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April 17 2020

COVID-19: Who Are the Most Vulnerable?

The COVID-19 pandemic has created a public health emergency across the globe, with medical professionals, health experts, and scientists racing to not only treat people, but also uncover more information on the virus, including possible cures such as medications, as well as a vaccine.
SARS-CoV-2, the virus causing COVID-19, was first identified as the culprit behind a respiratory illness outbreak in Wuhan, China, in late 2019. Symptoms include coughing, fever, fatigue, and shortness of breath, manifesting anytime from two to 14 days after exposure.
Currently, the Center for Disease Control and Prevention (CDC) estimates that about 3.6% of all COVID-19 cases are deadly, with the mortality rate rising to 20% for people aged 80 years old and above. Treatment for the virus through a vaccine is not yet available—instead, medication is given to manage the patient’s symptoms.
It has become clear that nobody is immune to this virus. However, some groups carry a bigger risk of infection and even an increased chance of dying from COVID-19. It becomes all the more critical to identify these vulnerable groups to better protect them from the disease.

Risk Factors for COVID-19
• Age
The CDC reports that a majority of deaths from the initial outbreak in China occurred among adults aged 60 and above. Italy, a country with one of the world’s oldest populations and also one of the most affected by the outbreak, found that the average age of patients who died from COVID-19 is 81.
This is because as people age, the body’s immune system begins to decline. This results in a decrease in their white blood cell count, with these cells also becoming more ineffective at identifying new pathogens.
Studies show that there is a steep decline in immune functions after reaching 70, making the elderly more likely to suffer from infection and develop related complications. Additionally, COVID-19 exhibits a behavior of damaging immune cells that can overcome the virus, making an elderly’s immune system more susceptible to it.
• Underlying medical conditions
While COVID-19 causes only mild symptoms in most people infected with it, those with pre-existing medical conditions are faced with the threat of developing severe complications from the virus, including pneumonia and death.
High-risk conditions include chronic lung disease, moderate to severe asthma, serious heart conditions, hypertension, and severe obesity (BMI of 40 and above). Other medical conditions that are not well managed—diabetes, renal failure, or liver disease—can also be grounds for an increased risk.
• Compromised immune system
Those who are immunocompromised have a reduced ability to fight off and recover from infections, increasing their risk of contracting COVID-19, among others, and developing more severe symptoms.
In addition, some treatments and medication—both for autoimmune diseases and other concerns like cancer and bone marrow or organ transplantation—can weaken a person’s immune response.
• Pregnancy
Despite more cases being detected worldwide, it is unclear if being pregnant increases one’s risk for COVID-19. However, the changes in a pregnant woman’s body can put them at higher risk for other infections.
Viruses in the same family as COVID-19, as well as other viral respiratory infections like influenza, pose a higher risk of developing into more severe forms in pregnant women that may also affect the baby.
How to Protect the Most Vulnerable from COVID-19
The best way to protect these vulnerable groups is to avoid any chance of being exposed to COVID-19. Everyday preventive action can go a long way in averting the spread of COVID-19 to those most at-risk.
• Don’t allow them to come into contact with sick people
Those who are infected with COVID-19 and those close to them can quickly spread the virus to others, especially with close contact of around 6 ft. or less. Completely avoiding contact with the sick helps protect high-risk people. Arrangements should be made to ensure they are separated from the infected to lessen the risk.
• Encourage them to stay home and avoid
Given that COVID-19 is a new disease, there is no existing immunity for it, making it more likely for the virus to quickly spread widely. High-risk people are advised to stay home and avoid crowds.
• Make sure their hands are always washed clean with soap and water or disinfected with alcohol or hand sanitizers
Regular and frequent hand washing is one of the most effective ways of killing the novel coronavirus. Hand washing should last for at least 20 seconds and include scrubbing the back of the hands, the spaces between fingers, and underneath the fingernails. If soap and water are not available, any disinfectant that contains at least 60% alcohol can suffice for the time being.
• Teach them to avoid touching their face
The COVID-19 virus can easily enter the body through the eyes, nose, and mouth, especially when in a public area, making it all the more important  for high-risk people not to touch their faces. If necessary, they first need to ensure their hands have been thoroughly disinfected and use a clean tissue to touch the specific area.
• Help them avoid contact with frequently touched surfaces in public areas
Handrails, door handles, elevator buttons, and the like are understandably filled with germs and bacteria—even those causing COVID-19. If a loved one or companion cannot handle these surfaces on their behalf, it is recommended to cover the area with a tissue before touching.
• Routinely disinfect surfaces in living and working spaces
Doorknobs, tabletops, faucet handles, telephones and cellphones are just some of the living and working spaces that can carry the virus. Regularly disinfecting with alcohol, bleach, and other disinfection substances lessens the potential exposure to COVID-19.
• Practice respiratory hygiene
People, especially ones working or living with high-risk individuals, should be extra cautious. Covering the nose and mouth with a clean tissue or the inside of the elbow when sneezing or coughing prevents these droplets from completely entering the public space and increasing the spread of infection.
• Ensure their maintenance medication and treatments are continued
For those with underlying medical conditions or are receiving treatment that suppresses the immune system, there are significant risks involved if treatment and medications suddenly stop. High-risk people need to continue their medication or treatment to avoid worsening their conditions during the outbreak.
• Encourage them to practice regular care and health habits
The cure for COVID-19 has yet to be discovered, so maintaining a healthy lifestyle to keep up the body’s natural disease-fighting capabilities is their first line of defense. High-risk people need to focus on eating a well-balanced diet, managing stress levels, and getting adequate sleep.

Flattening the Curve
It has become clear that the mortality rate of COVID-19 is especially high for vulnerable groups—the elderly, those with underlying medical conditions, the immunocompromised, and pregnant women.
During this public health crisis, it is critical to protect high-risk individuals from becoming infected. Something as simple as making adjustments to daily routines and habits can go a long way in reducing the potential exposure and infection of those who are most vulnerable and eventually curb the outbreak.
If you suspect that you or a loved one may have COVID-19 or are displaying symptoms of this infectious disease or may have been exposed to a confirmed positive case, please call the Department of Health hotline at (02) 8651 7800 local 1149 or 1150.