May 15, 2020 11:00 AM

Author: Centers for Disease Control and Prevention


COVID-19 is a new disease and there is limited information regarding risk factors for severe disease. Based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.

Based upon available information to date, those at high-risk for severe illness from COVID-19 include:

People of all ages with underlying medical conditions, particularly if not well controlled, including:

  • People with chronic lung disease or moderate to severe asthma
  • People who have serious heart conditions
  • People who are immunocompromised
    • Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
  • People with severe obesity (body mass index [BMI] of 40 or higher)
  • People with diabetes
  • People with chronic kidney disease undergoing dialysis
  • People with liver disease

Older Adults

Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness.

Reduce Risk of Getting Sick

There are things you can do to reduce your risk of getting sick.

  • Stay home if possible.
  • Wash your hands often.
  • Avoid close contact (6 feet, which is about two arm lengths) with people who are sick.
  • Clean and disinfect frequently touched surfaces.
  • Avoid all cruise travel and non-essential air travel.
  • Call your healthcare professional if you have concerns about COVID-19 and your underlying condition or if you are sick.
  • For more information on steps you can take to protect yourself, see CDC’s How to Protect Yourself.

Develop a Care Plan

A care plan summarizes your health conditions, medications, healthcare providers, emergency contacts, and end-of-life care options (for example, advance directives). Complete your care plan in consultation with your doctor, and if needed, with help from a family member or home nurse aide.

A care plan can have benefits beyond the current pandemic. You can update your care plan every year, or any time you have a change in your health or medications. Care plans can help reduce emergency room visits and hospitalizations, and improve overall medical management for people with a chronic health condition, resulting in better quality of life.

During the COVID-19 pandemic, having a care plan is an important part of emergency preparedness.

Pregnant Women

There is not currently information from published scientific reports about susceptibility of pregnant women to COVID-19. Pregnant women experience immunologic and physiologic changes which might make them more susceptible to viral respiratory infections, including COVID-19.

Pregnant women should do the same things as the general public to avoid infection. You can help stop the spread of COVID-19 by taking these actions:

  • Cover your cough (using your elbow is a good technique)
  • Avoid people who are sick
  • Clean your hands often using soap and water or alcohol-based hand sanitizer

Children

There is no evidence that children are more susceptible to COVID-19. In fact, most confirmed cases of COVID-19 reported from China have occurred in adults. Infections in children have been reported, including in very young children. There is an ongoing investigation to determine more about this outbreak. This is a rapidly evolving situation and information will be updated as it becomes available.

People Who are Immunocompromised

Many conditions and treatments can weaken a person’s immune system (making them “immunocompromised”). Some of these include:

  • Cancer
  • Bone marrow transplant
  • Solid organ transplant
  • Stem cells for cancer treatment
  • Genetic immune deficiencies
  • HIV
  • Use of oral or intravenous corticosteroids or other medicines called immunosuppressants that lower the body’s ability to fight some infections (e.g., mycophenolate, sirolimus, cyclosporine, tacrolimus, etanercept, rituximab)

Prevent COVID-19

If you are immunocompromised, the best way to prevent COVID-19 is to avoid being exposed to this virus. For details, see CDC’s advice for what you can do to prepare for COVID-19 and how to protect yourself and others.

  • Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
    • If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
  • Avoid leaving home as much as possible and practice social distancing.
    • If you must leave home, avoid other people as much as possible by practicing social distancing. Maintain a distance of at least 6 feet (2 meters) between you and people outside your household.
    • Avoid large gatherings or places where people congregate.
    • Have supplies, food, and medicine delivered to your home.
  • Cover your mouth and nose with a cloth face covering when around others to protect other people in case you are infected, and ask others to do the same.
    • Remember, do NOT place cloth face coverings on children younger than 2 years old, anyone who has trouble breathing, or anyone who is unconscious, incapacitated or otherwise unable to remove the cover without assistance.
  • Clean AND disinfect frequently touched surfaces. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.

People with Asthma 

People with moderate or severe asthma may be at higher risk of getting very sick from COVID-19 based on what the CDC currently knows about the spread and severity of coronavirus disease 2019. COVID-19 can affect the respiratory tract (nose, throat, lungs), cause an asthma attack, and possibly lead to pneumonia and acute respiratory disease.

Prepare for COVID-19

  • Stock up on supplies.
  • Take everyday precautions to keep space between yourself and others.
  • When you go out in public, keep away from others who are sick.
  • Clean your hands often by washing with soap and water or using an alcohol-based hand sanitizer.
  • Avoid crowds and people who are sick.
  • Avoid cruise travel and non-essential air travel.
  • During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.
  • If someone in your home is sick, have them stay away from the rest of the household to reduce the risk of spreading the virus in your home.
  • Avoid sharing personal household items such as cups and towels.

Follow your Asthma Action Plan

  • Take your asthma medication exactly as prescribed. Talk to your healthcare provider, insurer, and pharmacist about creating an emergency supply of prescription medications, such as asthma inhalers. Make sure that you have 30 days of non-prescription medications and supplies on hand too in case you need to stay home for a long time.
  • Know how to use your inhaler.
  • Avoid your asthma triggers.
  • Clean and disinfect frequently touched surfaces like tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks daily to protect yourself against COVID-19. Avoid disinfectants that can cause an asthma attack.
  • As more cases of COVID-19 are discovered and our communities take action to combat the spread of disease, it is natural for some people to feel concerned or stressed. Strong emotions can trigger an asthma attack. Take steps to help yourself cope with stress and anxiety.

Clean and disinfect things you or your family touch frequently

  • If possible, have someone who doesn’t have asthma do the cleaning and disinfecting. When they use cleaning and disinfecting products, have them:
    • Make sure that people with asthma are not in the room.
    • Minimize use of disinfectants that can cause an asthma attack.
    • Open windows or doors and use a fan that blows air outdoors.
    • Clean and disinfect surfaces like phones, remotes, tables, doorknobs, light switches, countertops, handles, desks, keyboards, toilets, faucets, and sinks daily.
    • Always follow the instructions on the product label.
    • Spray or pour spray products onto a cleaning cloth or paper towel instead of spraying the product directly onto the cleaning surface (if the product label allows).

People with HIV

Although the risk of serious illness from COVID-19 for people with HIV is not known, people with HIV may have concerns and questions related to their risk.

People with Liver Disease

Older adults and people of any age who have serious underlying medical conditions, including people with liver disease, might be at higher risk for severe illness from COVID-19. People with chronic liver disease, including hepatitis B and hepatitis C, may have concerns and questions related to their risk.

People Experiencing Homelessness 

People experiencing unsheltered homelessness (those sleeping outside or in places not meant for human habitation) may be at risk for infection when there is community spread of COVID-19. This interim guidance is intended to support response planning by local and state health departments, homelessness service systems, housing authorities, emergency planners, healthcare facilities, and homeless outreach services. Homeless shelters and other facilities should also refer to the Interim Guidance for Homeless Shelters. Community and faith-based organizations can refer to the Interim Guidance for Community and Faith-based Organizations for other information related to their staff and organizations.

COVID-19 is caused by a new coronavirus. There is much to learn about the transmissibility, severity, and other features of the disease. Everyone can do their part to help plan, prepare, and respond to this emerging public health threat.

Lack of housing contributes to poor health outcomes, and linkage to permanent housing should continue to be a priority. In the context of COVID-19, the risks associated with sleeping outdoors in an encampment setting are different than with staying indoors in a congregate setting such as an emergency shelter or other congregate living facility. Outdoor settings may allow people to increase distance between themselves and others. However, sleeping outdoors often does not provide protection from the environment, quick access to hygiene and sanitation facilities, or connection to healthcare. The balance of risks should be considered for each individual experiencing unsheltered homelessness.

 

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