Town Hall – Survey Results

Seniors Speak Out conducted a poll to give America’s seniors a chance to speak out about the impact that the COVID pandemic has had on them and their attitudes concerning vaccinations. We had over 400 responses and reviewed those responses at a virtual town hall last Wednesday, April 14. I was joined on the town hall by Nona Bear, a trusted colleague and an experienced senior advocate who has worked on issues concerning older Americans for over 40 years. You can click here to view the recorded town hall.

Since Nona and I have been vaccinated and have waited the appropriate time after our second shot we, in compliance with CDC guidelines allowing us to “Visit with other fully vaccinated people indoors without wearing masks or physical distancing,” did the town hall sitting next to each other without wearing masks. It was exhilarating to communicate directly back and forth with Nona during the town hall. People commented afterwards how different it was to have two people in the same screen box actually speaking back and forth without unmuting (or forgetting to unmute) themselves. It seemed like a first step on the road back to normalcy.

We do these polls periodically to check the pulse, and understand the attitudes, of older Americans on relevant issues. We’ve all been inundated with information from a multitude of sources concerning COVID-19. This poll gave seniors a chance to reveal how they digested all this information and how they personally feel about the pandemic and the vaccines that will give us a chance to return to normal. Seniors Speak Out focuses on older Americans -- and those who completed the survey reflected that focus, 90% were over 65 and 30% were over 75.

We went through the questions as they were presented to the poll takers, discussing the results, and adding any insight we might have.

Question – Have you tested positive for COVID-19 or has a healthcare professional told you that you had COVID-19?

• Yes à 7.2% (29 respondents)
• No à 92.8% (376 respondents)

Discussion – Only 7.2% of our poll takers caught the virus compared with just under 10% for America as a whole. I pointed out that 80% of the deaths from COVID occurred to those over 65. Seniors bore the brunt of this virus. I recounted that an assisted living facility near me, which had been absolutely off limits to visitors since the pandemic began, now has a big banner that proclaimed, “we are all vaccinated, come visit.” That is literally a sign of progress.

Question – Have you received the COVID-19 vaccine or are you scheduled or on a waiting list to receive the vaccine?

• Yes, I've received or waiting to get vaccinated à 81.7% (308 respondents)
• No, I have not received the vaccine, nor do I plan on getting vaccinated à 18.3% (69 respondents)

Discussion – Both Nona and I recalled what a sense of relief and empowerment we felt when we got our vaccinations. Our poll went on to ask those who had replied no to this question some follow-up questions.

Follow-up question – Why haven’t you received the vaccine or signed up to receive one?

• Getting an appointment was too hard à 5.8% (4 respondents)
• Getting to the vaccination site was too hard à 5.8% (4 respondents)
• I'm waiting to see if there are side effects or other health issues with the vaccine à 34.8% (24 respondents)
• I am not planning on getting the vaccine à 53.6% (37 respondents)

Discussion – We pointed out that getting appointments should improve each day and with pharmacies beginning to give vaccinations it should be easier to get to the inoculation site. The people in the third category were the “wait and see” people. That category of vaccine hesitancy has been steadily shrinking. In last week’s blog I encouraged people in this group to talk with someone they trust to get their advice. Nona talked about some of her friends who had been hesitant. A total of 9% of our poll respondents fell into the fourth category, they were not going to get vaccinated. Nationally, 14% of us are in this category. This percentage hasn’t changed over the last months. We felt like these people, for whatever reason, were not going to change their mind. It will be up to the rest of us to get our country to herd immunity.

The poll then stopped the follow-up questions and asked everyone the following questions.

Question – Do you think a vaccinated person needs to still wear the mask?

• Yes à 75.3% (305 respondents)
• No à 24.7% (100 respondents)

Discussion – The 75% who responded ”yes” were echoing the CDC guidelines for being with non-vaccinated people, in big groups, in public places and indoors. I pointed out that maybe the other 25% were thinking about the situation like this one, meeting with vaccinated people or were just willing to take the risk. Nona and I then discussed how each of us have our own level of risk that we are willing to tolerate. This level of risk is a very personal thing and should be based on the science but remains a product of our own experience and our personality.

Question – Do you think a vaccinated person’s chance of getting hospitalized or dying of COVID-19 is?

• 0% à 14.8% (60 respondents)
• 5% à 43% (174 respondents)
• 10% à 26.9% (109 respondents)
• Higher à 15.3% (62 respondents)

Discussion – When it was revealed that the first two vaccines that gained emergency authorization were 95% effective, it seemed natural that 5% would be the logical answer to this question. Actually, in the trials, of the people who tested positive after being vaccinated, none were hospitalized or died. We have experienced some hospitalizations and even a few deaths in the over 75 million vaccinations that have been given but the odds of getting seriously ill after getting vaccinated remain very, very low.

Question – Concerning the impact of the restrictions of COVID-19 on your physical health – check all that apply:

• It has been more difficult to get my medicine à 8.5% (39 respondents)
• It has been harder or I've been hesitant to see a doctor or other healthcare professional à 41.6% (190 respondents)
• I've had trouble receiving home healthcare à 2.4% (11 respondents)
• I've had trouble receiving home services (cleaning, food delivery, etc.) à 9.2% (42 respondents)
• Other à 38.3% (175 respondents):

Discussion – Nona talked about the importance of returning to see our doctor if we have delayed or cancelled appointments. We discussed later in the town hall how important it is to follow-up on our other vaccines, shingles, pneumonia, flu, etc. We hope that there wouldn’t be an increase in some illnesses, like colon cancers due to people delaying their colonoscopies due to the pandemic. We were encouraged by the increase in the use of telemedicine. 

Question – In their responses to COVID-19, do you think the healthcare sector (hospitals, drug and device manufacturers, insurers, Medicare, Medicaid, VA) has:

• Performed better than expected à 40% (162 respondents)
• Performed as expected à 42.5% (172 respondents)
• Performed worse than expected à 17.5% (71 respondents)

Discussion – 82% said the healthcare sector performed as expected or better than expected. That’s a rousing vote of confidence. We felt like it was a recognition of the heroes that have helped us through this pandemic and quickly developed a vaccine to combat it.

Question – In their responses to COVID-19, do you think the Biden Administration and new Congress has:

• Performed better than expected à 43.5% (176 respondents)
• Performed as expected à 20.2% (82 respondents)
• Performed worse than expected à 36.3% (147 respondent

Discussion – While the Biden administration’s numbers are better than the last poll of the Trump administration (64% to 46%), it is important to note that much of the initial successful research and response to the pandemic occurred under the Trump administration. The main point is that America senses that the momentum to conquer the pandemic has strengthened and will continue.

Question – Concerning the impact of the restrictions of COVID-19 on your emotional health – what worries you the most?

• Becoming sick with COVID-19 à 13.1% (75 respondents)
• The COVID-19 vaccine not working à 13.5% (77 respondents)
• Family members becoming ill with COVID-19 à 27.1% (155 respondents)
• Loss of retirement income à 7.2% (41 respondents)
• Loneliness à 21% (120 respondents)
• Access to healthcare à 8.4% (48 respondents)
• Other à 9.6% (55 respondents)

Discussion – Nona noted that the second most popular response was loneliness and that it certainly impacted a lot of seniors. She also noted that it seemed that older people have found ways to cope with their loneliness . . . that maybe their life experiences helped them weather this storm. The number one response (27%) was fear that a family member would get COVID, in true selfless fashion they were twice as worried about their family than they were about their own health (13.5%).

Question – What top two healthcare priority issues are you concerned with this year?

• Prescription drug costs à 27.1% (185 respondents)
• COVID-19 treatments and research to prevent another pandemic à 25.8% (176 respondents)
• Problems with Medicare coverage and/or costs à 25.8% (176 respondents)
• Making healthcare more accessible à 17.6% (120 respondents)
• Other à 3.7% (25 respondents)

Discussion – We thought it was interesting that concern over how much we were paying for prescription drugs and treatment and research were at the top of our concerns. A significant portion of our drug costs pays for research on new drugs. We discussed how critical it will be to reach a balance in these two areas. Another top concern was problems with the cost and coverage of Medicare. We can expect proposals to change Medicare to be submitted sooner rather than later. It will be important for us to understand those changes and the impact they could have on each of us. 

Question – Do you have family members helping you make healthcare decisions?

• Yes, a spouse, other family member, or home healthcare worker helps me make healthcare decisions à 18.8% (76 respondents)
• No, I handle my healthcare decisions on my own with my doctor’s consultation à 81.2% (329 respondents)

Discussion – We were amazed at the self-reliance of the respondents. We conjectured that maybe the emergence of Zoom and other electronic methods that let us stay in contact with our families helped us to be better on-line researchers and find our own answers to questions. There is no doubt that we have become better informed.

Question – Are you worried the new Administration will restrict your access to care?

• Yes à 41.7% (169 respondents)
• No à 58.3% (236 respondents)

Discussion – 42% is not a small number of people that are worried about their access to healthcare. The pandemic has magnified how important healthcare is to each one of us. I’ll keep this in mind as we discuss existing and future proposed changes to Medicare.

Question – What do you think the Biden Administration should prioritize?

• Lowering prescription drug costs à 53.3% (247 respondents)
• Reforming health insurance à 34.3% (159 respondents)
• Other à 12.3% (57 respondents)

Discussion – Prescription drug costs was at the top of the list. I always point out that the true impact of prescription drug costs is the out-of-pocket money each of us pays for our prescription drugs. As I’ve discussed in my blogs, one solution that has gained some bi-partisan support in the past has been putting a yearly cap on our Medicare Part D out-of-pocket costs. We pointed out that we have had caps on these costs as part of our private insurance when we were younger and introducing this cap in Medicare could really help the sickest amongst us.

We purposedly spent very little time during the town hall discussing the pause in the Johnson and Johnson vaccinations. It happened the day before our town hall and there wasn’t very much information available. We know that it is a concern for all of us and because of that we will be re-releasing the survey in the next few weeks to ascertain if this pause has changed your attitudes. We hope it will not.

As always, we left some time for questions. The first question was:

• How do we obtain a balance between lowering prescription drug prices and maintaining the robust research and development environment that discovers new medicines?

I replied that if I had the exact answer everyone would be seeking my opinion on a variety of topics. I commented that we need to somehow find this balance and that the drug manufacturers want to come to the table and find a solution. Nona pointed out that all the progress in oncology treatments were made possible because investors were willing to invest in the research and development. The two German scientists who worked for 5 years to pioneer the science for the vaccines that will conquer the COVID virus were financed by someone who was willing to take the risk.

• A follow-up question was asked to expand on why it is a bad idea to import drugs from other countries.

I pointed out that some states have passed legislation to allow drugs to be imported from Canada, but nothing has happened because the Canadian government couldn’t or was unwilling to support it and that the drugs that would come through Canada would be manufactured in other countries and would be outside of the pipeline that the FDA and HHS monitors in order to guarantee the drugs are safe. For decades, the secretary of HHS has had the ability to authorize the importation of drugs. No secretary, whether it was under a Republican or Democrat administration, has allowed importation, simply because they couldn’t guarantee the safety. There are ways to solve this problem so America doesn’t bear the brunt of the cost for R&D, importing drugs is not a viable solution.

• Nona was asked a question about how we would know when it was safe to go back to the doctor.

She said that it is vitally important that you feel comfortable going to see your doctor. She recommended that you call the doctor and ask as many questions as needed about how they will keep you safe until you feel comfortable. She encouraged everyone to use telemedicine as much as possible. I pointed out that Medicare quickly authorized payment for the use of telemedicine. We also touched on the importance of preventative care, we may have got behind on some of our vaccines and we need to get back on schedule.

• The last question was about loneliness and how it has affected older Americans and whether there was a chance to learn from our experience of the last year?

Nona pointed out that the impact of loneliness on our health is often under recognized and that all age groups are impacted. We added that there might be some silver linings to this experience because we became much better at using technology to combat loneliness and that we experienced huge strides in expanding the use of telemedicine.

We closed by reminding everyone that there will be another virtual town hall in June and that we will be sending out the survey again in a few weeks to gauge if there has been any changes in our attitudes on vaccines and the pandemic. We will also be asking for ideas for the subject of the June town hall. I will publish the link to our follow-up survey on my weekly blog.

Best, Thair