By Glenn Ellis
Since the start of the COVID-19 pandemic, we’ve known that people with pre-existing chronic conditions are more vulnerable to becoming infected. At this point, the Centers for Disease Control and Prevention (CDC) has found that 78 percent people admitted into intensive care for COVID-19 had at least one underlying chronic condition.
It’s certainly no secret to anyone that the entire African American population in this country is at highest risk of infection and death from the COVID-19 virus.
One of the most important things for black folks to realize is that, unlike how it’s being depicted on the news, this is affecting the entire African American community; not just isolated incidents in certain cities. If we failed to understand this, then we will foolishly believe that what’s happening in areas like Philadelphia; Chicago; the Bronx; District of Columbia; and New Orleans, is unique. Make no mistake; it’s clear that there’s a disproportionate impact of COVID-19 cases and deaths among African Americans.
Special interest, as always, to our elders. It’s clear that older adults are more likely to experience severe symptoms with COVID-19, the respiratory disease caused by the coronavirus. And a lot of that has to do with “a gradual deterioration of their immune system” that happens as with aging.
Here are the facts: about 80 percent of older adults have at least one chronic disease. More than two-thirds of all health care costs (out of a more than $3 trillion budget) are for treating chronic diseases while 95 percent of health care costs for older Americans can be attributed to chronic diseases.
For African Americans, it’s worse. Seventy percent of retirement-age blacks have, or are being treated for high blood pressure. African Americans have higher rates of diabetes, hypertension, and heart disease than other groups. The Department of Health and Human Services’ data shows that African American adults are 60 percent more likely to have been diagnosed with diabetes by a doctor, and three and a half times more likely to die as a result of the diabetes. Nearly 15 percent of all African Americans have diabetes. Up to a third of diabetics have never been diagnosed. Viral infections also can increase inflammation in people with diabetes and raise the risk for a life-threatening condition where the blood becomes too acidic, according to the American Diabetes Association (ADA). Both the virus, and the condition it can trigger in diabetics, can be life-threatening.
The Greater Risk
Keep in mind that having diabetes, alone, doesn’t put you at greater risk. It’s really uncontrolled diabetes that puts you at risk for secondary infections like this coronavirus.
Underlying heart conditions can escalate the seriousness of any infection, including COVID-19. That’s because someone who has had a heart attack or has chronic high blood pressure can also have a weak heart muscle. This means that the virus makes the heart and the lungs work harder, and this leads to added stress on the heart, which then can have a ripple effect on other organs, causing kidney failure; even cause multi-organ failure.
We must become more diligent about paying proper attention to older African Americans in our families and in our lives.
Specific attention has to paid to the challenges for people living with dementia and similar forms of cognitive impairment. They may have difficulty understanding the dangers of infection. Also, they may forget to follow safety precautions, such as washing their hands or practicing physical distancing. Those who care for people with dementia and have contracted the virus may also avoid seeking treatment or being hospitalized because they cannot afford to leave their elders alone.
On the other hand, people with dementia themselves who have COVID-19 and need hospitalization may avoid it because they fear that, due to hospital triaging protocols, they may fall at the bottom of the ladder when it comes to receiving medical resources and attention.
The final saving grace for us all will be when we reach a point of herd immunity. The American Heart Associations’ Chief Medical Officer for Prevention issued the following statement: “If a large group of people – the herd – is immune to a virus, then an individual in the middle of this group is unlikely to become infected. Herd immunity, then, happens when people in a community are protected from a virus and its associated disease to a degree that people who are not immune are still protected because of the high population immunity.”
It is important that under no circumstances should we, or the people are caring for during this time, with pre-existing chronic conditions, neglect continuing to take their medications and follow other treatment plans from their doctor.
Whether this happens by way of a vaccine that enough of us take, or by enough of us going outside, without following precautions, and get infected. This is the only way we will have any degree of protection as a society. Either way, we should all expect that the length of the pandemic will likely be 18 to 24 months, as herd immunity gradually develops.
Until then, even when restrictions are totally lifted, as long as just one person is infected in the community, it is best to keep your guard up and practice social distancing and frequent hand washing. And wear a face mask…especially if you are African American. The odds, as always, are against us.
Don’t Forget Your Face Mask…
Glenn Ellis, is a Harvard Medical School Research Bioethics Fellow and author of Which Doctor?, and Information is the Best Medicine. For more good health information visit: www.glennellis.com.