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.
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 with the following conditions are at increased risk for severe illness from COVID-19, the CDC says:
- Chronic kidney disease
- Chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate to severe), interstitial lung disease, cystic fibrosis and pulmonary hypertension
- Dementia or other neurological conditions
- Diabetes (type 1 or type 2)
- Down syndrome
- Heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension)
- HIV infection
- Immunocompromised state (weakened immune system)
- Liver disease
- Overweight and obesity (defined as a body mass index of 25 or greater)
- Sickle cell disease or thalassemia
- Smoking, current or former
- Solid organ or blood stem cell transplant (includes bone marrow transplants)
- Stroke or cerebrovascular disease, which affects blood flow to the brain
- Substance use disorders (such as alcohol, opioid or cocaine use disorder)
The FDA has issued emergency use authorization (EUA) for three COVID-19 vaccines developed by Pfizer-BioNTech, Moderna and Johnson & Johnson (J&J). All three vaccines are safe and highly effective at preventing severe disease, studies show.
After you’ve been vaccinated, the CDC still recommends taking precautions such as wearing a face mask, avoiding crowds, staying at least 6 feet from others and washing your hands frequently.
Avoid crowds and close contact with others
If you haven’t been vaccinated, 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).
Wear a mask
The CDC recommends wearing 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.
Wearing a surgical mask under a cloth mask significantly improves protection from the coronavirus by creating a tighter fit around the face, a CDC study published Feb. 10 found. The study showed that when a cloth mask was worn over a surgical mask, 92.5 percent of cough particles were blocked, compared to only about 42 percent from a cloth or surgical mask alone.
The CDC study also revealed that the performance of surgical masks can be improved by knotting ear loop strings where they meet the mask and folding in and flattening mask edges. The researchers said their results demonstrate the importance of ensuring a mask fits well, with no gaps around the edges.
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.
The CDC says both vaccinated and unvaccinated travelers should still follow these recommendations for traveling safely:
- Wear a mask over your nose and mouth. Masks are required on planes, buses, trains, and other forms of public transportation and in U.S. transportation hubs such as airports and stations.
- Stay 6 feet from others and avoid crowds
- Wash your hands often or use hand sanitizer
Travel guidance for fully vaccinated people. The CDC says fully vaccinated people can travel “at low risk to themselves” but should still wear masks, avoid crowds, socially distance and wash their hands frequently. They can leave the country without getting a COVID-19 test unless it’s required by their destination, and they do not need to self-quarantine after returning to the U.S. unless it’s required by a local jurisdiction.
However, vaccinated people are still required to have a negative COVID-19 test result before they board an international flight to return to the U.S., the CDC says, and they should take a COVID-19 test 3 to 5 days after returning. People are fully vaccinated two weeks after they receive their second dose of the two-dose COVID-19 vaccines or the single-dose Johnson & Johnson vaccine.
Travel guidance for unvaccinated people. The CDC recommends delaying travel until you are fully vaccinated because travel increases your chance of getting and spreading COVID-19.
Testing can help you travel more safely, the CDC says. The CDC recommends 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.
If you travel internationally, before you board a flight to return to the U.S., you are required to have a negative COVID-19 viral test result no more than 3 days before travel or documentation of recovery from COVID-19 in the past 3 months.
After you travel, get tested with a viral test three to five days after your trip and stay home and self-quarantine for a full seven days after travel, the CDC says, even if your test is negative. If you don’t get tested, stay home and self-quarantine for 10 days after travel.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. Cleaning surfaces with soap or detergent is enough to prevent the spread of coronavirus in most situations; disinfection is “likely not needed unless someone in your home is sick or if someone who is positive for COVID-19 has been in your home within the last 24 hours,” the CDC says.
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; pale, gray, or blue-colored skin, lips, or nail beds; 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 and etesevimab: This therapy, from drug manufacturer Eli Lilly, combines two monoclonal antibody drugs. The combination received an emergency use authorization (EUA) from the FDA on Feb. 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. Bamlanivimab alone has also been authorized as a treatment. The drugs are 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 FDA has issued emergency use authorizations (EUAs) for three vaccines: from Pfizer-BioNTech, Moderna and Johnson & Johnson.
All three vaccines are safe and effective at preventing severe disease, studies show, and adverse reactions have been extremely rare.
The Moderna and Pfizer-BioNTech vaccines call for two doses, spaced 21 days (Pfizer) or 28 days (Moderna) apart. However, if that is not feasible, the CDC has said the doses may be spaced up to six weeks apart.
The Johnson & Johnson vaccine requires only one shot.
You may experience temporary side effects after getting the vaccine, such as soreness in the arm, headache, fatigue, muscle and joint pain, nausea, fever or chills. They are a sign that the vaccine is working.
You are considered fully vaccinated two weeks after getting the Johnson & Johnson vaccine or after your second dose of the two-dose vaccines.
High-risk populations — health care workers, residents in long-term care facilities, adults 65 and older and people with medical conditions that put them at increased risk for severe illness from COVID-19 — were among the first groups eligible for vaccination. All American adults will be eligible for a vaccine beginning April 19.
Two other vaccines are in phase 3 clinical trials in the U.S. 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 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. Studies indicate it may carry an increased risk of death.
Early data indicate the current COVID-19 vaccines are likely to be effective against the British variant.
Other variants of concern include one first discovered in South Africa (B.1.351) and another (P.1) first found in Brazil. The CDC is also tracking two variants that are spreading in California and New York City.
Early studies indicate that the current COVID-19 vaccines may be less effective against some of those strains, although the vaccines would still provide some protection.
The COVID-19 vaccine makers have already announced that they are working to modify their vaccines – and possibly to create booster shots – to better protect against variants.
Do some people have lingering symptoms?
Many COVID-19 survivors battle lingering symptoms for weeks or months after infection. Sometimes called “long-haulers,” they suffer from dizziness, insomnia, confusion, a racing heart or a host of other lasting effects that keep them from getting back to their normal lives.
A study published Jan. 8 in the journal The Lancet found that more than 75 percent of patients hospitalized with COVID-19 still suffered from at least one symptom six months later. The study revealed that fatigue, muscle weakness and sleep difficulties were the most common post-COVID symptoms, but patients also reported anxiety, depression, loss of taste or smell, heart palpitations and hair loss.
Experts encourage COVID-19 patients experiencing continuing symptoms to seek care from a medical provider. Many U.S. hospitals have set up special clinics for survivors and have already learned a lot about the best ways to help.
What should I know about testing?
- You have symptoms of COVID-19.
- You have had close contact (within 6 feet for a total of 15 minutes or more) with someone with confirmed COVID-19. (Fully vaccinated people with no COVID-19 symptoms and people who have tested positive for COVID-19 within the past 3 months do not need to be tested following an exposure.)
- You have taken part in activities that put you at higher risk for COVID-19, such as travel, attending large social or mass gatherings, or being in crowded or poorly ventilated indoor settings.
- You have been asked to get tested by a healthcare provider or state or local health department.
The most accurate COVID-19 tests use a method called polymerase chain reaction, or PCR. PCR tests require your sample to be sent to a lab, so it can take a few days to get results.
The FDA has also given emergency use authorization to rapid tests that use what’s called antigen technology. Antigen tests are faster because samples don’t have to be sent out to a lab, but studies show they are less accurate, especially if you are asymptomatic.
The FDA has also given the green light to five at-home COVID-19 tests that deliver results in real time at home, including four that will be sold over the counter without a doctor's prescription. They are expected to go on the market sometime this year.
This story will be updated periodically with new developments. Check back regularly.