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It’s Never Too Late to Stop Smoking
Most people know that smoking is one of the worst things you can do to your body. Still, quitting is really hard for anyone who has been smoking for a long time. The nicotine in tobacco is a drug and, like many drugs, it is addictive.
However, quitting is the best thing you can do for yourself, no matter how old you are. It’s always a good time to stop smoking.
Ending Decades of Damage
It seems the older someone is, the less likely they are to try to stop smoking. Not only is it a difficult addiction to manage, some people have the mindset that if the damage has been done, why bother quitting?
For one thing, you will live longer.
More than 160,000 people over the age of 70 completed a questionnaire about their smoking habits as part of a diet and health study from the National Cancer Institute and National Institutes of Health.
Those surveyed who didn’t smoke lived longer than those who did. However, those who had quit at some point, still lived longer than those who continued to smoke.
The longer they had gone without smoking as much as doubled their chances of living longer than someone who smoked.
Long-Term Hazards
Smoking dramatically increases your risk for many serious diseases, and it’s responsible for one in five deaths in the U.S. each year. It leads to:
- Lung disease — Chronic bronchitis and emphysema are two conditions that make it hard to breathe.
- Heart disease — Smoking increases the chance of heart attack or stroke.
- Cancer — Smoking not only leads to lung cancer, it can also cause cancer of the bladder, cervix, esophagus, kidneys, larynx, liver, mouth, and pancreas.
- Respiratory problems — Smoking makes it harder to recover from COVID-19 and leaves you more susceptible to the flu, pneumonia, and other respiratory infections.
- Osteoporosis — Smoking limits your body’s ability to absorb calcium which could lead to weaker bones.
- Eye disease — Smoking can cause cataracts, macular degeneration, an eye diseases that causes vision loss, and even blindness.
- Diabetes — Smoking increases the chance of developing type 2 diabetes and, if you already have diabetes, smoking makes it more difficult to manage. Poorly managed diabetes can lead to heart disease, kidney failure, blindness, and amputations.
Besides these very serious conditions, smoking can contribute to sagging skin – not only on your face but all over your body, age spots, stains and damage to your teeth, and accelerated hair loss.
Immediate Benefits
Stubbing out your last cigarette yields results almost immediately and the benefits add up the longer you remain tobacco free.
- 20 minutes later — Heart rate returns to normal
- 12 to 24 hours later — Carbon monoxide level in blood returns to normal. Heart attack risk drops.
- 2 weeks to 3 months later — Heart attack risk dramatically drops. Lung function starts to improve.
- 1 to 9 months later — Decrease in coughing and shortness of breath.
- 1 year later — Coronary heart disease risk drops up to 50%.
- 5 to 15 years later — Stroke risk reduced to that of someone who hasn’t smoked. Risk of mouth, throat, and esophagus cancer is half that of someone who still smokes.
- 10 years later —Risk decreases for cancer of cervix, larynx, kidney, or pancreas. Risk of dying from lung cancer or getting bladder cancer is half of those who still smoke.
- 15 years later — Risk of coronary heart disease is the same as someone who doesn’t smoke.
Don’t Give Up
One major hurdle to quitting is going through withdrawals: symptoms include restlessness, irritability, anxiousness, or tension. It might be hard to sleep or you may feel drowsy during the day. Even though withdrawal symptoms can be severe, they usually pass within two weeks.
As much as possible, avoid the situations or triggers that made you want to smoke, such as feeling stressed out or drinking alcohol or coffee.
To help deal with cravings, Smokefree.gov recommends the following:
- Drink water — Six to eight glasses a day
- Deep breaths — Take a few of these when you feel like smoking
- Delay smoking — The urge usually lasts a few minutes so meditate to resist the immediate urge
- Distract yourself — Suggestions include:
- Read
- Change your routine
- Try substitutes like carrots, sugarless gum, or breath mints
- Exercise
- Call a friend
Our Doctors Can Help
For many people, willpower alone is not enough. Your doctor can prescribe medications, offer advice, and provide support as you work to kick the smoking habit.
If you’re a caregiver or a senior who wants to stop smoking, or just live a healthier life, AltaMed offers coordinated care and services, including medical treatment, physical therapy, and social services.
For more information about services or eligibility, visit AltaMed.org or call (855) 252- (7223).
Most people know that smoking is one of the worst things you can do to your body. Still, quitting is really hard for anyone who has been smoking for a long time. The nicotine in tobacco is a drug and, like many drugs, it is addictive.
However, quitting is the best thing you can do for yourself, no matter how old you are. It’s always a good time to stop smoking.
Ending Decades of Damage
It seems the older someone is, the less likely they are to try to stop smoking. Not only is it a difficult addiction to manage, some people have the mindset that if the damage has been done, why bother quitting?
For one thing, you will live longer.
More than 160,000 people over the age of 70 completed a questionnaire about their smoking habits as part of a diet and health study from the National Cancer Institute and National Institutes of Health.
Those surveyed who didn’t smoke lived longer than those who did. However, those who had quit at some point, still lived longer than those who continued to smoke.
The longer they had gone without smoking as much as doubled their chances of living longer than someone who smoked.
Long-Term Hazards
Smoking dramatically increases your risk for many serious diseases, and it’s responsible for one in five deaths in the U.S. each year. It leads to:
- Lung disease — Chronic bronchitis and emphysema are two conditions that make it hard to breathe.
- Heart disease — Smoking increases the chance of heart attack or stroke.
- Cancer — Smoking not only leads to lung cancer, it can also cause cancer of the bladder, cervix, esophagus, kidneys, larynx, liver, mouth, and pancreas.
- Respiratory problems — Smoking makes it harder to recover from COVID-19 and leaves you more susceptible to the flu, pneumonia, and other respiratory infections.
- Osteoporosis — Smoking limits your body’s ability to absorb calcium which could lead to weaker bones.
- Eye disease — Smoking can cause cataracts, macular degeneration, an eye diseases that causes vision loss, and even blindness.
- Diabetes — Smoking increases the chance of developing type 2 diabetes and, if you already have diabetes, smoking makes it more difficult to manage. Poorly managed diabetes can lead to heart disease, kidney failure, blindness, and amputations.
Besides these very serious conditions, smoking can contribute to sagging skin – not only on your face but all over your body, age spots, stains and damage to your teeth, and accelerated hair loss.
Immediate Benefits
Stubbing out your last cigarette yields results almost immediately and the benefits add up the longer you remain tobacco free.
- 20 minutes later — Heart rate returns to normal
- 12 to 24 hours later — Carbon monoxide level in blood returns to normal. Heart attack risk drops.
- 2 weeks to 3 months later — Heart attack risk dramatically drops. Lung function starts to improve.
- 1 to 9 months later — Decrease in coughing and shortness of breath.
- 1 year later — Coronary heart disease risk drops up to 50%.
- 5 to 15 years later — Stroke risk reduced to that of someone who hasn’t smoked. Risk of mouth, throat, and esophagus cancer is half that of someone who still smokes.
- 10 years later —Risk decreases for cancer of cervix, larynx, kidney, or pancreas. Risk of dying from lung cancer or getting bladder cancer is half of those who still smoke.
- 15 years later — Risk of coronary heart disease is the same as someone who doesn’t smoke.
Don’t Give Up
One major hurdle to quitting is going through withdrawals: symptoms include restlessness, irritability, anxiousness, or tension. It might be hard to sleep or you may feel drowsy during the day. Even though withdrawal symptoms can be severe, they usually pass within two weeks.
As much as possible, avoid the situations or triggers that made you want to smoke, such as feeling stressed out or drinking alcohol or coffee.
To help deal with cravings, Smokefree.gov recommends the following:
- Drink water — Six to eight glasses a day
- Deep breaths — Take a few of these when you feel like smoking
- Delay smoking — The urge usually lasts a few minutes so meditate to resist the immediate urge
- Distract yourself — Suggestions include:
- Read
- Change your routine
- Try substitutes like carrots, sugarless gum, or breath mints
- Exercise
- Call a friend
Our Doctors Can Help
For many people, willpower alone is not enough. Your doctor can prescribe medications, offer advice, and provide support as you work to kick the smoking habit.
If you’re a caregiver or a senior who wants to stop smoking, or just live a healthier life, AltaMed offers coordinated care and services, including medical treatment, physical therapy, and social services.
For more information about services or eligibility, visit AltaMed.org or call (855) 252- (7223).
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Grow Healthy at Every Age with Recommended Health Screenings for Seniors
Thanks in large part to improved medical care and changes in how most of us work, people are living longer. Someone born today is expected to live until they’re 77.8 years old.
How well you age depends largely on how well you live. A big part of that includes getting regular preventive health screenings for general physical health, cancer, and mental capacity.
No matter how old you are, AltaMed can help you grow healthy with caring, attentive service and age-appropriate care. Read on to learn about the screenings and routine visits that are recommended for seniors.
Physical Screenings
Screenings can help you stay on top of chronic illnesses: if you do have a condition, it’s best to catch it early as treatment might not need to be as aggressive or invasive, and costs could be less.
Recommended physical screenings include:
- Blood pressure — Almost half of all adults have high blood pressure, so it’s important to have yours checked at least once a year (or as often as your doctor recommends).
- Cholesterol — Many people are able to reduce their cholesterol with a healthy diet and exercise, but sometimes medication is needed.
- Obesity — Being obese is hard on the heart, liver, and joints and puts you at risk for serious conditions.
- Blood glucose and Type 2 Diabetes — Medicare covers screenings in people with one or more risk factors.
- Vision — Your eyes change with age and you run the risk of developing glaucoma, macular degeneration, dry eyes, and loss of peripheral vision.
- Abdominal aortic aneurysm — This is a standard check of the heart for men 65 to 75, who have smoked.
- Osteoporosis — Bone-density tests are covered once every two years for women over 65. Post-menopausal women younger than 65 should also be screened.
- Hepatitis C — Medicare covers at least one screening for adults born specifically between 1945 and 1965.
- HIV — Older adults at higher risk include people with multiple partners, men who have had sex with other men, and people with past and present injection drug use.
- Other STIs — Sexually active adults at all ages should be screened regularly.
Cancer screenings
Age is a leading risk factor in a number of cancer types, though it’s not really clear why. So, it’s incredibly important to get screened. A number of cancers are easily detectible and can be treated successfully if diagnosed early.
- Colorectal cancer — Routine screening should start at 50 unless there is a family history. Then it should be earlier and more often. Otherwise, a colonoscopy is recommended every 10 years.
- Breast cancer — Medicare covers screening mammograms every 12 months.
- Cervical cancer — Older women who have never been screened should have a Pap smear at least once. Women at high risk should have one every 12 months.
- Lung cancer — This screening is recommended for adults aged 55-80 who were heavy smokers (about 30-packs a year) or who quit in the last 15 years.
- Prostate cancer — Men can choose between a digital rectal exam or a prostate-specific antigen test. Screenings are recommended between 55 and 69 years of age.
Mental and safety screenings
When your AltaMed doctor asks questions about your life and what’s been on your mind, it’s not just to be polite: they may be looking for clues about your mood, mental state, and mental sharpness. These are delicate topics, but your answers can help identify:
- Depression — The goal is to make sure you are not on a path that could lead to harming yourself or others. Therapy, medication, or a combination can help control depression.
- Cognitive impairment — Cognitive Impairment is when a person has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life, and ranges from mild to severe. Doctors want to ensure you can still function in your current living situation. This may require input from a caregiver.
- Falls and functional ability — Part of Medicare’s Annual Wellness Visit includes looking at the ability to manage the activities of daily living. Doctors will ask questions about mobility and the risk of falling which could lead to a traumatic brain injury (TBI) or breaking a hip, wrist, or some other joint.
- Substance use — Someone who has been drinking, smoking or doing drugs their entire life will eventually pay the price for it. Answer honestly about alcohol, tobacco, and recreational drug use.
PACE Yourself with AltaMed
Making these screenings a regular part of your healthy habits could help you feel great and stay independent for longer. Talk to your doctor to get their personalized recommendations.
If you’re a caregiver or a senior with complex medical needs, AltaMed PACE offers coordinated care and services, including medical treatment, physical therapy, and social services. The program even offers meals, exercise, social activities, and transportation for qualified seniors.
There are 11 AltaMed PACE facilities in the greater Los Angeles area including two new locations in Orange County:
Anaheim
1325 N. Anaheim Blvd., Suite 100
Anaheim, California 92801
Santa Ana
3601 W. Sunflower Ave., Suite 100
Santa Ana, California 92704
AltaMed PACE has made a difference for seniors like Antonio, Kenneth, and Rodolfo and Bertha – it may be right for you, too.
For more information about services or eligibility, visit AltaMed.org/PACE or call (855) 252-PACE (7223).
Thanks in large part to improved medical care and changes in how most of us work, people are living longer. Someone born today is expected to live until they’re 77.8 years old.
How well you age depends largely on how well you live. A big part of that includes getting regular preventive health screenings for general physical health, cancer, and mental capacity.
No matter how old you are, AltaMed can help you grow healthy with caring, attentive service and age-appropriate care. Read on to learn about the screenings and routine visits that are recommended for seniors.
Physical Screenings
Screenings can help you stay on top of chronic illnesses: if you do have a condition, it’s best to catch it early as treatment might not need to be as aggressive or invasive, and costs could be less.
Recommended physical screenings include:
- Blood pressure — Almost half of all adults have high blood pressure, so it’s important to have yours checked at least once a year (or as often as your doctor recommends).
- Cholesterol — Many people are able to reduce their cholesterol with a healthy diet and exercise, but sometimes medication is needed.
- Obesity — Being obese is hard on the heart, liver, and joints and puts you at risk for serious conditions.
- Blood glucose and Type 2 Diabetes — Medicare covers screenings in people with one or more risk factors.
- Vision — Your eyes change with age and you run the risk of developing glaucoma, macular degeneration, dry eyes, and loss of peripheral vision.
- Abdominal aortic aneurysm — This is a standard check of the heart for men 65 to 75, who have smoked.
- Osteoporosis — Bone-density tests are covered once every two years for women over 65. Post-menopausal women younger than 65 should also be screened.
- Hepatitis C — Medicare covers at least one screening for adults born specifically between 1945 and 1965.
- HIV — Older adults at higher risk include people with multiple partners, men who have had sex with other men, and people with past and present injection drug use.
- Other STIs — Sexually active adults at all ages should be screened regularly.
Cancer screenings
Age is a leading risk factor in a number of cancer types, though it’s not really clear why. So, it’s incredibly important to get screened. A number of cancers are easily detectible and can be treated successfully if diagnosed early.
- Colorectal cancer — Routine screening should start at 50 unless there is a family history. Then it should be earlier and more often. Otherwise, a colonoscopy is recommended every 10 years.
- Breast cancer — Medicare covers screening mammograms every 12 months.
- Cervical cancer — Older women who have never been screened should have a Pap smear at least once. Women at high risk should have one every 12 months.
- Lung cancer — This screening is recommended for adults aged 55-80 who were heavy smokers (about 30-packs a year) or who quit in the last 15 years.
- Prostate cancer — Men can choose between a digital rectal exam or a prostate-specific antigen test. Screenings are recommended between 55 and 69 years of age.
Mental and safety screenings
When your AltaMed doctor asks questions about your life and what’s been on your mind, it’s not just to be polite: they may be looking for clues about your mood, mental state, and mental sharpness. These are delicate topics, but your answers can help identify:
- Depression — The goal is to make sure you are not on a path that could lead to harming yourself or others. Therapy, medication, or a combination can help control depression.
- Cognitive impairment — Cognitive Impairment is when a person has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life, and ranges from mild to severe. Doctors want to ensure you can still function in your current living situation. This may require input from a caregiver.
- Falls and functional ability — Part of Medicare’s Annual Wellness Visit includes looking at the ability to manage the activities of daily living. Doctors will ask questions about mobility and the risk of falling which could lead to a traumatic brain injury (TBI) or breaking a hip, wrist, or some other joint.
- Substance use — Someone who has been drinking, smoking or doing drugs their entire life will eventually pay the price for it. Answer honestly about alcohol, tobacco, and recreational drug use.
PACE Yourself with AltaMed
Making these screenings a regular part of your healthy habits could help you feel great and stay independent for longer. Talk to your doctor to get their personalized recommendations.
If you’re a caregiver or a senior with complex medical needs, AltaMed PACE offers coordinated care and services, including medical treatment, physical therapy, and social services. The program even offers meals, exercise, social activities, and transportation for qualified seniors.
There are 11 AltaMed PACE facilities in the greater Los Angeles area including two new locations in Orange County:
Anaheim
1325 N. Anaheim Blvd., Suite 100
Anaheim, California 92801
Santa Ana
3601 W. Sunflower Ave., Suite 100
Santa Ana, California 92704
AltaMed PACE has made a difference for seniors like Antonio, Kenneth, and Rodolfo and Bertha – it may be right for you, too.
For more information about services or eligibility, visit AltaMed.org/PACE or call (855) 252-PACE (7223).
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Drinking (or Not) During the COVID-19 Pandemic
For many of us, COVID-19 has put our lives on hold or dramatically reshaped them. We’re being told to relax and embrace a new normal. Should that include more drinking, less drinking, or quitting altogether?
That all depends on who you are, your health, and your family history.
The Health Benefits of Alcohol
Not surprisingly, many people are drinking, and drinking more, right now. And that’s not entirely a bad thing. Alcohol can provide a temporary escape from worry and stress. Occasional or moderate drinking (according to the CDC, two drinks or fewer a day for men; one drink or fewer a day for women) has been proven to produce feelings of euphoria and happiness while helping to reduce tension – in fact, those who drink in moderation are less likely to suffer from depression, compared to both non-drinkers or heavy drinkers.
Alcohol can also provide other health-boosting benefits. You’ve probably heard that an occasional glass of wine is good for you – and there’s some science to back this up. Red wine, in particular:
- Provides antioxidants that may help your cells fight off disease to help you live longer
- Promotes an anti-inflammatory response that can help decrease pain
- Contains a compound called resveratrol that may reduce cholesterol and prevent blood clots
But before make a shopping trip just to pick up a case of wine or beer, you should figure out if the benefits are worth the potential risks.
Why Drinking Might Not Be for You
For some, an occasional drink is harmless. However, alcohol can pose serious health risks for others. People who should not drink include:
- Anyone under the age of 21
- Women who are pregnant or breastfeeding
- Those with diseases of the liver or pancreas
- Those who have had problems with alcohol or drug addiction in the past, or come from a family with a history of alcoholism or drug addiction
- Anyone with certain medical conditions or on medications that may have a negative reaction to alcohol. Talk to your doctor or pharmacist if you are on medication for:
- Diabetes
- Heart failure
- High blood pressure
- Irregular heart rhythm
- A history of strokes
Consider Mindful Drinking
Recently, there’s been a trend known as “mindful drinking.” Unlike sobriety programs like Alcoholics Anonymous that focus on not drinking at all, mindful drinking is about making sure you’re drinking the right amount for the right reason -- because it gives you some kind of pleasure and not out of habit or because you can’t otherwise cope. Before you drink, ask yourself these questions:
- Why am I choosing to have this drink?
- Do I need to have it right now?
- Am I enjoying it?
- How do I feel?
Another part of mindful drinking is setting limits: for example, you might limit yourself to no more than two drinks, or you might only drink two nights per week. This can help you drink in moderation and keep your drinking from becoming a habit.
The Benefits of Quitting Drinking
Even though drinking in moderation has been tied to health benefits, your health and well-being will improve, across the board, if you decide to stop drinking.
Statistically speaking, you’re more likely to live longer, since more than half of all serious trauma injuries and deaths from burns, drownings, and homicides involve alcohol. In addition, you will see positive changes, including:
- A better night’s sleep
- Lower blood pressure
- A healthier liver
- A stronger immune system
- Improved memory
- More money in the bank
The Benefits of Not Drinking at All
If you don’t drink, the best thing you can do is to continue not to drink. Even with the benefits of an occasional glass of wine, studies show that non-drinkers live longer, have decreased risks for diseases including cancer, diabetes, heart disease, and dementia. Nondrinkers also never have to worry about DUIs or hangovers!
There are many different alternatives that let you experience the benefits of drinking. If you’re looking for something tasty to sip during your next online happy hour, you can try a fruity mocktail – drinks that use fruit juices and mixers without the alcohol.
If you’re looking for a way to blow off some stress, try meditation or vigorous exercise. Both can help you lower your blood pressure, too.
If you’re looking to fight depression and loneliness, make time to connect with your friends and family, even if you have to do it virtually.
And you can get the same anti-inflammatory benefits found in red wine from eating some delicious grapes, which also provide dietary fiber and immunity-boosting vitamins A and C.
Salud!
Your good health is our main concern. No matter what, we’re here for both your mental and physical health needs. If you need care, call us at (888) 499-9303.
AltaMed can provide information to you and your family about the best way to protect yourself and your family from COVID-19. To receive the latest news and information about the coronavirus pandemic, sign up today.
For many of us, COVID-19 has put our lives on hold or dramatically reshaped them. We’re being told to relax and embrace a new normal. Should that include more drinking, less drinking, or quitting altogether?
That all depends on who you are, your health, and your family history.
The Health Benefits of Alcohol
Not surprisingly, many people are drinking, and drinking more, right now. And that’s not entirely a bad thing. Alcohol can provide a temporary escape from worry and stress. Occasional or moderate drinking (according to the CDC, two drinks or fewer a day for men; one drink or fewer a day for women) has been proven to produce feelings of euphoria and happiness while helping to reduce tension – in fact, those who drink in moderation are less likely to suffer from depression, compared to both non-drinkers or heavy drinkers.
Alcohol can also provide other health-boosting benefits. You’ve probably heard that an occasional glass of wine is good for you – and there’s some science to back this up. Red wine, in particular:
- Provides antioxidants that may help your cells fight off disease to help you live longer
- Promotes an anti-inflammatory response that can help decrease pain
- Contains a compound called resveratrol that may reduce cholesterol and prevent blood clots
But before make a shopping trip just to pick up a case of wine or beer, you should figure out if the benefits are worth the potential risks.
Why Drinking Might Not Be for You
For some, an occasional drink is harmless. However, alcohol can pose serious health risks for others. People who should not drink include:
- Anyone under the age of 21
- Women who are pregnant or breastfeeding
- Those with diseases of the liver or pancreas
- Those who have had problems with alcohol or drug addiction in the past, or come from a family with a history of alcoholism or drug addiction
- Anyone with certain medical conditions or on medications that may have a negative reaction to alcohol. Talk to your doctor or pharmacist if you are on medication for:
- Diabetes
- Heart failure
- High blood pressure
- Irregular heart rhythm
- A history of strokes
Consider Mindful Drinking
Recently, there’s been a trend known as “mindful drinking.” Unlike sobriety programs like Alcoholics Anonymous that focus on not drinking at all, mindful drinking is about making sure you’re drinking the right amount for the right reason -- because it gives you some kind of pleasure and not out of habit or because you can’t otherwise cope. Before you drink, ask yourself these questions:
- Why am I choosing to have this drink?
- Do I need to have it right now?
- Am I enjoying it?
- How do I feel?
Another part of mindful drinking is setting limits: for example, you might limit yourself to no more than two drinks, or you might only drink two nights per week. This can help you drink in moderation and keep your drinking from becoming a habit.
The Benefits of Quitting Drinking
Even though drinking in moderation has been tied to health benefits, your health and well-being will improve, across the board, if you decide to stop drinking.
Statistically speaking, you’re more likely to live longer, since more than half of all serious trauma injuries and deaths from burns, drownings, and homicides involve alcohol. In addition, you will see positive changes, including:
- A better night’s sleep
- Lower blood pressure
- A healthier liver
- A stronger immune system
- Improved memory
- More money in the bank
The Benefits of Not Drinking at All
If you don’t drink, the best thing you can do is to continue not to drink. Even with the benefits of an occasional glass of wine, studies show that non-drinkers live longer, have decreased risks for diseases including cancer, diabetes, heart disease, and dementia. Nondrinkers also never have to worry about DUIs or hangovers!
There are many different alternatives that let you experience the benefits of drinking. If you’re looking for something tasty to sip during your next online happy hour, you can try a fruity mocktail – drinks that use fruit juices and mixers without the alcohol.
If you’re looking for a way to blow off some stress, try meditation or vigorous exercise. Both can help you lower your blood pressure, too.
If you’re looking to fight depression and loneliness, make time to connect with your friends and family, even if you have to do it virtually.
And you can get the same anti-inflammatory benefits found in red wine from eating some delicious grapes, which also provide dietary fiber and immunity-boosting vitamins A and C.
Salud!
Your good health is our main concern. No matter what, we’re here for both your mental and physical health needs. If you need care, call us at (888) 499-9303.
AltaMed can provide information to you and your family about the best way to protect yourself and your family from COVID-19. To receive the latest news and information about the coronavirus pandemic, sign up today.