Tag: CDC

CDC Expands List of Those with Higher COVID-19 Risks: What to Know

  • The Centers for Disease Control and Prevention has added new underlying conditions to its list of conditions that can lead to more serious COVID-19 cases.
  • Among the conditions added are diabetes and pregnancy.
  • The agency also has amended its guidelines on aging, now saying people are more vulnerable to serious cases as they get older instead of just people over the age of 65.

The Centers for Disease Control and Prevention (CDC) has updated its listTrusted Source of underlying conditions that may lead to more severe outcomes from a COVID-19 diagnosis.

The agency is warning that people with type 2 diabetes, kidney disease, whole organ transplants, and women who are pregnant could experience more severe outcomes if they contract COVID-19.

The updated guidelines also remove 65 as the age when more severe outcomes may occur. Instead, it is suggesting as people age, the chance of severe outcomes increases.

What does this mean to the public?

By removing a set age cut off, the updated guidelines give notice to people with underlying conditions of all ages that they are more likely to end up in an intensive care unit (ICU) if they contract the virus.

The guidelines do not suggest that people with these underlying conditions are more susceptible to developing COVID-19.

What should the public do?

Experts say the key is to stay in the know and practice safe habits such as masking, physical distancing, and, when needed, isolation.

A close look at the new conditions

Here’s a look at some of the underlying conditions added to the CDC list.


“Pregnancy is a situation with all kinds of hormonal changes in the mix,” said Dr. Alan Fishman, medical director for Obstetrix Medical Group in San Jose, California, and board certified in obstetrics and gynecology and maternal-fetal medicine. “Pregnancy is a stress on a healthy woman’s body.”

That’s why, he said, a pregnant woman who contracts COVID-19 may face more severe outcomes.

“It appears that pregnant women [who contract COVID-19] are 5.5 times more likely to be hospitalized than a non-pregnant woman,” Fishman told Healthline. “That’s pretty significant.”

“There is zero evidence that women who are pregnant are more likely to get COVID-19,” he added.

But the risks mean his office is carefully counseling those considering pregnancy.

“I counsel them to think about this information and how it sits with them,” he said. “They have to remember that it is not a good idea to skip a medical appointment or space them out more.”

While some pregnancy appointments can be done virtually, many must be done in person.

So what should a pregnant woman do?

“Common sense still holds,” Fishman said.

Wear a mask, wash your hands, keep a physical distance, and isolate when needed is still the key, along with not missing any medical appointments.

“Clearly these types of modifications are going to be with us for a long time,” he said.


There’s been some confusion around COVID-19 in the diabetes community.

First, there’s no evidence yet that people with diabetes are more likely to contract the novel coronavirus.

“The CDC has not come out and said that type 1 or type 2 diabetes makes you more susceptible [to COVID-19],” said Dr. Joshua Miller, the medical director of diabetes care for Stony Brook Medicine and an assistant professor of endocrinology and metabolism at the facility’s New York Campus, told Healthline.

However, there is research that concludes people with diabetes can develop more serious cases of COVID-19.

“What we are absolutely seeing are that people who carry a comorbidity struggle more when they contract this,” Miller told Healthline.

Figuring out what is going on with those with diabetes who contract COVID-19 is a challenge for healthcare providers.

“It’s challenging looking at the numbers and statistics because the way in which we [track diabetes] in the medical world is a challenge,” Miller said.

Even in medical reports, he said, type 1 can be mixed up with type 2.

Miller is working with the National Institutes of Health (NIH) to gather and assess data around COVID-19 patients with diabetes. But he points out that mixed information makes it harder to rely on the data.

Right now, the CDC has listed people with type 2 diabetes as being “at increased risk” of more severe outcomes if they contract COVID-19, and people with type 1 diabetes as “might be at an increased risk.”

Miller, who has had type 1 diabetes for 21 years, knows one thing for sure.

“When [a person with diabetes] is in the hospital for this, their insulin needs go way up,” he said.

Even those with type 2 diabetes who take medication may need injected insulin during treatment, he added.

His advice for those with any kind of diabetes?

“The big lesson we are learning here is simply this,” he said. “The healthier our patients are, the better they do with COVID-19. Focus in earnest more than ever on your health. Across the board, the best outcomes come from this.”

“While the area you live in has confirmed community spread, your risk is higher than not,” he added. “Stay at home if you can. And always, wear the mask, wash your hands, keep that distance. Be smart, be safe.”

The aging population

The CDC has moved away from a specific age cutoff for heightened concern to a more general statement on aging.

The CDC now says, “People in their 50s are at higher risk for severe illness than people in their 40s. Similarly, people in their 60s or 70s are, in general, at higher risk for severe illness than people in their 50s. The greatest risk for severe illness from COVID-19 is among those aged 85 or older.

That, say aging experts, is an important change.

“I have to give credit to the CDC for really clarifying that,” Dr. Ronald Caplan, author of “The Care of the Older Person” and “Long Life Strategy,” told Healthline. “Prior to this we were saying 65 and beyond, like the Cinderella phenomenon. At midnight (in this case 65 years of age) your coach just turns into a pumpkin? This is not the way medicine and real life works.”

Caplan says that when you consider that 60 percent of Americans have some kind of underlying health condition, that 40 percent of adults are obese, and that many aging Americans have heart health issues, it just makes sense that as a person ages, a COVID-19 battle gets more challenging.

What should older people do?

“The more you know, the safer you can make yourself and the less anxious you will be,” Caplan said. “We are all getting more familiar with this. We can see [the disease] attacks major organ systems, so knowing how to treat any [comorbidities] you have now will help you later.”

His best tips for older adults?

“Older people should not neglect seeing their healthcare providers, now more than ever,” Caplan said. “And get your vaccinations [for] flu and whatever else you need.”

The older population should also be careful about self-isolating when there is community spread, but they should do so with support.

“Suicide among older people is a non-talked about thing, but it is a thing,” Caplan said. “You lose a spouse, a friend or friends and all of a sudden you are alone, and then this virus comes along. It can be overwhelming.”

He suggests for those who must isolate making a small trusted bubble of friends or family who visit and check on you.

He also repeats the suggestions to wear masks, maintain distancing, and wash hands.

“All those common sense measures that the CDC is giving us all go back to when I was a kid, before vaccinations,” Caplan said. “This is what we did. And now, the answer is we need an effective vaccination. We’re going to have to wait for that, though, and do the right thing in the meantime.”

What’s next

Expect additions, subtractions, and other changes to this list as the pandemic continues, experts say.

“It’s a fascinating virus,” Dr. Mary Dale Peterson, MSHCA, FACHE, FASA, president of the American Society of Anesthesiologists, told Healthline. “It has a propensity to attack organs, but we are still very much learning as we go along.”

Some of what medical professionals are seeing makes historic sense, she added, such as people with obesity having more difficulty recovering and pregnancy taxing the heart and lungs.

As one who sees the impact of comorbidity on COVID-19 recovery first hand, Peterson has suggestions.

“The way I look at it is this: We all have our own set of risk factors,” she said. “So look at what are in your spheres of control.”

“I can make sure I take care of my chronic disease. I can eat a good diet. I can get up and actually not be a couch potato as tempting as it is to be one right now,” she explained.

“Physical activity is actually a treatment we use in the hospital on COVID-19 patients,” she added. “Double down on your healthy habits. It will only help.”


CDC Updates COVID-19 Risk Factors

With COVID-19 cases rising in younger Americans, the CDC had a clear message for all adults Thursday: When it comes to age, there’s no bright line for risk.

“There’s not an exact cutoff of age at which people should or should not be concerned,” Jay Butler, MD, said at a news briefing. Butler is the CDC’s deputy director of infectious diseases.

After analyzing cases across the U.S., the CDC announced updates to the characteristics that seem to leave people vulnerable to the worst COVID-19 outcomes: hospital stays, intensive care, and death.

For starters, it got rid of the age category “65 and older.” Instead, under the tab “People Who Need Extra Precautions,” there’s a category called “Older Adults.”

The page now explains that risk from a COVID-19 infection increases with advancing age. In general, people in their 50s are at a higher risk than people in their 40s. Likewise, people in their 60s and 70s are at a higher risk than those who are in their 50s.

“We know that risk is a continuum. It’s not just risk to those ages 65 and older,” said CDC Director Robert Redfield, MD.

The CDC has also updated the list of health conditions that make a person more likely to have severe outcomes from COVID-19.

Conditions in which there’s strong evidence of increased risk include:

Conditions that might place a person at a greater risk for a severe outcome from COVID-19 are:

The revisions call into question the role of high blood pressure (hypertension), which was flagged early on as a risk factor among severe cases in China. About 50% of American adults live with high blood pressure.

Butler said hypertension had been moved to the list of conditions that could place a person at increased risk because they had learned more about the role of hypertension, on its own, and some of the things that hypertension can lead to, like kidney damage and heart disease.

“We’ve been able to tease apart a little more how much just having hypertension alone, as opposed to having some of those end-organ manifestations of hypertension, might be driving the increased risk,” he said.

Obesity, in contrast, seemed to be its own, independent risk, even apart from other health conditions that may also happen in people who are obese, like diabetes.

Finally, a new study by the CDC showed that pregnancy can make the course of COVID-19 more severe for women, though it doesn’t seem to increase their risk of death.

In a study that compared COVID-19 outcomes among women between the ages of 18 and 44 by pregnancy status, nearly one-third of the pregnant women were hospitalized for their infections, while only about 6% of the non-pregnant women had to be admitted to the hospital. Pregnant women were also more likely to need ICU care and to receive breathing support from a ventilator, but they were not more likely to die. About 0.2% of both pregnant and non-pregnant women died of COVID-19 during the study period.

Study authors stress that women who are pregnant during the pandemic should take extra care by staying at home whenever possible, wearing a mask in public, standing or sitting at least 6 feet away from others when they do have to go out, and washing their hands often.


As Summer begins, CDC Updates Social Guidelines

As states lift restrictions and people begin to resume normal activities such as hosting cookouts or going to the nail salon, the Centers for Disease Control and Prevention has issued tips for reducing the risk of catching or spreading the coronavirus.

“I know that the people are eager to return to normal activity and ways of life,” Dr. Robert Redfield, director of the US Centers for Disease Control and Prevention, said on Friday, according to CNN. “However, it is important that we remember that this situation is unprecedented, and that the pandemic has not ended.”

In the guidance titled “Deciding to Go Out,” the CDC urges people to follow the basic rules of life in 2020: Wash your hands often, practice social distancing, wear face coverings, disinfect surfaces, and stay home if you’re sick.

The CDC also offers specific tips for different activities.

If you’re hosting a cookout or some other gathering, encourage guests to bring their own food and drinks. If food is being served, only one person should do it. Provide face masks and seating spaced for social distancing. Keep a list of guests in case contract tracing is necessary.

Before you visit a nail salon, make your appointment in advance. Wait in your car until it’s time for the appointment, if possible, or stay socially distant in the waiting area. Wear a mask and wash your hands — and make sure the employees are doing the same.

Call restaurants in advance to make sure the staff will be wearing masks and that socially distant seating is available. Sit outside if possible. Choose food and beverage options that are not self-serve. Ask about self-parking to avoid the use of valet parking.

Going to the library? Use advance checkout systems, if possible, and seek out digital materials over print. Curbside pickup of materials is best. Disinfect library materials in plastic containers, such as CDs or audio books, during returns and/or exchanges.

At the gym, don’t use shared items that can’t be easily disinfected, such as resistance bands and weightlifting belts. Wear a mask and perform vigorous exercises outside when possible. Don’t be surprised if showering is not allowed. No high fives.

If you’re traveling, ask the motel or hotel about their cleaning policies. Take the stairs instead of the elevator. Avoid places like fitness centers and game rooms where socially distancing is difficult.

The CDC provides a list of questions each person should ask before going out, such as: Is COVID-19 spreading in my community? What are the local orders in my community? Will my activity put me in close contact with others? Will I have to take mass transit?

The CDC emphasizes these guiding principles for gatherings:

  • The more people an individual interacts with and the longer the interaction lasts, the higher the potential risk of becoming infected.
  • The higher the level of community transmission in the area that the gathering is being held, the higher the risk of COVID-19 spreading.
  • The size of an event or gathering should be determined based on state, local, territorial or tribal safety laws and regulations.

“As communities and businesses are opening, you may be looking for ways to resume some daily activities as safely as possibly,” the CDC said on its website. “While there is no way to ensure zero risk of infection, it is important to understand potential risks and how to adopt different types of prevention measures to protect yourself and to help reduce the spread of COVID-19.”


When can you be around others? CDC updates coronavirus guidance

People who have been sick with coronavirus infections should stay away from other people until they’ve gone at least three days with no fever, have seen symptoms improve, and until it’s been 10 days since they first noticed symptoms, the US Centers for Disease Control and Prevention said in updated guidance.

The CDC updated guidance on when it’s safe to leave quarantine, as well as some consumer-friendly guidance on using public transit and ride shares as states loosen restrictions on opening schools, businesses and leaving home.
People who have been infected need to be sure they won’t spread the virus, even if they feel better, the CDC advised.

“Depending on your healthcare provider’s advice and availability of testing, you might get tested to see if you still have Covid-19. If you will be tested, you can be around others when you have no fever, symptoms have improved, and you receive two negative test results in a row, at least 24 hours apart,” the CDC said in the new guidance.
Waiting to mingle
People who tested positive but had no symptoms can still infect others, and the CDC says people should wait for 10 days after a positive test before mixing with other people again.
“People with conditions that weaken their immune system might need to stay home longer than 10 days,” the CDC said.
And people who are exposed to someone with coronavirus need to stay at home for at least 14 days, the CDC said, since it can take that long for symptoms to develop.

The CDC’s updated practical advice for using public transportation, ride shares and other transportation was consistent with other advice on preventing infection: wash your hands and be careful what you touch.
But the CDC also advises opening windows when possible to improve air circulation, especially in cars.
Wash again and again
“Limit touching frequently touched surfaces such as kiosks, digital interfaces such as touchscreens and fingerprint scanners, ticket machines, turnstiles, handrails, restroom surfaces, elevator buttons, and benches as much as possible,” the CDC advises.
“If you must touch these surfaces, as soon as you can, wash your hands for 20 seconds with soap and water or rub your hands with sanitizer containing 60% alcohol,” it adds.

“Use touchless payment and no-touch trash cans and doors when available. Exchange cash or credit cards by placing them in a receipt tray or on the counter rather than by hand, if possible.”
Social distancing is also important in both cars and on public transit, the CDC said.
“When possible, consider traveling during non-peak hours when there are likely to be fewer people,” it advises. “Follow social distancing guidelines by staying at least 6 feet (2 meters) from people who are not from your household. For example:
• Avoid gathering in groups, and stay out of crowded spaces when possible, especially at transit stations and stops.
• Consider skipping a row of seats between yourself and other riders if possible.
• Enter and exit buses through rear entry doors if possible.
• Look for social distancing instructions or physical guides offered by transit authorities (for example, floor decals or signs indicating where to stand or sit to remain at least 6 feet apart from others).
In taxis and ride shares, the CDC advises touching as few places as possible, frequent hand cleaning and avoiding taking water bottles or other items being offered. “Limit the number of passengers in the vehicle to only those necessary,” it adds.

“Avoid pooled rides or rides where multiple passengers are picked up who are not in the same household. Sit in the back seat in larger vehicles such as vans and buses so you can remain at least six feet away from the driver.”
And, open the windows. “Ask the driver to improve the ventilation in the vehicle if possible — for example, by opening the windows or setting the air ventilation/air conditioning on non-recirculation mode.”


The Impact Of The COVID-19 Pandemic On Older Adults

As part of a new series of features, MNT has looked into how the pandemic affects women’s reproductive rights, people that may find themselves in an abusive relationship, as well as the mental health of people of color and those belonging to an ethnic minority group.

In this Special Feature, we examine the impact that the pandemic has had on another group that gets frequently overlooked: older adults.

From the likelihood of developing a more severe form of COVID-19 to the risks of isolation and mental health problems, this feature looks at ways in which older adults have taken the brunt of the pandemic.

Old age and preexisting health conditions
The COVID-19 disease, in itself, has hit older adults harder than other age groups.

Older adults are more likely to already have underlying conditions such as cardiovascular disease, diabetes, or respiratory illness — comorbidities that we now know raise the risk of severe COVID-19 and COVID-19-related death. In addition, a likely weaker immune system makes it harder for older adults to fight off infection.

As a result, the impact on older adults is notable. According to World Health Organization (WHO) data from April 2020, more than 95% of COVID-19 deaths were among people over 60 years of age, and more than half of all deaths occurred in people of 80 years-plus.

In Sweden, for example, 90% of the deaths from COVID-19 were among people more than 70 years of age.

The Chinese Centers for Disease Control and Prevention offered data in March showing an average COVID-19 case fatality rate of 3.6% for adults in their 60s, 8% for those in their 70s, and 14.8% for people 80 years and above.

“Older adults are at a significantly increased risk of severe disease following infection from COVID-19,” said Dr. Hans Henri P. Kluge, WHO Regional Director for Europe in a WHO press briefing, who added:

“Supporting and protecting older people living alone in the community is everyone’s business.”

COVID-19 deaths in care homes
While the wider community should indeed be preoccupied with the health and well-being of older adults, there are epicenters to the current crisis, and nursing homes, alongside hospitals, are one such place.

The United States Centers for Disease Control and Prevention (CDC) warn that “nursing home populations are at the highest risk of being affected by COVID-19,” compounding not only the risk for older people but also placing care workers at risk.

The New York Times (NYT) gathered recent data showing that in the U.S., at least 28,100 residents and workers have died from a SARS-CoV-2 infection in a nursing home or in another long-term care facility for older people.

Overall, more than a third — that is, 35% — of all COVID-19 deaths in the U.S. occur in long-term care facilities, comprising residents and workers.

“While just 11 percent of the country’s cases have occurred in long-term care facilities,” say the authors of the NYT report, “deaths related to COVID-19 in these facilities account for more than a third of the country’s pandemic fatalities.”

In other parts of the world, the situation looks dire, too. Data collected by researchers at the London School of Economics (LSE), in the United Kingdom, suggest that the majority of COVID-19-related deaths occurred in nursing homes.

In Belgium, for example, 53% of the country’s entire number of COVID-19 deaths occurred in care homes.

In Canada, this proportion was 62%.
In France, the figure ranges from 39.2–51%.
In Spain, 67% of all COVID19 deaths occurred in care homes.
In the U.S., nearly 60% of all care home-related COVID-19 deaths occurred in the state of New York.
The danger of the new coronavirus spreading in care homes, and affecting workers as well as residents, is amplified by the fact that most of the cases doctors confirmed in these environments were asymptomatic.

In Belgium, for example, 72% of staff diagnosed with COVID-19 showed no symptoms at the time; neither did 74% of the residents who had tested positive for the new coronavirus.

Despite these alarming figures, the U.S. federal government are not keeping track of this data. Withholding key nuanced information about whom the pandemic is affecting hardest is in the way of directing resources where people need them the most.

“It’s impossible to fight and contain this virus if we don’t know where it’s located,” David Grabowski, a professor of healthcare policy at Harvard Medical School, told NBC News.

Prof. Grabowski added that knowing this information could help predict where the next outbreak will be; other NGO advocates agree that knowing which nursing homes have the highest number of cases can help states direct resources where the need is the greatest.

Living with dementia during COVID-19
According to the CDC, at least half of the older adults living in these care facilities have Alzheimer’s disease or other forms of dementia, which makes it more difficult to contain possible infections with the new coronavirus.

One of the specific challenges for people living with dementia and similar forms of cognitive impairment is that they may have difficulty understanding the dangers of infection. Also, they may forget to follow safety precautions, such as washing their hands or practicing physical distancing.

Those who care for people with dementia and have contracted the virus may also avoid seeking treatment or being hospitalized because they cannot afford to leave their elders alone.

On the other hand, people with dementia themselves who have COVID-19 and need hospitalization may avoid it because they fear that, due to hospital triaging protocols, they may fall at the bottom of the ladder when it comes to receiving medical resources and attention.

Furthermore, people may be discouraged from seeking medical attention for dementia itself if they start to display symptoms; memory clinics are shutting, as seeing new patients is perceived to be riskier than for some people not to receive a dementia diagnosis.

While this cost-benefit reasoning made sense in the short term, doctors are becoming increasingly worried that as the pandemic extends, more people may develop dementia and not receive the care they need.

Pandemic exposes ageism, gaps in care
Some have suggested that ageism — that is, a discriminatory attitude towards people of more advanced age — may have significantly contributed to the detrimental effects on the health and longevity of older adults with COVID-19.

For instance, Joan Costa-Font, an associate professor at LSE’s department of health policy, suggests that countries that tend to view their elders with more respect have implemented physical distancing measures more promptly, even if such measures primarily impacted the social lives of younger people.

“Differences in social perceptions underpin the social environment in European countries where we have observed delays in policy interventions, such as lockdown, (which are detrimental to the social lives of younger cohorts), and why countries like China implemented more stringent measures.”

– Joan Costa-Font

However, it is worth noting that other countries, for example, Japan, where there is a tradition of respecting the elders, did not choose to have a lockdown.

According to the same author, “a delayed introduction of a lockdown is not the only way we reveal the low social value of older individuals.”

The COVID-19 pandemic has also shown how poorly funded, and disorganized long-term care facilities are in several European countries. In the U.K., for example, a government study that used genome tracking to investigate the spread of outbreaks has only recently discovered that temporary staff had unwittingly spread SARS-CoV-2 between care homes as the pandemic grew.

As a result of this revelation, some politicians have said the pandemic “brutally exposed how insecure, undervalued, and underpaid care work is,” with “the prevalence of zero-hours contracts, high vacancy rates, and high staff turnover” having all contributed to the pandemic.

Furthermore, “In the absence of affordable formal care, older individuals are informally cared for by family members (or go with unmet needs). Reliance on informal care explains the early expansion of the pandemic in countries with stronger family ties such as Italy, Spain, China, and Korea,” notes Costa-Font.

The author goes on to highlight the particularly severe impact that quarantines have on older people who tend to live alone and need more care.

“In many countries, caregivers have been forced to reside with older people in need to reduce the chance of contagion. But when older people are less disabled, they are more likely to be left on their own, with unmet needs.”

Furthermore, other authors have analyzed the ageist portrayal of older adults in social media, which reflects a similar attitude of indifference through disparaging twitter hashtags (such as referring to COVID-19 as the #boomerremover) and other memes.

An ageist attitude, combined with policy responses, has a range of negative effects on older adults, including leading to social isolation, loneliness, and a rise in elder abuse.

Mental health and elder abuse
Loneliness is a known factor that negatively affects a person’s mental health and well-being, and some older adults were already at a higher risk of experiencing it. Deteriorating health or the death of partners and friends may get in the way of maintaining a healthy social circle.

However, the pandemic and the quarantine heighten this risk of loneliness.

“Loneliness is a complex, subjective emotion, experienced as a feeling of anxiety and dissatisfaction associated with a lack of connectedness or communality with others,” explain Joanne Brooke and Debra Jackson in a paper appearing in the Journal of Clinical Nursing.

The authors go on to highlight the importance of loneliness and social isolation for mental and physical health.

“The acknowledgment of social isolation and loneliness of older people is essential and paramount due to the detrimental impact on their physical and mental health, which has been recognized for over two decades. Social isolation and loneliness increases older people’s risk of anxiety, depression, cognitive dysfunction, heart disease, and mortality.”

— Joanne Brooke and Debra Jackson

What is more, emerging reports have shown that lockdowns raise the risk of abuse among older people.

During the pandemic, older adults have become even more dependent on their caregivers, and, in a pattern similar to the one that has raised the rates of domestic violence, some caregivers have used the pandemic to exercise their control and abuse further.

Elder abuse tends to occur more frequently in communities that lack mental health or social care resources. The perpetrators of the abuse also tend to have mental health problems, as well as reporting feelings of resentment with their informal caregiving duties.

According to a recent paper appearing in the journal Aggression and Violent Behavior, people who experience “elder abuse” are more likely to develop mental health problems such as depression, high stress, and self-neglect — conditions that can only be made worse by lockdowns.

Overall, lockdowns mean that more elders are trapped with their abusers, that some perpetrators of abuse reluctantly find themselves in a caregiving role, and that, as a result, there is a higher need for mental health and community support services.

Paradoxically, however, the funds and staff for these services have been slashed — now, when they are needed the most.

While some countries have acknowledged the fact that they have “failed to protect [their] elderly,” and in doing so, failed “society as a whole,” others, like the U.S. or the U.K., have yet to make the necessary amends.

As can be seen from the consequences of the pandemic on both the mental and physical health of older adults, governments in several countries have yet to pay heed to the WHO’s advice — that we do not forget that protecting our elders is “everyone’s business.”