Navigating COVID-19 Re-Openings if You’re High Risk
Many states are starting to open back up. But what does that mean for you if you have a chronic condition?by Sarah Ellis Health Writer
Just a few weeks ago, all anyone could talk about was the coronavirus lockdown. Almost every U.S. state (not to mention many countries around the world) imposed restrictions on non-essential social gatherings and movement outside the home. Now, many states have begun a partial reopening process.
This, however, means something a little different depending on where you live. For instance, Alabama is allowing retail stores to operate at 50% capacity, while Colorado is allowing personal care businesses to reopen without official distancing restrictions – yet the governor has urged citizens to maintain some level of distance and discretion. With all this ambiguity (not to mention alarming daily news reports about the virus), it’s tough to know what’s safe to do and what’s not. This is especially true if you’re chronic. As your friends and family begin to talk about returning to “regular” life, you’re probably wondering, what about me? Can I go back to work, to restaurants, to hanging out with my friends? These are complicated questions that demand thoughtful and thorough answers. We spoke to doctors specializing in various chronic conditions to get their advice on moving forward in this “reopening” phase of the pandemic, with caution and as much confidence as possible.
Who should be especially careful?
By now, you’ve heard the fact that some groups of people are at higher risk of serious complications from COVID-19 than others. The Centers for Disease Control and Prevention (CDC) list the following people as being part of the “high-risk” demographic:
People 65 years or older, especially those who live in a long-term care facility
People who are immunocompromised
People with chronic lung diseases, asthma, or serious heart conditions
People with diabetes
People with a BMI of 40 or higher
People with kidney or liver disease
These people are the ones who should be most careful as states begin to ease lockdown restrictions, explains Robert Brodell, M.D., professor and chair of the Department of Dermatology at University of Mississippi Medical Center in Jackson, MS. “Older patients, and patients with diabetes, heart disease, and lung disease that are at particular risk if exposed to COVID-19 should continue to work with their bosses and try to figure out how they can do telecommuting.” If you work in a job that lets you work from home, now is not the time to return to the office if you can at all avoid it.
If you’re wondering about your specific risk level, and the safety of any medications you’re currently on, your doctor can be a resource for you. They can also advise you as to how to navigate the question of when and how to return to work—and write a doctor’s letter for your boss if they need to see one.
What’s safe to do right now, and what’s not?
Salim Virani, M.D., chair for the Prevention Section of the American College of Cardiology and professor at Baylor College of Medicine in Houston, TX, urges caution in doing anything that requires close interaction with other people. So, essentially, keep doing what you’ve already been doing these last few months, watch the data and keep up to date on what your local health department is recommending. “We still know that this disease is having community spread,” Dr. Virani says, meaning that people are transmitting it to one another within geographic communities, often without realizing they are contagious. This makes the coronavirus’ spread very difficult to track, especially in the absence of widespread testing. “States loosening their restrictions in terms of stay-at-home orders, or allowing more businesses to reopen, is not a license for the vulnerable segments of the population to go out,” Dr. Virani says. “This is not the time to let their guard down.”
If you must go out for an essential errand, Dr. Virani says to continue to social distance appropriately: wear a face mask, maintain appropriate distance, wash your hands with soap, and use hand sanitizer when you’re out and about. “Always ask the question, ‘Is this something that I really need to do? Is this something that my family or neighbors can help out with,’” Virani suggests. Lean on the people around you to help with basic errands like grocery runs.
This isn’t to say you need to shut yourself inside 24/7 and live with worry. “It is important for us to maintain not only our physical health, but also our mental health,” Dr. Virani says. In general, the lowest-risk situations are those where you can safely distance from other people–such as going for a run in a quiet suburb or park, or spending one-on-one time outdoors (six feet apart) with one or two friends. Find support from other people living with chronic conditions (we have several HealthCentral Facebook groups to choose from!). Use this “extra” time at home to continue to stay virtually connected, which may help to mitigate the FOMO when your friends and family are starting to meet back up.
What if I live with someone who is going back to work and returning to “normal”?
Did your partner, roommate, or child get the go-ahead to return to work? You’ll need to be cautious about how to protect yourself now that they’re at a heightened risk of contracting the virus. “People going out to work have to be especially careful when returning to their families,” Dr. Virani notes. “When they come back home, have a separate area where they take their shoes off, wipe down all things they are carrying, take their clothes off, [and] take a good shower.” After that, you’ll be safe to interact with one another, if no one is showing symptoms.
If the person you’re living with does begin to show symptoms consistent with COVID-19—cough, fever, shortness of breath, loss of smell—follow the CDC guidelines for isolating them. Use a separate bedroom and bathroom (if possible), disinfect everything they’ve touched recently, and monitor your own health closely as well.
How can I take extra precautions?
One thing you can do for your own peace of mind is to purchase a good thermometer and fever reducer like acetaminophen or ibuprofen. You could also consider ordering a pulse oximeter, which will allow you to check on your oxygen saturation levels by simply pressing your finger on a sensor. This can help you detect the COVID-19 phenomenon known as “silent hypoxia,” where some patients arrive at the hospital with dangerously low oxygen levels in their blood but without severe shortness of breath. Talk with your doctor if you’re interested in getting one so they can help you interpret the data correctly. Long story short: There is no quick “return to normal” scenario for people living with chronic conditions, especially those who are at high risk of serious illness if they contract COVID-19. As doctors learn more about this virus (and work toward creating effective treatments), rest assured that you will be able to venture out safely again at some point. But for now, it’s best to prioritize your health and safety in whatever ways you’re able.
U.S. State-by-State Reopening Map: New York Times. (2020). See Which States Are Reopening and Which Are Still Shut Down.” nytimes.com/interactive/2020/us/states-reopen-map-coronavirus.html
COVID-19 High-Risk Groups: Centers for Disease Control and Prevention. (2020). “Coronavirus Disease 2019: People Who Are at Higher Risk.” cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html
CDC Isolation Guidelines: Centers for Disease Control and Prevention. (2020). “Coronavirus Disease 2019: Caring for Someone.” cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for-someone.html
Silent Hypoxia Op-ed: New York Times. (2020). “The Infection That’s Silently Killing Coronavirus Patients.” nytimes.com/2020/04/20/opinion/sunday/coronavirus-testing-pneumonia.html