BBC News reports that a new study suggests people are most likely to pass on COVID-19 within the first five days of having symptoms, with "live" virus detected up to nine days after manifestation of symptoms. The study in Lancet Microbe reviewed 79 global studies on COVID-19, involving symptomatic people in hospitals who had already tested positive for the pathogen. Scientists could identify and replicate viable virus from throat samples taken up to nine days after infections began, and the amount of viral RNA particles in the throat samples peaked at the time symptoms started or within five days. Moreover, inactive viral RNA fragments continued to show up in nose and throat samples for up to 17 days after symptoms began, on average. However, no viable replicating virus was found after nine days, meaning most people were unlikely to still be highly contagious past that point. "People really need to be supported to make sure they isolate as soon as they get symptoms, however mild," advised the University of St. Andrews' Muge Cevik. "By the time some people get the results of swabs, they may be past their most infectious phase."

A study from the Brookings Institution reports that a serious rethink about what ages should be considered when discussing the extension of working lives is in order, when accounting for workforce nonparticipation among Americans in their 50s. In the U.S. policy dialogue about working longer, ages 67 and 70 stand out as benchmarks, yet issues with working longer begin much earlier for a large number of employees — by 10 or more years for many. In the long term, policymakers should push for a labor market in which workers of all ages, including those lacking college degrees, can get decent jobs that offer adequate pay, sustainable schedules, and the flexibility for workers to care for themselves and their families. Such a labor market would be expected to produce lower rates of job turnover for lower-wage workers in their 50s. Lower turnover would cut the number of people who retire early due to job loss, and who cannot find another suitable job. Longer and more stable employment histories would consequently deliver higher Social Security retirement benefits and retirement savings. Better jobs would therefore raise both the probability and the value of working longer.

UConn Today reports that 10 University of Connecticut (UConn) School of Social Work students in the Master of Social Work and Bachelor of Social Work programs are partnering with older adults in Hartford and the surrounding region to help fight isolation during the pandemic as part of the Social isolation/Loneliness Intergenerational Project (SLIP). The students are each matched with four or five seniors, most of whom typically visit Hartford senior communities run by Catholic Charities, communicating by phone or video chat twice weekly. The students will be trained to perform reminiscence therapy and life review techniques, using them to foster connections with their senior matches. Participants' loneliness will be assessed at the beginning and end of the eight-week project. Visits will initially be phone-based since most seniors are comfortable with that mode of communication, but may graduate to video calls if they show interest, possibly using the OneClick.chat platform. The platform is designed for ease of use by older adults, and the U.S. National Institutes of Health has funded studies on its use in combating social isolation. UConn Professor Rupal Parekh says SLIP offers "a way to introduce students to how wonderful it can be to work with older adults. It's critical that we do that in the School of Social Work."

The Yale School of Medicine reports that a study in the American Journal of Geriatric Psychiatry suggests regular phone calls could lift the spirits and reduce loneliness of loved ones in long-term care, especially during the pandemic. The researchers polled more than 160 Americans with at least one close relationship with someone in a long-term care community. Phone calls and e-mails were associated with more positive emotions for family members, friends, and residents, while written letters were connected to more negative emotions. Many respondents said they had phone conversations with loved ones at least once a week, while a smaller group texted with similar regularity. Respondents who tried calling while communicating through a window said they did so on average of about once weekly. Yale School of Public Health Professor Joan Monin said with the pandemic still raging, phone calls could be a great way to stay in touch with those in long-term care communities. "It's an easy way for people to communicate and it doesn't have as much burden on staff to help facilitate as some of the other methods like video chat or window visits," she noted. It remains uncertain as to why video conversations did not yield an added benefit, and Monin thinks older adults are more acclimated with using the phone to talk to family members than video chat.

AstraZeneca and the University of Oxford announced earlier today that their COVID-19 vaccine boasts average efficacy of 70 percent and is well tolerated with no serious treatment-related adverse events, reports the Wall Street Journal . Efficacy with AZD1222 was 62 percent when administered as two full doses but increased to 90 percent when a half dose was administered followed by a full dose, based on data from large clinical studies in the United Kingdom and Brazil. Late-stage U.S. trials are ongoing, and the partners are unlikely to seek FDA approval for the vaccine until they have those results. Still, the news is promising for near-term availability of a third vaccine developed by Western manufacturers. AZD1222 will not require subzero storage temperatures. AstraZeneca and Oxford also have vowed to distribute the product across a much broader geographic footprint and to forfeit any profits during the pandemic. While the collaborators will wait to apply for FDA approval, they do plan to request emergency-use authorization from the World Health Organization to initiate distribution in low-income countries. Pending approval, a senior AstraZeneca executive said, the company aims to make the vaccine available by the end of the year.

With coronavirus cases in Northeast Wisconsin continuing to grow, assisted living communities are striving to offer residents holiday cheer, reports WFRV-TV . Although traditional in-person visits have been suspended since March, residents' families can still participate in other ways. "We are having family members send in photos, leave messages, and we're able to play those on a loop on a slideshow," said Tim Neuman, administrator at Brewster Village in Appleton, Wis. Meanwhile, turkey dinners are planned for Thanksgiving, and Christmas and other holiday decorations will be put up throughout Brewster Village and other similar communities. "I believe 16 team members . . . have volunteered to be a part of a choir to do the Christmas caroling throughout the halls here," Neuman added. Brewster Village residents also can visit loved ones virtually with video chats.

CNN reports that Moncef Slaoui, the head of the U.S. government's effort to develop a vaccine against COVID-19, said the first Americans to receive a vaccine — if things proceed on schedule — could be as soon as the second week of December. "Our plan is to be able to ship vaccines to the immunization sites within 24 hours from the approval, so I would expect maybe on day two after approval, on the 11th or on the 12th of December . . . the first people will be immunized across the United States, across all states, in all the areas where the State Departments of Health will have told us where to deliver the vaccine," he announced. Pfizer on Friday submitted an application to the Food and Drug Administration (FDA) for emergency use authorization for its COVID-19 vaccine candidate, and an FDA vaccine advisory committee is supposed to meet Dec. 10. If so authorized, the vaccine could be rolled out on Dec. 11, Slaoui said. He added that if things go as planned, the percentage of the American population to be vaccinated in order for life to resume normalcy is likely to be reached in May. Following Slaoui's statement, leading U.S. infectious disease expert Anthony Fauci said while he "totally agrees" with Slaoui that there could be herd immunity by May, it would require the bulk of the country to be immunized. It will be the states' responsibility to determine local vaccine distribution.

CNBC reports that a World Health Organization (WHO) panel broke with the U.S. Food and Drug Administration (FDA) by warning doctors against using Gilead Sciences' antiviral drug remdesivir as a treatment for patients hospitalized with COVID-19, citing no current evidence that it extends survival or accelerates recovery time. In a recommendation published in The BMJ , the WHO Guideline Development Group said its conclusions are derived from new findings on the effects of several drug treatments. The FDA on Oct. 22 formally approved remdesivir for adults and children 12 and older who require hospitalization for COVID-19. Gilead has publicly disputed the findings of the WHO study, claiming that multiple randomized, controlled trials show the drug speeds up recovery time. The WHO panel admitted that the evidence thus far fails to prove that remdesivir "has no benefit," but added that in view of the potential for harm and the high cost and resources for administering the drug, it is an "appropriate recommendation."

A Brookings Institution report notes that a large portion of older Americans do not have sufficient savings for retirement, concurrent with the U.S. economy's growing reliance on older workers. "A significant challenge to continued employment at older ages is that workers often must change jobs late in life," the authors write, adding that such displacement may accelerate amid rapid technological change and globalization. They also observe that the federal-state workforce system is failing to meet older adults' requirements, particularly because there currently are no special programs to serve older job seekers. "Moreover, the measures used by the U.S. Department of Labor to evaluate state workforce agencies' performance create a disincentive to provide services to older workers," the authors point out. "Especially given today's high level of unemployment, the large share of affected workers who are older, and the inadequacy of many older adults' retirement savings, the need to address these shortcomings is urgent." The authors suggest a number of relatively inexpensive policy reforms, including posting specialized staff at job centers who understand older workers' needs and who can serve them more effectively. Other proposals include experimenting with job placement programs designed for older workers; promoting self-employment among older adults; targeted skills development for older workers; and eliminating disincentives using separate program performance standards for older adults. Also recommended is reinstating funding to the Senior Community Service Employment Program, and assessing the new programs and initiatives to verify their intended effect.

New research in the Journal of Neurology, Neurosurgery & Psychiatry indicates that a frailty index score could help doctors identify patients at risk for cognitive dysfunction and dementia, reports HCPLive . The data suggests health-deficit accumulation among older Americans influences the probability of progressive cognitive impairment, and the likelihood of cognitive improvement independent of the APOE e4 allele. The researchers focused on participants aged 50 and older from the National Alzheimer's Coordinating Center. Among the 9,773 participants not cognitively impaired (NCI), each 0.1 increment increase in score was associated with a greater risk of mild cognitive impairment (MCI) and dementia. Overall, the study covered 14,490 participants with a mean age of 72.2 years. The 4,717-participant MCI sub-sample at baseline showed more frailty associated with a lower probability of being reclassified as NCI from MCI, more risk of reverting to MCI in those reclassified as NCI, and more risk of progressing to dementia. "We conclude that frailty is a key risk factor for age-related cognitive dysfunction and dementia, representing both a target for interventions aimed at the prevention of age-related cognitive impairment and possible prognostic marker among those who have MCI," the authors said.