Coronavirus precautions for patients and others facing higher risks

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Eduardo Sanchez, M.D., M.P.H., FAAFP, the American Heart Association’s Chief Medical Officer for Prevention, shares advice and resources for patients and others concerned about the coronavirus.

The American Heart Association is advising caution and preparation for elderly people with coronary heart disease or hypertension because it appears they may be more likely than others to be infected by the coronavirus that causes COVID-19 and to develop more severe symptoms. Others with heart disease are also among those facing a higher risk of complications from COVID-19, and people who have survived a stroke may face a higher risk of complications.

As a result, people who have heart disease or another underlying condition should stay home to limit their risk of contracting the virus.

The overall risk of getting this virus is still low for most people in the United States, but the U.S. Centers for Disease Control and Prevention says the risk is expected to increase. The CDC has confirmed 427,460 U.S. cases and 14,696 deaths as of Wednesday, and the situation is rapidly evolving. Over 1.4 million coronavirus cases have been confirmed worldwide – with the U.S. continuing to record more cases than any other country, according to the latest data – and over 85,000 people globally have died, the World Health Organization reported Wednesday.

For most patients with heart disease, prevention is key. Your risk is not higher for getting COVID-19 as a patient, but if you do get it you have a higher chance of complications. Others facing this higher risk include people 60 and over, pregnant women, young children, people with diabetes, those with serious chronic lung and kidney conditions, and people with compromised immune systems. As mentioned, stroke survivors may also have a higher risk of complications.

The first cautionary step is to remember the basics in your everyday activities: Wash your hands often with soap and water for at least 20 seconds, cover coughs and sneezes with a tissue and then throw the tissue away – or cough or sneeze into your long sleeve at the elbow fold – stay home from work if you’re sick or at increased risk, avoid touching surfaces in public, try not to touch your face, and avoid people who seem visibly sick. Also practice social distancing when in public or in any gatherings: Try to maintain a 6-foot perimeter around you.

The CDC also now recommends wearing cloth face coverings in public places such as grocery stores and pharmacies. That’s because recent studies indicate even people who aren’t showing symptoms could spread the virus through close speaking, coughing or sneezing. Face coverings are a way to protect yourself and everyone else. And it’s important to remember that face coverings work in addition to other social-distancing measures, not instead of them. You can learn how to easily make a cloth face covering in this video featuring Dr. Jerome Adams, the U.S. surgeon general.

If there is an active virus in your area, consider totally avoiding crowded places or situations. If there isn’t an active virus near you, factor in your personal health status when considering whether to go someplace where there are many people.

And please note that on April 8 the CDC released guidance regarding safety practices for critical workers who may have been exposed to someone with suspected or confirmed COVID-19. The CDC says those workers may be permitted to continue working provided they remain asymptomatic and additional precautions are taken to protect them and others.

Those precautions include pre-screening such employees for fever and other symptoms before they start work, regularly monitoring their condition while they’re on the job, and having them wear a mask and practice social distancing at work. For more details, including who the CDC considers critical workers, check out the CDC’s guidance regarding safety practices for critical workers.

Get prepared at home
Think about how you would manage your condition if for some reason you were advised to stay home for an extended time because of coronavirus. These tips can help you prepare for such a situation:

  • Make sure you can reach your doctor quickly. Gather contact information for your health care providers and store in an easy-to-locate place. Get office phone numbers, emergency numbers and email addresses. And check to see whether electronic consulting or instant messaging options are available.
  • If you live alone, gather a list of support contacts who you might call on if needed, such as friends, relatives, colleagues and neighbors. Keep this contact information all together in one easy-to-find place as well.
  • Take stock of your medications. Make sure you have enough for an extended time. Also figure out how you would get refills if you couldn’t leave home. Find out if your pharmacy can deliver refills. Your health care provider or health plan may help advise you here as well.
  • Take stock of food, beverage and hygiene supplies for yourself, your family and your pets.

What if you have symptoms of coronavirus?

Common symptoms include fever and cough. Contact your health care provider if you have these symptoms. If you experience shortness of breath or other heart attack or stroke warning signs, call 911.

If health experts are investigating you as someone with a possible case, or if you are confirmed to have coronavirus but are stable enough to be treated at home, consider these precautions advised by the CDC:

  • Make sure appropriate caregivers are available at home.
  • Ensure there’s a separate bedroom where the patient can recover without sharing immediate space with others.
  • Make sure everyone living in your household can adhere to precautions recommended as part of home care or isolation. That includes covering coughs or sneezes, relentless handwashing, not touching your face and being sure to regularly wipe down surfaces with household cleaners.
  • Set up some basic rules for making sure the person being isolated can get food and other necessities with minimal risk.

If you have any questions or concerns, contact your health care provider or consult the CDC’s website.

Microscopic image of COVID-19. (Hannah A. Bullock, Azaibi Tamin/CDC)
Microscopic image of COVID-19. (CDC/Hannah A. Bullock, Azaibi Tamin)