Are older adults at higher risk of illness?
Older adults and people with chronic underlying health conditions are more likely than younger, healthier people to experience serious illness from COVID-19, the disease caused by the coronavirus. There is no specific age at which risk increases. Rather, the Centers for Disease Control and Prevention (CDC) says “risk increases steadily as you age” with the greatest risk for severe illness being among those age 85 and older. Ninety-five percent of COVID-19 deaths in the U.S. have occurred among people who were 50 or older. Eight out of 10 COVID-19 deaths reported in the U.S. have been in people 65 and older, according to the latest demographic data available from the CDC.
Part of the reason risk increases with age is that people are more likely to have other health issues later in life, and underlying health conditions are a huge driver of complications that arise from COVID-19. A June report from the CDC found that hospitalizations for people with COVID-19 were six times as high for patients with chronic health conditions, compared to otherwise healthy individuals; deaths among this population were 12 times as high.
People of any age with the following conditions are at increased risk of severe illness from COVID-19, according to the CDC:
- Serious heart conditions, such as heart failure, coronary artery disease or cardiomyopathies
- Chronic kidney disease
- COPD (chronic obstructive pulmonary disease)
- Obesity (BMI of 30 or greater)
- Severe obesity (BMI of 40 or greater)
- Sickle cell disease
- Immunocompromised state from solid organ transplantation
- Type 2 diabetes
People with the following conditions might be at increased risk for severe illness from COVID-19:
- Asthma (moderate to severe)
- Cerebrovascular disease
- Cystic fibrosis
- Hypertension or high blood pressure
- Neurologic conditions, such as dementia
- Liver disease
- Overweight (BMI between 25 and 30)
- Pulmonary fibrosis (having damaged or scarred lung tissue)
- Thalassemia (a blood disorder)
- Type 1 diabetes
- Weakened immune system from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune-weakening medicines
Avoid crowds and close contact with others
The best way to dodge a coronavirus infection is to avoid being exposed to the virus. Limit interactions with people outside your household as much as possible, keep a distance of at least 6 feet from others and wash your hands often with soap and water (or use an alcohol-based hand sanitizer if soap and water are not an option).
The CDC defines close contact as being within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period. People who come into close contact with someone who has COVID-19 are advised to quarantine for two weeks, ideally. A 10-day quarantine is an acceptable alternative if no symptoms are noticed, the CDC says. So is a seven-day quarantine if the person in quarantine tests negative for the virus after seven days of staying away from others.
Wear a mask
The CDC recommends “universal use of face masks” in indoor settings (other than your own home, as long as no one is sick with the virus) and outdoors when a minimum physical distance of 6 feet from others cannot be maintained. Face masks help protect the wearer from coronavirus infection, in addition to helping protect others from being infected by the wearer.
The CDC recommends, in particular, the use of multilayer cloth face masks without valves, which are shown to reduce the transmission of respiratory droplets and fine particles. A study published in JAMA Network found that a snug-fitting, two-layer, consumer-grade mask is “nearly equivalent to or better” than a medical-grade mask.
Take precautions in public places
If you need to run out for necessities, the CDC offers this guidance on how to do so safely:
- Wear a mask.
- Stay at least 6 feet away from others while shopping and while in line.
- Consider running your errands first thing in the morning or at the end of the day when fewer people are likely to be shopping. Some stores have special shopping hours for high-risk individuals.
- Disinfect your shopping cart or basket with disinfectant wipes.
- Use hand sanitizer right away if you handle money, a card or a keypad.
- Wash your hands when you get home.
- When getting gasoline, use disinfectant wipes on handles and buttons before you touch them; use hand sanitizer immediately after.
- Headed to the bank? Use drive-through banking services, automated teller machines (ATMs) or mobile banking apps for routine transactions that do not require face-to-face assistance as much as possible.
Have a plan in case you or someone in your household gets sick
Identify a designated sickroom in your home that can be used to separate sick household members from healthy ones. Make sure you have at least a 30-day supply of prescription medicines on hand to cut down on the number of trips you need to make to the pharmacy. It’s also important to have over-the-counter medications in the house to treat fever, cough and other symptoms, as well as tissues and common medical supplies. You also may want to purchase a pulse oximeter to have on hand. A small device that measures someone’s oxygen saturation level, it can be a useful tool because a falling oxygen level can be an early sign that a COVID-19 patient's health is deteriorating.
What about travel?
Before you make travel plans be sure to double-check any rules pertaining to your destination and mode of transportation. Many countries and states have travel restrictions or guidelines in place that could affect your trip — the same goes for airlines. AARP has a list of coronavirus restrictions and quarantine rules for travelers in every state.
It’s important to note that “travel increases your chance of getting and spreading COVID-19” and that “staying home is the best way to protect yourself and others” from the virus, the CDC says.
For older adults and others at high risk for severe illness from a coronavirus infection, traveling can be dangerous, especially if you are in close contact with others.
Some travel-related activities are considered higher risk than others, including: going to a large social gathering like a wedding or funeral, attending a big event such as a concert, and traveling on a cruise ship or riverboat.
Testing can help you travel more safely, the CDC says. Consider getting tested with a viral test one to three days before your trip. Keep a copy of your test results with you during travel; you may be asked for them.
Also consider getting tested with a viral test three to five days after your trip and reduce nonessential activities for a full seven days after travel, the CDC says, even if your test is negative. If you don’t get tested, consider reducing nonessential activities for 10 days after travel.
Do not travel if you are sick or if you have been around someone with COVID-19 in the past 14 days.
AARP has information about specific travel advisories, airline change fees and more on how to stay safe when you travel.
The virus is thought to spread mainly between people in close contact with one another by respiratory droplets produced when an infected person coughs, sneezes or talks, according to the CDC. Those droplets can land in the mouths or noses of nearby people or be inhaled into the lungs. Aerosol transmission (tiny exhaled particles that can linger in indoor air for longer durations and travel farther than 6 feet) can also play a role in the spread of the virus, which reinforces the importance of mask wearing, experts say.
According to the CDC, “the virus may be spread in other ways,” including by touching a contaminated surface or object and then touching your mouth, nose or eyes. However, this is not thought to be the main way the virus spreads, the agency maintains.
Finally, it’s important to note that COVID-19 can be spread by people before they start showing symptoms of COIVID-19 (presymptomatic) or even if they never develop symptoms (asymptomatic). A study published Jan. 7 in JAMA Network Open found that people without symptoms account for about 59 percent of all COVID-19 transmission, The study underscores why it’s important to wear a mask, practice social distancing, avoid crowds and take other precautions, whether you have symptoms or not.
People with COVID-19 have reported a wide range of symptoms that typically appear two to 14 days after exposure to the virus. Here is the latest list of symptoms, according to the CDC:
- Fever or chills
- Shortness of breath or difficulty breathing
- Muscle or body aches
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
The CDC acknowledges this list is not exhaustive; skin rashes or lesions may also be a sign of the virus.
Health experts are asking anyone who experiences symptoms to call their health care provider or local health department for advice before seeking care to avoid spreading germs to others. Those who are feeling sick and are unsure of their symptoms can also check the CDC’s interactive guide for advice on appropriate medical care.
However, if you develop emergency warning signs — pain or pressure in the chest, new disorientation or confusion, a blue tint in your face or lips, difficulty breathing, or an inability to wake or stay awake — get medical attention immediately, health officials warn.
The CDC also has tips for what to do if you are diagnosed with COVID-19.
How is COVID-19 treated?
Remdesivir: Remdesivir is the first — and so far, only — treatment for COVID-19 to receive approval from the U.S. Food and Drug Administration (FDA). Research shows it can help hospitalized COVID-19 patients recover faster.
Dexamethasone and other corticosteroids: The World Health Organization (WHO) on Sept. 2 issued new guidelines that strongly recommend the use of dexamethasone (along with other inexpensive and common corticosteroids such as hydrocortisone) for the treatment of patients “with severe and critical COVID-19.” Clinical trials found that corticosteroids cut the risk of death in patients hospitalized with the disease.
Bamlanivimab: A monoclonal antibody, this drug received an emergency use authorization (EUA) from the FDA on Nov. 9 to treat mild to moderate cases of COVID-19 in patients at high risk of severe disease, including people 65 and older and those with chronic medical conditions. It is not approved to treat hospitalized patients or those who require oxygen.
Casirivimab and imdevimab: Another antibody treatment, Regeneron's COVID-19 monoclonal antibody cocktail received an EUA on Nov. 21 for the treatment of mild to moderate COVID-19 in non-hospitalized patients who are at high risk of progressing to more severe illness, including people 65 and older and those with chronic medical conditions.
Convalescent plasma: Blood plasma donated by individuals who have recovered from coronavirus infection contains antibodies that may speed recovery when administered to patients hospitalized with COVID-19. The FDA granted an EUA for convalescent plasma on Aug. 23. A study published Jan. 6 in the New England Journal of Medicine found that giving plasma infusions to patients 65 and older experiencing mild COVID-19 symptoms within a few days of symptom onset significantly reduced the need for oxygen support.
The U.S. has begun the rollout of the first coronavirus vaccines after the FDA issued EUAs for vaccines from Pfizer-BioNTech and Moderna.
Both require two doses and both have been found to be about 95 percent effective at preventing illness caused by the coronavirus in clinical trial participants, regardless of age, race or health risks known to complicate COVID-19. A panel of independent experts, known as the Vaccines and Related Biological Products Advisory Committee, concluded that the benefits of the vaccines outweigh the risks.
Adverse reactions have been rare. Of 1.9 million people who received their first dose of the COVID-19 vaccine, only 21 developed anaphylaxis, a severe allergic reaction, the CDC said. Seventeen of the 21 who experienced anaphylaxis had a history of similar reactions to other vaccines or medications, the CDC said, and all 21 recovered. The CDC recommends that people with a history of anaphylaxis be observed for 30 minutes after getting the shot; other recipients should be observed for 15 minutes.
The federal government is overseeing the distribution of the coronavirus vaccines, and officials say it will be months before everyone who wants the vaccine is vaccinated. Health care workers and residents and staff of long-term care facilities are the first group targeted for vaccination.
Two other vaccines are in phase 3 clinical trials in the U.S. There’s also one from AstraZeneca and the University of Oxford, and another from Johnson & Johnson. A phase 3 clinical trial is when researchers study the safety and effectiveness of the vaccine candidates against a placebo in a large population.
How can I take care of a sick friend?
Health officials stress that it’s important to take care of sick friends and neighbors in the community — and there’s a way to do so safely. If you are taking food to a neighbor, consider leaving it at the door.
If you are caring for someone who has COVID-19, keep a safe distance. Wash your hands often, wipe down high-touch surfaces and remind the person who is sick to wear a face mask. You should wear a face mask, too. Offer to help with groceries and errands, if possible.
Finally: Watch for warning signs of serious illness. Call the doctor if the person’s condition worsens, and seek immediate medical attention if they have difficulty breathing, pain or pressure in the chest, new confusion, an inability to wake or stay awake, or blueish lips or face.
What if a loved one is in a nursing home?
Adults living in nursing homes and long-term care facilities are at high risk for severe sickness if infected with the coronavirus, which is why many facilities across the country are continuing to limit visitation. (You can check the status of nursing home visits in your state on AARP.org.)
If you have a loved one in a nursing home or long-term care facility, visit with them virtually: Stay in touch through videoconferencing, emails and phone calls. Send pictures or letters or drop off a care package. (Not all facilities may allow this, so check first.)
Also: Identify a point of contact on staff for when you have questions and concerns. Facilities are required by the federal government to alert residents, their families and the CDC within 12 hours if a case of COVID-19 is confirmed.
AARP has a list of six key questions to ask about circumstances at your loved one’s nursing home and questions for assisted living facilities — plus extensive coverage on the crisis in nursing homes. You can also track coronavirus cases and deaths in specific nursing homes on a website that the federal government unveiled on June 4. AARP is also keeping track of this data.
What should I know about coronavirus variants?
Public health officials have identified new strains of the coronavirus that are more contagious, worrying experts who say they could lead to a surge in COVID-19 cases as vaccinations are getting underway.
The first strain, known as B.1.1.7., was discovered in the United Kingdom but is now circulating in more than 45 countries, including the United States. Another variant was discovered in South Africa and is mostly circulating in Africa.
Experts say early data indicate the current COVID-19 vaccines are likely to be effective against the variants. There is no evidence that the new strains cause more severe illness or increased risk of death, the CDC said.
This story will be updated periodically with new developments. Check back regularly.