Special Issue: What Everyone Over the Age of 50 and Living in Central Vermont Needs to Know About the Novel Coronavirus, COVID-19

By Peter Kelman Ed.D
(Updated March 11, 14,15 and 17)

AUTHOR'S NOTE: The information collected and synthesized below is based on studies, articles, and public health advisories publicly available as of March 9, 2020.
As of 10:00 PM March 17, 2020 everything written below remains accurate, including the continued scarcity of COVID-19 test kits in most states and localities.

Because of the rapidly changing landscape of COVID-19, including the response to it by public health organizations, the Aging Intentionally e-Newsletter will be updating information about COVID-19 as often as possible on its website: agingintentionally.org

However, if you have the time and inclination to track the latest developments more frequently yourself, you may want to bookmark one or more of the following constantly updating sites: 
All of the following sites continue to be updated with new information about the spread of COVID-19; however, the basic advice on what to do remains the same, as described below.
What are the chances that I will become infected by COVID-19? 
It is likely that a large percentage of the world’s population (including those in the United States) will be infected by COVID-19. Why? Largely because this is a brand-new virus for humans, so few, if any, people will have natural immunity to it and there is not yet a vaccination for it. 
Moreover, because it can take 2-14 days for symptoms to appear, carriers of the virus are likely to pass it on unknowingly even before they develop symptoms. Thus, people who have been in close contact with a person infected by COVID-19 or people who live in or have recently visited an area where there is an on-going outbreak are at increased risk of exposure and infection. 

What are the symptoms of COVID-19?
Milder cases may resemble a seasonal flu or bad cold with symptoms like a fever and a persistent cough. Other flu-like symptoms might include digestive problems or diarrhea. More serious cases may include difficulty breathing and/or shortness of breath. People at high risk due to age, existing illnesses, and/or chronic conditions (e.g., cardiovascular disease, diabetes, chronic respiratory disease, and persistently high blood pressure) may experience a range of severe symptoms, usually related to their compromised health.  

What should I do if I feel sick with any of the above symptoms?
The current recommendation from the Centers for Disease Control and Prevention (CDC) is that you should contact a health professional for advice: if you develop symptoms AND you have been in close contact with a person known to have COVID-19 or live in or have recently traveled from an area with an ongoing outbreak of COVID-19. 

In general, the CDC suggests that if you think you may be sick as a result of COVID-19, the best thing to do for yourself and to protect your family, friends, and community is to remain at home, with the possible exception of visiting a health professional, as described in the next question.

If I experience symptoms, should I visit a healthcare professional?
Although there are no known treatments to “cure” a COVID-19 infection, it may nevertheless be advisable for you to see a healthcare provider in person so they can examine you and propose an appropriate plan of care for your particular symptoms, especially if you are in a high-risk population. 
However, you should not just “show up” at a health provider’s office or urgent care facility or hospital emergency room. Instead, you should first phone them and describe your symptoms and any ways in which you think you may have been exposed to COVID-19 (e.g., through recent travel or proximity to someone who may have been infected).
Calling a health professional or medical facility ahead of time will allow them to prepare for your visit and prevent the spread of the virus to other people who may be present when you arrive. If you are able, you should wear a mask when you go to any medical facility (or other public place) in order to reduce the likelihood of your spreading the virus to others through coughing or sneezing. The CDC also suggests that if you are experiencing symptoms, you should avoid using public transportation, ride-sharing services, or taxis to travel to a healthcare facility (or anywhere else you might need to go).

If I experience symptoms, should I be tested for COVID-19?
Only health professionals can make the decision whether or not testing for COVID-19 is medically necessary for a given patient. They will make this determination based on their assessment of your symptoms, possible exposure, risk factors and any other relevant aspects of your health history.
Your health provider may decide to arrange for you to be tested in order to help them determine an appropriate course of care for you, as well as to provide public health officials with important population data for determining rates of infection, severity, and recovery in various age, gender, and specific risk groups. 
On the other hand, because there still (as of April 2) appear to be limited quantities of test kits and limited staff capacity to process them, health professionals must balance the wishes of anxious patients against the necessity to serve those most at risk. 
The articles below trace, in reverse order, the sequence of events regarding the scarcity of COVID-19 test kits; as of March 15, the test kits promised by the administration since March 3 have not been produced or provided to state health authorities and facilities in substantial quantities, so that it may still be difficult to get tested. As soon as testing becomes truly available to all who need it, we will update this entry.

What are the chances that I will become seriously ill from COVID-19?
The good news is that a new study of confirmed cases in China found that the vast majority of those infected (possibly greater than 80%) experienced only mild symptoms. 
The bad news is that this same study found an age-related increase in the likelihood of severe illnesses (e.g., pneumonia, severe acute respiratory syndrome, kidney failure), including a fatality rate of roughly 15% of confirmed cases among those 80 years old and over. 
The study also identified existing illnesses that placed those infected by COVID-19 at greatest risk: cardiovascular disease, followed by diabetes, chronic respiratory disease, and hypertension. (These chronic illnesses tend to be more prevalent among the elderly and so may account for some of the reported age-related risk increase.)
Finally, it is generally known that people with compromised immune systems are more susceptible to infection by any virus and more likely to develop severe reactions and complications.
The CDC has just published detailed recommendations for “People at Higher Risk for COVID-19 Complications.”

What can I do to reduce the likelihood that I will be infected by COVID-19?
There is currently no vaccine to prevent infection by COVID-19, although research scientists seem fairly confident that by sometime in the next 18 months there will be such a vaccine.
In the meantime, the best way to prevent illness from COVID-19 is the same as for any other virus or bacteria: Avoid being exposed to it. The CDC and other experts suggest strictly adhering to the following, perhaps obvious, recommendations:
  • Do not travel to locations where COVID-19 outbreaks have been reported.
  • Avoid close contact (6 feet or less) with anyone showing symptoms of respiratory illness such as coughing and sneezing.
  • Avoid shaking hands and other greetings that involve body contact.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; handling coins or paper currency; touching anything in public places (especially restrooms and dining facilities); and before eating or preparing food. (Viruses are invisible to the naked eye, so don’t assume you only need to wash your hands if they look dirty.)
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. 
  • Clean and disinfect frequently touched objects and surfaces (e.g., smart phones, computer keyboards, credit cards, doorknobs, light switches, handles, desks, tables, chairs, toilets, faucets, sinks; as well as car door handles, keys and steering wheels). Use regular household cleaners and EPA-registered disinfectants that are appropriate for the surface, following label instructions for safe and effective use of the cleaning product. 
  • You may also wish to avoid being in enclosed spaces with large numbers of people, such as airplanes and movie theaters.


If I am infected with COVID-19, what should I do to avoid infecting others?
Most of what the CDC and other experts recommend would fall under the general label of “self-quarantine.” Rather than listing these recommendations here, we suggest you read a highly informative, clearly-written article published in the March 6, 2020 New York Times entitled “How to Quarantine Yourself.” 
Vermonters should also be aware of guidelines from the VT State Department of Health that those who have visited Italy, Iran, South Korea and China follow CDC travel health notices and stay at home for 14 days to limit the spread of the disease; and travelers who have recently been to Japan should monitor their health for 14 days, but do not have to self-isolate.
What if I have questions or concerns about COVID-19 that this special Issue of Aging Intentionally e-Newsletter didn’t address satisfactorily or at all?
We know there are many aspects of COVID-19 that we did not include in this special Issue, mainly so that we could address in a timely manner what seem to us to be the most pressing questions we have heard from people 50 and up. Please email any questions or concerns you may have to phkelman@gmail.com.

What if I can’t read a linked article because I’m not a subscriber to the provider or because the link doesn’t go to the article listed? 
If you encounter either of these problems with links, email phkelman@gmail.com and explain the situation clearly. We will make every effort to address the problem you identify.

No comments:

Post a Comment