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PUMPING IRONY: A Dose of Reality

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There’s not been much about the federal government’s handling of the COVID-19 pandemic to inspire confidence, so I was not surprised to learn that the experts who gathered last month to help the FDA figure out how to deliver an effective vaccine at “warp speed” seemed unable to even reach a consensus on what the drug should be designed to do.

Some members of the advisory committee, pointing to the pandemic’s recent surge of hospitalizations and its mounting death toll, argued that approval of any vaccine that didn’t demonstrate an ability to save lives was a waste of time and resources — and wouldn’t be accepted by an already skeptical public. “Simply preventing mild cases is not enough and may not justify the risks associated with vaccination,” Peter Doshi, PhD, an associate professor at the University of Maryland School of Pharmacy, tells Kaiser Health News.

But developing a vaccine with proven ability to prevent severe illnesses isn’t something that can be done at a politically palatable speed. Only a handful of new vaccines have been introduced in the past 25 years; a vaccine for HIV, for instance, has eluded Big Pharma since the 1980s. So other members of the panel argued that we will probably have to be content with a dose of something that will prove only marginally effective.

“We’re probably not going to have the perfect vaccine,” concedes Corey Casper, MD, MPH, of Seattle’s Infectious Disease Research Institute. “But I do think we’re likely to have vaccines that, if we can show they’re safe, can put an inflection point on this pandemic.”

Supporters of fast-tracking the vaccine trials point to the measles vaccine as an example of a drug that was initially thought to prevent only mild cases of the disease and later proved to reduce mortality. And while no one is suggesting current efforts would produce something that effective, Casper says the group was “trying to lower that bar and determine how much lower is acceptable.”

But, as Merck CEO Ken Frazier has pointed out, the government’s sprint to a much-hyped vaccine solution to the pandemic does “a grave disservice” to the public. “What worries me the most is that the public is so hungry, is so desperate to go back to normalcy, that they are pushing us to move things faster and faster,” he said in a recent Harvard Business School interview. “Ultimately, if you are going to use a vaccine in billions of people, you’d better know what that vaccine does.”

Amid the controversy over the vaccine’s development, there may be a flawed assumption at work here: As William Haseltine, PhD, president of Access Health International, puts it, “Everyone thinks COVID-19 will go away with a vaccine.”

And that’s not very likely to occur — especially among my compatriots here in Geezerville, who account for 80 percent of pandemic deaths in the United States. Older adults are notoriously prone to infectious diseases and generally not well protected by vaccines. Even in those years when the seasonal flu shot happens to hit on the right viral strain, for example, it only reduces our risk of infection by about half. And just because a vaccine is available doesn’t mean everyone will roll up their sleeves.

Distribution among the Medicare set also presents a challenge. As Thomas Lally, MD, and Marc Rothman, MD, explain in STAT News, some 2 million seniors are permanently homebound and untold millions more suffer from conditions that make even a trip to the doctor a sketchy endeavor. Getting whatever vaccine is eventually approved to them will require a level of strategic competence we’ve not recently observed from federal agencies.

“These challenges must be addressed before a vaccine arrives by putting into place strategies to gain the trust of the public and reach essential adherence rates, which is needed to bring good health to all, including vulnerable and underserved populations,” they write. “To that end, the home setting should be included in vaccine distribution planning.”

Both Lally and Rothman work in the home healthcare industry, so their interest in persuading government to utilize their expertise in fighting the pandemic shouldn’t be surprising. Indeed, they’d like to see public-health officials use the current flu season to test-drive an in-home vaccine program in preparation for the eventual roll-out of the COVID-19 vaccine.

If the current state of affairs at the FDA is any indication, though, they may be expecting way too much way too soon. While Big Pharma struggles and the government dithers, we might be better advised to simply mask up and maintain our social distance — tools that require nobody’s approval but our own.


Craig Cox
is an Experience Life deputy editor who explores the joys and challenges of aging well.

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Health & Fitness

PUMPING IRONY: Not the Retiring Type

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One of the few prescient insights I can recall from my wayward postcollege days was the notion that a full retirement would surely elude my grasp. Social Security was certain to go bankrupt at some point, I figured, and even if it survived, the paltry income I’d earn as a freelance writer and editor would hardly translate into a monthly government check that would allow much in the way of work-free leisure in my dotage. Better to just grind away in scarcity mode, keep expenses to a minimum, and narrow my horizons. As Thoreau put it, “Simplify, simplify, simplify.”

The intervening 40-odd years have proven that life is complicated. I married, children appeared along with mortgages, car payments, and other financial realities. And, while I eventually began to earn a living wage at a succession of fragile publications, we struggled to put money away for the future. It was only after securing my current position several years ago that My Lovely Wife and I were able to begin building some long-term savings. But, like most of our peers, we’ve invested too little, too late to ensure that at some future date we’ll be able to pay the bills without a steady paycheck.

About 45 percent of our boomer compatriots have no retirement savings, according to a 2019 survey by the Insured Retirement Institute, and Social Security offers scant financial comfort: The average monthly check is only about $1,500. The future is notably brighter for the 31 percent of retirees who receive a monthly pension from their former employers, but that cohort has been shrinking since 1982, when Congress amended federal tax laws to offer fewer incentives for companies to maintain defined benefit plans.

“We’ve probably peaked in terms of retirement security — and it’s not great,” Monique Morrissey of the Economic Policy Institute tells reporter Will Englund in the Washington Post. “And now it’s all downhill. Unless something changes, we’re going to start seeing much more hardship.”

So, I was intrigued by a recent study from Georgetown University’s Center for Retirement Initiatives (CRI) describing the benefits of broadening access to retirement savings accounts for employees at all stages in their working lives. Currently, companies employing some 40 percent of the nation’s private-sector workers — 57.3 million people — offer no way to save. Mandating such options, while exempting small firms and making employer financial contributions voluntary rather than mandatory, would help individuals build their retirement savings over the long term. One model suggests that as many as 40 million more workers would have accumulated retirement funds by 2040 if these accounts were made widely available.

“Addressing the retirement savings crisis can be done in a simple, cost-effective way using private-sector solutions paired with a national requirement for employers to provide options to their employees,” says CRI executive director Angela Antonelli. “Millions of American workers would benefit from universal access to Auto-IRAs, 401(k)s, or other savings arrangements.”

Those benefits would also accrue to the overall economy, Antonelli argues, by adding up to $96 million to the nation’s gross national product by 2040 and reducing federal and state financial assistance to cash-strapped retirees by some $8.7 billion. Ten states have already passed legislation requiring companies to provide these options, she notes, offering ample evidence of its salutary effects. “Our research shows how expanding universal access to the national level can make a profound difference in individual lives and the broader economy in a relatively short period of time.”

I can’t help but applaud Antonelli’s optimistic view, though it’s hard to imagine how folks toiling away for minimum wage at some fast-food joint would find enough surplus in their monthly income to sock anything away in a 401(k). If I’ve learned anything from 50-odd years in the workforce, it’s how hard it is to adhere to a budget — much less save for a rainy day — when the checks barely cover the rent and groceries.

Besides, work isn’t always about the money. My ancient résumé is littered with jobs I sought because they offered a fresh occupational challenge or the opportunity to contribute to some broader social mission. Long-term financial planning was never a primary consideration. As struggling boomer retiree Terry Koch, 69, explains in Englund’s Post feature, for many of our generation it was more about enjoyment than anything else.

“We were a people who said we kind of like to have job satisfaction up front,” he says. “And so we didn’t think about the long run of things. To not be thinking about the future, to be more of a Zen thing. . . . And it wasn’t pure hedonism. There was some purity. And we’re still very much that way. I would rather be happy today than miserable 25 years from now. And so I made choices based on that rather than on the economics, which, you know, one could argue fairly successfully that I made some pretty stupid decisions.”

Forced out of the job market by health issues, Koch and his 70-year-old wife, Nancy, live in a rent-subsidized apartment in West Allis, Wis., and subsist on about $2,500 in monthly Social Security income. About $1,500 of that goes for rent and Medicare supplemental insurance coverage. There’s no savings. Yet, they soldier on more enthusiastically than you might imagine. “You know,” Nancy says, “neither of us thought we’d be alive at this age.”

It’s a sentiment that crosses my mind more than occasionally these days, and it often reminds me of my immense good fortune. A leisurely retirement may not await me in the years ahead, but just knowing I’ve made it through another day sometimes feels like money in the bank.


Craig Cox
is an Experience Life deputy editor who explores the joys and challenges of aging well.

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