Who is high risk for coronavirus? Here's what older adults, nurses and prisoners need to know

·Writer
·8 min read

The coronavirus has reached nearly every state in the U.S., and the number of confirmed cases continues to climb. To date, there are more than 5,700 U.S. cases, and more than 80 Americans have died, according to data from Johns Hopkins University.

While anyone can suffer serious complications from the coronavirus, and even die from it, the virus has largely caused severe infections in people who are older. Because of that, there has been a lot of talk about social distancing and doing your best to avoid getting sick in order to protect the older people in your life, like your parents and grandparents.

Still, older people aren’t the only group more vulnerable to serious illness from the coronavirus. Here’s why, and what you can do to protect yourself if you happen to be one of them.

Older adults

"As people are older, they’re more likely to have a health condition, as well as general frailty that can lead to complications from COVID-19,” says Iahn Gonsenhauser, MD, chief quality and patient safety officer at The Ohio State University Wexner Medical Center. (Photo: Getty Images)
"As people are older, they’re more likely to have a health condition, as well as general frailty that can lead to complications from COVID-19,” says Iahn Gonsenhauser, MD, chief quality and patient safety officer at The Ohio State University Wexner Medical Center. (Photo: Getty Images)

The Centers for Disease Control and Prevention (CDC) specifically calls out older adults as being at risk for serious complications from the coronavirus. The CDC doesn’t give an exact age, but some experts think this includes adults over the age of 50. “The average age group of infection in China is 56.2,” Rajeev Fernando, MD, an infectious disease expert in Southampton, N.Y, tells Yahoo Lifestyle. “Age is definitely a risk factor,” David Cutler, MD, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, Calif., tells Yahoo Lifestyle.

There is a “wide range” to this group, with some being healthy, others being frail and elderly, and plenty in between, Iahn Gonsenhauser, MD, chief quality and patient safety officer at The Ohio State University Wexner Medical Center, tells Yahoo Lifestyle. “But in general, as people are older, they’re more likely to have a health condition, as well as general frailty that can lead to complications from COVID-19,” he says.

The CDC currently recommends that people in this group do the following to lower their risk of contracting coronavirus:

  • Stock up on supplies like groceries and medications.

  • Take everyday precautions to keep space between yourself and others.

  • Keep away from others who are sick when you go out in public.

  • Limit close contact with others.

  • Wash your hands often.

  • Avoid crowds as much as possible.

  • Avoid cruise travel and non-essential air travel.

  • During the coronavirus outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.

People with lung conditions

People with lung conditions have an additional potential complication of developing bacterial pneumonia after a respiratory infection like coronavirus, says Gonsenhauser. (Photo: Getty Images)
People with lung conditions have an additional potential complication of developing bacterial pneumonia after a respiratory infection like coronavirus, says Gonsenhauser. (Photo: Getty Images)

This group includes anyone with chronic obstructive pulmonary disease (COPD), lung disease and breathing issues like asthma. People who fall into this category often have changes to the actual anatomy of their lungs, as well as their ability to breathe properly, Gonsenhauser says. “These changes can make people more predisposed to getting respiratory infections,” he explains. “COVID-19 is the same — it’s also a respiratory virus like the flu.”

People with lung conditions have an additional potential complication of developing bacterial pneumonia after a respiratory infection like coronavirus, says Gonsenhauser.

Because of this, it’s best for this group to do their best to practice social distancing, Cutler says. “They should be at home and should not be going out, other than when it is an absolute necessity.” This is the case even when there aren’t confirmed local cases. “The CDC is telling us that it’s coming to you,” Cutler says. “We’ve had plenty of cases that were diagnosed in the past week, but we probably had more before then.”

If you rely on oxygen supplementation, anticipate that it may become less available in the future, Fernando says. “Check with your local pharmacy and make sure they have a two to three month supply ordered.”

People with autoimmune conditions

People with autoimmune conditions such as multiple sclerosis also tend to take immunosuppressive medications that lower their immune system’s ability to work well. (Photo: Getty Images)
People with autoimmune conditions such as multiple sclerosis also tend to take immunosuppressive medications that lower their immune system’s ability to work well. (Photo: Getty Images)

According to Perry N. Halkitis, Ph.D., dean of the Rutgers School of Public Health, individuals with autoimmune conditions like diabetes, lupus, multiple sclerosis and HIV have immune systems that don’t work as well as others, and that can be an issue. “People with depressed immune systems are not able to fight off infections as efficiently as those with healthy and robust immune systems,” he says. And, Halkitis points out, “individuals also don’t just fit in one category.” Meaning, someone can be older and have an autoimmune condition, or have a lung condition, along with an autoimmune condition. “With each addition of a stressor, risk increases.”

People with autoimmune conditions also tend to take immunosuppressive medications that lower their immune system’s ability to work well, Cutler says. “That’s generally true of almost any infection if you’re taking medications that suppress the immune system.”

The CDC currently recommends that people with autoimmune conditions follow the same precautions as older Americans to lower their risk of contracting the coronavirus.

Prisoners

Family medical physician David Cutler notes that prisoners also aren’t usually able to practice social distancing and may not be able to wash their hands regularly or use hand sanitizer. (Photo: Getty Images)
Family medical physician David Cutler notes that prisoners also aren’t usually able to practice social distancing and may not be able to wash their hands regularly or use hand sanitizer. (Photo: Getty Images)

This is a group that doesn’t get a lot of attention, but it should, says Fernando. “This truly is a nightmarish situation should this infection start spreading amongst prisoners,” he says. “Picture one thousand cruise ships at the same time.” Many prisoners also have other medical conditions, he points out, and that can also add to their risk.

Prisoners also aren’t usually able to practice social distancing and may not be able to wash their hands regularly or use hand sanitizer, Cutler says — and that’s a problem. “This disease is more likely to spread the more people with whom one is in contact,” says Halkitis.

To lower the odds prisoners will contract the virus, Cutler recommends following the CDC’s recommendations as much as possible. “Wash your hands frequently and don’t touch your face.”

Medical staff

The CDC currently recommends that medical staff evaluating people with a suspected case of coronavirus wear a face mask, eye protection, gown and gloves. (Photo: Getty Images)
The CDC currently recommends that medical staff evaluating people with a suspected case of coronavirus wear a face mask, eye protection, gown and gloves. (Photo: Getty Images)

Nurses, doctors and other medical-industry workers are on the front lines, Fernando says, and that means they may be regularly exposed to the virus. “Whoever is around the virus the most is at the greatest risk,” Cutler explains. “Many healthcare workers were affected in China, where the outbreak began.”

Current recommendations on what medical staff can do to protect themselves are “somewhat fluid because we don’t really know the infectious properties of COVID-19,” Cutler says. Still, the CDC currently recommends that medical staff evaluating people with a suspected case of coronavirus wear a face mask, eye protection, gown and gloves. “That recommendation could very well change,” he adds. “In fact, current Los Angeles County Department of Public Health recommendations call only for a surgical mask and gloves in this situation.”

Service industry and medical cleaners

Environmental cleaning teams in hospitals, grocery stores and other areas are a crucial part of helping to stop the spread of coronavirus. Frequent hand washing and not touching the face can help minimize spread of the coronavirus. (Photo: Getty Images)
Environmental cleaning teams in hospitals, grocery stores and other areas are a crucial part of helping to stop the spread of coronavirus. Frequent hand washing and not touching the face can help minimize spread of the coronavirus. (Photo: Getty Images)

Environmental cleaning teams in hospitals, grocery stores and other areas are a crucial part of helping to stop the spread of coronavirus. Hospitals will typically have a team of people take 30 to 60 minutes to clean an area after a patient with coronavirus uses equipment, like a CT scanner, explains Cutler. “If they’re wearing gloves, they’re in no danger,” he says. “The virus is spread through droplets that will fall to the floor.”

However, he believes, advice for these workers isn’t uniform. “There is an existing 32-page manual from the Occupational Safety and Health Administration on Preparing Workplaces for COVID-19 which calls for cleaning crews to wear full protective equipment including a gown, face mask, eye protection and gloves,” says Cutler. “These conflicting recommendations are an indication that we are still early enough on in this epidemic that we just may not yet know with certainty what is best. But we should err on the side of caution."

Regardless, anyone whose hand touches surfaces where those droplets have fallen are at risk if they then touch their nose, mouth, or eyes. “Cleaners need to wash their hands frequently and avoid touching their faces,” Cutler says.

It can be scary if you fall into a high-risk group, but Fernando advises that you shouldn’t panic. “It’s important that we all stay calm and follow the appropriate guidelines to stay safe,” he says.

For the latest news on the evolving coronavirus outbreak, follow along here. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC and WHO’s resource guides.