What can older adults do to reduce their 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” and despite initial warnings from the agency, “it’s not just those over the age of 65 who are at increased risk for severe illness.”
Part of the reason risk increases with age is because 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.
Health conditions most associated with severe illness from COVID-19 include:
- Chronic kidney disease
- Chronic obstructive pulmonary disease (COPD)
- A weakened immune system from organ transplant
- Obesity (BMI of 30 or higher)
- Serious heart conditions, such as heart failure, coronary artery disease or cardiomyopathies
- Sickle cell disease
- Type 2 diabetes
Health conditions that might increase risk for severe illness from COVID-19 include:
- Asthma (moderate to severe)
- Cerebrovascular disease
- Cystic fibrosis
- Hypertension or high blood pressure
- A weakened immune system
- Neurologic conditions, such as dementia
- Liver disease
- Pulmonary fibrosis (having damaged or scarred lung tissues)
- Thalassemia (a type of blood disorder)
- Type 1 diabetes mellitus
The CDC has issued specific guidance for older adults and people at high risk for serious outcomes. Here’s what the agency recommends:
Avoid close contact with others
Older adults and people with underlying health conditions are encouraged to limit interactions with people outside their household as much as possible and to take preventive measures when interactions do take place. Wash your hands often with soap and water and use an alcohol-based hand sanitizer when soap and water are not an option. Keep a distance of at least 6 feet from others when in public; cover your coughs and sneezes; and disinfect high-touch surfaces often.
The CDC also recommends wearing a cloth face covering in public to help slow the spread of the virus.
It’s a good idea to draft a plan in case you do become sick, experts say. Identify a designated sickroom in your home that can be used to separate sick household members from healthy ones. And identify aid organizations in your community that you can contact for help should you need it.
Stock up on supplies
Older Americans and adults who routinely take medications should make sure they have at least a 30-day supply of prescription medicines on hand. It’s also important to stock up on over-the-counter medications to treat fever, cough and other symptoms, as well as tissues and common medical supplies.
Major health insurers have pledged to relax prescription refill limits on “maintenance medications” in the wake of the coronavirus outbreak. Prescription refill limits are also being waived for many Medicare Advantage and Part D beneficiaries.
If you run into difficulty stocking up on your prescriptions at the pharmacy, consider refilling your medications with a mail-order service, the CDC says. You can also ask your physician to switch your prescription from a 30-day supply to a 90-day supply to make sure you have enough medication to get through a longer period of time.
And make sure you have enough food in the house in case you have to stay home for an extended period. If you need to run out for necessities, the CDC has guidance on how to do so safely. On the list:
- Stay at least 6 feet away from others while shopping and while in line.
- Cover your nose and mouth with a cloth face covering.
- 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.
Save 25% when you join AARP and enroll in Automatic Renewal for first year. Get instant access to discounts, programs, services, and the information you need to benefit every area of your life.
What about travel?
The government advises against all nonessential international travel, including cruise ship travel, during the pandemic. As far as domestic travel is concerned, the CDC encourages travelers to study the current situation ahead of their trip to “learn if coronavirus is spreading in your local area or in any of the places you are going.”
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. “People at higher risk for severe illness need to take extra precautions,” the CDC says. Staying home is still the best way to protect yourself and others from getting sick, the agency adds.
If you do decide to travel, the CDC outlines steps you can take to reduce your chances of getting sick:
- Avoid contact with sick people.
- Avoid touching your eyes, nose or mouth with unwashed hands.
- Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.
- Wear a cloth face covering in public settings.
The CDC also recommends making sure that you are up to date with your routine vaccinations before you travel, including the measles-mumps-rubella (MMR) vaccine and the seasonal flu vaccine. And do not travel if you are sick or if you have been around someone with COVID-19 in the past 14 days.
How is the coronavirus spreading?
The virus is thought to spread mainly from person to person by respiratory droplets 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. The CDC says “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.
Health officials are still working to better understand how easily the virus is spread from person to person. Research shows that COVID-19 can be spread by people who are not showing symptoms. A population-based study in Iceland, for example, found that 43 percent of participants who tested positive for the virus reported no symptoms at the time of the test. Similarly, 45 percent of positive cases in an Indiana-based population survey were asymptomatic when tested, and about 18 percent of people onboard the Diamond Princess cruise ship never developed symptoms of a coronavirus infection.
What are the symptoms?
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.
The CDC is 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. Many patients with severe complications from the virus develop pneumonia and may require assistance breathing with a ventilator.
Doctors who suspect COVID-19 can order a test. Legislation signed into law March 18 makes coronavirus tests available at no cost.
The CDC also has tips for what to do if you become infected with COVID-19.
What do we know about minority populations?
More data show African Americans, Hispanics and Native Americans are disproportionately being affected by the virus and the illness it causes.
A handful of recent studies report Black Americans are more likely to be hospitalized with COVID-19 than their non-Hispanic white counterparts. The Black population is also shouldering a disproportionate number of deaths from the coronavirus. Blacks account for nearly 23 percent of COVID-19 deaths in the U.S. to date, even though Black Americans make up about 13 percent of the country's population, according to the latest data from the CDC. In several states, including Michigan, Arkansas and Alabama, and in the District of Columbia, the disparity in deaths is even more pronounced.
Several states report the share of COVID-19 cases among Hispanics to be higher than their share of the population, according to the COVID Racial Data Tracker, a collaboration between the COVID Tracking Project and the Antiracist Research & Policy Center. In New York City, the epicenter of the epidemic in the U.S., more Hispanics per capita have succumbed to the illness than any other ethnic group, an April report showed.
And death rates have been especially high in the Navajo Nation, which has land in Arizona, New Mexico and Utah. American Indians make up 21 percent of deaths in Arizona but only 4 percent of the state's population, according to data from the Kaiser Family Foundation. In New Mexico, Native Americans account for 37 percent of coronavirus cases but only 9 percent of the population. Utah does not have racial data on its cases.
The federal government on June 23 announced a $40 million initiative with Morehouse School of Medicine to fight COVID-19 in racial and ethnic minority, rural and socially vulnerable communities.
How is it treated?
The Food and Drug Administration (FDA) on May 1 issued an emergency use authorization (EUA) for Gilead Sciences’ antiviral drug remdesivir as a treatment option for people who are hospitalized with COVID-19.
The news came shortly after the NIH announced preliminary results from an international clinical trial testing remdesivir as a potential treatment for COVID-19. Researchers found that patients with severe illness who received the drug recovered faster than those who received a placebo. “Results also suggested a survival benefit,” the NIH said in a news release. The mortality rate for the group that received remdesivir was lower than for the placebo group.
The EUA — which is not the same as official FDA approval — “allows for remdesivir to be distributed in the U.S. and administered intravenously by health care providers” to treat patients who have low blood oxygen levels or who need breathing support by way of a mechanical ventilator.
Preliminary results from a study led by the University of Oxford also found the steroid drug dexamethasone reduced deaths by up to a third in severely ill patients hospitalized with COVID-19. The federal government has distributed both remdesivir and dexamethasone to states across the country.
What are prospects for a vaccine?
Several clinical trials testing the safety and effectiveness of potential vaccine candidates are underway, including one from drugmaker Moderna. Phase three of its clinical trial is expected to begin in July.
So when will a vaccine be available? Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and a key member of the White House coronavirus task force, said in a June 23 hearing before the House Energy and Commerce Committee that he is “cautiously optimistic” the U.S. will have a vaccine for the coronavirus by the end of 2020 or early in 2021. He confirmed that several vaccine candidates are moving through clinical trial phases and that the federal government is taking financial risks “so that when — and I believe it will be when, not if — we get favorable candidates with good results, we will be able to make them available to the American public.” More than 100 research teams around the world are working on vaccine development, according to the Milken Institute’s COVID-19 Treatment and Vaccine Tracker.
Will a flu shot provide protection?
There is no evidence that the flu shot or the pneumococcal vaccination will provide any protection from the coronavirus, according to CDC official Nancy Messonnier. Both, however, will increase your chances of staying healthy and staying out of the hospital during the pandemic.
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. Since COVID-19 is most likely passed by respiratory droplets, this will eliminate the chance of the virus spreading.
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. And make sure the person who is sick drinks lots of fluids and rests.
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 facilities across the country are banning visitation (with special consideration given to end-of-life cases).
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 new website that the federal government unveiled on June 4. AARP is also keeping track of this data.
When will long-term care facilities ease up on their visitation policies? It could be a while. The Centers for Medicare & Medicaid Services (CMS) on May 18 said nursing homes should be “among the last to reopen” and announced recommendations to state and local governments for the reopening process. On the list: Facilities need to have routine testing and adequate supplies of personal protective equipment (PPE) and cleaning and disinfection materials. Nearby hospitals also need to have enough beds to take care of any residents who need to be transferred there. AARP has an FAQ resource for family and friends of nursing home residents who are eager to resume visits.
What is the advice on face masks?
The CDC is encouraging all Americans — even people who feel healthy — to wear cloth face masks or homemade face coverings in public when 6-feet social distancing is difficult to maintain in an effort to help slow the spread of the coronavirus. The guidance, announced April 3, is a reversal from previous CDC recommendations that face masks only need to be worn by people who are sick with COVID-19 or by those caring for someone who is sick.
The masks the CDC is recommending can be purchased online or made at home. Health officials stress N95 respirator masks and surgical masks should be reserved for frontline health care workers.
AARP has a tutorial on how to make a face mask at home.
What, exactly, is the coronavirus?
Coronaviruses, named for their crownlike shape, are a large family of viruses that are common in many species of animals. Several coronaviruses can infect people, according to the CDC. These strains mostly cause cold-like symptoms but can sometimes progress to more complicated lower respiratory tract illnesses, such as pneumonia or bronchitis.
On rare occasion, animal coronaviruses can evolve and spread among humans, as seen with MERS and SARS. The virus at the center of the latest outbreak is being referred to as a novel (new) coronavirus, since it’s something that health officials have not seen before.
This story will be updated periodically with new developments in the global outbreak. Check back regularly.