat emptor.
FDA News Release
FDA Authorizes First Over-the-Counter At-Home Test to Detect Both Influenza and COVID-19 Viruses
Agency Continues Its Commitment to Increase Availability of Home Diagnostic Test
Today, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the first over-the-counter (OTC) at-home diagnostic test that can differentiate and detect influenza A and B, commonly known as the flu, and SARS-CoV-2, the virus that causes COVID-19. The Lucira COVID-19 & Flu Home Test is a single-use at-home test kit that provides results from self-collected nasal swab samples in roughly 30 minutes.
“Today’s authorization of the first OTC test that can detect Influenza A and B, along with SARS-CoV-2, is a major milestone in bringing greater consumer access to diagnostic tests that can be performed entirely at home,” said Jeff Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health. “The FDA strongly supports innovation in test development, and we are eager to continue advancing greater access to at-home infectious disease testing to best support public health needs. We remain committed to working with test developers to support the shared goal of getting more accurate and reliable tests to Americans who need them.”
The Lucira COVID-19 & Flu Home Test is a single use test for individuals with signs and symptoms consistent with a respiratory tract infection, including COVID-19. The test can be purchased without a prescription and performed completely at-home using nasal swab samples self-collected by individuals ages 14 years or older or collected by an adult for individuals 2 years of age or older.
The test works by swirling the sample swab in a vial that is placed in the test unit. In 30 minutes or less, the test unit will display the results that show whether a person is positive or negative for each of the following: Influenza A, Influenza B and COVID-19. Individuals should report all results obtained to their healthcare provider for public health reporting and to receive appropriate medical care.
In individuals with symptoms, the Lucira COVID-19 & Flu Home Test correctly identified 99.3% of negative and 90% of positive Influenza A samples, 100% of negative and 88.3% of positive COVID-19 samples and 99.9% of negative Influenza B samples. Since there are currently not enough cases of Influenza B circulating to include in a clinical study, validation confirmed that the test can identify the virus in contrived specimens, and the EUA requires Lucira to continue to collect samples to study the test’s ability to detect Influenza B in real-world settings.
As with all rapid diagnostic tests, there is a risk of false positive and false negative results. Individuals who test positive for either flu or COVID-19 should take appropriate precautions to avoid spreading the virus and should seek follow-up care with their physician or healthcare provider as additional testing may be necessary. Negative results for SARS-CoV-2 and influenza B should be confirmed, if necessary for patient management, with an authorized or cleared molecular test performed in a CLIA-certified laboratory that meets requirements to perform high or moderate complexity tests. Individuals who test negative and continue to experience symptoms of fever, cough and/or shortness of breath may still have a respiratory infection and should seek follow up care with their healthcare provider.
The collective impact of COVID-19, flu and RSV underscore the importance of diagnostic tests for respiratory viruses, and the FDA recognizes the benefits that home testing can provide. The agency will continue to use its authorities to increase the number of appropriately accurate and easy to use at-home tests available to the public, especially tests that detect these highly contagious respiratory viruses.
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The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
Respiratory viruses are spiking statewide, but San Antonio may not see a big surge until 2025
Cold and flu season is underway this year with spikes in respiratory virus activity. Experts said the spike hasn’t quite hit San Antonio’s adults, but kids are already dealing with illnesses.
COVID-19, the flu and RSV are on the rise again. The number of cases statewide for the flu have increased, with the Texas Department of State Health Services reporting 717 pneumonia and influenza related deaths, though COVID-19 cases and fatalities dropped.
Dr. Jason Bowling, the top infectious disease physician at University Health and UT Health San Antonio, said he expected the spikes to really hit the city around the new year.
“So one [scenario] that is talked about is people gathered together in indoor spaces when it’s cold outside. We really don’t get super cold in San Antonio, but people do get together for the holiday celebrations,” Bowling said. “One of the things during the colder months is that the relative humidity decreases. It becomes a bit drier, which makes it a little bit easier to transmit respiratory viruses.”
Bowling said the best way to prevent spread is to get vaccinated for all three major viruses, flu, COVID-19, and RSV and to wear a mask in crowded public spaces during peak season.
Dr. Norm Christopher, the chief medical officer of CHRISTUS Children, said in the past few weeks, medical professionals have seen an increase of patients in the emergency rooms with a respiratory virus.
“We’ve been seeing longer waits in our emergency rooms,” Christopher said. “As the weather gets cooler, kids are back in school, and after the summer being away, they’re more likely to be exposed.”
He added that they prep each year for the surge in influenza, RSV and COVD-19 for the winter season. He said that the typical handwashing and avoiding people who are sick is not a practical thing to ask of young kids. But everyone gets the advice to stay home when sick and keep young babies away from social events where they can be exposed to viruses.
“The signs and symptoms that a parent should look for are … a little bit of nasal congestion, a runny nose, a little bit of a dry, hacking cough. Oftentimes that’s about as bad as it gets, that’s about as severe as it gets,” he said.
Christopher said to call primary care physicians first before heading to the ER if the symptoms are mild.
According to a report from NPR, new at-home over-the-counter tests can prevent a visit to the doctor. Testing for both COVID and both strands of influenza can be done at home. However, Bowling said some symptoms do call for a visit to the doctor.
“So if anybody has severe symptoms, they need to go be seen. If somebody is having shortness of breath, pain in their chest, if they’re having trouble staying awake … really not able to stay awake more sleepy than usual,” Bowling added “In conjunction with symptoms of infection, those are all warning signs that they need to go be seen by a provider.”
Medicare or Medicare Advantage? What to know and how to choose for 2025
Enrollment is underway for Medicare. What’s the difference between the traditional program and Advantage?
The choice between the government-run, no-frills traditional Medicare and an Advantage plan with bells and whistles is genuinely confusing. Yet the decision has enormous consequences because at least 15% of your spending in retirement will go toward health care, RBC Wealth Management reported.
Almost 60% of lifetime spending on health care comes after the age of 65 for those lucky enough to live to 85, the National Institutes of Health determined. Estimates run from $165,000 to $189,000, most of which is spent in the final 12 months of life.
No single Medicare plan fits all. Preexisting conditions, personal wealth, access to health plans and where you live will determine your options. The hard part is sorting through all the cable television marketing and thick manuals filled with indecipherable jargon.
Almost every American loses their private health insurance when they turn 65. In 1965, President Lyndon B. Johnson signed Medicare into law to decrease widespread suffering and illness among elderly people who could not afford health care.
Johnson and Congress recognized that private insurers couldn’t cover the health care costs for the elderly without insanely high premiums. So, they decided workers should pay into a trust fund that would subsidize their premiums after age 65.
For decades, the only choice was traditional Medicare, overseen by the federal Center for Medicare Services. Part A covers hospitals; Part B pays for doctors and other service providers. In 2003, Congress added Part D for prescription drugs.
Traditional Medicare covers a lot but is neither free nor comprehensive. To offset what traditional Medicare does not pay, most enrollees buy a private Medigap policy, which is only guaranteed to be available when you first enroll. Your total cost depends on how long you paid into Medicare, your income and the amount of extra coverage.
The best thing about traditional Medicare is that patients may visit any provider that accepts it, and coverage is set by law. It’s not cheap, but you get a lot of choices.
Private health insurance companies thought they could do better and convinced Congress to create Part C, known as Medicare Advantage. Private companies recruit seniors with an advertising blitz, offering low premiums and more coverage.
In return for lower premiums and more services, Medicare Advantage enrollees accept a limited network, and the insurer gets to pre-authorize services before they are performed. Healthy people love Advantage plans because they save money, and the insurers love them back with things like gym memberships.
If you need a lot of care, however, Advantage plans can get real expensive real quick because they often require deductibles and copayments not required by traditional Medicare.
Studies show no significant difference in the quality of care between traditional and advantage programs. Traditional Medicare tends to pay higher rates to hospitals and doctors, making accessing care easier.
Congress created Medicare Advantage because private insurers promised to save the federal government money by improving efficiency. But in the 35 years since private insurers began offering Advantage, they have never saved the government money, the watchdog Medicare Payment Advisory Commission says.
The insurance lobby has turned Medicare Advantage into a huge moneymaker, and working Americans are paying more for people on Advantage plans than those on traditional Medicare.
The United States spends more per capita on health care than any other nation, yet Americans are in poorer health and live shorter lives than people in similarly wealthy countries. Every year, the president and Congress try to improve Medicare, especially Advantage plans, and 2025 brings changes.
Most Medicare Advantage plans will reduce costs by shifting higher deductibles and copayments to patients. For example, deductibles for prescription drugs will rise to $225 from $59, the nonpartisan KFF think tank calculated. They also are changing what drugs they cover.
Half of American seniors are on Medicare Advantage because they are cheaper. But a Wall Street Journal investigation found that when people get sick and struggle to find care, they switch to traditional Medicare because the coverage is better. That shifts the bills to taxpayers.
The problem for the patients is that they cannot find an affordable Medigap policy to cover what traditional Medicare does not. Their out-of-pocket expenses skyrocket when they need care the most.
If you can afford traditional Medicare, great, but if money is tight, Advantage works too. Sadly, though, making the right decision will require fresh research every November for the rest of your life.
Award-winning opinion writer Chris Tomlinson writes commentary about money, politics and life in Texas. Sign up for his “Tomlinson’s Take” newsletter at houstonchronicle.com/tomlinsonnewsletter or expressnews.com/tomlinsonnewsletter.
