All the questions you may have about COVID-19!

COVID-19 and chronic illness: Who is at higher risk?

As the COVID-19 pandemic has progressed and understanding has evolved over the past few months, so too have the criteria for identifying people at risk of developing a serious form of infection.

What makes one at increased risk?

You are considered to be at increased risk if you find yourself in one of the following situations:

• You are an older adult (65+)
• You have cancer
• You have chronic kidney disease
• You have COPD
• You have a heart condition, such as heart failure, coronary artery disease, or cardiomyopathy
• You are in an immunocompromised state (weakened immune system) from a solid organ transplant
• You are obese (BMI of 30 kg/m² or higher, but <40 kg/m²)
• You are severely obese (BMI of 40 kg/m²or higher)
• You have sickle cell disease
• You are a smoker
• You have type 2 diabetes

You might be considered at an increased risk if you find yourself in one of the following situations:

• You have moderate-to-severe asthma
• You have a cerebrovascular disease (affects blood vessels and blood supply to the brain)
• You have cystic fibrosis
• You have hypertensions or high blood pressure
• You are in an immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
• You have a neurologic condition, such as dementia
• You have liver disease
• You are overweight (BMI > 25 kg/m², but < 30 kg/m²)
• You are pregnant
• You have pulmonary fibrosis (damaged or scarred lung tissue)
• You have thalassemia (a type of blood disorder)
• You have type 1 diabetes

Find all our articles dedicated to COVID-19 and chronic illness:

• Coronavirus and Chronic Illness
• HIV and the Coronavirus
• Rheumatoid arthritis and the Coronavirus
• Multiple sclerosis and the Coronavirus
• Gastrointestinal disorders and the Coronavirus
• Diabetes and the Coronavirus
• Kidney disease and the Coronavirus
• Coronavirus and Obesity
• COPD and the Coronavirus
• Coronavirus and Hypertension
• Coronavirus and Cancer

To find out about specific actions you can take based on the medical conditions listed above, consult the CDC's Coronavirus information pages here.

Which treatments are the subject of guidance in relation to COVID-19? 

Non-steroidal anti-inflammatory drugs:

At this time, the FDA finds that there is no scientific evidence that NSAIDs (ibuprofen, naproxen, diclofenac, high-dose aspirin) can worsen coronavirus (COVID-19). If you wish to use treatment options other than NSAIDs, there are many over-the-counter (OTC) and prescription medications approved for pain relief and fever reduction. If you have been prescribed NSAIDS for your chronic condition, do not stop taking them without consulting your doctor by phone or tele-consultation. 

Immunosuppressive treatment, biotherapy or corticosteroids:

If you are affected by an autoimmune or auto-inflammatory disease and are under immunosuppressive treatment, biotherapy or corticotherapy:

• You should never stop or change your chronic treatment, whether immunosuppressive or not, without consulting your doctor first. This could lead to a worsening of your condition and complications specific to it. It will also not protect you against the coronavirus.
• For certain COVID-19 patients, it may be possible to temporarily stop corticosteroid/immunosuppressive/biologic medications to reduce the risk of serious complications, but only under medical supervision. Decisions should be made on a case-by-case basis with a doctor.

If you have cancer, the CDC recommends:

• That you have a conversation with your healthcare provider or care team to discuss your individual level of risk based on your condition, your treatment, and the level of transmission in your community.
• That you do not stop taking your medicines or alter your treatment plan without talking to your healthcare provider
• That you make sure that you have at least a 30-day supply of your medicines.
• That you do not delay life-saving treatment or emergency care
• That you call your healthcare provider or care team if you have concerns about your condition, your treatment, think you may have been exposed to COVID-19, or any other questions

Managing medical appointments by phone or online (telemedicine)

In recent months following the COVID-19 crisis, the healthcare community has turned to remote consultations to minimize the risk of infection for both patients and medical staff. Now, primary care physicians and other health professionals are encouraged to conduct non-urgent consultations remotely by telephone, video, and online consultations where possible.

Some tools recommended by the American Academy of Family Physicians include:

• Doxy.me
• eVisit
• SimpleVisit
• Spruce

Some patients may feel like they should avoid getting help when they're feeling sick because they are worried about putting additional pressure on their doctor or the healthcare system or are worried about catching the virus by going to their doctor's office or to the hospital. However, your health needs remain as important as before and you should not hesitate to seek out the help you need.

If you feel sick, you can still see your doctor, though he or she may prefer to do this over the phone or by online video chat rather than in person. Make sure to call your doctor's office or visit their website for an appointment and take note of any measures being taken to keep patients safe (mask requirements, cleaning protocols, etc.). You shouldn't go to their office in person unless advised to do so.

Which appointments should I do online? Which appointments need to be done in person?

Depending on the condition, some appointments will still need to be done in person:

• Allergy immunotherapy (allergy shots) or biologic treatments for asthma: People with allergies and asthma need regular treatments for the benefits of treatment to be maintained. These treatments do more than just reduce allergy symptoms, they help to control asthma flare-ups that can put a patient in the hospital.
• Immunizations for children up to 24 months old: It is important that newborns and infants, whose immune systems are not fully developed, continue to see their pediatricians on schedule.
• Cancer treatments
• Dialysis
• Prenatal care: Certain appointments for prenatal care can be done online, but certain tests like ultrasounds and lab work must be done in person.

Virtual appointments can be particularly useful for:

• Patients with chronic conditions who may only need simple adjustments to their care, such as those with diabetes, hypertension, Crohn's or colitis, postoperative patients
• Psychiatric/mental health consultations

In certain situations, you may be asked to do a first consultation online, and then be asked to come in for an appointment in person. In all cases, make sure to call your doctor's office or visit their website to ask how to proceed.

COVID-19 and work: Telework, staying safe, taking leave...

As states reopen their economies as we progress through the COVID-19 pandemic, employers have begun calling back their employees. Employers should be taking steps to ensure the safety of their employees. The CDC recommends the following considerations when returning to work.

If you have or think you might have COVID-19, or if you've been around someone who has the virus:

• If you have or think you might have COVID-19, you should self-isolate, whether or not you have symptoms.
• If you may have been exposed to COVD-19, you should stay home in quarantine.

If you or someone else in your household is at increased risk:

• If you are considered to be at increased risk, check with you employer to see what policies or practices are in place to keep you safe. These may include telework, modifying the hours you work, your job responsibilities, etc.

Protecting yourself and others at work:

• Stay home when needed: As previously mentioned, if you have or think you might have COVID-19, if someone in your household has COVID-19, or if you've been in recent contact with someone who has COVID-19, stay home and follow CDC guidelines on what to do if you are sick.
• Monitor your health: Be alert for symptoms and take your temperature if you develop symptoms.
• Wear a mask: Wear a mask in public settings where social distancing is not possible. Mask can help prevent the spread of the virus.
• Social distance in shared spaces: Maintain at least 6 feet of distance between you and others, especially in indoor spaces.
• Wash your hands frequently: Wash your hands often with soap and water for at least 20 seconds or use hand sanitizer gel with at least 60% alcohol if soap and water are unavailable.
• Cover your mouth and nose when you cough or sneeze: Make sure to cough or sneeze into a disposable tissue or into your elbow and dispose of used tissues immediately.
• Avoid sharing objects and equipment: Try to avoid using other employees' offices, desks, phones or other work equipment where possible. Make sure to disinfect before and after use if you cannot avoid it.
• Clean and disinfect frequently touched objects and surfaces: Disinfect objects and surface that you use frequently at work, such as telephones, keyboards, workstations, doorknobs, and handrails.

I'm at increased risk for COVID-19 and I'm afraid of catching it if I go back to work. What are my rights?

Under the Americans with Disabilities Act (ADA), if you work for a company that has 15 or more employees, you have the right to request a "reasonable accommodation" if it does not cause "undue hardship" to the company, or an action requiring "significant difficulty or expense," as defined by the Equal Employment Opportunity Commission (EEOC). If the accommodation

Telework is considered to be a reasonable accommodation during the COVID-19 pandemic, and employers that are under the ADA must consider it and take steps to accommodate it.

If your company has fewer than 15 employees and therefore does not have to comply with the ADA, you can check the enforcement agency in your state to see if there are laws that apply to smaller employers.

I'm in the increased risk group for COVID-19 but my employer won't let me telework, even with a doctor's note. What can I do?

You should first contact your employer in writing and ask for a clarification as to why you were denied and to discuss the situation further. Your employer may be willing to reconsider their decision after further discussion or may be willing to consider other accommodation options. If the discussion in unsuccessful, you can file a complaint with the EEOC.

My job can't be done from home or by telework. What options do I have?

Under the ADA, you can request a leave of absence as an accommodation. Another option would be to talk with your manager or supervisor about possible accommodations that could be made to help reduce your exposure, such as temporarily modifying your job role or tasks, modifying the times you work, or finding a separate workspace for you.

You may also be eligible for paid leave under the Families First Coronavirus Response Act (FFCRA), which applies to government and public school employees and to those who work for companies with 50 or more employees. The FFCRA goes through December 31, 2020, and incorporates two parts: paid sick leave and paid expanded family and medical leave. It provides relief for:

• Employees who are under a quarantine or self-isolation order by their local government or by the advice of their healthcare provider
• Employees who are caring for someone else in quarantine
• Employees who have COVID-19 symptoms
• Employees who have to care for a child because of school closing, shelter-in-place order, or other COVID-19-related reasons

Eligible employees can receive two weeks (80 hours) of paid leave at their regular pay rate if they are unable to work (or telework) because they are quarantined or have COVID-19 symptoms. If they can't work because they are taking care of a child whose school is closed or someone in quarantine, they may receive up to two weeks of paid sick leave at two-thirds of their regular rate. Under the expanded family and medical leave, an employee who has been working for at least 30 days and has to take care of a child because of school closures may receive up to 10 additional weeks of paid leave at two-thirds of their regular rate.

If you are an independent contractor, you may be eligible for unemployment benefits under the CARES (Coronavirus Aid, Relief and Economic Security) Act, which allows states to extend unemployment to people who are usually not eligible. Each state decides independently how to implement this.

Testing for COVID-19: What kind of tests are there? Who should be tested? Where can I get tested?

Since August 24, 2020, the CDC recommends COVID-19 tests for people who are exhibiting COVID-19 symptoms, people who have had close contact with someone confirmed to have COVID-19, or people who have been asked or referred to get a test by their healthcare provider, local, or state health department.

We recently published an article detailing the latest information on types of tests and testing locations across the US: How to get tested for the coronavirus (COVID-19)?

Self-isolation, quarantine? What to do after being tested for COVID-19?

If the result is positive:

A positive result means you had coronavirus when the test was done. If your test is positive, you shouldstay home and self-isolate.

• Stay home and away from others except to get medical care
• As much as possible, stay in a specific room and away from other people in your home. If you need to be around other people at home, wear a mask.
• Monitor your health - follow care instructions from your healthcare provider and local health department
• Look for emergency warning signs for COVID-19 (trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, bluish lips or face). If you or someone else is showing any of these signs, call 911 or call ahead to your local emergency facility.
• Call ahead before visiting your doctor - call ahead, many medical visits for routine care are being postponed or done by phone or telehealth.
• Rigorously follow the barrier gestures.
• You can be around others after:
• 24 hours with no fever, and
• Respiratory symptoms have improved (e.g., cough, shortness of breath), and
• 10 days since symptoms first appeared

If you tested positive for COVID-19 but had no symptoms, you can be with others after 10 days have passed since you had a positive viral test for COVID-19.

If you test positive for COVID-19, someone from the health department may contact you to check on your health, discuss who you have been around, and ask where you have spent time while you may have been able to spread COVID-19 to others. This is called contact tracing. It is important to trace close recent contacts to inform those who may be at risk, reduce the spread of the infection, and potentially save lives.

If the result is negative:

A negative result means the test did not find coronavirus. The test result only means that you did not have COVID-19 at the time of testing. In this case, there are two scenarios:

• People experiencing COVID-19 symptoms
• People who have been in contact with a sick person

If you are still having COVID-19 symptoms but have tested negative, you should still continue to take steps to protect yourself (follow the barrier gestures and respect a period of isolation until at least 10 days since you symptoms first appeared).

If you've been in close contact (within 6 feet for at least 15 minutes) of someone who has COVID-19:

• You should stay home for 14 days after your last contact with a person who has COVID-19
• Watch for fever (100.4°F) , cough, shortness of breath, or other symptoms of COVID-19
• Stay away from others

If the result is unclear, void, borderline or inconclusive:

An unclear, void, borderline or inconclusive results means that it's impossible to say if you had coronavirus at the time of the test. In this case, you should get another test done as soon as possible.

If you had the test done because you were exhibiting symptoms, you should continue self-isolating and get another test within 5 days of the first signs of symptoms.

Wearing masks: When to wear one? What happens if I don't wear one? How to keep my glasses from fogging up? How to avoid skin issues?

When should I wear a mask? Are there any exceptions to wearing a mask?

The CDC does not recommend wearing a mask in the following cases:

• Children younger than 2 years old
• Anyone who has trouble breathing
• Anyone who is unconscious, incapacitated, or otherwise unable to remove the mask without help

Note: These exceptions may vary across the US, make sure to check with your state or local health department here.

Face shields:

Face shields are principally used to protect the eyes. It is not yet known what level of protection a face shield provides to people nearby from the spray of respiratory droplets from the wearer. The CDC does not currently recommend use of face shields as a substitute for masks.

What happens if I don't wear a mask?

Depending on the situation and location, you may be denied services, asked to leave a business, fined, or even charged for not wearing a mask. Make sure to consult your state or county government's website to find out about mask regulations in your area.

For a detailed overview of the mask regulations, types of masks, and more, check out our recent article: Coronavirus (COVID-19) masks: Legislation, types, prices and more!

How to keep my glasses from fogging up with a mask?

While masks are already a challenge within themselves due to their hot or uncomfortable nature, those of us who wear glasses may have an additional hurdle in getting used to them: fogged lenses.

Glasses tend to fog up when you wear a mask due to a simple scientific explanation: when warm air (like your breath) hits a cold surface (such as your lenses), condensation can form. Here are a few tips to help prevent this from occurring:

• Use your glasses to seal your mask closed: By wearing your mask higher up on your nose, you can place your glasses over the top of the mask to seal the mask closed and keep the warm air from exiting.
• Make sure to choose a well-fitting mask: A mask with a nose-bridge may help to keep the warm air escaping from the top of your mask and fogging up your lenses. You can purchase masks that have a nose bridge or that can be molded to the face. If you've chosen to make one yourself, you can sew a pipe cleaner or twist tie into the top so it can be shaped to fit the nose.
• Rinse your lenses in soap and water: Simply wash your lenses with soapy water and let them air dry or wipe them with a dry cloth. The soap will leave behind a thin film that will act as a barrier against condensation. Some glasses may have a special coating on them, so make sure to check with your optician before trying!
• Use an anti-mist wipe or spray: Some chemists or opticians may sell specials sprays or wipes for exactly this purpose. Before trying, make sure to check the ingredients so that it won't damage the coatings on your lenses or hurt your eyes.

How to avoid skin issues caused by wearing a mask?

“Facial skin is not physiologically adapted for wearing a mask. It is thin and reacts more quickly to abrasion”, explains dermatologist Dr. Radostina Bachvarova. She continues: "The friction of the mask on the fragile areas of the face, especially on the top of the nose where some masks equipped with a steel bar rest. This irritates the skin and damages the natural cutaneous barrier. When this skin barrier is damaged, skin problems occur."

The most common skin issues that can occur are:

• Eczema: also called atopic dermatitis, this is an inflammation of the skin that can result from pruritus in the areas where the mask sits, i.e. itching and associated redness.
• Psoriasis of the face: repeated friction from the mask can irritate the skin, plaques psoriasis may appear.  
• Acne and rosacea: acne and redness on the skin appear as a result of repeated friction from the mask on the skin and are aggravated by heat and perspiration.

Here are a few tips to help you cope with wearing a mask:

• Refresh your face regularly (with a thermal water spray),
• Drink plenty of water
• For men, shave your beard
• Apply less make-up
• Choose anti-irritating moisturizing creams, to be applied morning and evening.
• Cleanse your skins with a neutral pH or slightly acidic product to restore the balance of the skin's microbiota
• Avoid neoprene masks, especially for those with latex allergies, synthetic materials or masks that are very colorful and contain irritating dyes or substances. Instead, choose a surgical mask or a fabric mask made of cotton and in a neutral, pale color.

Can breathing difficulties be avoided when wearing a mask?

People with asthma, COPD, cystic fibrosis, pulmonary fibrosis or bronchitis should pay attention to their choice of mask. "A mask that is too airtight, like respirator masks, will be difficult to wear for a prolonged period of time" says allergist Dr. Sophie Silcret-Grieu.

For people who suffer from respiratory problems, it is therefore advisable to be cautious when choosing a mask, "preferably a surgical type, but the best thing is to try several models and to opt for the one that suits you best," recommends the doctor.

Do you become immune after having COVID-19?

It is now a certainty: you can catch COVID-19 twice, and even be sicker the second time. These cases of re-infection are still very rare but raise many questions about the duration of immunity and the course of the pandemic.

According to medical journal The Lancet Infectious Diseases, five cases have been confirmed worldwide so far: in Hong Kong (this was the first, announced on August 24th), Belgium, the Netherlands, Ecuador and in Nevada.

In patients in Nevada and Ecuador, the second infection was more severe than the first, while this was not the case in the other three. For scientists, the fact that the Hong Kong patient did not develop symptoms the second time is a sign that his immune system learned to defend itself after the first infection - his second COVID-19 infection had been discovered by chance, thanks to a screening test at the airport when he was returning from Europe.

People who have tested positive for COVID-19 should therefore continue to take all possible precautions, including social distancing, wearing a mask and washing their hands, as re-infection is possible.

Thank you for participating in this important survey, which has allowed us to answer questions you may have had. We are committed to relaying the most relevant information to you and through this survey, we were able to do so.

Please don't hesitate to let us know if other surveys of this type might be of interest to you in the comments below!

Was this article helpful to you?

Share your thoughts and questions with the community in the comments below!

Take care!