Why are older adults and those with chronic health conditions at higher risk?
Older adults and individuals with chronic health conditions including heart disease, lung disease, diabetes, cancer, and hypertension are at higher risk for more serious COVID-19 illness and death. This is because our immune systems grow weaker as we age, which makes it more challenging for older adults to fight off infectious diseases. Chronic diseases are also more common with age, and can compromise the immune system, making older adults more vulnerable to serious complications. Because of the rapid spread of COVID-19, the Centers for Disease Control and Prevention (CDC) has issued guidance for people who are at the highest risk for severe illness from the virus. It is imperative that older adults and others who are at high risk follow the advice of CDC.
What are the symptoms of COVID-19 and how is it different from flu and allergies?
The main symptoms of COVID-19, which may appear between 2 to 14 days after exposure, can include: fever or chills, coughing, difficulty breathing or shortness of breath, fatigue, muscle or body aches, headache, sore throat, congestion or runny nose, new loss of taste or smell, nausea or vomiting, and diarrhea. There are other symptoms that are not as common—like a rash or discoloration of the hands or feet—that may be a sign of COVID-19 so contact your healthcare professional if you are concerned. Not everyone with COVID-19 will experience symptoms, or symptoms may be mild enough that they are dismissed, but individuals may still be contagious without symptoms.
When should I call a healthcare professional?
Call 911 and seek emergency care if you or a loved one have trouble breathing, feel pain or pressure in the chest, experience new confusion, are unable to wake or stay awake, have bluish lips or face, or think you may need immediate care.
If you think you may have COVID-19 or have been exposed to someone who had COVID-19, contact a healthcare professional or the public health department to see if you are eligible for a COVID test and where to go if you are.
How do they test for COVID-19?
To diagnose a potential case, healthcare professionals may run tests to rule out influenza and other common infections. Not all healthcare facilities are able to test for COVID-19. There are a number of different tests, some involving swabbing the nose and throat, while others required taking samples of saliva. Others may require a blood draw. Note that COVID-19 tests that detect active infection will not detect previous infection or antibodies.
Will I have to pay for testing?
The Centers for Medicare and Medicaid Services (CMS) is taking important steps to waive cost-sharing for COVID-19-related testing and treatment to ensure all patients who need it have access to care. Medicare and Medicare Advantage Plans will cover lab tests for COVID-19 with no out-of-pocket costs, any necessary hospital care, and telehealth services including virtual check-ins and full visits for those living in rural areas.
How can I best protect myself?
COVID-19 is thought to spread mainly between people in close contact with one another through respiratory droplets from coughs or sneezes. It may also be transmitted when you touch a surface or object with the virus on it, then touch your mouth, nose, or eyes.
It is important to avoid people who may be infected. Older adults and those with underlying health conditions that can put them at increased risk should stay home to avoid being around others. Nursing homes and retirement and long-term care facilities should continue to limit all visitors, including social visits.
The best way to prevent illness is to avoid being exposed to the virus. Restrictions and recommendations vary by state and city but generally, it is best to avoid
- Gatherings where social distancing (staying at least 6 feet apart) is not possible,
- Any indoor gatherings where masks are not required/used,
- Non-essential air travel, and
- Cruise ships (Note that major cruise lines have suspended trips and others are restricting passengers over the age of 70)
For older adults and adults with underlying health conditions, CDC advises taking extra measures to put distance between yourself and others including:
- Staying home whenever possible
- Wearing a mask whenever you go out—especially in settings where social distancing is not possible. Cloth masks can keep people from spreading the virus through talking, coughing, or sneezing, even among those who may not realize they are carrying the disease. Studies show that people can spread the virus before they have symptoms, or even if they are infected but never develop symptoms.
- Take hand sanitizer when you go out and use when soap and water are not available
- Use proper handwashing techniques—using soap and water for at least 20 seconds, especially after blowing your nose, coughing, sneezing, or using the bathroom
- Avoid handshakes and touching high-traffic surfaces in public places—for example, elevator buttons, door handles, handrails, or counters. Use a tissue or your sleeve to cover your hand or fingers if you must touch shared surfaces.
- Avoid touching your face, nose, eyes, and mouth as much as possible
Until there are licensed vaccines widely available in the US to prevent COVID-19, you should still ensure that you and your family are up to date on all recommended vaccines, including influenza (flu) and pneumococcal (pneumonia) vaccines. Experts are concerned that individuals who get sick with flu or pneumonia, while sick with COVID-19, will have worse outcomes and will be at higher risk of death. In addition, simultaneous outbreaks of flu and COVID-19 would overwhelm the already stressed US healthcare system. Learn more about the benefits of influenza and pneumonia vaccination.
How can I prepare to be at home for an extended period of time?
Here are some important but simple steps you can take in preparing to remain at home for an extended period:
Getting Medicines and Medical Supplies
Ask your physician or local pharmacy if ordering your medicines online is an option. Many online pharmacies (including national chains) will fill valid prescriptions and ship them directly to your door allowing you to avoid going to the pharmacy in person. CMS is also working with private plans to waive prescription drug refill limits and to relax restrictions on home or mail delivery of prescription drugs. However, only order from a reputable online pharmacy. The United States Food and Drug Administration (FDA) warns consumers about rogue online pharmacies that claim to sell prescription medicines at deeply discounted prices. Read the FDA warning. If you have questions, call a healthcare professional. Also, be sure you have over-the-counter medicines and medical supplies (fever reducers, tissues, hydrating beverages, etc.) to treat fever and other symptoms.
Ordering Groceries
Have enough basic household items and groceries on hand so you are prepared to stay at home for an extended period of time. Most major grocery chains have made it possible to order groceries online and have them delivered to your door. Check the websites of local or national grocery stores that may allow you to select your items online and then arrange for shipping. Keep in mind, however, that many of these services are experiencing delays due to the high volume of people choosing the safety of online ordering rather than in-person shopping. This means you will need to plan ahead. If you have questions or concerns about the delivery timeline, speak to a customer service representative.
If you must go out for groceries, try to find a local grocery store that offers hours just for older adults. Most of these hours are earlier in the day and offer a chance for older adults to shop without as much exposure. Remember to cover your nose and mouth with a face covering, stay vigilant with handwashing, and avoid touching your eyes, mouth, and nose since COVID-19 can remain on certain surfaces for hours and in some cases, days.
How can I help loved ones at risk?
Everyone has a role to play in reducing community spread. The same recommendations for people at risk should be adhered to by everyone to help protect the more vulnerable in our communities. Businesses, schools, and local and federal government should all work together to mitigate community spread of COVID-19 and help protect older adults and those with pre-existing medical conditions.
If you are a caregiver for someone in a long-term care facility, respect their rules on who can come and go, ask about the health of the other residents frequently, and know the plan if there is an outbreak.
If your loved ones live alone, check on them frequently and find out what services your local Area Agency on Aging offers.
What should I do if I get sick?
If you do get sick, first call a healthcare professional. Unless you need immediate medical care, you should stay at home to avoid spreading your illness. Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, and others if you become sick. Determine who can provide you with care if your caregiver gets sick. If you or a loved one needs help, contact your local public health department to connect with caregiving services.
If you develop emergency warning signs for COVID-19, call 911 and get medical attention immediately. In adults, emergency warning signs include:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse and/or
- Bluish lips or face
What are other reliable resources for the most up-to-date information?
- Administration for Community Living: acl.gov/COVID-19
- United States Centers for Disease Control and Prevention: coronavirus.gov
- World Health Organization: who.int
Note: This resource is based on content developed jointly by NFID and the Alliance for Aging Research, reflecting the latest information about COVID-19.
Reviewed: December 2020
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