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Return of free Covid tests, telemed visits

Last month, the federal government expanded the Home Test to Treat program — a virtual health program that offers free Covid-19 health services including at-home rapid tests, telehealth sessions and at-home treatments.

Home Test to Treat, which is a collaboration of the National Institutes of Health, the Administration for Strategic Preparedness and Response, and the Centers for Disease Control and Prevention, launched as a pilot in select locations earlier this year.

With its expansion, the Home Test to Treat program will now offer nationwide free testing, telehealth and treatment for both Covid-19 and for influenza (flu) A and B.

It is the first public health program that includes home-testing technology at such a scale for both Covid-19 and the flu. The program provides Pfizer’s Covid-19 & Flu Home Test, the first FDA-authorized test that can detect both viruses in a single test at home.

For people who test positive, treatment must begin soon after the onset of symptoms. Test to Treat provides these services virtually, while individuals remain at home, to expedite the time to treatment and the convenience of accessing services virtually from home.

Any adult (18 years and older) with a current positive test for Covid-19 or the flu can enroll to receive free telehealth care and, if prescribed, medication delivered to their home. Adults who do not have Covid-19 or the flu may enroll and receive free tests if they are uninsured or are enrolled in Medicare, Medicaid, Veterans Affairs health care system, or the Indian Health Services.

If recipients test positive at a future time, they can receive free telehealth care and, if prescribed, treatment.

For more information or to obtain help, visit test2treat.org or call 1-800-682-2829.

—National Institutes of Health

Ironically, excessive fear of illness raises risk of death

A large Swedish study has uncovered a paradox about people diagnosed with an excessive fear of serious illness: They tend to die earlier than people who aren’t hypervigilant about their health.

Hypochondriasis, now called illness anxiety disorder, is a rare condition with symptoms that go beyond average health worries. People with the disorder are unable to shake their fears despite normal physical exams and lab tests. Some may change doctors repeatedly. Others may avoid medical care.

“Many of us are mild hypochondriacs. But there are also people on the other extreme of the spectrum who live in a perpetual state of worry and suffering and rumination about having a serious illness,” said Dr. Jonathan E. Alpert of Montefiore Medical Center in New York.

People with the disorder are suffering, and “it’s important to take it seriously and to treat it,” said Alpert, who was not involved in the new study.

Treatment can involve cognitive behavioral therapy, relaxation techniques, education and sometimes antidepressant medication.

The researchers found that people with the diagnosis have an increased risk of death from both natural and unnatural causes, particularly suicide.

Chronic stress and its impact on the body could explain some of the difference, the authors wrote.

Older research had suggested the risk of suicide might be lower for people with the condition, but “our hunch, based on clinical experience, was that this would be incorrect,” said David Mataix-Cols, of the Karolinska Institute in Sweden, who led the recent research.  In the study, the risk of suicide death was four times higher for the people with the diagnosis.

They looked at 4,100 people diagnosed with hypochondriasis and matched them with 41,000 people similar in age, sex and county of residence. They used a measurement called person years, which accounts for the number of people and how long they were tracked.

Overall death rates were higher in the people with hypochondriasis, 8.5 versus 5.5 per 1,000 person years. People with the condition died younger than the others, a mean age of 70 versus 75. Their risk of death from circulatory and respiratory diseases was higher. Cancer was an exception; the risk of death was about the same.

Referring an excessively anxious patient to mental health professionals takes care, said Alpert, who leads the American Psychiatric Association’s council on research. Patients can be offended, because they feel they’re being accused of imagining symptoms.

“It takes a great deal of respect and sensitivity conveyed to patients that this itself is a kind of condition, that it has a name,” Alpert said. “And, fortunately, there are good treatments.”

 —AP