Doctor’s Note: Coronavirus and ‘underlying health conditions’

It is becoming a bit of a mantra; we hear it whenever anyone is talking about the coronavirus: “The elderly and those with underlying health conditions are most at risk.”

But what are these underlying health conditions we should worry about and does that mean that anyone with a long-term health issue is doomed to fall victim to the complications of Covid-19?

Well, the short answer is, not necessarily.

There is a good chance that even those who have underlying health conditions will make a full recovery from the virus, but they are at increased risk of complications such as shortness of breath, pneumonia, and in some cases, needing a machine and intensive hospital treatment to help them breathe. 

We are learning new things about the virus all the time but current evidence shows that people who have diabetes (of any kind) are most at risk of developing complications and needing intensive hospital care, followed by those with underlying heart conditions, then lung conditions such as asthma and chronic obstructive pulmonary disease (COPD).

So, in addition to washing your hands, practising “social distancing” and sticking to good overall hygiene measures, there are a few other things you can do to minimise your risk.

Here are some of the long-term health conditions we need to be concerned about.

Diabetes

Some 415 million people around the world are thought to have diabetes. People with diabetes do not produce enough of the hormone, insulin, or their body has become resistant to the effects of insulin.

Insulin is needed to break down sugar and release energy for your body to use. If you are not producing insulin, sugar can build up to harmful levels in your blood.

Diabetes is top of the coronavirus risk list for a good reason – high levels of sugars in your blood can dampen your immune system. If your blood sugars have been poorly controlled for some time, this can cause the white cells that help fight off infection to become weaker and fewer in number, leaving you prone to catching infections as well as suffering from the complications of them.

It doesn’t matter what type of diabetes you have – now is a really good time to get on top of your sugars.

Speak with the clinician who manages your diabetes and make sure you are on the right medication. 

Ensure you are taking your medication as prescribed. It may sound silly but lots of my patients forget to take their medication or only take it when they see fit.

Improving your diet by cutting down on carbohydrate-rich foods (bread, chapattis, potatoes and pasta, as well as cakes and sweets) and increasing your physical activity levels will help to bring your blood sugars down and help give your immune system the best possible chance of fighting off the coronavirus.

If you are self-isolating, there are simple exercises you can do at home. Brisk walks around the garden for 10 to 15 minutes a day and climbing the stairs a few times a day is enough to get your heart racing and get you breathing a bit harder – all of which will go some way to improving your physical health.

Heart conditions

According to the World Health Organization (WHO), heart disease is the number one cause of death worldwide for both men and women of all races. We must manage this as best we can during the coronavirus outbreak.

In my experience, people with high blood pressure or high cholesterol frequently fail to take their medication as prescribed because they do not always have any physical symptoms of either of those things.

But over time, high blood pressure and high cholesterol will put considerable pressure on your heart and its ability to pump blood around your body, making you prone to infections.

The same advice applies here; take your medication and look at your diet and lifestyle choices. Once again, avoiding carbohydrate-heavy foods and increasing your uptake of vegetables and lean meats such as chicken and fish will help. These simple changes may just save your life.

Asthma and COPD

Approximately 235 million people worldwide have asthma and 65 million have COPD.

Most people who have significant asthma or COPD are prescribed two groups of inhalers. The first are preventers, which are taken every day (even if you are feeling well) to help improve your background lung function and reduce the risk of a flareup of your condition. The others are relievers – usually a blue inhaler that is taken only when you are feeling short of breath or wheezy. Really, you should not need this inhaler much. 

If you are using your reliever inhaler more than two to three times per week, it would suggest your background lung health is not under control and you should speak with the clinician who manages your condition to see whether or not you need stepping up your treatment. 

Having good background lung health will go a long way towards reducing your risk of Covid-19 complications including severe respiratory problems and even pneumonia.