From pre-pandemic (2018) to the height of the pandemic (2020), heavy alcohol use among Americans rose by 20%, and any alcohol use rose by 4%. In 2022, the increases were sustained.  

The rise in drinking was seen across all age groups, genders, race, ethnicities and regions of the country, except for Native Americans and Asian Americans. Adults ages 40-49 had the highest increase in heavy alcohol use.  

“These numbers reflect an alarming public health issue that could result in severe health consequences for far too many people,” said Brian P. Lee, MD, MAS, a hepatologist and liver transplant specialist with Keck Medicine of USC and principal investigator of the study. “Our results suggest men and women under 50 are at special risk.” 

Excessive alcohol use is a leading preventable cause of illness and death in the United States, according to the Centers for Disease Control and Prevention. Half of all liver-related deaths are caused by alcohol, and alcohol-related cirrhosis is now the leading cause of liver transplants, according to Lee.  

To reach their conclusions, researchers studied data from the National Health Interview Survey, one of the largest and most comprehensive health surveys in the country. The survey collected alcohol use information as well as demographic and socioeconomic data for more than 24,000 adults age 18 or older. They compared 2018 with 2020 alcohol use numbers, then 2018 with 2022. 

While the U.S. Department of Health and Human Services announced the official end of the pandemic in May 2023, the study defined the year 2022 as post-pandemic, as behaviors were beginning to return to normal.  

Adults were characterized as having any alcohol use or heavy alcohol use within one year of the survey, and researchers calculated the rate of both measures of alcohol use. Heavy drinking was defined as greater than or equal to five drinks a day or 15 drinks a week for men, and greater than or equal to four drinks a day or eight drinks a week for women.  

The study did not analyze why there was an increase in alcohol consumption between 2018 to 2022, but Lee hypothesizes that pandemic stress may have caused drinking to become more normalized. He further speculates that the effects of the pandemic, including disruptions to school and work, may have driven the increases in alcohol use in adults ages 40-49. 

Lee hopes the study will bring more awareness to the issue. “We encourage health care providers to offer more screenings for harmful drinking as well as interventions for at-risk populations,” he said. 

Divya Ayyala-Somayajula, MD, from Thomas Jefferson University in Philadelphia, was lead author of the study. 

Jennifer Dodge, MPH, an associate professor of research medicine and population and public health science at the Keck School of Medicine of USC, Adam Leventhal, PhD, professor of population and public health sciences at the Keck School and director of the USC Institute for Addiction Science, and Norah Terrault, MD, a Keck Medicine gastroenterologist and division chief of gastroenterology and liver diseases at the Keck School, were also study authors.  

LOS ANGELES — The much-awaited fall COVID-19 vaccine will be available within the next few days. The flu shot is already available, as is a newly approved vaccine for respiratory syncytial virus (RSV), a virus that is especially harmful to infants and older adults.

What can we expect from the vaccines, how important are they and can you get them at the same time? Keck Medicine of USC experts have the answers. 

The new COVID-19 vaccine

The updated COVID-19 vaccine is designed as a single annual dose that targets the Omicron subvariant XBB.1.5 and any XBB substrains. The vaccine is offered by Pfizer and Moderna.

The Centers for Disease Control and Prevention (CDC) recommends that everyone six months and older be vaccinated. 

The CDC is also tracking the rise of a new variant called BA.2.86. Health experts are studying the virus to understand it better, but they still believe the new vaccine is the best way to avoid serious illness, hospitalization and death from all currently circulating COVID-19 variants.

The federal government’s COVID-19 Vaccine Distribution Program, which provided free vaccinations, has ended. However, insurance should pick up the cost of COVID-19 vaccines. For those uninsured or underinsured, the CDC is launching the Bridge Access Program, which partners with state and local programs to provide and distribute free vaccines.  

-- Edward Jones-Lopez, MD, MS, is an infectious disease expert with Keck Medicine of USC. He is available for interviews in English and Spanish.  

Why COVID-19 vaccines are still needed  

Research shows about 75% of Americans have retained at least some immunity from a prior infection of the virus. However, immunity fades over time and the individual risk of getting COVID-19, despite some immunity, is varied and inconsistent. The protection offered by vaccines also diminishes over time.  

Despite advances in treating COVID-19, it still can be a difficult and deadly disease that can lead to hospitalization, long-term symptoms or death. The side effects of the vaccine have proven to be minimal, so it is recommended that everyone who is eligible gets vaccinated, especially as we are coming off an end-of-summer surge and there may be future outbreaks over the holidays.  

If you have any concerns about the vaccine due to a health condition, please consult your health care provider.  

-- Earl Strum, MD, is the medical director of Employee Health Services for Keck Medicine of USC and clinical professor of population and public health science with the Keck School of Medicine of USC.  

Timing your vaccines safely and effectively

It is recommended that everyone six months or older be vaccinated against influenza every year. The best time to get the flu shot is September or October, so you will be inoculated in plenty of time before the high-flu season of the holidays. 

It is safe to get the flu shot at the same time as your COVID-19 vaccine. For some people, one or both vaccines may result in mild flu-like symptoms that should pass within a few days. For those concerned about soreness at the site of the jab, consider getting one shot in one arm and one in the other arm to avoid overtaxing one limb. Also, if a local reaction does occur, you will know which vaccine was responsible. If not insured, you can find a free flu shot at a local health clinic, pharmacy or even grocery store.  

RSV is a highly contagious virus that causes infections of the lungs and breathing passages, particularly among the young and old. The CDC recommends adults 60 years and older receive a single dose of the RSV vaccine in consultation with their health care provider. Additionally, the FDA has approved the RSV vaccine for use in pregnant individuals to protect infants from the virus.  

Clinical trials have shown that there are minimal side effects of the vaccine, and any mild symptoms far offset the possible serious complications RSV can cause. Talk to your health care provider should you have any questions or concerns about this new vaccine, including if you can receive it at the same time as your other vaccines and your payment/insurance options.  

-- Krist Azizian, PharmD, MHA, is the chief pharmacy officer for Keck Medicine of USC. 

The core team works together – simultaneously seeing patients in one visit if needed – to create an initial comprehensive workup while partnering with a nurse navigator to implement an integrated, personalized treatment plan.

“Given the extremely high number of people experiencing lingering, and oftentimes quite disruptive symptoms, we need to find ways to help patients get back to functioning in their lives,” said Caitlin McAuley, DO, family medicine physician with Keck Medicine and specialist who works with long COVID-19 patients. “As an academic medical center, Keck Medicine is dedicated to learning all we can about long COVID-19 to improve treatment options so we can provide our patients with the care they need and deserve.”

While many recover from COVID-19 without any noticeable issues, the Centers for Disease Control and Prevention estimates one-in-three individuals infected experience long COVID-19 after they are virus-free for weeks, and even months. Many experience a wide range of symptoms including fatigue, breathlessness, body aches, joint pain, cough and chest pain, diarrhea, dizziness, brain fog, vision blurriness, anxiety and sadness and more.

Keck Medicine patient Morgan Stephens, 31, tested positive for COVID-19 in November 2020. Just a few weeks after recovering from a mild case of COVID-19, she began to experience debilitating, and otherwise unexplainable, symptoms.

She kept a diary to log her symptoms, which totaled more than 50 by the time she was no longer able to work, and moved from the East Coast to Los Angeles to receive specialized care from Keck Medicine physicians who were dedicating time to long COVID-19 patients. Here, the health system began treating her severe brain fog, body tremors, headaches, insomnia, vertigo, fatigue and depression.

“Coming to Keck Medicine was absolutely necessary for me. I’d been repeatedly dismissed and told I was just being dramatic by those that didn’t believe long COVID-19 was real,” said Stephens. “Keck Medicine’s doctors are up to date on the latest research and best treatments available to help get me better and back to my normal life. Their knowledge and dedication has made all the difference in my successful recovery journey.”

Now, a year-and-a-half after the start of her first long COVID-19 symptoms, Stephens has made tremendous progress. While she still experiences headaches and vertigo, she feels well enough to move back to the East Coast to resume working full-time, confident that she can manage her remaining symptoms thanks to her team of Keck Medicine physicians.
 

Who is eligible for the program?

Eligible patients include those who have had a positive PCR test result for COVID-19 with persistent symptoms, eight weeks or more after diagnosis. For more information, call 323-442-9209 or email covidrecovery@med.usc.edu.

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