Common Questions and Answers About COVID-19 For Older Adults and People With Chronic Health Conditions

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Note: This resource is based on content developed jointly by National Foundation for Infectious Diseases and the Alliance for Aging Research, reflecting the latest information about COVID-19. (Last updated: 10/14/2020).

According to the United States Centers for Disease Control and Prevention (CDC), coronaviruses are a large family of viruses that are common in humans and can cause illnesses ranging from mild respiratory infections like the common cold to serious illnesses, such as pneumonia or Severe Acute Respiratory Syndrome (SARS). The novel coronavirus (COVID-19) has now been detected in more than 200 countries, including the U.S.

WHY ARE OLDER ADULTS AND PEOPLE WITH CHRONIC HEALTH CONDITIONS AT HIGHER RISK?
Older adults and people who have chronic medical conditions including heart disease, lung disease, diabetes, cancer, and hypertension are at higher risk for more serious COVID-19 illness and death. This is because our immune systems grow weaker as we age, which makes it more challenging for older adults to fight off infectious diseases. Chronic diseases are also more common with age, and can compromise the immune system–making people more vulnerable to serious complications. Because of the rapid spread of COVID-19, the CDC issued guidance for people who are at the highest risk for severe illness from the virus. It is imperative that older adults and others who are at high risk heed the advice of the CDC.

WHAT ARE THE SYMPTOMS OF COVID-19 AND HOW IS IT DIFFERENT FROM FLU AND ALLERGIES?
The main symptoms of COVID-19, which may appear between 2 to 14 days after exposure, can include: fever* or chills, cough, difficulty breathing or shortness of breath, fatigue, muscle or body aches, headache, sore throat, congestion or runny nose, new loss of taste or smell, nausea or vomiting, and diarrhea. There are other symptoms that are not as common–like a rash or discoloration of the hands or feet–that could be a sign of COVID-19 so contact your healthcare professional if you are concerned. Not everyone with COVID-19 will experience symptoms, or they may be mild enough that they are dismissed, but they can still be contagious. These symptoms can also seem similar to flu and seasonal allergies but there are some differences.

*Note that normal body temperature can be lower in older adults–and therefore fevers can be lower. A single temperature reading over 100°F, multiple readings above 99°F, or a rise in temperature greater than 2°F above the your normal baseline temperature may be signs of an infection.

WHEN SHOULD I CALL A HEALTHCARE PROFESSIONAL?
You should call 911 and seek immediate emergency care if you or a loved one have trouble breathing, feel pain or pressure in the chest, experience new confusion, are unable to wake or stay awake, have bluish lips or face, or think you may need immediate care.

If you think you may have COVID-19 or have been exposed to someone who had COVID-19, call your healthcare professional or call your public health department to see if you are eligible for a COVID test, and where to go if you are.

HOW DO THEY TEST FOR COVID-19?
To diagnose a potential case, healthcare professionals may run tests to rule out influenza and other common infections. Not all healthcare facilities are able to test for COVID-19 at this time. There are a number of different tests. Some involve swabbing the nose and throat while others require collectionof saliva. Some also require blood. Note that COVID-19 tests that are looking for active infection will not tell you if you have been previously infected, or have the antibodies.

WILL I HAVE TO PAY FOR TESTING?
The Centers for Medicare and Medicaid Services (CMS) is taking important steps to waive cost-sharing for COVID-19-related testing and treatment to ensure all patients who need it have access to care. Medicare and Medicare Advantage Plans will cover lab tests for COVID-19 with no out-of-pocket costs, any necessary hospital care, and telehealth services including virtual check-ins and full visits for those living in rural areas.

HOW CAN I BEST PROTECT MYSELF?
COVID-19 is thought to spread mainly between people in close contact with one another through respiratory droplets from coughs or sneezes. It may also spread through simply talking or breathing in close proximity and enclosed spaces. Experts are estimating that as many as 50% of transmissions are from people who are infected but don’t yet have symptoms, or never develop them. The virus can also be transmitted when you touch a surface or object with the virus on it, then touch your mouth, nose, or eyes, although it is not thought to be a primary way the virus spreads.

It is important to avoid people who may be infected. Older adults and those with underlying health conditions that can put them at increased risk should stay home to avoid being around others. Nursing homes and retirement and long-term care facilities should continue to limit all visitors, including social visits.

The best way to prevent illness is to avoid being exposed to the virus. Restrictions and recommendations vary by state and city but generally, it’s best to avoid:

  • Gatherings of more than 10 people or any gatherings where social distancing (staying 6 feet or more apart) is not possible,
  • Any indoor gatherings where masks are not required and used,
  • Non-essential air travel, and
  • Cruise ships (Note that major cruise lines have suspended trips and others are restricting passengers over the age of 70)

For older adults and adults with underlying health conditions, the CDC advises taking extra measures to put distance between yourself and others including:

  • Staying home whenever possible.
  • Wearing a mask whenever you go out–especially in settings where social distancing is not possible. Cloth masks can keep people from spreading the virus through talking, coughing, or sneezing–even those who do not realize they are carrying the disease. Studies are finding that people can spread coronavirus before they have symptoms, or if they are infected but never develop symptoms (a significant number of cases). The U.S. Surgeon General Dr. Jerome Adams demonstrates how to easily make a simple cloth face covering in this brief video. Surgical masks and N-95 respirators have been in short supply but are easier to find than at the start of the pandemic.
  • Take hand sanitizer when you go out and use when soap and water are not available.
  • Use proper hand washing techniques–using soap and water for at least 20 seconds especially after blowing your nose, coughing, sneezing, or being in a public place.
  • As much as possible, avoid handshaking and touching high-traffic surfaces in public places–for example elevator buttons, door handles, handrails or counters. Use a tissue or sleeve to cover your hand or finger if you must touch something.
  • Although there is no vaccine available to prevent COVID-19 at this time, you should still ensure that you and your family’s vaccinations are up to date, including influenza (flu) and pneumococcal (pneumonia) vaccines. Experts are concerned that individuals who get sick with influenza or pneumonia, while sick with COVID-19, will have worse outcomes and will be at higher risk of death. They are also concerned that simultaneous influenza and COVID-19 outbreaks would overwhelm our already stressed healthcare system. Learn more about the benefits of influenza and pneumonia vaccines here.

HOW CAN I PREPARE TO BE AT HOME FOR AN EXTENDED PERIOD OF TIME?
Here are some simple ways to prepare to remain at home for an extended period:

Getting Medicines and Medical Supplies
Ask your physician or local pharmacy if ordering your medicines online is an option. Many online pharmacies (including national chains) will fill valid prescriptions and ship them directly to your door allowing you to avoid going to the pharmacy in person. CMS is also working with private plans to waive prescription drug refill limits and to relax restrictions on home or mail delivery of prescription drugs. However, only order from a reputable online pharmacy. The United States Food and Drug Administration (FDA) warns consumers about rogue online pharmacies that claim to sell prescription medicines at deeply discounted prices. Read the FDA warning here. If you have questions, call a healthcare professional. Also, be sure you have over-the-counter medicines and medical supplies (fever reducers, tissues, hydrating beverages, etc.) to treat fever and other symptoms.

Ordering Groceries
Ordering Groceries
Have enough basic household items and groceries on hand so you are prepared to stay at home for an extended period of time. Most major grocery chains have made it possible to order groceries online and have them delivered to your door within hours or days. Check the websites of local or national grocery stores that may allow you to select your items online and then arrange for shipping. Keep in mind, however, that many of these services are experiencing delays due to the high volume of people choosing the safety of online ordering rather than in-person shopping. This means you will need to plan ahead – perhaps even a week or two in advance. If you have questions or concerns about the delivery timeline, speak to a customer service representative. Additionally, don’t be afraid to ask your friends, family, and/or neighbors to add a few of your desired items to their own online grocery order!’

If you must go out for groceries, try to find a local grocery store that offers hours just for older adults. Most of these hours are earlier in the day and offer a chance for older adults to shop without as much exposure. Many local authorities are now requiring people to wear face coverings or masks when they are out in public as a way of preventing further spread of the virus. Remember to cover your nose and mouth with a face covering, stay vigilant with handwashing and avoid touching your eyes, mouth, and nose since the coronavirus can remain on some surfaces for hours and in some cases, days.

HOW CAN I HELP LOVED ONES AT RISK?
Everyone has a role to play in reducing community spread. The same recommendations for people at risk should be adhered to by everyone to help protect the more vulnerable in our communities. Businesses, schools, and local and federal government should all work together to mitigate community spread of COVID-19 and help protect older adults and those with pre-existing medical conditions.

If you are a caregiver for someone in a long-term care facility, respect their rules on who can come and go, ask about the health of the other residents frequently, and know the plan if there is an outbreak.

If your loved ones live alone, check on them frequently and find out what services your local Area Agency on Aging offers.

WHAT SHOULD I DO IF I GET SICK?
If you do get sick, first call a healthcare professional. Unless you need immediate medical care, you should stay at home to avoid spreading your illness. Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, and others if you become sick. Determine who can provide you with care if your caregiver gets sick. If you or a loved one needs help, contact your local public health department to connect with caregiving services.

If you develop emergency warning signs for COVID-19, call 9-1-1 and get medical attention immediately. In adults, emergency warning signs include:

  • Difficulty breathing or shortness of breath,
  • Persistent pain or pressure in the chest,
  • New confusion or inability to arouse, and/or
  • Bluish lips or face

WHAT ARE OTHER RELIABLE RESOURCES FOR THE MOST UP-TO-DATE INFORMATION?

 

ADDITIONAL INFORMATION FROM ALLIANCE FOR AGING RESEARCH:

HOW CAN I COPE WITH THE STRESS OF THIS OUTBREAK?
Many people are understandably feeling anxious right now. It’s important to take care of your mental health and to know the signs of stress so you can help yourself or loved ones during this difficult time. The CDC has guidance on managing anxiety and stress and this resource from the World Health Organization covers mental health considerations during the COVID-19 outbreak.

HAVE YOU CONSIDERED ADVANCE CARE PLANNING?
Advance care planning involves having discussions with loved ones and care providers and making decisions about your healthcare wishes and priorities if you are facing a serious illness or medical crisis. Questions to think about and to put in writing are what types of treatment you would or would not want. Additionally, consider identifying the person you choose to speak for you should you be unable to speak for yourself. Documenting your wishes can be done by completing an advance directive form which lets you share your wishes for treatment and designate your healthcare proxy (sometimes called a healthcare power of attorney). An important part of advance care planning is sharing your decisions with loved ones and going over your wishes with your healthcare proxy. You do not need a lawyer to complete an advance directive. Once you complete your advance directive, you should share copies with your family members and healthcare providers. The National Hospice and Palliative Care Organization (NHPCO), offers state-specific advance directive forms and additional information to help you understand advance care planning and how to talk with your loved one and healthcare provider. See NHPCO CaringInfo.org for more information.

PROTECTING YOURSELF FROM SCAMS
Unfortunately, there are people trying to take advantage of this crisis. Scammers are offering everything from fake COVID-19 tests to checks from the government.  Many are asking for personal information like Medicare numbers. Only share your Medicare number with your health care professionals and report any scams you experience to www.Medicare.gov/fraud