More seniors may have become homebound during COVID-19, study says
The number of older adults who are homebound (leaving home once a week or less) increased in 2020 over the prior decade, according to a research letter yesterday in JAMA Internal Medicine. The researchers say that this could affect social, psychological, and physical needs because of factors such as physical distancing and caretaker or telehealth access.
The data used survey responses from the US National Health and Aging Trends Study from May 1, 2011, to Oct 31, 2020, which included 10,785 people 70 and older observed an average of 4.6 times. The prevalence of homebound adults ages 70 to 75 years more than doubled, from approximately 5.0% (1.6 million) from 2011 to 2019 to 13.0% (4.2 million) in 2020.
The population increase is most likely because of COVID-19 mitigations, according to the researchers. They note that in 2020, being homebound increased the most among Hispanic people (34.5% vs 12.6% to 17.2% in previous years), followed by Black people (22.6% vs 6.9% to 9.9%), and White people (10.1% vs 3.7% to 6.0%).
In 2020, non-White, homebound adults 70 and older were more likely to live with more people; for instance, 18.8% of White people lived with at least two other people, compared with 47.6% of Hispanics and 37.5% of Black people. About 44% of homebound White people lived alone. The researchers say that those who live alone may not be receiving adequate care, but conversely, those who live with others may have been at increased risk for SARS-CoV-2 exposure.
Also in 2020, 27.8% of all respondents did not have a cellphone, 50.8% did not have a computer, and more than half had not used email or texted (52.0%) or gone online (55.2%) in the last month. Not only could this affect social and psychological wellbeing during the pandemic, but the researchers suggest this could also affect access to digital services such as telehealth.
Aug 23 JAMA Intern Med study
Post-vaccination SARS-CoV-2 antibodies found in breast milk
After COVID-19 vaccination, 21 lactating healthcare workers showed significant increases in SARS-CoV-2 antibodies in their breast milk, according to a study published in Breastfeeding Medicine late last week.
The researchers recruited from the University of Florida health system from December 2020 to March 2021 and sampled blood and breast milk pre-vaccination, 16 to 30 days after the first dose, and 7 to 10 days after the second dose. All healthcare workers received either the Pfizer/BioNTech or Moderna vaccine.
Data showed that from pre-vaccination to after the second dose, SARS-CoV-2–specific immunoglobulin G (IgG) and immunoglobulin A (IgA) significantly increased in breast milk, with IgA positivity in 85% of 21 participants and IgG positivity in 100% of 10 participants. In blood, IgG seropositivity was found after the first and second doses, and IgA seropositivity significantly increased after full vaccination. For both IgA and IgG, data showed a positive link between breast milk and blood antibodies.
“We saw a robust antibody response in blood and breast milk after the second dose—about a hundred-fold increase compared with levels before vaccination,” noted Lauren Stafford, a doctoral student working in the lab of senior author Joseph Larkin III, PhD, in a University of Florida press release.
The average age of the cohort was 34 years, and all but one participant was White. Three had a lower milk supply after the COVID-19 vaccination, but the study did not do a longer-term follow-up to see if the effect resolved. Future areas of research include understanding the effectiveness of breast milk antibodies, how long they linger, and if they can stimulate babies to create their own COVID-19 antibodies.
Aug 20 Breastfeed Med study
Aug 24 University of Florida press release