Protecting the Most Vulnerable from Exposure to COVID-19

The coronavirus 2 (SARS-CoV-2) outbreak has impacted every aspect of our lives. The way we used to interact with each other by meeting at a cafe or watching a movie in a crowded movie theater is now a high-risk activity. Social distancing is the “new normal” as we attempt to protect ourselves from the virus. Worklife has also seen major changes. Millions of Americans are now unemployed, furloughed, working from home, or taking extreme safety precautions to safeguard their health. The extra cautions are for themselves and protect their family members’ health when they come home.  There’s a special group of people in our local communities who need extra care. Older adults, asthmatics, and those who are immunocompromised are most vulnerable to complications from COVID-19 disease.

There’s a special group of people in our local communities who need extra care. Older adults, asthmatics, and those who are immunocompromised are most vulnerable to complications from COVID-19 disease. They need to take stronger measures to protect themselves and rely on others to take more caution around them. Most people are aware of this and do their part to protect their communities by following the shelter in place orders. However, many people protest these orders, putting their loved ones and society at risk. Perhaps they don’t fully understand the repercussions of their decisions to not listen to healthcare and government authorities.

 

What can be done to safeguard those who are most vulnerable and susceptible to catching the virus? How can those with chronic illnesses maintain their health while quarantined? And what can family practitioners do to ensure patient safety in this increasingly uncertain time? The healthcare industry is adapting to the sudden challenges the new coronavirus has thrown its way. Let’s look closer at how high-risk patients and medical practitioners can work together to navigate safely through these challenging and uncertain times.

 

A Closer Look at How the Virus Spreads From One Person to the Other

There is much research left to do to understand the characteristics of the virus fully. One thing is clear, however. SARS-COV-2 is a highly contagious virus. In a COVID-19 webinar for Devry University, internal medicine specialist, Dr. Arnot, states “the most common transmission of coronavirus is person to person (within 6 feet) and from surfaces, although that appears to be less common and with no documented cases.”

That is why most experts agree that distancing from others is the safest way to avoid transmitting the virus—the fewer moving about to contract the virus, the better for society. Staying at home reduces the load to hospitals of extremely ill patients coming in for treatment.

Data suggests that 80% of individuals with COVID-19 infections have mild symptoms or are asymptomatic. Asymptomatic carriers may be the most dangerous because they appear perfectly fine, leading to a false sense of security around them. They may be inadvertently passing the virus to others who are at risk for complications leading to hospitalization.

Besides the direct transmission of SARS-COV-2 from one person to another, a new study has found that the virus “can hang in the air for hours.” Even if someone keeps a distance of six feet from another, the virus could “float” in the air for someone to walk into.

Researchers in Wuhan examined the virus content in two of the hardest-hit hospitals in the city where the pandemic originated. The researchers found SARS-COV-2 aerosols in inpatient wards. Most alarmingly, very high concentrations were found in the rooms where medical staff removed protective equipment. That means frontline workers exposed to the virus after protective gear such as gloves, masks, and gowns, were removed.

How Surface to Person Transmission Works

 

Studies do show that the coronavirus can live on surfaces for long periods of time. As Dr. Arnot mentioned, contracting the virus from surfaces appears less common, but it’s still a possibility that should be considered when protecting oneself from infection.

The New England Journal of Medicine states the current facts on how long SARS-COV-2 can live on these surfaces:

• Copper: Up to four hours
• Cardboard: Up to 24 hours
• Plastic: Up to two to three days
• Stainless steel: Up to two to three days

Consider the following scenario. A SARS-COV-2 carrier sneezes into his or her hand. The individual then goes and opens the door to enter an office, clinic, or store. The virus is now on the doorknob, and another person comes to open the door. According to The New England Journal of Medicine, the virus can survive on the metal doorknob for two to three days. When the next person opens the door, they may come into contact with the SARS-COV-2 microbes. The virus is now in their hand. A single brush to move the hair away from their eyes or scratch their nose can introduce the virus into the mucus membranes, leading to COVID-19 infection.

A 2015 study found that observed participants touched their faces 23 times per hour for those who find the possibility unlikely. 44% of the face contacts were to the mucous membranes of the mouth, nose, and eyes. Most people unconsciously touch their faces constantly. Some may rest their chin on their hand. Others may frequently adjust their eyeglasses. If SARS-COV-2 can live on surfaces for hours to days, the virus’s transmission is possible from the surface to the hands, to the face.

Which Patients Are at Special Risk of Complications From COVID-19?

Researchers are concluding in their findings that many people have COVID-19 without even realizing it. Others may suffer from mild to medium symptoms that don’t require much more than rest. But for individuals with pre-existing medical conditions or compromised immune systems, a case of COVID-19 can be deadly. Individuals who could suffer from serious complications from COVID-19 should exercise extra safety measures to protect their health.

The Centers for Disease Control and Prevention (CDC) has outlined which portion of the population is at higher risk for severe COVID-19 symptoms. According to the CDC, “older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.” The following individuals are considered high-risk:

• People who are 65 years old and older
• Older individuals who live in long-term care facilities or nursing homes

• Anyone with chronic lung disease, including people who have been exposed to asbestos and suffer from lung damage
• Individuals diagnosed with serious heart conditions
• People of all ages who suffer from moderate to severe asthma
• Smokers
• People living with Diabetes
• Patients who are undergoing cancer treatment or organ or bone marrow transplantation
• People with immune deficiencies
• Individuals with poorly controlled HIV or AIDS
• Patients who have been using corticosteroids and other immune weakening medications for prolonged periods of time
• The severely obese with a body mass index (BMI) of 40 or higher
• Patients with chronic kidney disease undergoing dialysis
• Diagnosed liver disease patients

Patients with any of the above conditions need special guidance to safeguard their health. They’re most likely to suffer from complications leading to hospitalization and intubation. Older patients are especially vulnerable. People 65 years of age and older account for over 59% of U.S. hospitalizations.

What Measures Can High-Risk Patients Take to Protect Themselves and Maintain Their Health While at Home?

Medical practitioners should advise their high-risk patients to remain home. It’s the safest place for them at this time because they can better control their surroundings. There are several ways patients can stay safe and maintain their health from home:

Improve Daily Personal Hygiene Habits

Everyone should wash their hands more often. As highlighted above, people frequently touch their faces without even realizing they’re doing so. Keeping their hands clean is a good way to minimize the risk of catching the virus. Although alcohol-based hand washes are handy, they aren’t essential. The simple use of soap and water can be far more effective. Any soap that creates a good foam and sometimes is all that’s needed. People should diligently wash their hands, making sure they soap up all areas. This includes their palms, backs of their hands,  between the fingers, and wrists.

Sanitize All Surfaces Regularly

Cleaning and sanitizing all surfaces should also be part of the new routine. Patients can use store-bought disinfectants or wipes. They can also make their own bleach and water sanitizing solution by mixing 1/3 cup of bleach with a gallon of water or four teaspoons of bleach with one quart of water. Then they can dampen a rag and wipe down all surfaces they regularly come in contact with. Some priority areas to wipe down include phones, doorknobs, remote controls, light switches, and countertops.

Wash Potentially Contaminated Clothes Separately

Some high-risk individuals share a home with someone who still commutes to work each day. It’s important to separate clothing and articles that have been outside and wash them separately in the hottest water possible. Family members who come home from work should remove their clothing at the home entrance to be washed right away.

What Measures Can High-Risk Patients Take to Protect Themselves Outside?

A high-risk person’s best bet is to avoid going out altogether. Groceries and food can be ordered online and delivered to their doors in a matter of hours. As a medical practitioner, you can also do your part to keep your immunocompromised patients safe. Offer phone or video medical consultations. More people are becoming comfortable with telehealth services as an alternative to visiting a clinic or medical center.

Expanding into teleconsultations is not only a good healthcare marketing strategy but can also protect you and your staff from exposure to the virus. Schedule video or phone consultations with patients to inform them about measures they can take to stay protected. It’s also a good opportunity to instruct them on how they can know the difference between allergies, a cold, or the COVID-19 illness. This can save them from going to one of the highest contaminated places for treatment — a hospital.

It’s challenging to stay all day indoors. It can affect a person’s mental health. Some patients can weather extended periods of time indoors, but it may not be best for others. Patients with cardiac conditions or who suffer from depression or anxiety may need to go outside daily. High-risk patients should wear a mask when they go out for a walk, a drive, or do errands. To avoid coming into contact with the virus, they should refrain from using outdoor workout stations or sitting on public benches. Carrying a small bottle of alcohol-based hand wash with them will come in handy to clean their hands as they enter and exit places. They must keep a safe distance of at least six feet or more from others, and they should avoid crowded places.

Helping the Most Vulnerable Protect Themselves

It takes a whole community to protect the most vulnerable from COVID-19. Because a large portion of the population may be asymptomatic, wearing a mask when out is a good way to minimize the virus’s spread to others who may not be as lucky if they contract it. Everyone should get into the habit of wearing a mask outside of the house until the outbreak is mitigated.

There are science-based reasons why governments around the world have mandated citizens to stay home. A lot isn’t understood about the spread of the virus and why some people are prone to complications from the COVID-19 illness. Until more is known, people should heed shelter at home orders and only go out for essentials. Doing so could relieve the hospital load of COVID-19 patients suffering from severe complications from the virus.

Technology that’s being widely used today may lead to more virtual visits to treat less critical conditions tomorrow. Healthcare may never be the same after COVID-19. For now, medical practitioners can help educate their most vulnerable patients on measures they can take to avoid exposure to SARS-COV-2. Most of the things everyone, including higher-risk individuals, can do are simple. Patients should stay home as much as possible, wash their hands often, and avoid close contact with others. It’s best to wait things out and shelter at home.  It may feel like a lot to ask. Until we have a better grasp on the outbreak and how to treat everyone who contracts it, however effectively, it’s the wisest plan.