Correcting This Faulty Belief About COVID-19 Will Save Lives


By Kenneth E. Thorpe

In times of emergency, misperceptions can prove deadly. That's certainly the case today, amid widespread belief that COVID-19 mainly threatens older Americans.

In reality, those of any age suffering from an underlying health condition are at significant risk of complications from COVID-19. And when these patients fail to take proper precautions, they put their own lives -- and the health of millions of people -- in jeopardy.

By and large, younger Americans have been the slowest to respond to the COVID-19 pandemic. Many in this group continue to frequent bars, attend parties, travel, and eat in restaurants, especially outside major cities where most establishments are now closed.

This response is partly the result of a misunderstanding. The Centers for Disease Control specifically highlighted the threat COVID-19 posed to older individuals and those with preexisting chronic conditions. Many Americans felt they didn't fall under this warning. For them, it conjured distant images of 90-year-olds on ventilators.

But the health conditions that can complicate COVID-19 aren't unique to the elderly. Heart disease, hypertension, diabetes, lung disease, and asthma all impact younger and middle-aged people, too.

For instance, nearly four in five Americans with heart disease are younger than 65. More than a one in three in their 40s or 50s have high blood pressure. And roughly one in six of those aged 45 to 64 have some form of diabetes.

This means that many Americans who appear perfectly healthy actually fall within the high-risk group. The failure to internalize this fact has already led to avoidable tragedy. As of March 16, one in five people hospitalized due to COVID-19 were aged 20 to 44, and well over half were under the age of 65.

It's time Americans came to grips with the unsettling truth about this pandemic. If chronically ill patients of all ages don't take proper precautions, many will see their health deteriorate quickly.

Imagine a 34-year-old woman with Type 1 diabetes. Given that she's lived with her illness for years, she might not consider herself particularly high-risk. In response to the COVID-19 outbreak, she might exercise fewer precautions than recommended.

But the fact is, any fluctuations in glucose levels can weaken her immune system.

If she acquires COVID-19, the disease could progress at an accelerated pace. At first, she might experience a fever and shortness of breath. Within a few days, her breathing could become so labored that she requires hospitalization. Soon, she may need a ventilator. And if her case is severe, these measures may not be enough to save her life.

This risk isn't hypothetical. One recent analysis of 44,672 confirmed COVID-19 cases in China -- published in the Journal of the American Medical Association -- put the death rate for patients with diabetes at 7.3 percent. That's more than three-times the overall case fatality rate.

This warning also applies to the 45-year-old with high blood pressure and the 50-year-old with heart disease. The same JAMA study found that the death rate for patients with cardiovascular disease was 10.5 percent. According to a separate report, 40 percent of those hospitalized from COVID-19 had some form of heart or vascular condition.

It's time all patients with underlying conditions adequately protected themselves -- and others -- from this deadly pandemic. Here's how:

• Regularly wash your hands with soap for at least 20 seconds -- especially after sneezing or coughing. If running water and soap isn't available, use hand sanitizer containing at least 60 percent alcohol.

• Avoid touching your eyes, nose, or mouth.

• Stay at home as much as possible. And work from home if you can.

• If someone in your home is sick or has been in contact with a sick person, avoid them.

• Disinfect frequently touched surfaces in your home every day.

• If you must leave your home, remain at least 6 feet away from anyone you encounter. No handshakes. No large gatherings.

• If you develop a fever or cough, contact your doctor as soon as possible.

Make no mistake: These are extreme measures, and they will require sacrifice. But those with underlying conditions who fail to heed this guidance -- no matter their age -- are putting their lives at risk and helping to spread this dangerous illness.

Kenneth E. Thorpe is a professor of health policy at Emory University and chairman of the Partnership to Fight Chronic Disease.

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