Coronavirus and the immunocompromised: Your questions answered

We answer reader questions related to COVID-19 and potentially high-risk patients, including the elderly and those with underlying health issues.

coronavirus immunocompromised elderly

An electron microscopic image of an isolated sample of COVID-19, gathered by the Centers for Diseases Control and Prevention from the first U.S. case of the virus. The spherical viral particles, colorized blue, contain cross sections through the viral genome, seen as black dots. (CDC)

There's hardly a corner of Washington unaffected by the novel coronavirus outbreak. For people over the age of 60 or who already have a compromised immune system, the possibility of infection presents an even more urgent risk of severe and even fatal respiratory issues like pneumonia. With no known cure or vaccine on the horizon, we will answer questions about what readers can do to help themselves or people they know.

Crosscut will update this article as we continue our reporting to answer your questions. 

How can immune-compromised people over 50 best prepare and protect themselves?

The general advice for older people and those more vulnerable to catching illnesses is simple: Stay home as much as possible. The state Department of Health has more ideas to help you hunker down:

  • Keep contact information for your regular health care providers handy. 
  • Ask your health care provider to write prescriptions for extra supplies of medications to avoid trips to the pharmacy for refills.
  • Prepare a list of phone contacts, group text or social media group with people who can help you if you need extra assistance. Ask them to check up on you, but make sure they understand not to drop by for visits.
  • Consider stocking up on extra food or personal hygiene products to cut down on trips to the store.
  • If you’re not feeling well, make sure you take your temperature before you take any medications. Write down your symptoms and note when they appeared. Write down any medications you’ve taken to treat the symptoms (including over-the-counter products).
  • Before visiting any medical center, call your health care provider first. They might be able to give you advice or instructions that will save you a trip or help you avoid exposure to other immune-compromising situations.

Dr. Tania Busch Isaksen, a senior lecturer with University of Washington’s Department of Environmental and Occupational Health Sciences, points to two sites for safety tips for older and immunocompromised people: Public Health — Seattle & King County’s first-person guidance on making recommendations to at-risk loved ones during an outbreak, and the above Department of Health guidance to high-risk individuals.

See a personal story: As coronavirus spreads, a Seattle politician with MS feels vulnerable


 

I am immunosuppressed and in my mid 70s. How will hospitals protect me from COVID-19 in their facilities?

If you have a doctor’s appointment, call your health care provider to ask whether your visit could be held remotely over the phone or by video conference.

“Ask [the health care provider] what’s the best treatment for you,” says Susan Gregg, director of media relations at Harborview Medical Center. “It depends on each person's situation.”

Gregg says hospital workers are outfitted with the proper protective gear, so they can do “everything humanly possible to keep our patients safe and the staff safe.” 

“We're trying to limit the visitors coming in unless they meet exceptions, like a mother delivering a baby and wanting their partner there,” she says.

For patients who are “obviously very ill” when they arrive, Gregg says medical staff will put them in a mask and isolate them.


 

What are early symptoms? Do they vary across age groups?

As with many illnesses, the symptoms can vary by person. The main symptoms are fever, a dry cough and shortness of breath and appear two to 14 days after infection. Other agencies and outlets say symptoms tend to appear five or more days into infection, and also include fatigue and production of sputum (a mixture of saliva and mucus). 

There are many similarities between coronavirus, the flu and the common cold ⁠(also caused by a strain of coronavirus), making it difficult to distinguish between them. As Public Health works to stop the spread of the virus, it recommends that anyone who is sick stay home

More on this topic: What are symptoms of coronavirus? reported by the New York Times.


 

If someone does get sick from the virus, and then recovers, is that person now immune and cannot get sick from it again?

It’s unclear whether people can get reinfected — but it’s unlikely. STAT's Helen Branswell, a veteran health journalist, backs this up with her reporting.

"People probably aren’t being reinfected after recovery,” Branswell writes. “There has been concern on social media about reports of people getting infected, recovering and then later developing symptoms again. Some scientists from China have suggested the virus is able to reinfect people after a very short time.

MORE REPORTING: Before coronavirus: How Seattle handled the Spanish flu

“In fact, it would be unusual if an immune system that had just fought off a viral invader would forget how to recognize it and fend it off within a period of days or a few weeks.” Instances where people seem to test positive again, she reports, likely indicate how testing was done, rather than how the infection has actually progressed. 


 

What age group was most affected by COVID-19 in China?

While testing that would confirm COVID-19 diagnoses has lagged in the United States, China’s testing program has been able to account for more than 80,000 infected people,with at least 61.8% confirmed cases. Researchers from the Chinese Center for Disease Control and Prevention evaluated data on more than 72,000 of those cases in mid-February to identify who was getting infected and suffering the worst. 

The analysis found that the majority of infections ⁠— 86.6% ⁠— occurred in people between 30 and 79. Where the mortality rate hovered around 3.4% at the time, the elderly were more likely to die, with people over 80 experiencing a 14.8% fatality rate. “By contrast,” notes STAT’s Helen Branswell, “the fatality rate was 1.3% in 50-somethings, 0.4% in 40-somethings, and 0.2% in people 10 to 39.” The majority of people who developed the most severe symptoms, which resulted in the highest likelihood of death, were an average age of 61.

People still aren’t sure why more children aren’t being infected, or whether those infections are going unaccounted for. A recent Johns Hopkins University study based on infections in Shenzhen, China, puts forward that children are just as likely to be infected as adults, but simply don’t get as ill. That has implications for how health care professionals work to reduce the likelihood of infection elsewhere in the world. If kids are just as likely to be carriers of disease as adults, the researchers told Wired, “closing schools might be an important thing to do to prevent onward transmission.”


 

If a person with the virus on their hands touches a doorknob, how long will the virus be active?

It depends on the surface and factors like temperature and humidity. It’s not certain, but the World Health Organization says COVID-19 “seems to behave like other coronaviruses.” That would mean germs could last a few hours to several days. You can clean surfaces with mild disinfectants or soap and water to help mitigate the virus lingering on surfaces.


 

Pollen allergies are also kicking up for a lot of people. How can we tell the difference between allergies and the coronavirus? What about the flu?

It’s hard to give a definitive answer. Both the seasonal flu and coronavirus share many of the same symptoms, according to Johns Hopkins Medicine, including fever, cough, body aches, fatigue and sometimes vomiting and/or diarrhea. Both can manifest as mild or severe cases in different people.

But there are key differences. Itchy, watery eyes are not a listed symptom of the common flu or coronavirus, according to advice from the Mayo Clinic. Allergies also don’t cause body aches and rarely cause a fever — a main symptom for both the common flu and coronavirus. 


 

Are there any small, portable UV zappers to kill the virus on doorknobs, handrails, surfaces? Do they work?

Plenty of news outlets have been sharing information about supposed “UV zappers” that clean phones, laptops and other screens known for carrying germs. Even CNN has promoted something called the “PhoneSoap,” calling it “the phone sanitizer you didn’t know you needed.” 

However, UV lamps should not be used to sterilize hands or other areas of skin. UV radiation can cause skin irritation, according to the World Health Organization.

Dr. Busch-Isaksen says, “I would recommend against their use. The inappropriate/untrained use of high-intensity UV bulbs can result in nontrivial injuries to the skin and eyes.” 

High-touch surfaces should be cleaned daily, as should any surfaces that come into contact with blood, stools or bodily fluids. The best tool for the job is a household cleaning spray or wipe, used safely according to its instructions. 

“I don’t know about that item but you can find cleaning recommendations here,” the Department of Health’s Danielle Koenig said via email, pointing to the CDC’s cleaning tips webpage. 


 

I'm wondering what King County is doing to help protect the homeless population from coronavirus. For those living on the street, handwashing can be challenging. Further, many are living close together, and chronic diseases are common, which could increase their risk.

Sherry Hamilton, communications director of the King County Department of Community and Human Services, says the county is working with its provider network and outreach teams to continue shelter services countywide and launch a few activities specific to COVID-19. 

READ MORE: Coronavirus threatens 'extraordinarily vulnerable' homeless population

Focus areas include how to respond to cases of COVID-19; providing hygiene and sanitation services; and setting up shelters for quarantine, isolation and recovery in partnership with the city of Seattle. Hamilton says modular units will be placed at one site in White Center and one in North Seattle, in addition to a motel in Kent and recovery center in Interbay. The total capacity for the four sites is 213 people. 

Hamilton says more than 200 people (including city planners, homeless services providers and others) have joined weekly conference calls about updates and training opportunities around COVID-19. The county co-launched a web-based, recorded hygiene and sanitation training module Friday, and scheduled six Q+A webinars for homeless service staff over this week “and will add more if needed.”

Ana Sofia Knauf contributed to this report.

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