CDC: For People At Higher Risk From COVID-19

Credit CDC

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The very good news is - if you are healthy, and under the age of 40 - COVID-19 is likely to be more of an inconvenience than a serious health threat to you. Yes, you are still likely to get infected, but your odds of having serious illness - while not zero - are a lot lower than for older individuals, or those with comorbidities.

For years we've been watching other potential pandemic threats - particularly H5N1 - which tend to impact younger people hardest, especially kids. The other `bird flu' of great concern - H7N9 - seems to target older people instead.

Which is why researchers often say, if you've seen one pandemic . . . . you've seen one pandemic.

Assuming COVID-19's preferences don't change, we've had a stroke of luck.  But still, roughly half the population is at substantial risk. And for those over the age of  80 - or with serious comorbidities - this virus appears to be a particularly efficient killer.

How this virus will react in other vulnerable populations, is unknown.  There are grave concerns over its impact in developing countries, particularly since many who could be saved by modern medical care, probably won't have access to it. 

Here in the United States, the biggest risks are to older parents and grandparents, and those with significant pre-existing medical conditions. Twelve years ago I began urging everyone - but particularly those who are elderly, or who live alone - to Line Up A `Flu Buddy'.

Someone you can call if you get sick, who will then check on you every day (by phone, social media, or in person), make sure you have the food and medicines you need (including fetching prescriptions if appropriate), help care for you if needed, or who can call for medical help if your condition deteriorates.

This advice is doubly important now - along with the advice to have enough food, OTC and Rx medical supplies, and other necessities on hand to stay home for at least a couple of weeks - in case you fall ill or it is not a good idea to go out in public (see An Appropriate Level Of Personal Preparedness For COVID-19).

Yesterday the CDC released updated guidelines for these vulnerable populations, which includes many of these same suggestions.  I'll return with a brief, but important, postscript after the break.

People at Risk for Serious Illness from COVID-19

If you are at higher risk of getting very sick from COVID-19, you should:
Stock up on supplies.

Take everyday precautions to keep space between yourself and others.
When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.

Avoid crowds as much as possible.

Avoid cruise travel and non-essential air travel.

During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.

Who is at Higher Risk?

Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:

• Older adults

• People who have serious chronic medical conditions like:

• Heart disease

• Diabetes

• Lung disease

If a COVID-19 outbreak happens in your community, it could last for a long time. (An outbreak is when a large number of people suddenly get sick.) Depending on how severe the outbreak is, public health officials may recommend community actions to reduce people’s risk of being exposed to COVID-19. These actions can slow the spread and reduce the impact of disease.

If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of getting sick with the disease.

Get Ready for COVID-19 Now

• Have supplies on hand

• Contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time.

• If you cannot get extra medications, consider using mail-order for medications.

• Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.

• Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.

Take everyday precautions

• Avoid close contact with people who are sick
• Take everyday preventive actions
• Clean your hands often
• Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
• If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
• To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
• Wash your hands after touching surfaces in public places.
• Avoid touching your face, nose, eyes, etc.
• Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
• Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
• Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.
• If COVID-19 is spreading in your community, take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus.
• Stay home as much as possible.

Consider ways of getting food brought to your house through family, social, or commercial networks

• Have a plan for if you get sick:
• Consult with your health care provider for more information about monitoring your health for symptoms suggestive of COVID-19.
• Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, etc. if you become sick.
• Determine who can provide you with care if your caregiver gets sick
• Watch for symptoms and emergency warning signs
• Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call your doctor.

If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs*:

• Difficulty breathing or shortness of breath

• Persistent pain or pressure in the chest

• New confusion or inability to arouse

• Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

What to Do if You Get Sick

• Stay home and call your doctor

• Call your healthcare provider and let them know about your symptoms. Tell them that you have or may have COVID-19. This will help them take care of you and keep other people from getting infected or exposed.

• If you are not sick enough to be hospitalized, you can recover at home. Follow CDC instructions for how to take care of yourself at home.

• Know when to get emerge

Get medical attention immediately if you have any of the emergency warning signs listed above.

What Others can do to Support Older Adults

Community Support for Older Adults

• Community preparedness planning for COVID-19 should include older adults and people with disabilities, and the organizations that support them in their communities, to ensure their needs are taken into consideration.

• Many of these individuals live in the community, and many depend on services and supports provided in their homes or in the community to maintain their health and independence.

• Long-term care facilities should be vigilant to prevent the introduction and spread of COVID-19. Information for long-term care facilities can be found here.

• Family and Caregiver Support

• Know what medications your loved one is taking and see if you can help them have extra on hand.

• Monitor food and other medical supplies (oxygen, incontinence, dialysis, wound care) needed and create a back-up plan.

• Stock up on non-perishable food items to have on hand in your home to minimize trips to stores.

• If you care for a loved one living in a care facility, monitor the situation, ask about the health of the other residents frequently and know the protocol if there is an outbreak.

Prevention and Treatment
Get Your Household Ready

In addition to this excellent advice from the CDC, I would like to add:

For many young, working families with kids, some of the community mitigations - like school closures - are going to create serious logistical problems.  While you may be desperate to find someone to watch your kids so you can go to work - kids can carry the virus asymptomatically -  so dropping them off at Grandma's shouldn't be an option. 

A benign looking sniffle in a child can quickly turn into respiratory failure in a vulnerable older adult.  

I know this is going to wreck a lot of Mother's Day plans this year, and make things much more difficult for working parents, but COVID-19 poses a serious threat to older people.  Even casual exposure to others can be risky, so use your phone, or Skype, or some other way to keep in contact with older people whenever you can.

No matter what we do, we stand to lose a lot of older adults to this virus.  We certainly don't want to do anything to increase its efficiency.