Vitamin D and COVID-19 Research

A new research study at the University of Chicago Medicine has found that when it comes to COVID-19, having vitamin D levels above those traditionally considered sufficient may lower the risk of infection, especially for Black people.

The study, published March 19 in JAMA Open Network, retrospectively examined the relationship between vitamin D levels and likelihood of testing positive for COVID-19.

While levels of 30 ng/ml or more are usually considered “sufficient,” the authors found that Black individuals who had levels of 30 to 40 ng/ml had a 2.64 times higher risk of testing positive for COVID-19 than people with levels of 40 ng/ml or greater.

Statistically significant associations of vitamin D levels with COVID-19 risk were not found in white people.

The study looked at data from over 3,000 patients at UChicago Medicine who had had their vitamin D levels tested within 14 days before a COVID-19 test.

Source: https://www.sciencedaily.com/releases/2021/03/210322175028.htm

The Delta Variant: What You Should Know

Delta variant is causing vaccine breakthrough infections.

The Delta variant is an example of how the virus that causes COVID-19 can change as it spreads and has caused nearly 75% of the current infections in the U.S., according to the Centers for Disease Control and Prevention.

New evidence is showing that the delta variant is as contagious as chickenpox and this has prompted U.S. health officials to consider changing advice on wearing masks.

The CDC is encouraging all Americans to get vaccinated, recommending masks for everyone and requiring vaccines for doctors and other health care providers.

If you are fully vaccinated, your risk of infection is lower, but some people can still spread the Delta variant. When “breakthrough cases” of COVID-19 do occur in vaccinated people, nearly all are avoiding serious illness, hospitalization, or death. cdc.gov/coronavirus

To maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.

For schools, CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Children should return to full-time in-person learning in the fall with layered prevention strategies in place.


References:

  1. https://www.cdc.gov/coronavirus/2019-ncov/index.html

What to Expect after Getting a COVID-19 Vaccination

Adverse reactions are usually mild to moderate in intensity and resolve within a few days following receipt of the Moderna COVID-19 vaccine, according to the CDC. The most common adverse reactions reported after vaccination in clinical studies included:

  • Pain at injection site (92.0%)
  • Fatigue (70.0%)
  • Headache (64.7%)
  • Muscle pain (51.5%)
  • Joint pain (46.4%)
  • Chills (45.4%)
  • Nausea/vomiting (23.0%)
  • Axillary swelling and tenderness of the vaccination arm (19.8%)
  • Fever (15.5%)
  • Injection site swelling (14.7%)
  • Injection site redness (10.0%)

It takes time for your body to build protection after any vaccination. COVID-19 vaccines that require 2 shots may not protect you until about 2 weeks after your second shot.

After receiving the COVID-19 vaccination, the side effects you may experience are normal signs that your body is building protection and they should go away in a few days.


References:

  1. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html

COVID-19, One Year Later. Here’s What We’ve Learned.

“The vaccines are our best hope to contain the virus; and while the CDC’s guidance may change based on new evidence, you should follow their current guidance: Keep wearing your mask, practice social distancing and wash your hands.”  Dr. Andrea Klemes

By Dr. Andrea Klemes, MDVIP’s Chief Medical Officer

It was March 11 last year when the World Health Organization first announced that the coronavirus had reached pandemic stage. At the time, there were 118,000 cases in 114 countries. A year later and there are more than 114 million cases and 2.5 million deaths worldwide.

In the year since the pandemic officially started, doctors, researchers and the American public have learned a lot about the virus. We know how it spreads — through droplets and in the air; we know how it likely doesn’t spread — on surfaces (you should still wash your hands regularly); we know the virus isn’t seasonal like flu – it didn’t go away during the summer; and we know that we can fight it, both through prevention and treatment.

Speaking of treatment, we’ve learned a lot about what works in the fight against COVID-19, the condition caused by the coronavirus. The anti-inflammatory steroid drug dexamethasone, for example, works in many patients on supplemental oxygen or ventilators. Antibodies — either from convalescent plasma or man-made ones from monoclonal antibody treatments — seem to keep some patients from more severe illness. These treatments have been granted emergency use authorization by the Food and Drug Administration.

Even simple things, like turning patients prone (lying face down) have turned out to be lifesaving for many people hospitalized with the disease.

But there’s still much we don’t know. And there’s still a lot of misinformation and myths swirling around 12 months after the pandemic began. I thought it would be helpful to recap some key learnings.

Vaccines are here, but the virus isn’t going away any time soon.

See the source image
It’s hard to believe that in a little less than a year scientists created numerous vaccines to combat the coronavirus. In fact, the Food and Drug Administration approved a third vaccine last week — and this one, from Johnson & Johnson, is a single-dose vaccine that’s easier to transport and store. It should help vaccines become more widely available in the next couple of months.

If you’ve already gotten your vaccine, your behavior shouldn’t change — that’s the advice of the Centers for Disease Control and Prevention. That’s because the vaccines prevent severe illness from infection. You may still be able to get the virus and spread it.

This advice may change. Promising but unpublished studies suggest that vaccinated individuals carry lower viral loads and may be at lower risk to spread the virus. If you’re thinking, why get the vaccine if I still have to wear a mask? Get the vaccine when it’s your turn. The vaccines are our best hope to contain the virus; and while the CDC’s guidance may change based on new evidence, you should follow their current guidance: Keep wearing your mask, practice social distancing and wash your hands.

One rule that has changed for those who have been vaccinated: You may not have to quarantine after exposure if you meet certain criteria and it’s been more than two weeks since your last dose.

Eating at a restaurant increases your risk of getting the virus.
We love eating at restaurants, but many are poorly ventilated and crowded with people. Even at reduced capacity, the CDC rates eating inside at a restaurant to be higher risk than other activities. A study from six months ago suggested that COVID-19 positive patients were twice as likely as those who tested negative to have eaten at a restaurant in the two weeks leading up to their illness.

It’s possible that people who eat at restaurants during the pandemic take other risks that increase their chances of getting the virus, but there are also early studies that track breakouts to restaurant eaters.

It’s still safer to get your food to go — or eat outside away from other diners.

So does gathering with your family.
Just like eating out, there are plenty of studies showing the transmission of the virus when families get together. Among adults with COVID-19, 42 percent reported close contact with a person with COVID-19 — and most of those close contacts were with family members.

In one case study from last summer, a single COVID-positive adolescent on a family vacation with three different families spread the illness to 11 other family members. There are dozens of cluster studies like these from contact tracing efforts — weddings, reunions, holiday parties, barbecues and even more intimate gatherings. Getting together with family without proper protocols can result in spreading events.

Even without gatherings, household members are often the point of contact for new COVID cases. Household transmission of this coronavirus is 16.6 percent higher than with past pandemics like SARS and MERS.

To be fair, more infections have been traced to other kinds of activities than seeing family — from workplaces to prisons to assisted living facilities to colleges. But you shouldn’t let your guard down when you’re around your family.

Six feet of distance probably isn’t enough.
Early guidance from the CDC defined close contact as spending 15 minutes or more within six feet of a person infected with COVID-19. The six-foot distance was based on COVID transmission from droplets, which we emit when we talk, sneeze or cough. We’ve been studying viral transmission by droplets since the 1890s.

Of course, there are plenty of studies over the years that suggest droplets can travel further. The problem with COVID is that you can become infected from aerosol transmission — smaller droplets and particles can float in the air for minutes and hours and travel far from the source. Still, the CDC says that most transmission comes from close contact with infected individuals.

As for time, that one’s trickier. Some school systems and employers liberally interpreted the 15 minutes to mean that as long as you kept contact brief, you were okay. But repeated exposure can also result in an infection, which is one reason the CDC changed the guidance last fall to 15 minutes over a 24-hour period. Here’s the bottom line: The more you interact with others and the longer that interaction lasts, the greater your chance of contracting COVID.

The best way to prevent spread is to avoid unnecessary exposure.

Yes, masks help prevent the spread of the virus.
I know a lot of people have had a hard time warming up to face masks. Early in the pandemic, public health officials lacked clear evidence about the effectiveness of masks and hesitated to recommend them. But 12 months later, there’s a raft of evidence that masks (double ply cloth, surgical and N95) reduce the transmission of the coronavirus. In fact, the Proceedings of the National Academy of Sciences of the U.S., which recently published a review of studies about masks and COVID-19 transmission, concluded:

“The preponderance of evidence indicates that mask wearing reduces transmissibility per contact by reducing transmission of infected respiratory particles in both laboratory and clinical contexts.”

Some study highlights:

Masks were 79 percent effective at preventing household transmission, if used by all members of the household before symptoms showed.

The devil is in the details. We know from COVID studies and previous viral studies that masks reduce risk of transmission for the wearer and for the people around them if the wearer is sick.

Double masks may even be better.
One mask works if you wear it correctly. Two might actually be better.

The CDC recently released new masking guidelines based on studies it did to determine how to improve their efficacy. The agency looked at wearing a cloth mask over a medical procedure mask (often called a surgical mask, but not an N95) and whether knotting the ear loops of a medical procedure mask and then tucking in and flattening the extra material close to the face would reduce risk.

Both modifications improved the masks effectiveness. According to the CDC’s experiments, an unknotted medical procedure mask blocked 42 percent of the particles from a simulated cough. A cloth mask blocked 44.3 percent. Knotting the surgical mask alone blocked 63 percent of particles. When the cloth mask was combined with the knotted surgical mask, it blocked 92.5 percent of particles.

The CDC has since updated its recommendations. If you use an N95 or KN95 mask, the agency does not recommend double masking. It also doesn’t recommend doubling up surgical masks.

Testing negative doesn’t mean you stay negative.
This may be one of the hardest things for people to understand. A lot of people get tested after they’re exposed, but you can test negative one day and positive the next, depending on the time from when you were exposed, the course of the infection and the type of test you took.

When you’re exposed to someone with the virus and become infected, symptoms may show a few days after exposure or up to two weeks later. If you test too soon, a test may not pick up the infection. If you’re asymptomatic, a rapid antigen test may not pick up your infection at all. Accuracy is lower in antigen tests than PCR tests, especially in those who aren’t showing symptoms.

That’s why it’s so important to observe CDC guidelines when it comes to testing and exposure. If you’ve been exposed to the virus, the CDC recommends you quarantine for 10 days, provided you remain asymptomatic. You can reduce this time to seven days if you show no symptoms and do not test positive for the virus on day 5 or later.

The new variants are a reason to be vigilant.
The new variants are more than troublesome. Many of them are more communicable and one, the British variant, is looking like it may be more virulent. This is why we need to keep washing our hands, wearing masks and practicing social distancing. And why we should get the vaccine when it’s our turn. Don’t let up now!

With a little extra effort from all of us, I believe we can beat back this virus, and we’re well on the way. We’re better at treating it, and we know how to stop its spread. If enough of us do these things, there’s a chance these variants won’t make the impact that some researchers currently fear.

We may have to take booster shots in the future, but that’s a lot better than where we were a year ago when we had no vaccine, few promising treatments and knew very little about COVID-19.

What a difference a year makes.


Reference:

  1. https://www.mdvip.com/about-mdvip/blog/what-you-need-know-about-coronavirus-or-covid-19

COVID-19 Pandemic End is in Sight

“When it comes to COVID-19, we are optimistic that the end of the beginning is near.” Bill Gates

Billionaire philanthropist and Microsoft Founder Bill Gates believes that we will get COVID-19 under control in calendar 2021. What he means by “under control” is that America and the world will be heading back to something approaching normal again.

Gates is optimistic that the number of cases and deaths will start to go down—at least in wealthy countries—and life will be much closer to normal than it is now for two main reasons:

  • One is that masks, social distancing, and other interventions can slow the spread of the virus and save lives while vaccines are being rolled out.
  • The other reason is that in the spring of 2021, the vaccines and treatments will start reaching the scale where they’ll have a global impact.

In Gates’ view, the coronavirus is somewhat seasonal. He suggests that once the Northern Hemisphere gets into summer, the numbers should go way down, and he expects that countries will not experience another COVID-19 wave in the fall.

He stresses that vaccinations by the fall should be “bearing the brunt” of ending the pandemic. He feels that there will still be some COVID restrictions on public gatherings, because, as “long as the disease is out there in other countries, you can still get big chains of infection anywhere on the globe”.

But if we get the vaccination levels up within the communities and across the globe this fall, all the schools will be able to reopen under some protocol. Moreover, entertainment, travel and hospitality will be open. And, the economy will be on the mend in a big way. The good news according to Bill Gates is that the pandemic, as bad as it’s been, the end is in sight.

“Humans have never made more progress on any disease in a year than the world did on COVID-19 this year”, Gates wrote in a recent Gatesnote. “Under normal circumstances, creating a vaccine can take 10 years. This time, multiple vaccines were created in less than one year.”

The Bill and Melinda Gates foundation has invested more than $1.75 billion in the fight against COVID-19. Most of that funding has gone toward producing and procuring crucial medical supplies. For example, the foundation backed researchers developing new COVID-19 treatments including monoclonal antibodies, and they worked with partners to ensure that these drugs are formulated in a way that’s easy to transport and use in the poorest parts of the world so they benefit people everywhere. Which is pretty remarkable—especially considering that COVID-19 was a virtually unknown pathogen at the beginning of 2020 and how rigorous the process is for proving a vaccine’s safety and efficacy. The vaccine still had to meet strict guidelines before being approved.


References:

  1. https://www.gatesnotes.com/About-Bill-Gates/Year-in-Review-2020?WT.mc_id=20201222100000_YIR2020_BG-TW_&WT.tsrc=BGTW
  2. https://www.pbs.org/newshour/amp/show/bill-gates-on-tackling-climate-change-and-the-ongoing-pandemic-response?__twitter_impression=true

Daily COVID-19 Infections, Hospitalizations and Deaths Declining

COVID-19 Cases Are Dropping Fast. Four reasons: social distancing, seasonality, seroprevalence, and shots.

COVID-19 is in retreat in America. New daily cases have plunged, and hospitalizations are down almost 50 percent in the past month. The reason for the decline range Americans’ good behavior in the past month combined with (mostly) warming weather across the Northern Hemisphere has slowed the pandemic’s growth; at the same time, partial immunity and vaccines have reduced the number of viable bodies that would allow the coronavirus to thrive.

The current decline of COVID-19 is crystal clear.

There has been a five-week downward trend in cases, according to data collected by the Centers for Disease Control and Prevention. The highest 7-day moving average occurred on January 11, 2021 and was 249,048. The current 7-day average is 77,385 cases, which is a 68.9% decline.

Furthermore, the 24.5% decrease in the 7-day average number of daily cases reported compared with the prior week also provides an encouraging sign of recent progress. Even with these declines, however, the 69,165 cases reported on February 17 remains higher than what was seen during either of the first two peaks in the pandemic.

Daily Trends in COVID-19 Cases

The numbers of new hospital admissions of patients with confirmed COVID-19 have decreased from the national peak of 18,006 admissions on January 5, 2021 to 6,841 admissions on February 16 (a 62% decrease). The average number of daily admissions fell by 21.8% compared to the previous week.

Nationally, the number of COVID-19 deaths continue to fluctuate. There has been over 500,000 total COVID-19 deaths reported with 2,601 new deaths reported as of February 23, 2021. The 7-day average number of new deaths decreased by 9% to 2,708** new deaths per day compared to the previous 7-day period.

Why the decline?

Americans’ good behavior in the past month combined with warming weather across the Northern Hemisphere to slow the pandemic’s growth; at the same time, partial immunity and vaccines have reduced the number of viable bodies that allow the coronavirus to thrive.

According to a piece that ran in the Atlantic.:

1. Behavior: Americans finally got on board with wearing a mask and social-distancing thing.

Officials pointed to Google mobility data that demonstrated that Americans withdrew into their homes after the winter holidays and hunkered down during the subsequent spike in cases that grew out of holiday season socializing. New hospital admissions for COVID-19 peaked in the second week of January—another sign that social distancing during the coldest month of the year bent the curve.

2. Seasonality: The coronavirus is perhaps seasonal and destined to decline.

Behavior can’t explain everything regarding the decline. Mask wearing, social distancing, and other virus-mitigating habits and behaviors had some impact. But bottomline, COVID-19 is in retreat across North America and Europe. Since January 1, daily cases are down 70 percent in the United Kingdom, 50 percent in Canada, and 30 percent in Portugal. This raises the possibility that SARS-CoV-2, the virus that causes COVID-19, is seasonal.

Many viruses fare best in cold and dry conditions; they’re not well designed to thrive in warmer, sunnier, and more humid outdoor areas, Harvard epidemiologist Michael Mina told New York magazine. Each virus is a bundle of genes and protein encased in a fatty lipid molecule. This fatty shell breaks down more easily in warmer and more humid environmental conditions.

3. Partial immunity: The virus is running out of bodies to infect

The coronavirus needs bodies in order to survive and replicate, and it now has access to fewer welcome hosts. Fifteen to 30 percent of American adults have already been infected with COVID-19, according to CDC estimates.

America’s seroprevalence—that is, the number of people with coronavirus antibodies from a previous infection—is probably concentrated among people who had little opportunity to avoid the disease.

This is partial immunity among the very populations that have been most likely to contract the disease, perhaps narrowing the path forward for the original SARS-CoV-2.

4. Vaccines: Despite naysayers and a few reluctant family members, the shots work.

The vaccines are highly effective at preventing infection. But preventing infection is not all they do. Among those infected, they also reduce symptomatic illness. And among those with symptoms, they reduce long-term hospitalization and death to something like zero.

It’s simple to show why this period of declining hospitalizations should keep going. Assuming the CDC is correct that about 25 percent of adults have COVID-19 antibodies from a previous infection and add to that number the 10 percent of adults who have received vaccine shots since December, that would mean one-third of adults currently have some sort of protection, either from a previous infection or from a vaccine. Thus, sometime this spring, half of American adults should have some kind of coronavirus protection.

Although the pandemic is far from over, the U.S. has reached the beginning of the end of COVID-19 as a threat to the health-care system and the senior citizen population.


References:

  1. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
  2. https://www.theatlantic.com/ideas/archive/2021/02/why-covid-19-cases-are-falling-so-fast/618041/

Celebrating American Heart Month

#1 cause of death in the U.S. is HEART DISEASE!

Heart disease is a catch-all phrase for a variety of conditions that affect the heart’s structure and function. Coronary heart disease is a type of heart disease that develops when the arteries of the heart cannot deliver enough oxygen-rich blood to the heart.

Despite the devastating toll of COVID-19, heart disease remains the most costly and leading cause of death in the United States. Specifically, myocardial infarction (MI) and coronary artery disease (CAD) are the leading causes of death in the U.S. and other Western societies.

Coronary heart disease is often caused by the buildup of plaque, a waxy substance, inside the lining of larger coronary arteries. This buildup can partially or totally block blood flow in the large arteries of the heart.

Some types of this condition may be caused by disease or injury affecting how the arteries work in the heart. Coronary microvascular disease is another type of coronary heart disease. It occurs when the heart’s tiny blood vessels do not work normally.

The death rate from heart attacks has risen dramatically during the COVID-19 pandemic because people are delaying or not seeking care after experiencing mild symptoms. And, symptoms of coronary heart disease differ from person to person even if they have the same type of coronary heart disease. However, because many Americans have no symptoms, they do not know they have coronary heart disease until they have chest pain, a heart attack, or sudden cardiac arrest.

Protect yourself…

90% of heart disease and stroke is preventable through lifestyle changes and risk factor modification. During Heart Month, it is critical to recommit to fighting this disease by promoting better health, wellness, and prevention awareness in your homes and communities.

There’s a lot you can do to prevent heart disease. You and your friends and family can begin by working together to meet your heart health goals. Move more, work on your weight and salt intake, quit smoking—it’s all easier when you have social support.

Motivating Americans to adopt healthy lifestyles to prevent heart disease is the goal of Heart Month. Focusing on your heart health has never been more important. People with poor cardiovascular health are also at increased risk of severe illness from COVID-19.

Let’s celebrate American Heart month by incorporating heart-healthy cardio activity into your day today:

  • Get Moving (exercise)
  • Quit Smoking (No More Excuses)
  • Lose Weight (Your weight matters)
  • Eat Heart Healthy Foods (talk to a doctor or a nutritionist)
  • Don’t Overeat
  • Don’t Stress

Make heart health a regular part of your self-care routine.

Wish all a Happy Valentine’s Day, and to remind you to take care of your heart


References

  1. https://www.nhlbi.nih.gov/health-topics/education-and-awareness/american-heart-month/about
  2. https://www.nhlbi.nih.gov/health-topics/education-and-awareness/heart-month/help-prevent-heart-disease

Double-Masking Offers More Protection

As more transmissible variants of the coronavirus spread, the CDC says wearing a cloth mask over a surgical mask offers increased protection against the virus.

The Centers for Disease Control and Prevention (CDC) found that wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks.

For optimal protection, the CDC says to make sure the mask fits snugly against your face and to choose a mask with at least two layers.

In laboratory testing, CDC discovered that wearing a cloth mask over a surgical mask, and tying knots on the ear loops of surgical masks and then tucking in and flattening the extra material against the face produced substantially improved protection against transmission of and exposure to infectious COVID-19 aerosols.

“A well-fitting masks provided the greatest performance at both blocking emitted aerosols and exposure of aerosols to the receiver”, CDC Director Rochelle Walensky said. “In the breathing experiment, having both the source and the receiver wear masks modified to fit better reduced the receiver’s exposure by more than 95%, compared to no mask at all.”

Walensky said the laboratory findings underscore the importance of wearing a mask correctly and ensuring it fits snugly over your nose and mouth.

Correct and consistent mask use is a critical step everyone can take to prevent getting and spreading COVID-19. Masks work best when everyone wears them, but not all masks provide the same protection, according to the CDC. When choosing a mask, look at how well it fits, how well it filters the air, and how many layers it has.

Two important ways to make sure your mask works the best it can:

  1. Make sure your mask fits snugly against your face.  Gaps can let air with respiratory droplets leak in and out around the edges of the mask
  2. Pick a mask with layers to keep your respiratory droplets in and others’ out.  A mask with layers will stop more respiratory droplets getting inside your mask or escaping from your mask if you are sick.

Where your mask after receiving the vaccine

No one knows and there is no ongoing research to determine how well do the approved Pfizer and Moderna vaccines protect against asymptomatic infection and thereby help achieve herd immunity And, the other looming mystery is how long vaccine-induced immunity lasts.


References:

  1. https://www.npr.org/sections/coronavirus-live-updates/2021/02/10/966313710/cdc-now-recommends-double-masking-for-more-protection-against-the-coronavirus
  2. https://www.cdc.gov/coronavirus/2019-ncov/your-health/effective-masks.html

Johnson & Johnson Vaccine

A single-shot coronavirus vaccine from pharmaceutical giant Johnson & Johnson was effective at preventing illness, hospitalizations and deaths in global trial. But its protection against sickness was stronger in the United States and weaker in South Africa, where a worrisome coronavirus variant now dominates.

The results, once granted emergency use authorization by the FDA, would put a third vaccine on the market in the United States. A third vaccine could accelerate the ability to broaden immunity, as variants that challenge the current generation of vaccines spread across the world.

The vaccine trial was primarily designed to measure how well the vaccine prevented illness. It was 66 percent effective overall at preventing moderate and severe disease: it was 72 percent effective at protecting against moderate to severe illness in the United States, but it was 66 percent effective in Latin America and 57 percent effective in South Africa, where concerning variants have taken root.

Company officials emphasized the vaccine was 85 percent effective at preventing severe illness, and there were no cases of COVD-related hospitalization and death in people who received the vaccine. There were five COVID-related deaths in the trial, all in people who received the placebo, not the vaccine.

Johnson & Johnson is expected to apply for emergency use authorization from the Food and Drug Administration late next week. If the review follows the path of two earlier vaccine candidates, the shot could be authorized and available to the public by March.

The J&J vaccine uses a different technology than the two FDA  authorized mRNA vaccines. This vaccine employs ‘a harmless cold virus’ to deliver a gene that carries the blueprint for the spiky protein found on the surface of the coronavirus. The virus infects cells, which then follow the genetic instructions to construct a replica of the coronavirus spike.

In contrast, the Pfizer and Moderna vaccines use a strip of genetic material called messenger RNA to instruct cells to build the spiky protein found on the surface of the coronavirus. In both cases, the immune system learns to recognize the real virus by mustering an immune response to the spike.


References:

  1. https://www.washingtonpost.com/health/2021/01/29/covid-vaccine-johnson-and-johnson
  2. https://www.washingtonpost.com/health/2020/09/23/coronavirus-vaccine-jj-single-shot/?itid=lk_inline_manual_2

Creating a Comprehensive Financial Life Plan

A Financial Life Plan can help you get on the path to financial freedom.

A comprehensive life financial plan provides a picture of your current finances, financial goals and any strategies you’ve set to achieve those goals. The plan should include details of your cash flow, savings, debt, investments, and other elements of your financial life.

Creating a life financial plan can help bring things into focus—it’s like a roadmap to help you figure out how to reach your financial goals. a clear picture of what you want to accomplish, but the details of how to make it happen.

Financial planning involves identifying financial goals you want to achieve and making sure you have the “what-ifs” covered. This can help guide you through key decisions in life and make you less vulnerable to setbacks and financial hardships down the line. You can feel more confident about financial decision-making when you have a comprehensive plan to guide you. Your financial plan might cover a number of areas, from managing debt and saving for the future to building wealth and protecting your money.

Financial Life Planning connects our financial realities with our values and the lives we dream to live. It helps both pre-retirees and retirees identify their core values and connect them with their financial decisions and life’s financial, health and emotional goals.

It is a financial planning and investing approach which helps people align their investment portfolio with their values and with the things which are important to them. Think of it like a holistic roadmap for your financial well-being.

Financial life plan focuses on the emotional side of financial planning. It considers people’s anxiety, habits, behaviors and other emotions (e.g., fear and greed) tied to investing money and accumulating wealth. People struggling with retirement and other finances really need a plan that helps them manage their attitudes, habits, behaviors, goals and resources.

“The right plan, executed faithfully, can be the difference between success and failure in any endeavor.” Brett N. Steenbarger, Ph.D., author of The Psychology of Trading

Whether you need to reduce spending and eliminate debt, increase your savings, or just refine the details, once you understand your financial mindset and associated behaviors; once you know where you are and where you need to go financially—a financial life plan can provide a more coherent sense of direction.

Market downturns and investment risk management

During periods of high market volatility and declines, financial life planning, when done correctly, assumes there will be these periods of volatility, panic selling and downturns like the equity markets are experiencing today as a result of COVID-19 pandemic. Any actions taken to significantly reduce or eliminate equity allocation could result in investors coming up short in retirement.

The risk of outliving their assets might be the biggest risk that retirees face today. With many of Americans living longer and the rising costs of healthcare in retirement, most retirees need a level of exposure to stocks in their portfolio for growth and to maintain their standard of living.

Steps to creating a Comprehensive Financial Life Plan

  1. Develop a Positive Financial Mindset
    The most important step in developing and following a financial life plan is to examine your mindset about money.
    – Are you ready to accept responsibility for changing your financial situation?
    – Do you believe that you can and will change the way you make financial decisions?
    – Can you identify at least one benefit you hope to gain by changing your financial behavior?
    Financial mindset consists of a predetermined set of beliefs, thoughts, habits and behaviors an individual has about saving by paying yourself first, investing for the long-term and accumulating wealth for financial well-being.
    Every person has a set of financial beliefs, thoughts, habits and behaviors about money and personal finance. Even if they can’t express what their thoughts and mindset are, they still exist both consciously and subconsciously. Just by observing your own financial reality and outcomes, you can begin to better understand your financial mindset, behaviors and habits.
    Thus, it becomes important to develop and nurture a positive financial mindset. Since, it is difficult to develop the good financial habits and behaviors that will be necessary to lead to an improved financial outcome and overall financial well-being without a positive financial mindset.
  2. Write down your goals
    One of the first things you should ask yourself is what you want your money to accomplish. Financial goals will differ in the length of time needed to achieve them. Be sure every goal has a specific purpose, a dollar amount that it will cost, and a realistic target date. Make sure your goals are realistic and not set too high, or frustration may keep you from reaching them.
    – What are your short-term needs? Short-term goals are priorities that can be accomplished within two years.
    – Mid-term goals are priorities that can be accomplished within two to five years.
    – What are you saving for long term? What do you want to accomplish in the next 5 to 10 years? Long-term financial goals are priorities that may take more than five years to accomplish. Most long-term goals require investing.
    It’s easy to talk about goals in general, but get really specific and write them down. Which goals are most important to you? Identifying, prioritizing and aligning your goals with your values, your goals will act as a motivator as you dig into your financial details.
  3. Create a net worth statement
    Achieving your goals requires understanding where you stand today. So start with what you have.
    – First, make a list of all your assets—things like bank and investment accounts, real estate and valuable personal property.
    – Now make a list of all your debts: mortgage, credit cards, student loans—everything.
    – Next, subtract your liabilities from your assets and you have your net worth.
    If you’re in the plus, great. If you’re in the minus, that’s not at all uncommon for those just starting out, but it does point out that you have some work to do. But whatever it is, you can use this number as a benchmark against which you can measure your progress.
  4. Know your cash flow
    Cash flow simply means money in (your income) and money out (your expenses). It will show you if you’re spending more or less than you earn.
    – How much money do you earn each month? Be sure to include all sources of income.
    – Now look at what you spend each month, including any expenses that may only come up once or twice a year. Do you consistently overspend? How much are you saving? Do you often have extra cash you could direct toward your goals?
  5. Your budget and manage your expenses
    A budget is telling your money where to go instead of wondering where it went.” John C. Maxwell
    For most people, financial success depend solely on how much they spend. This, it is important to find out where your money is going. Your budget will let you know how you’re spending.
    – Write down your essential expenses such as mortgage, insurance, food, transportation, utilities and loan payments. Don’t forget irregular and periodic big-ticket items such as vehicle repair or replacement costs, out of pocket health care costs and real estate taxes.
    – Then write down nonessentials—restaurants, entertainment, even clothes.
    Does your income easily cover all of this? Are savings a part of your monthly budget? Examining your expenses helps you plan and budget when you’re building an emergency fund. It will also help you determine if what you’re spending money on lines up with what is most important to you.
  6. Start (or build up) your emergency fund.
    Building a strong financial foundation starts with saving for emergencies. When you have a safety net for unexpected expenses, you don’t have to worry about throwing your budget out of whack. You can be confident that you’re ready for a car breakdown, home repairs, medical expenses or other emergencies that pop up. It’s OK to start small—saving $50 in an account you’ve designated for emergencies is a good starting point. You might work up to saving $1,000 and then eventually aim to save enough to cover three to six months’ worth of living expenses in an emergency fund. An emergency fund is essential because you need to absorb life’s surprises without making things worse. Without a stash of cash, you may have to take on debt for unexpected car troubles or surprise medical expenses. And, the fund can be kept in a savings account kept separate from your regular checking account. It’s not an account that should be dipped into often — unless there’s an emergency.
    If you already have an emergency fund, consider giving it a boost. An emergency fund should consist of three to six months’ worth of expenses, which is a different different amount for everyone. If you don’t think you’d survive financially if you missed a paycheck, then your an ideal candidate for needing an emergency fund.
  7. Focus on debt management
    Debt can derail you, but not all debt is bad. Yet, freedom from debt is an achievable goal for everyone.
    Some debt, like a mortgage, can work in your favor provided that you’re not overextended. It’s high-interest consumer debt like credit cards that you want to avoid. Try to follow the 28/36 guideline suggesting no more than 28 percent of pre-tax income goes toward home debt, no more than 36 percent toward all debt. Look at each specific debt to decide when and how you’ll systematically pay it down. Do you know how much debt you currently have (credit cards, student loans, auto loans, mortgage, etc.) and how long it will take to pay off each debt at your current rate of payment? It’s important to make a long-term plan for debt repayment so you can focus your efforts on the most efficient ways to reduce your debt. This might include tackling high-interest rate debts first or loan consolidation. Create a running list of all your loan balances and interest rates so you can see where you stand today and identify ways to make a dent in your debt. For example, you might make extra payments on your loan with the highest interest rate. A financial advisor can help you review your debt and create a debt elimination plan. Use our Debt Roll-Down Calculator to find the best way to pay off your credit cards.
    If you’ve been struggling with old debt, such as credit cards, student loans or medical bills, now is the time to pay them off for good. If you’re not sure which debt to pay off first, consider the one with the highest interest. High-interest debt, like credit cards, can compound through hefty interest charges, late fees and other penalties. pay down the principal of your student loan. The sooner you pay it all off, the less burden you carry.
  8. Get your (retirement) savings and investing on track by paying yourself first
    Whatever your age, retirement saving needs to be part of your financial plan. The earlier you start, the less you’ll likely have to save each year. You might be surprised by just how much you’ll need—especially when you factor in healthcare costs. But if you begin saving early, you may be surprised to find that even a little bit over time can make a big difference.
    Spending time today to plan your path to retirement can provide you peace of mind in the future. Getting started is the most important step you can take—it’s never too early or too late to save for retirement! The key is to continue saving consistently and make retirement savings a priority in your budget. Individual retirement accounts (IRAs) and employer-sponsored retirement plans, such as 401(k)s, offer tax benefits that can help your savings grow faster. As you near retirement, you’ll want to set a strategy for tapping retirement assets.
    Your financial plan should outline your retirement savings goals and ways to boost your savings (e.g., increasing your contributions every year or when you get a bonus or raise). Run the numbers using our Retirement Planner Calculator or review your retirement plans with a financial advisor.
    Calculate how much you will need and contribute to a 401(k) or other employer-sponsored plan (at least enough to capture an employer match) or an IRA. Save what you can and gradually try and increase your savings rate as your earnings increase. Whatever you do, don’t put it off.
    And, make the savings a priority by paying yourself first. This means that instead of saving what remains after paying your monthly expenses, individuals should pay themselves first by setting aside at least 10% to 15% of their monthly income as their first expense, and then pay the rest of their monthly expenses. Paying yourself means that your savings and other financial goals are taken care of before you allow yourself to spend money on less important items.
  9. College Savings.
    Parents and guardians face the challenge of balancing multiple financial demands, including your own retirement and future health care costs as well as education expenses for your dependents. Having a financial plan helps ensure you’re taking the right steps to address all areas of your financial life. Choosing the right college savings vehicle and planning ahead to take advantage of financial aid, loans and scholarships can help make college more affordable.
    Determine how much you want to save for college and the best way to grow your savings. Our College Savings Calculator can help you estimate how much you’ll need to save.
  10. Stay invested in the market for the long-term and check-in with your portfolio regularly.
    If you’re confident in your financial life plan and investment strategy, leaving your investments alone during short-term market corrections and Bear markets could help you accumulate wealth over the long-term and help ensure your retirement nest egg.
    When was the last time you took a close look at your portfolio? There are no guarantees when it comes to investing, but it seems that fear and uncertainty tends to put investors on the sidelines when markets plunge and become highly volatile.
    Markets go up and go down down in the short-term which can have a real effect on the relative percentage of stocks and bonds you own—even when you do nothing. And even an up market can throw your portfolio out of alignment with your feelings about risk. Don’t be complacent. Review and rebalance on at least an annual basis.
  11. Make sure you’re adequately insured
    Having adequate insurance is an important part of protecting your finances and family. Insurance is essential to protect your family and your financial future. Having health insurance, auto insurance and homeowners or renters insurance protects you when you need it. You may consider options for life and disability insurance, which can help protect your family’s finances if something happens to you. Review your insurance coverage and beneficiaries, especially if you’ve had any major changes in your family and life. A total risk assessment with an insurance professional can make sure you have the right level of coverage.
    We all need health insurance, and most of us also need car and homeowner’s or renter’s insurance. While you’re working, disability insurance helps protect your future earnings and ability to save. You might also want a supplemental umbrella policy based on your occupation and net worth. Finally, you should consider life insurance, especially if you have dependents. Review your policies to make sure you have the right type and amount of coverage. You never know what the future may hold—but it helps to be prepared for anything. What if you or a loved one experienced major medical issues or needed assisted living or nursing home care? Making decisions about long-term care can be stressful and emotionally difficult, and the costs can drain your family’s finances.
    You may want to explore options for long-term care insurance to help pay for long-term care needs such as nursing home care. You may also decide to write an advance care directive regarding your wishes for medical care and name a power of attorney to make financial decisions on your behalf if you’re unable to do so.
  12. Know your income tax rate
    Taxes are one of the most insidious destroyers of wealth, along with debt. You should make sure you’re prepared for the annual tax season and review your withholding, estimated taxes and any tax credits you may have qualified for in the past. The IRS has provided tips and information; take advantage of tax deferred accounts like IRAs and 401(k)s can help you save money on taxes and accumulate wealth more efficiently.
  13. Create or update your will and estate plan
    At the minimum, have a will—especially to name a guardian for minor children. Also check that beneficiaries on your retirement accounts and insurance policies are up-to-date. Complete an advance healthcare directive and assign powers of attorney for both finances and healthcare. Medical directive forms are sometimes available online or from your doctor or hospital. Working with an estate planning attorney is recommended to help you plan for complex situations and if you need more help.
  14. Invest in yourself and continue to learn
    “An investment in knowledge pays the best interest.” Benjamin Franklin
    While college is a great self-investment, there are other ways you can invest in yourself. Consider taking courses in a field or industry you’re interested in pursuing.
    If you’ve been contemplating a career change, use your money to invest in that switch. If you need capital to start your own business, this could be your chance. Also consider using it to give yourself a much-needed break. Whether this is a vacation fund or simply money for a massage or spa day to recharge, reset and refocus. Focused on what would improve your well-being in the long-term, not a quick fix. Continuous learning and growth are the key.
  15. Three Pillars (financial wealth, physical health and emotional well-being)
    Financial assets like stocks, bonds and real estate are forms of personal wealth. However, Americans need to also focus their attention on staying emotionally and physically healthy. Self-care is paramount in all three facets of life which include financial wealth, physical health and emotional well-being. Eating a balanced diet, exercising, getting enough sleep and connecting regularly with family and friends, are essential to live a purposeful and fulfilling life.
  • Take control of your future with a financial plan for the next five, ten or more years.
  • Insurance Protection. Ensure you have adequate Medical insurance and consider purchasing Long-Term Care insurance.

References:

  1. https://www.brownleeglobal.com/financial-life-planning/?preview=true&frame-nonce=60592dd178
  2. https://www.schwab.com/resource-center/insights/content/10-steps-to-diy-financial-plan?SM=uro#sf228155652
  3. https://www.cnet.com/personal-finance/how-to-invest-your-tax-refund/
  4. https://www.moneymanagement.org/credit-counseling/resources/financial-literacy-month