The Problem with How COVID-19 Risk Is Being Discussed

This content originally appeared here. Republished with permission.

By Caroline Levens

There are 24 confirmed cases of COVID-19 in my county, and I’ll admit it: I’m very worried about the outbreak. Call me crazy as I sit in my apartment with mountains of supplies and food that could easily get me through June, but I’m part of the group largely dismissed by mainstream media. I’m immunocompromised and have underlying chronic health conditions.

Article after article says something along the lines of “most COVID-19 illness is mild, only those over the age of 70 or who are immunocompromised or have existing health conditions, such as diabetes, asthma and heart disease, are likely to experience serious illness.” They then go on to say that most people with mild conditions will recover, so people just need to stay calm and wash their hands. Aside from that sole line, the high-risk group has no other mention in the article.

If you’re in the majority group and are indeed at lower risk, I’m glad COVID-19 may not be as threatening to you. But here’s the thing: you likely have parents, grandparents, friends, colleagues and maybe even children who read the exact same statement from the other side. In fact, according to a Department of Health and Human Services analysis, over 50 million non-elderly Americans have some type of pre-existing health condition.

Facts are facts, and believe me, I want the facts. So what’s wrong with saying those groups are at a greater risk? Absolutely nothing – what’s wrong is the insensitive tone they come across with when they give the fact a quick nod and devote the remainder of the article to the people who don’t need to worry, and that saying ‘only’ the “the elderly, immunocompromised and unhealthy” belittles the value of this group. Comparing the average low-risk American to the high-risk group to help reassure them that at least their personal odds are better than some is in poor taste.

Sure, they’re writing towards mass America. But “the elderly, immunocompromised and unhealthy” is no small group, and the people in this group deserve better. While at a bare minimum an emphatic tone would be appreciated, the articles could share what precautions low risk individuals could take to protect those who are at higher risk. Their “mild” case could be life-threatening to someone else who contracts it from them, and it’s important they’re aware of that and how to minimize spread. Current articles make little sense: they focus on reassuring the people at lowest risk and exclude the high-risk group who needs it most. And it’s not just the high-risk group this matters for: it’s their children, grandchildren, parents and caretakers, among others.

The truth is, you have no idea who might be in this high-risk group, or who has loved ones that are in this high-risk group. Just the other day I was told I was taking excessive precautions and I’d be fine because I’m in my late-20s and look healthy (that’s exactly what invisible illness is!). And if you’re fortunate enough to be low-risk, let me tell you, it doesn’t feel great seeing the mortality rate for your condition five times higher than the average American, based on the limited data available from the Chinese Center for Disease Control & Prevention. I should also add the concern isn’t just about getting COVID-19; it’s about COVID-19 putting such a strain on the health system that individuals with chronic health conditions may not have access to the physicians, medications and treatments they need.

So all in all: please consider how you’re coming across when you talk about COVID-19. If you’re able to go about your day-to-day life unaffected, I’m glad you’re in good health and feeling little disruption. But there is nothing wrong with preparedness or being overly cautious. Life is precious, and I’ll happily work, eat and hang at home to reduce my risk and the anxiety stemming from the staggering fatality figures.

Source: diabetesdaily.com

COVID-19: Perspective of a Type 1 Healthcare Worker

Kelly Pearson is a family nurse practitioner who works at a busy urgent care center, and also lives with type 1 diabetes. Kelly took the time to answer some of our most pressing questions concerning the Coronavirus outbreak. Thank you, Kelly, for your time, and for being on the front lines during such an uncertain time, putting yourself at risk to help others.

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I understand you work for Fairview Health Services, one of the largest Urgent Care in our country, in suburban St. Paul, MN. At what point did your organization start preparing for the COVID-19 breakout? 

I’m not sure, but we started testing for COVID-19 via drive up cars at my urgent care 8 days ago [around March 10th].

As a family nurse practitioner who is on the front lines, seeing how medical professionals are preparing, do you think we as a country will be able to handle the outbreak and treat all necessary patients?

I have friends that work as ER docs at Hennepin County Medical Center, a large teaching hospital in downtown Minneapolis, and their ultimate plan is to hand out flyers at the door stating that there is no medicine and no testing available for COVID and that the recommendation is to go home and get people to voluntarily sign out. Sadly, they are legally required to see all patients that want to be seen, which will overwhelm the healthcare system quickly if people refuse to go home, and you simply can’t keep them from infecting others in a crowded waiting room. That may simply include a vital sign and lung check and discharge home. I don’t know anything about the ICU capacity and how that’s going, but if regular hospitals are full, we can access the VA.

I don’t know how this will go. I think there will be harder hit areas and nurses from one state may need to up and leave to help as travelers. I hope they will suspend lengthy state-to-state nursing and physician license issues for this.

I read that people with diabetes are not more susceptible to contracting the virus, but the concern is what happens once we get it. What are the main concerns specific to people with diabetes? And, is the risk different for those who have type 1 vs.type 2 diabetes?

I would read this to answer this question. The key message is that well-controlled diabetics seem to do as well as other people their age, assuming they have no additional comorbid conditions, such as heart disease.

Being around patients who have the virus, what do you see as the most challenging aspect of the illness. What should people be most concerned about?

In Urgent Care, the most difficult thing is keeping people out of Urgent Care. We have had patients ignore signs telling them to go back to their car and call-in number for further advice and contaminate the whole clinic, for instance. People need to know that we are not able to help you at all, at least in Minnesota, unless you are severely ill and can’t breathe and then you need to go to the hospital. We are not even allowed to give a nebulizer to an asthmatic with likely Coronavirus because it will cause the virus to live in the air for several hours. You want to help, but you can’t. It sucks.

COVID-19 Perspective of a Type 1 Healthcare Worker 2

Kelly at work with her coworker in the Urgent Care, Jason Kimmel, PA

Having type 1 diabetes yourself, how are you staying healthy so that you don’t contract it? I’m sure you are stressed, tired and overworked?

Unfortunately, my gym closed until further notice today. The gym owners are putting up home workouts and actually let us borrow equipment to take home. Today, I did a bodyweight workout that actually kicked my butt.

I’m tired AF.

Something I didn’t think about was how tiring it is to always be aware of what you’re touching, including your face and surfaces. At work, I go by the presumption that all surfaces that come into contact with patients are at least intermittently contaminated with the virus. Information also changes by the hour, and we have to learn something and then unlearn it an hour or two later.

The thing that has stressed me out the most this week was the announcement this morning that no patients will receive COVID-19 testing unless they are healthcare workers or hospitalized. Minnesota only had the capacity to do testing for those with fevers, coughs with international travel or known exposures for 7 days. Basically, the only thing we’re tracking now is hospitalizations.

Do you feel comfortable being around loved ones knowing that you’ve been in such close contact, despite the hospitals taking all protective measures?

Good question. I think people are more scared of me because I work in a testing site.  I think my boyfriend is starting to get scared of me, but he’s still being supportive anyway. To make things worse, I get seasonal allergies right around now, so I’ve been aggressively treating those. I otherwise live alone.

As someone who has seen the symptoms and complications associated with this disease, as a person with diabetes, are you worried about your own health if you should contract COVID-19? I’ve read that vitamin D might help?

Yes, I’m worried about my health. I hope that being a lifelong athlete will do something. I think vitamin D helps all infections, but I don’t know of any statistic off the top of my head.

Many people are taking this very seriously, but some are not, including some millennials and the elderly. What would your message be to them?

As a Christian, we are supposed to work together, love your neighbor as yourself, not be selfish. I’ve seen a lot of instances of this so far. I think folks are coming around overall, but we’ve shut everything down to prove our point, too.

As this was so far an international travel and cruise ship issue for the most part (the overwhelming majority of patients are white and upper-middle-class), I’m mostly worried about when it hits our refugee and the immigrant population, who cannot readily access written information and may not trust information from the government. I have not seen information posted in other languages in the community. Hopefully, it’s getting there and accurate.

Overall, leaving politics out of it (albeit challenging), some people think we may be overreacting or that the media is hyping this up. How serious do you think this virus is and how serious should people take the instructions coming from ours/their government? 

Computer models show we’re about 11 days behind Italy. We’re really only a week into this here. During H1N1, we ran out of ventilators at our hospital in downtown Saint Paul, and I (ER nurse at the time) hand-ventilated a lady who needed a ventilator for two hours while the respiratory therapist called all over the Twin Cities at 3 am begging other hospitals to loan us ventilators. We were able to find one total. I think this is the best case scenario. Coronavirus is much more deadly than H1N1. Listen and stay home, wash your hands like your neurotic cousin. Assume any temp over 99.5 with even a minimal cough is corona, and don’t you dare leave.  Have an agreement with someone who will pick up your food and medications for you and you for them.

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Thank you again, Kelly for taking the time to talk to us today. Stay safe and thank you for everything you do.

Source: diabetesdaily.com

What Should I Do If I Have Symptoms of COVID-19?

As the global viral outbreak continues, you may be wondering what special considerations there are for people with diabetes to keep in mind. In particular, what should you do if you begin to experience symptoms consistent with the infection? This article reviews the most common COVID-19 symptoms, discusses potential issues specific to people with diabetes, and provides a guideline of how to respond if you become sick.

Symptoms of COVID-19

Be on the lookout for the following most common symptoms of COVID-19:

  • Fever
  • Coughing (especially dry)
  • Shortness of breath

Other symptoms may include fatigue, body aches, and sore throat, among others.

Special Considerations for People with Diabetes

You may have heard that people with certain medical conditions, including those with diabetes, are considered to be in the high-risk group for developing more serious symptoms of the disease, and have been reported to have a significantly higher mortality rate than those without underlying conditions. While these statistics are both relevant and can be scary, it is also important to keep in mind that your individual risk will vary widely depending on your specific health status, regardless of your diabetes diagnosis. Your age, other related and unrelated health conditions, and blood glucose management profile, all play a role in determining your overall risk. So, while as a whole population, people with diabetes are at higher risk for complications, your individual risk could be much lower than that.

For instance, as per the JDRF, those who have type 1 diabetes are  “not necessarily at higher risk of developing serious complications from the disease. Those at greatest risk are those who have another, or second chronic disease (such as a compromised immune system, heart disease or renal failure).

Talk to your healthcare provider to better understand your individual risk level and recommendations.

Have a Plan of Action If Symptoms Arise

Being adequately prepared ahead of time can help you feel calmer and more empowered if you do get sick. Consider taking the following steps today, if you haven’t already:

  • Take preventative measures. Stay home. Practice social distancing (note: if you already have symptoms, self-isolate!)
  • Wash your hands. Avoid touching your face. Disinfect “high-touch” surfaces regularly.
  • Make sure that your medication refills are up-to-date so that you have the supply you need if you will stay in your home for a long period of time (e.g., at least several weeks). Make sure that you consider supplies used for diabetes management as well as any other medications that you use.
  • Check that you have medications on hand that you would typically use to treat a viral infection, such as a fever-reducing agent, like acetaminophen (Tylenol). Consult with your healthcare provider for advice about their specific recommendations.
  • Have enough food and water in your home in case you stay home for a prolonged period of time (e.g., several weeks).
  • Review the “Sick Day Rules” for people with diabetes. COVID-19 causes mild symptoms in most of the people who are infected. This means most likely, you will be treating your symptoms at home. However, any illness can make blood glucose levels more challenging to manage. It is important to be aware of how illness can affect your management plan and make adjustments as needed, with the help of your healthcare provider, to keep yourself safe during the illness. You can find the standard “Sick Day Rules” as described by the Joslin Diabetes Center here, but discuss your specific recommendations with your healthcare provider.

So, what should you actually do (and not do) if you develop symptoms of COVID-19?

  1. Don’t panic.
  2. Self-isolate. Don’t go to urgent care or the emergency room, unless instructed to do so or you experience serious symptoms (see below). Stay home.
  3. Call your doctor and follow their advice closely.
  4. Keep a close eye on blood sugar levels. Work with your healthcare provider to make adjustments to medications, if needed, to help stay in the target glycemic range as much as possible. Keeping blood glucose levels in check as much as possible can go a long way to helping you avoid complications during any illness.
  5. Manage your specific symptoms (e.g., fever). Ask your healthcare provider for specific at-home treatment advice.
  6. Stay hydrated. This can help you keep your blood sugar levels in the target range and avoid complications.
  7. Be on the lookout for serious symptoms, including those of diabetic ketoacidosis (DKA), as well as the following “COVID-19 emergency warning signs”:
  • Difficulty breathing
  • Chest pain
  • Confusion or difficulty waking
  • Blue tint to the skin (on the lips or face, in particular)

If you experience these any of these symptoms, promptly seek medical care. Wear a mask if out in public.

  1. Continue to wash your hands and clean surfaces regularly.
  2. Continue to avoid contact with others (humans and pets).
  3. Do not discontinue isolation until you get the “all clear” from your healthcare provider.

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For even more detailed information on what to do if you are ill, read these guidelines from the CDC:

What to Do if You’re Sick

Guidelines for At-Risk Populations

Also, learn even more about COVID-19 illness with diabetes from the American Diabetes Association (ADA) here.

Source: diabetesdaily.com

Coronavirus and Diabetes: What You Need to Know

Unless you’ve been living under a rock the past few weeks, a new and deadly virus has quickly been spreading around the world: Coronavirus, or COVID-19, is a highly infectious, acute respiratory disease that is closely related to the SARS virus. This disease only affects mammals and birds, and seems to have originated from a seafood market in the Wuhan Province of China.

The numbers are changing daily, but the most recent numbers show that over 76,000 people have been infected with the virus, with 99% of them occurring within mainland China. There are now over 2,000 reported deaths, none of which have occurred within the United States. So how dangerous is the Coronavirus, and what do you need to know as a person living with diabetes? Read more to find out:

Do Not Panic

On January 30th, the World Health Organization declared the virus a global health emergency. There are currently protocols in place to restrict passengers entering the United States from mainland China (where the outbreak is the most devastating), and passengers suspected of being contaminated with the virus are being funneled through speciality airports with temperature screenings, to make sure they’re not bringing the virus into the United States. If someone is detected at an airport with the virus, they are being quarantined until they are no longer contagious, to stop the spread of the disease.

The Virus is Mostly Mild

Many people who are infected with the virus never seek treatment, and while COVID-19 is more contagious than SARS or MERS, the Chinese CDC estimates that the fatality rate is hovering around 2.3%. According to the World Health Organization, signs of the infection include fever, cough, shortness of breath, and difficulty breathing. If you suspect you may be infected, see your doctor right away.

Protect Yourself

To protect yourself from getting any type of seasonal virus, it’s best to avoid contact with other sick people, wash your hands frequently (especially and always after using the restroom and before preparing food!), wear a protective mask when traveling through airports or busy bus/train stations, get your flu vaccination, maintain a healthy sleep schedule, and eat plenty of fruits and vegetables. According to the CDC, Coronavirus is spread by respiratory droplets in the air, when an infected person sneezes or coughs. The virus can also be spread when an uninfected person touches a surface where the virus is (bathroom countertops or door handles), and then touches their face or mouth. Carrying antibacterial hand sanitizer with you can help to eliminate this threat!

Numbers Don’t Lie

Sometimes our diabetes gives us clues when we’re starting to get sick, and one of those clues is higher-than-normal blood sugars. If you’re starting to see your numbers creep up for no reason, it could be a sign that you’re coming down with something. Check out our sick day tips to stay on top of your diabetes when you get ill.

Seek Help

If you think you’ve become infected with the Coronavirus, call your doctor immediately. Even though most cases are mild, having a chronic illness and a virus at the same time can cause major trouble. If it’s severe enough, the Coronavirus can progress, eventually causing pneumonia and even death in some cases. Let your loved ones know you’re worried, and contact emergency medical help right away if you suspect something is wrong.

Have you or a loved one been affected by the international Coronavirus outbreak? Share your experience in the comments, below.

Source: diabetesdaily.com

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