This article was originally published on March 17, 2020. It was updated on June 30, 2020, to reflect new information about this rapidly evolving situation.
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As events get rescheduled for the fall, schools remain closed and communities are urged to practice social distancing and abide by stay-at-home orders in light of the COVID-19 (coronavirus) pandemic, you’ve probably heard that these actions are critical to help control the spread of the virus.
But limiting your social contact doesn’t just help protect you. It also helps protect the people who are most vulnerable to getting very sick from the virus.
Who are these especially vulnerable people? While the virus causes only mild symptoms in most people who are infected with it, in some it can lead to severe illness, including pneumonia and death. These serious complications of COVID-19 are most likely to develop in elderly people, as well as those who have weakened immune systems, or are immunocompromised, says infectious disease specialist Alan Taege, MD.
When people are immunocompromised, their body has a reduced ability to fight off and recover from infections. This could be because they have a certain chronic condition that affects the immune system, or because of certain medications they are taking. For example, some cancer treatments and medications used for autoimmune conditions weaken a person’s immune response, as do medicines that people take after having an organ transplant.
Here’s what you should know about protecting the most vulnerable populations.
Q: Who is most at-risk for getting severely sick from the coronavirus?
A: The coronavirus that causes COVID-19 is new, so we don’t yet understand exactly how it impacts specific groups of high-risk people. But, those who are thought to be most susceptible to serious complications of COVID-19 include people who:
- Are over age 65.
- Have cancer.
- Have hypertension.
- Have lung disease.
- Have diabetes.
- Have heart disease.
- Have another condition that compromises the immune system.
- Are taking medications that suppress the immune system.
Q: I’m over 65 — why am I more at risk?
A: Our immune system naturally becomes weaker as we age, which makes it harder for our bodies to fight off infections.
Q: I have a condition that puts me at high risk. How can I best protect myself?
A: Unfortunately, there is not yet a vaccine that can prevent COVID-19, so we cannot prevent the disease. But there are things you can do to minimize your risk.
For starters, it’s extra important for older adults and those with underlying medical conditions to avoid being exposed to the virus in the first place. It’s spread by droplets that come out the nose and mouth of someone who’s infected when they cough or sneeze, so you can get COVID-19 from being in close contact (within 6 feet or so) with an infected person who has these symptoms. You might also be able to get it from touching a surface that’s been contaminated with infected droplets.
To avoid exposure to the virus, it’s recommended that you:
- Avoid contact with people who are sick.
- Follow any shelter-in-place orders in your area and avoid going to crowded spaces where you’ll be in close contact with others.
- If you do need to go out for food or medicine, avoid doing so during peak hours and keep 6 feet of distance between yourself and others.
- Wash your hands often using soap and water for at least 20 seconds, especially after you’ve been in a public place. If soap and water aren’t available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.
- Keep your hands away from your eyes, nose and mouth, as this is how germs get into your body.
- Avoid touching high-traffic surfaces in public places, such as elevator buttons, door handles and shopping cart handles. Use a tissue or your sleeve to cover your hand if you must touch these surfaces.
- Make sure others in your household, or anyone you are regularly in close contact with, follow these same precautions. According to the CDC, infection can spread before someone develops symptoms (if they develop them at all), so someone could pass the virus on to you before they even know they are infected.
- Routinely disinfect surfaces in your home, such as doorknobs, faucet handles and cell phones.
- Avoid close contact with people who have recently traveled to an area with high COVID-19 activity.
- Maintain healthy habits, like eating well, getting enough sleep and managing your stress levels, in order to keep your immune system as strong as it can be.
If you develop COVID-19 symptoms such as fever or chills, cough, shortness of breath, difficulty breathing, muscle or body aches, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea, call your doctor.
Q: I’m immunocompromised. Should I still go to my medical appointments?
A: If you’re unsure whether you should keep your appointment, call your healthcare provider and ask. Some appointments might be able to be rescheduled, or handled virtually through a telemedicine visit or by phone. If you are scheduled to receive a treatment or have an exam that can’t be handled this way, plan to keep your appointment unless your provider tells you otherwise. Healthcare facilities are taking special precautions to protect the health and safety of patients during this time.
Q: I’m on immunosuppressing medications. Should I stop taking them?
A: Don’t stop taking your medications without talking to your healthcare provider first. Just as there is risk associated with having a compromised immune system, there is also risk associated with stopping medication suddenly and potentially having disease flares. If you have questions or concerns, or if you become sick, talk with your doctor.
Q: Should I wear a face mask?
A: The CDC recommends wearing a cloth face coverings in public, especially in places where it’s hard to maintain at least 6 feet of distance between yourself and another person. Cloth face masks are being recommended because we now know individuals with COVID-19 could have mild or no symptoms, while still spreading the virus to others.
The cloth face coverings recommended by the CDC are not surgical masks or N-95 respirators, which should be reserved for healthcare workers and first responders.
Q: If I’m at risk, what other steps should I take to prepare for a COVID-19 outbreak in my community?
A: Consider the following:
- Ask your healthcare provider if it’s possible to get an advance supply of your medications, in case there is an outbreak in your community and you need to stay home for more than a few weeks. You can also ask your healthcare provider or pharmacy if ordering medications online and having them shipped to your home is an option.
- Have enough groceries and household supplies on-hand so that you could comfortably stay home for a few weeks if you had to. Many grocers now offer online ordering and delivery, which could also help you avoid having to go out.
- Talk to your doctor to make sure you are up to date on your recommended vaccinations, such as the pneumonia and flu shots, which can help prevent those serious illnesses. These will not protect you against COVID-19, but they will protect you from other infections that could require you to seek medical care.
- Make a plan for who will take care of you if you do get sick.
- If you have a chronic condition and live alone, ask family members, friends or neighbors to check on you regularly during an outbreak. Ask them to call or contact you through email or social media.
- Pay attention to your local news so that you are up to date on whether the virus is circulating in your local community.
Q: What should I do if I’m exposed to someone who has or might have COVID-19?
A: The CDC recommends that you stay home and separate yourself from other people and animals in your home. If you develop potential COVID-19 symptoms such as fever, cough and shortness of breath, call your doctor, who will let you know what you should do next. If you develop severe symptoms such as difficulty breathing, dizziness, a severe headache or chest pain, call 911 or go to the emergency room.
Q: I’m not at high risk, but I have a loved one who is. How can I help?
A: You can start by checking in on your love one’s well-being frequently via phone, email or social media. You might also consider:
- Offering to pick up groceries or prescriptions and drop them off at your loved one’s home so they do not have to go out.
- Learning what medications your loved one is taking, and helping them get extra medication and supplies, if possible.
- If your loved one is in a hospital or long-term care facility, check ahead of time to see if they have restrictions on visitation. And never visit when you’re sick.
Q: I feel anxious. What should I do?
A: It’s normal to feel uneasy during this uncertain time. But remember that, while this virus is new, respiratory illnesses are not, and healthcare providers are trained to manage them. It’s also important to stay up to date with the latest news from trusted sources such as the CDC, but take a break from media coverage or social media if you find yourself feeling overwhelmed. Do normal relaxing activities such as music, yoga or exercise at home.