CDC Expands List of Those With Higher COVID-19 Risks: What to Know
By Moira McCarthy
The Centers for Disease Control and Prevention (CDC) has updated its list of underlying conditions that may lead to more severe outcomes from a COVID-19 diagnosis.
The agency is warning that people with type 2 diabetes, kidney disease, whole organ transplants, and women who are pregnant could experience more severe outcomes if they contract COVID-19.
The updated guidelines also remove 65 as the age when more severe outcomes may occur. Instead, it is suggesting as people age, the chance of severe outcomes increases.
What does this mean to the public?
By removing a set age cut off, the updated guidelines give notice to people with underlying conditions of all ages that they are more likely to end up in an intensive care unit (ICU) if they contract the virus.
The guidelines do not suggest that people with these underlying conditions are more susceptible to developing COVID-19.
What should the public do?
Experts say the key is to stay in the know and practice safe habits such as masking, physical distancing, and, when needed, isolation.
A Close Look at the New Conditions
Here's a look at some of the underlying conditions added to the CDC list.
"Pregnancy is a situation with all kinds of hormonal changes in the mix," said Dr. Alan Fishman, medical director for Obstetrix Medical Group in San Jose, California, and board certified in obstetrics and gynecology and maternal-fetal medicine. "Pregnancy is a stress on a healthy woman's body."
That's why, he said, a pregnant woman who contracts COVID-19 may face more severe outcomes.
"It appears that pregnant women [who contract COVID-19] are 5.5 times more likely to be hospitalized than a non-pregnant woman," Fishman told Healthline. "That's pretty significant."
"There is zero evidence that women who are pregnant are more likely to get COVID-19," he added.
But the risks mean his office is carefully counseling those considering pregnancy.
"I counsel them to think about this information and how it sits with them," he said. "They have to remember that it is not a good idea to skip a medical appointment or space them out more."
While some pregnancy appointments can be done virtually, many must be done in person.
So what should a pregnant woman do?
"Common sense still holds," Fishman said.
Wear a mask, wash your hands, keep a physical distance, and isolate when needed is still the key, along with not missing any medical appointments.
"Clearly these types of modifications are going to be with us for a long time," he said.
There's been some confusion around COVID-19 in the diabetes community.
First, there's no evidence yet that people with diabetes are more likely to contract the novel coronavirus.
"The CDC has not come out and said that type 1 or type 2 diabetes makes you more susceptible [to COVID-19]," said Dr. Joshua Miller, the medical director of diabetes care for Stony Brook Medicine and an assistant professor of endocrinology and metabolism at the facility's New York Campus, told Healthline.
However, there is research that concludes people with diabetes can develop more serious cases of COVID-19.
"What we are absolutely seeing are that people who carry a comorbidity struggle more when they contract this," Miller told Healthline.
Figuring out what is going on with those with diabetes who contract COVID-19 is a challenge for healthcare providers.
"It's challenging looking at the numbers and statistics because the way in which we [track diabetes] in the medical world is a challenge," Miller said.
Even in medical reports, he said, type 1 can be mixed up with type 2.
Miller is working with the National Institutes of Health (NIH) to gather and assess data around COVID-19 patients with diabetes. But he points out that mixed information makes it harder to rely on the data.
Right now, the CDC has listed people with type 2 diabetes as being "at increased risk" of more severe outcomes if they contract COVID-19, and people with type 1 diabetes as "might be at an increased risk."
Miller, who has had type 1 diabetes for 21 years, knows one thing for sure.
"When [a person with diabetes] is in the hospital for this, their insulin needs go way up," he said.
Even those with type 2 diabetes who take medication may need injected insulin during treatment, he added.
His advice for those with any kind of diabetes?
"The big lesson we are learning here is simply this," he said. "The healthier our patients are, the better they do with COVID-19. Focus in earnest more than ever on your health. Across the board, the best outcomes come from this."
"While the area you live in has confirmed community spread, your risk is higher than not," he added. "Stay at home if you can. And always, wear the mask, wash your hands, keep that distance. Be smart, be safe."
The Aging Population
The CDC has moved away from a specific age cutoff for heightened concern to a more general statement on aging.
The CDC now says, "People in their 50s are at higher risk for severe illness than people in their 40s. Similarly, people in their 60s or 70s are, in general, at higher risk for severe illness than people in their 50s. The greatest risk for severe illness from COVID-19 is among those aged 85 or older.
That, say aging experts, is an important change.
"I have to give credit to the CDC for really clarifying that," Dr. Ronald Caplan, author of "The Care of the Older Person" and "Long Life Strategy," told Healthline. "Prior to this we were saying 65 and beyond, like the Cinderella phenomenon. At midnight (in this case 65 years of age) your coach just turns into a pumpkin? This is not the way medicine and real life works."
Caplan says that when you consider that 60 percent of Americans have some kind of underlying health condition, that 40 percent of adults are obese, and that many aging Americans have heart health issues, it just makes sense that as a person ages, a COVID-19 battle gets more challenging.
What should older people do?
"The more you know, the safer you can make yourself and the less anxious you will be," Caplan said. "We are all getting more familiar with this. We can see [the disease] attacks major organ systems, so knowing how to treat any [comorbidities] you have now will help you later."
His best tips for older adults?
"Older people should not neglect seeing their healthcare providers, now more than ever," Caplan said. "And get your vaccinations [for] flu and whatever else you need."
The older population should also be careful about self-isolating when there is community spread, but they should do so with support.
"Suicide among older people is a non-talked about thing, but it is a thing," Caplan said. "You lose a spouse, a friend or friends and all of a sudden you are alone, and then this virus comes along. It can be overwhelming."
He suggests for those who must isolate making a small trusted bubble of friends or family who visit and check on you.
He also repeats the suggestions to wear masks, maintain distancing, and wash hands.
"All those common sense measures that the CDC is giving us all go back to when I was a kid, before vaccinations," Caplan said. "This is what we did. And now, the answer is we need an effective vaccination. We're going to have to wait for that, though, and do the right thing in the meantime."
Expect additions, subtractions, and other changes to this list as the pandemic continues, experts say.
"It's a fascinating virus," Dr. Mary Dale Peterson, MSHCA, FACHE, FASA, president of the American Society of Anesthesiologists, told Healthline. "It has a propensity to attack organs, but we are still very much learning as we go along."
Some of what medical professionals are seeing makes historic sense, she added, such as people with obesity having more difficulty recovering and pregnancy taxing the heart and lungs.
As one who sees the impact of comorbidity on COVID-19 recovery first hand, Peterson has suggestions.
"The way I look at it is this: We all have our own set of risk factors," she said. "So look at what are in your spheres of control."
"I can make sure I take care of my chronic disease. I can eat a good diet. I can get up and actually not be a couch potato as tempting as it is to be one right now," she explained.
"Physical activity is actually a treatment we use in the hospital on COVID-19 patients," she added. "Double down on your healthy habits. It will only help."
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By Joe Roman and Taylor Ricketts
The COVID-19 pandemic in the United States is the deepest and longest period of malaise in a dozen years. Our colleagues at the University of Vermont have concluded this by analyzing posts on Twitter. The Vermont Complex Systems Center studies 50 million tweets a day, scoring the "happiness" of people's words to monitor the national mood. That mood today is at its lowest point since 2008 when they started this project.
The Hedonometer measures happiness through analysis of key words on Twitter, which is now used by one in five Americans. This chart covers 18 months from early 2019 to July 2020, showing major dips in 2020. hedonometer.org<p>These same tweets also indicate a potential salve. Before pandemic lockdowns began, doctoral student <a href="https://scholar.google.com/citations?user=0P0ZYbIAAAAJ&hl=en" target="_blank">Aaron Schwartz</a> <a href="https://doi.org/10.1002/pan3.10045" target="_blank">compared tweets before, during, and after visits to 150 parks, playgrounds and plazas</a> in San Francisco. He found that park visits corresponded with a spike in happiness, followed by an afterglow lasting up to four hours.</p><p>Tweets from parks contained fewer negative words such as "no," "not" and "can't," and fewer first-person pronouns like "I" and "me." It seems that nature makes people more positive and less self-obsessed.</p><p>Parks keep people happy in times of global crisis, economic shutdown and public anger. Research has also shown that transmission rates for COVID-19 are <a href="https://www.sfchronicle.com/news/article/Is-risk-of-coronavirus-transmission-lower-15287602.php" target="_blank">much lower outdoors than inside</a>. As scholars who study <a href="https://scholar.google.com/citations?user=yFzb2EUAAAAJ&hl=en" target="_blank">conservation</a> and how nature <a href="https://scholar.google.com/citations?user=CCnUeN8AAAAJ&hl=en" target="_blank">contributes to human well-being</a>, we see opening up parks and creating new ones as a straightforward remedy for Americans' current blues.</p>
Park Visits Are Up During the Pandemic<p>According to the Hedonometer, sentiments expressed online started trending lower in mid-March as the impacts of the pandemic became clear. As lockdowns continued, they registered the lowest sentiment scores on record. Then in late May, effects from George Floyd's death in police custody and the following protests and police response once again could be seen on Twitter. May 31, 2020 was the saddest day of the project.</p><p>Recent surveys of park visitors around the University of Vermont have shown people <a href="https://osf.io/preprints/socarxiv/sd3h6" target="_blank">using green spaces more</a> since COVID-19 lockdowns began. Many people reported that parks were highly important to their well-being during the pandemic.</p>
<div id="4c7e4" class="rm-shortcode" data-rm-shortcode-id="bc0ac146ab2a94228f32d973fc2ab272"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1289428912879964160" data-partner="rebelmouse"><div style="margin:1em 0">#Goldengatepark #sf #quarantinemood https://t.co/9l3ufnbkt6</div> — Suvd (@Suvd)<a href="https://twitter.com/Suvd19486406/statuses/1289428912879964160">1596258783.0</a></blockquote></div><p>The powerful effects of nature are strongest in large parks with more trees, but smaller neighborhood parks also provide a significant boost. Their impact on happiness is real, measurable and lasting.</p><p>Twitter records show that parks increase happiness to a level similar to the bounce at Christmas, which typically is the happiest day of the year. Schwartz has since expanded his <a href="https://arxiv.org/pdf/2006.10658.pdf" target="_blank">Twitter study</a> to the 25 largest cities in the U.S. and found this bounce everywhere.</p><p>Parks and public spaces won't cure COVID-19 or stop police brutality, but they are far more than playgrounds. There is growing evidence that parks contribute to mental and physical health in a range of communities.</p><p>In a 2015 study, for example, Stanford researchers sent people out for one of two walks: through a local park or on a busy street. Those who walked in nature showed <a href="https://doi.org/10.1016/j.landurbplan.2015.02.005" target="_blank">improved moods and better memory performance</a> compared to the urban group. And a team led by <a href="https://penniur.upenn.edu/people/eugenia-gina-south" target="_blank">Gina South</a> of the University of Pennsylvania showed in a 2018 study that greening and cleaning up blighted vacant lots in Philadelphia <a href="http://dx.doi.org/10.1001/jamanetworkopen.2018.0298" target="_blank">reduced local residents' feelings of depression, worthlessness and poor mental health</a>.</p>
Creative Strategies<p>It isn't easy to create new parks on the scale of San Francisco's Golden Gate Park or the Washington Mall, but smaller projects can expand outdoor space. Options include greening vacant lots, closing streets and investing in existing parks to make them safer, greener and shadier and support wildlife.</p><p>These initiatives don't have to be capital-intensive. In the University of Pennsylvania study, for example, renovating a vacant lot by removing trash, planting grass and trees and installing a low fence cost only about US$1,600.</p><p>Urban green space is most needed in neighborhoods that have lacked funding for parks, especially given <a href="https://www.nytimes.com/2020/04/08/nyregion/coronavirus-race-deaths.html" target="_blank">COVID-19's disproportionate impact on Black and Latinx people</a>.</p><p>Cities can also create parklike spaces by <a href="https://theconversation.com/with-fewer-cars-on-us-streets-now-is-the-time-to-reinvent-roadways-and-how-we-use-them-140408" target="_blank">closing streets to cars</a>. Many cities worldwide are currently retooling their transportation systems for the post-COVID-19 world in order to <a href="https://thecityfix.com/blog/bicycles-slower-speeds-livable-city-paris-mayor-anne-hidalgo-plans-ambitious-second-term-dario-hidalgo/" target="_blank">reallocate public space</a>, widen sidewalks and make more space for nature.</p><p>Urban designers, artists, ecologists and other citizens can play a direct role, too, creating pop-up parks and green spaces. Some advocates <a href="https://www.bloomberg.com/news/articles/2017-09-15/a-brief-history-of-park-ing-day" target="_blank">transform parking spaces into mini-parks</a> with grass, potted trees and seating for just the time on the meter, to make a larger point about turning so much public space over to cars.</p><p>Or cities can invest a little more. Minneapolis, Cincinnati and Arlington, Virginia, have won <a href="https://www.tpl.org/parkscore" target="_blank">national recognition</a> for their ambitious investments in public park systems. These areas could serve as models for neighborhoods that lack access to parks.</p>
<div id="25fd0" class="rm-shortcode" data-rm-shortcode-id="383f0d2df0237e9359c30dcce6cd6c42"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1276558744835379201" data-partner="rebelmouse"><div style="margin:1em 0">Looking to safely get outside? Check out the best parks for social distancing in this year's top ten ParkScore citi… https://t.co/HJjEtDsrTD</div> — The Trust for Public Land (@The Trust for Public Land)<a href="https://twitter.com/tpl_org/statuses/1276558744835379201">1593190296.0</a></blockquote></div>
A New Park Deal?<p>The United States has historically driven economic recovery with major infrastructure investments, like the New Deal in the 1930s and the 2009 <a href="https://www.investopedia.com/terms/a/american-recovery-and-reinvestment-act.asp" target="_blank">American Reinvestment and Recovery Act</a>. Such investments could easily include nature-positive spaces.</p><p>Parks are not panaceas, as evidenced by the widely publicized <a href="https://www.nytimes.com/2020/07/06/nyregion/amy-cooper-false-report-charge.html" target="_blank">racist confrontation between a white woman and a Black birder</a> in New York's Central Park in early July. But Hedonometer data add to a <a href="https://advances.sciencemag.org/content/5/7/eaax0903?utm_source=miragenews&utm_medium=miragenews&utm_campaign=news" target="_blank">growing body of evidence</a> that they provide <a href="https://doi.org/10.1073/pnas.1807504116" target="_blank">clear mental health benefits</a>. Creating and expanding parks also <a href="https://www.nrpa.org/contentassets/f568e0ca499743a08148e3593c860fc5/economic-impact-study-summary.pdf" target="_blank">generates jobs and economic activity</a>, with much of the money spent locally.</p><p>We believe investments in nature are well worth it, offering both short-term solace in difficult times and long-term benefits to health, economies and communities.</p>
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<div id="7eb49" class="rm-shortcode" data-rm-shortcode-id="83819841e380a7072ec66d3186c160e8"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1291705003984510977" data-partner="rebelmouse"><div style="margin:1em 0">🚨RESPONSE to #Mauritius #OILSpill 🚨 “Once again we see the risks in oil: aggravating the #ClimateCrisis, as well as… https://t.co/PBLioZat6X</div> — Greenpeace Africa (@Greenpeace Africa)<a href="https://twitter.com/Greenpeaceafric/statuses/1291705003984510977">1596801446.0</a></blockquote></div><p>"There is no guaranteed safe way to extract, transport and store fossil fuel products. This oil leak is not a twist of fate, but the choice of our twisted addiction to fossil fuels. We must react by accelerating our withdrawal from fossil fuels," Greenpeace Africa Senior Climate and Energy Campaign Manager Happy Khambule said in a <a href="https://www.greenpeace.org/africa/en/press/11864/greenpeace-africa-response-to-mauritius-oil-spill/?utm_campaign=oil&utm_source=t.co&utm_medium=post&utm_content=single-image&utm_term=mauritius-oil-spill-reactive" target="_blank">statement Friday</a>. "Once again we see the risks in oil: aggravating the <a href="https://www.ecowatch.com/tag/climate-crisis" target="_self">climate crisis</a>, as well as devastating oceans and <a href="https://www.ecowatch.com/tag/biodiversity" target="_self">biodiversity</a> and threatening local livelihoods around some of Africa's most precious lagoons."</p>
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By Gianna-Carina Grün
While the first countries are easing their lockdowns, others are reporting more and more new cases every day. Data for the global picture shows the pandemic is far from over. DW has the latest statistics.
What's the Current Global Trend?<p>The goal for all countries is to make it to the blue part of the chart and stay there. Countries and territories in this section reported zero new cases both this week (past seven days) and the week before.</p><p>Currently, that is the case for 14 out of 209 countries and territories. </p>
How Has the Covid-19 Trend Evolved Over the Past Weeks?<p>The situation has improved slightly: 87 countries report more cases this week than last week. </p>
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