There are now more than 135,000 cases of COVID-19, the disease caused by the new coronavirus, in the United States—and numbers are rising daily. In fact, the World Health Organization (WHO) declared it a pandemic on March 11. And while WHO says most cases are turning out to be fairly mild, that may not bring much reassurance to those living with chronic illness, who are often already at increased risk of getting sick because of compromised immune systems.
“As the trajectory of the outbreak continues, many people in the U.S. will at some point, either this year or next, get exposed to this virus,” said Nancy Messonnier, M.D., director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC) March 9 in a media briefing. “And there’s a good chance many will become sick.”
If you’re living the chronic life, here’s what you need to know about your potentially higher risk and how to protect yourself from COVID-19.
#1 This Virus Is Brand New
Coronaviruses are a big family of viruses found in certain animals, according to the Centers for Disease Control and Prevention (CDC). In rare cases, they can infect people and start to spread between humans. This is what happened with Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS)—and now, this new coronavirus.
This new virus and the disease it causes, COVID-19, were first reported in Wuhan, China in late December 2019, explains Rashid A. Chotani, M.D., professor of epidemiology at University of Nebraska Medical Center and adjunct professor at George Washington University.
So this virus is just a few months old, which means experts are still uncovering the facts about COVID-19. Much of what we do know comes from educated guesses based on how other coronaviruses operate, like MERS and SARS—but we’re learning more every day.
According to the CDC, COVID-19 appears to spread in two main ways:
- Transmission between people in close contact (about 6 feet from each other or closer)
- Transmission from respiratory droplets produced when a person with the virus sneezes or coughs, which can then land in the noses or mouths of others nearby or maybe even be inhaled into someone else’s lungs
It’s also possible, the CDC sys, that the virus can spread from touching a surface or object with the virus on it and then touching your mouth, nose, or possibly eyes—but this isn’t one of the main ways it’s thought to spread.
People are likely most contagious when their symptoms are the worst and they’re feeling the sickest. And while it’s not thought to be the main way transmission occurs, some of the reported cases have been transmitted before the first infected person was even showing symptoms, the CDC says.
And while it’s not clear yet just how contagious the virus is, it does seem to be transmitting easily from person to person in some parts of the world.
#2 Some People Are at Greater Risk
It’s true—certain groups may be more susceptible to getting seriously ill with COVID-19 than others. And that includes those living with chronic illness.
“In the United States, the most vulnerable are the 2.5 million seniors residing in nursing homes and long-term or assisted living facilities. Anyone above the age of 50 years with co-morbidities (diseases like diabetes, cancer, lung disease, Parkinson’s disease, or cardiovascular diseases) is also at high risk,” says Dr. Chotani. “Healthcare workers caring for patients with the COVID-19 are also at a higher risk of acquiring the disease due to high exposure to the virus.”
Those who have traveled to areas where the outbreaks are worst—such as China, South Korea, Iran, and Japan or any high risk area where the disease has been identified; now essentially everywhere—are also at higher risk, he says.
The illness is more likely to stay mild if the virus stays in the nose and throat. It’s when the virus moves to the lungs that it gets more dangerous, the National Institute of Allergy and Infectious Diseases’ Jeffery K. Taubenberger told Bloomberg. That’s why people with co-morbidities like chronic illnesses are at higher risk—because their immune systems may be less able to fight off the virus before it reaches the lungs.
“Immunocompromised patients are those that have a weakened immune system. A weakened immune system means you may get sicker from COVID-19,” explains Dr. Chotani. “Patients who are immunocompromised do not have the same ability to fight infections and other diseases as those who do not have a compromised immune system. Not everyone will get sick from COVID-19, but there are those with a higher risk of complications from COVID-19 if they do get it.”
For perspective, a WHO report based on China’s cases found that:
- Fourteen percent of people with COVID-19 develop difficulty breathing and other severe complications.
- Six percent become critical, typically because of respiratory failure or failure of other vital body systems, or because of septic shock.
And a large Chinese study on how chronic illness affects the course of COVID-19, STAT reported, results showed that the people with at least one additional disease (including cardiovascular diseases, diabetes, hepatitis B, chronic obstructive pulmonary disease, chronic kidney diseases, and cancer) had a 79% higher chance of needing intensive care, a respirator, both, or of dying as a result of the disease. Those with two or more additional diseases had 2.5 times that risk.
#3 You Can Take Steps to Protect Yourself
While all these numbers can be scary, especially when you’re in a high-risk group, there are many steps you can take to reduce your risk of getting seriously ill with COVID-19.
The CDC recommends everyone take these precautions to help prevent the spread of respiratory illnesses like COVID-19 and the flu.
- Wash your hands, and often. “The first line of defense is everyday precautions such as hand washing,” Dr. Chotani says. Regular old soap and water does the trick, as long as you’re washing for at least 20 seconds. You can also use an alcohol-based hand sanitizer with at least 60% alcohol.
- Avoid close contact with people who are sick. Avoiding exposure to viruses in the first place is your safest bet. Similarly, when you’re sick, you should stay home too.
- Stop touching your face. Touching your nose, eyes, and mouth with unwashed hands is a quick way to spread germs.
- Cover your coughs and sneezes. Use a tissue to cover your cough or sneeze, then throw out the tissue and wash your hands.
- Keep your surroundings clean. It’s a good idea to regularly clean and disinfect high-traffic surfaces and objects, like kitchen counters, doorknobs, and kids’ toys, to name a few.
These steps are important for everyone, but for those with chronic illness, especially over age 50, "it is imperative for them to take actions to reduce their risk of getting sick with the disease,” says Dr. Chotani.
And if you are at higher risk of getting COVID-19 due to chronic illness or age, the CDC also recommends you take these additional steps:
- It’s time to keep your distance. Keep space between yourself and others—especially those who are sick. Things like large crowds aren’t a great idea right now because respiratory viruses love closed-in spaces with little air circulation. So that concert you were going to go to? Maybe skip it. Your health is more important. In general, it’s a good time to really lean in to being a homebody during this time. Queue up that Netflix show you’ve been meaning to binge, talk to your employer about working from home if you haven’t already, and get ready to lie low for a few weeks. If you do have to enter public spaces, says Dr. Chotani, “Avoid touching high-touch surfaces in public places—elevator buttons, door handles, handrails, handshaking with people, et cetera. Use a tissue or your sleeve to cover your hand or finger if you must touch something.”
- Reconsider your travel plans. The CDC says cruises are a big no-no right now, and any non-essential travel is probably unwise as well.
- Stock up on supplies. If you’re planning to stay home and reduce your risk of exposure, you’re going to need supplies. If you haven’t already made a trip to your local grocery store or pharmacy for the essentials, now’s the time.
- Make a plan for if you get sick. Now’s the time to plan ahead. Are their friends, family members, or neighbors you can reach out to if you need help when you get sick? If you already have a caregiver, make plans for the scenario in which they get sick, too. Make these arrangements now—and talk with your health care team about your plan, too.
These steps are even more important if COVID-19 is already spreading in your community. Speaking of supplies, what exactly should you be stocking up on? Here’s a good list, per the CDC:
- Medications. That means over-the-counter staples, like ibuprofen, and all of your regular prescription meds. If you are dependent on medications to manage a chronic illness, talk with your doctor about getting extra so you don’t run out if you need to stay home for a while. Dr. Chotani recommends having at least three months’ word of medications on hand. Look into mail-order options with your pharmacy, too.
- Other medical supplies. Make sure you’re stocked up on tissues and any other supplies you usually rely on when you’re sick. Soap and disinfectant products are also important to have on hand.
- Household items and groceries. Stock up on basic household items and groceries—hooray for frozen meals! That way you don’t have to worry about running out of these staples if you can’t make regular trips to the store. Grocery delivery services are a good idea, too, says Dr. Chotani.
Keeping your immune system as strong as possible is crucial right now, says Dr. Chotani. For those with chronic illness, that means working with your health care team to make sure your condition is well managed, including taking your medications as directed.
#4 Symptoms Might Mimic Some of Your Chronic Flare Symptoms
If you are diagnosed with a chronic illness, make note of any COVID-19 symptoms that may be similar to one’s you feel during your flares. Key symptoms to watch for are fever—take your temperature twice a day—and coughing. You should also keep an eye out for chills, body aches, sore throat, headache, diarrhea, nausea and vomiting, and runny nose. Call your doctor immediately if you develop any of these symptoms.
If you have any of these emergency warning signs of COVID-19, says the CDC, seek medical care right away:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
Make sure to tell your health care provider—on the phone before you go—if you’ve had close contact with someone with confirmed or possible COVID-19.
If you are diagnosed with COVID-19 but aren’t sick enough to be hospitalized, the CDC says you can recover at home as long as you know those emergency signs to watch out for. The CDC has a full list of steps to take to take care of yourself at home on their website.
#5 Take Care of Your Mental Health, Too
There’s no doubt that living with a chronic illness in the time of a pandemic can cause some anxiety. And that’s totally normal, mental health experts tell CreakyJoints, a nonprofit that supports people living with arthritis.
“Fears about the coronavirus can serve as a reminder to be alert and aware of the ways in which to keep healthy when living with chronic health conditions or disabilities,” licensed clinical psychologist Linda Mona, Ph.D., told CreakyJoints in a blog post.
But when anxiety gets out of control, it can actually harm your health. That’s why it’s extra important to take care of your mental health as well as your physical health—and that goes for all the time, not just during this pandemic.
Here are some helpful ways to reduce anxiety and stress:
- Seek therapy. Many psychotherapists are offering increased availability of telehealth counseling right now—if you’re struggling, don’t hesitate to reach out.
- Make relaxation a priority. What’s helped you relax in the past? It’s time to bring out those tried-and-true self-care techniques, whether that’s taking a warm bath, reading a good book, or drawing a picture. Learning some relaxation exercises or practicing mindfulness can also be super helpful in times of stress, the Mayo Clinic says. For example, try closing your eyes and counting deep breaths up to 10, then repeating, for a few minutes. You could even look up a video on YouTube for gentle yoga.
- Focus on sleep and nutrition. When stressed or anxious, it’s extra important to make sure you’re getting adequate sleep and eating healthy, says the Mayo Clinic.
Arming yourself with knowledge and taking the above steps to reduce your risk of infection can also help ease some of those worries.
“The critical thing is not to panic but to use common sense measures to protect yourself,” says Dr. Chotani