NBC News reports that a record number of people have been hospitalized with COVID-19, and forecasts indicate that the United States could see 20 million cases by Christmas if current infection rates persist. The number of new cases for the three weeks ending Nov. 9 nearly doubled to 1.9 million from the previous 21-day count of 1.07 million. The nation could have 13.6 million cases by Nov. 30 and 19.9 million by Dec. 21 if that rate continues. The COVID Tracking Project also estimates that U.S. hospitalizations have reached an all-time high, with 61,964 on Nov. 10. Michael Osterholm with the University of Minnesota's Center for Infectious Disease Research and Policy said pandemic fatigue and ire over having to wear masks and practice social distancing, along with colder weather driving people indoors, have created a "perfect storm" for new cases. Although leading U.S. infectious diseases expert Anthony Fauci called a Pfizer vaccine for the virus "extraordinary," it will not become available until the end of December. Osterholm warned that until then, the country should prepare for the "darkest weeks of this pandemic for us."

A study published in Lancet Psychiatry suggests that people who have had COVID-19 may be at higher risk of being diagnosed with a psychiatric disorder such as anxiety or depression, reports CNN . Researchers analyzed the medical records of 69 million people in the United States between Jan. 20 and Aug. 1, including 62,000 who contracted the coronavirus. In the three months following positive diagnosis, nearly one in five survivors received a psychiatric diagnosis — about twice as likely as for other groups of patients with different ailments and conditions. "The study reports that patients have a somewhat higher risk of being diagnosed with a psychiatric illness, mainly anxiety or depression, after a COVID-19 diagnosis than after certain other medical events," explained University College London and Queen Mary University Professor David Curtis. "For example, they show that there is an 18 percent chance of getting a psychiatric diagnosis after COVID-19 compared with 13 percent after influenza." University of Oxford Professor Paul Harrison said the connection between COVID-19 and psychiatric diagnosis could be explained by multiple factors, including a direct neurological or biological effect of the virus, the medications used to treat it, the anxiety caused by contracting the virus, and wider concerns about the pandemic. Having a psychiatric disorder in the previous year also was associated with a greater risk of contracting the virus, which could be underpinned by possible socioeconomic factors.

The Motley Fool reports that the U.S. Centers for Medicare and Medicaid Services announced a hike in Medicare Part B premiums next year. The standard monthly Part B premium will rise 2.7 percent from $144.60 to $148.50, which is more than twice the most recent Social Security cost-of-living adjustment (COLA). Moreover, the yearly deductible for Part B will climb from $198 in 2020 to $203 in 2021, while the Part A deductible per hospital benefit period will rise from $1,408 to $1,484. The upcoming 1.3 percent Social Security COLA is less than 2020's 1.6 percent COLA, which will translate into less than $20 extra in monthly income for average beneficiaries. Factoring in Part B's monthly $3.90 increase, this amounts to less than $200 extra in the course of the year when including the cost of Part B premium increases. With higher Part A and Part B deductibles accounted for, some seniors will only see a roughly $100 gain in 2021. Should Medicare costs continue to appreciate, Social Security beneficiaries will continue to be at a major financial disadvantage unless lawmakers intervene and amend COLA calculation.

A research brief from the Boston College Center for Retirement Research (CRR) suggests atypical work could help retirees extend their careers with more flexible hours and less strain, reports Reverse Mortgage Daily . "Researchers define nontraditional jobs in various ways, including gig-economy jobs, on-call work, temporary positions, part-time slots, and/or self-employment," the brief says. "Most of these definitions focus on the worker's relationship to the employer. This brief . . . instead looks at the characteristics of the jobs, defining nontraditional jobs simply as those with neither employer-provided health insurance nor a retirement savings plan." For retirees with not enough savings to cover retirement costs, the CRR study finds that their overall situation sees a notable improvement. "The results do not support the hypothesis that underprepared workers are more likely to use nontraditional jobs in late career," says the brief. "However, they do suggest that underprepared workers who switch to such jobs see a substantial improvement in their retirement security." Underprepared workers are more likely to look for atypical work in later years, which might help them close gaps in retirement financing.

Two studies published in The Lancet found cholesterol-lowering statins can reduce the risk of heart disease in older adults, according to United Press International . One study found that for 80 people 80 to 100 years old who take statins, one heart attack will be prevented — while three times as many people between age 50 and 59 would have to take the drugs to gain the same benefit. The second study indicated that cholesterol-lowering medications cut the risk for heart attack and stroke in those 75 years and older by 26 percent for every one-point reduction in low-density lipoprotein (LDL) cholesterol. Statins reduced the risk for these heart-related health events by 15 percent for every one-point reduction in LDL cholesterol among those 75 and younger. "With the proportion of people living beyond 70 years of age worldwide rapidly increasing, there is huge potential for . . . strategies aimed at lowering LDL cholesterol levels," said Copenhagen University Hospital Professor Børge Nordestgaard. However, the researchers stressed that these findings should not encourage people to wait to initiate statin treatment until they are older.

A study in Science Advances suggests it is possible to design drugs that can target the shape-shifting amyloid-beta protein involved in Alzheimer's disease, reports Medical Xpress . "By revealing a new drug-binding mechanism, we have extended traditional drug discovery approaches based on the optimization of the binding affinity to include disordered proteins," said Professor Michele Vendruscolo at the University of Cambridge. The approach is based on the disordered binding mechanism, in which small molecules cohere into a disordered complex with the protein target. Experimentation led to a mathematical model of how the drug inhibited the aggregation of amyloid-beta at the microscopic level, and later the atomic level. "In contrast to the traditional lock-and-key binding mechanism, in which a drug tightly interacts with its target in a specific conformation, we found that both the small molecule and the disordered protein remained extremely dynamic, and that the small molecule interacted with many parts of the protein," said Schmidt Science Fellow Gabriella Heller. She also observed that "disordered proteins are also involved in a wide range of diseases including cancer and cardiovascular disease. We hope that we can extend this understanding to also target disordered proteins involved in other diseases."

Hopes for a new Alzheimer disease (AD) treatment were dashed on Friday, when an FDA advisory panel concurred that the evidence for aducanumab (Biogen) was not compelling enough to win their backing, reports the New York Times . Ten of 11 panel members found that research presented during the 7-hour virtual meeting was not strong enough to support a push for the monoclonal antibody, which was being eyed as the first new AD therapy in nearly 20 years. The vote delivered an unexpected blow, considering that FDA had released documents just 2 days earlier indicating that most of its clinical reviewers thought the evidence convincing. The committee's recommendation is nonbinding and does not necessarily mean FDA will reject the drug, which targets patients in the early stages of AD when cognitive effects are still mild. A major sticking point for the advisory committee centered around clinical trials of aducanumab, one of which generated favorable results and one of which did not.

United Press International reports that a new program in Seoul, South Korea, employs robots to teach 3,000 participating seniors to use smartphones and touchscreen kiosks, in an attempt to close the digital divide between younger and older generations. Ten seniors recently engaged with the Torooc startup's Liku robot at the West Seoul Senior Welfare Center. Liku used voice instructions, gestures, and a modified smartphone to teach participants how to use the KakaoTalk messaging application. The humanoid robot is linked to a central server and can answer about 200 conversational questions, and supply information like the current weather. Liku features digital eyes and interacts through facial recognition and voice responses. Shin Eun-kyong with the Seoul Digital Foundation said, "We . . . think robots have some advantages over teaching with humans face to face. It can be tiring to go over the same things over and over, but a robot can repeat the instructions until the seniors understand."

An English study said high levels of T cells that respond to the coronavirus could shield against COVID-19 infection, reports Reuters . The analysis by Oxford Immunotec and Public Health England (PHE) looked at nearly 3,000 individuals, and found that no participants with a high T cell response developed symptomatic SARS-CoV-2 infection during follow-up. This was in comparison with 20 confirmed infections among participants who saw low T cell responses. "This suggests individuals with higher numbers of T-cells recognizing SARS-CoV-2 may have some level of protection from COVID-19, although more research is required to confirm this," said PHE Consultant Microbiologist David Wyllie. The investigators suggested that the importance of T cells in the immune response might indicate that serological testing to detect antibodies would not yield a complete perspective of who was at lower risk of infection. SARS-CoV-2 responsive T cell levels also declined with age, particularly in the absence of antibodies, which may explain why older people are at higher risk from COVID-19.

HealthDay News reports that screening for fall risk and targeted exercise, with or without a multifactorial intervention to prevent falls, does not reduce fractures in older adults. A study in the New England Journal of Medicine considered 9,803 persons aged 70 and older who were randomly assigned to receive fall prevention advice by mail only, falls-risk screening and targeted exercise plus mail advice, and falls-risk screening, exercise, and targeted multifactorial fall prevention in addition to advice by mail. The researchers determined that 89 percent of the exercise group and 87 percent of the multifactorial fall-prevention cohort returned completed fall-risk screening questionnaires, of whom 37 percent were considered to be at higher fall risk and were invited to receive the intervention. Fracture rates were not lower with screening and targeted intervention. The researchers observed only small gains in health-related quality of life and the lowest overall costs in connection with the exercise strategy. "Some possible benefits were associated with screening and a targeted offer of exercise, including small enhancements of quality of life and reduced healthcare costs," they concluded.