When the coronavirus first started to appear in the United States, I was worried.
I was just getting over a bout of the flu (by the way, this virus is NOT the flu — more on that later), I have a history of asthma, I am just now a year and a half away from my cancer diagnosis and I have autoimmune disease.
Many of these are the same risk factors that have been warned about with COVID-19. I was concerned that my body would not handle any kind of attack at that point in time.
Since that time, we have learned a lot more about this virus and how it acts, but guess what? It is a fickle virus.
It does not always follow a specified pattern, and just when you think you have some part of it figured out — BAZINGA — something different happens. It is called a novel virus because it is NEW — we have never seen it before, and therefore we knew absolutely nothing about it.
What we did know is how the MERS virus and the SARS virus and even the influenza virus acted. We have seen them, and we know a little more about them, but they too can be a little unpredictable. Any virus can mutate or change, and they do.
Currently, we still do not have all the answers. A quick look at clinicaltrials.gov shows me that there are 1450 clinical studies registered as of today looking at COVID-19. Until we have solid, randomized controlled studies, we really will not have good outcomes data. In the meantime, what we do have are anecdotal findings, smaller studies out of other countries and a few right here in the United States.
I have participated in countless webinars or webcasts over the past two months learning as much as I can about the role of nutrition in the critically ill COVID-19 patient, and every single one has prefaced it by saying that this data has not yet been validated or peer-reviewed. That means we have information, but we do not have all the answers. A quick media search will tell you the same thing. They bombard you with information about the latest and greatest treatment or medicine but again we are still trying things out — trying to see if the spaghetti sticks to the wall.
So, about those risk factors. The CDC currently says that based on what we know, some people might be at higher risk for severe illness from COVID-19. These include older adults (aged 65 or over) or people of any age with underlying health conditions. Some of these underlying health conditions include asthma, chronic kidney disease, chronic lung disease, diabetes, hemoglobin disorders, being immunocompromised, severe obesity and serious heart conditions. Serious heart conditions include heart failure, coronary artery disease, cardiomyopathies and pulmonary hypertension.
What can you do if you have any of these conditions? Keep your health conditions under control. That means following your medical management plan as well as your nutrition and exercise prescriptions. More specifically you should keep the following in mind:
Asthma or chronic lung disease
Follow your Asthma Action Plan.
Avoid triggers that make your condition worse.
Continue current medications.
Chronic kidney disease
If you are on dialysis, do not miss appointments.
Check your blood sugar.
Continue taking your diabetes pills and insulin as prescribed.
Know your sick day rules.
Immunocompromised (cancer therapy, HIV, and other immune weakening conditions)
Continue with recommended treatments.
Continue taking your medications as prescribed.
Manage and control blood pressure.
Severe obesity (BMI 40 or above)
Take medications for underlying health conditions.
These underlying health conditions, especially when not well-controlled, can lead to more serious complications with COVID-19. Think about it: If I have health issues when I am “well,” how much worse can they get when I am “sick.” My asthma is normally well-controlled, but when I had the flu, I had to pull out the nebulizer for more advanced treatment. Trying to keep things as in check as possible is the best route to go.
With COVID-19, things can rapidly go from bad to worse, and the truth is that we do not know which patients will do this. We know from looking at the data on patients diagnosed with COVID-19 that many with critical illness related to it also had underlying health conditions. Keep in mind that people of all ages and all degrees of health and illness have been diagnosed with this virus.
Now, back to that flu thing. One of my biggest pet peeves is when the naysayers say, “It’s just the flu.” I know that early on a lot of statements were made that some people only experience mild, flu-like symptoms. That is still true. Some people will have fever, cough, body aches or chills, nausea and diarrhea — many of the same things we know about the flu. And then it gets worse. Then it gets unpredictable. Then we are in territory where we simply do not have answers, where all of the things that usually work no longer work.
Let me reiterate that this is a NOVEL (translation: NEW) virus, and we do not have all the answers. What we do have is a dedicated team of health professionals that are collaborating both locally and across the country, even across the world, trying to find the solutions. We want everyone to do well, but we need you to do your part, too. If you are currently in good health — congratulations — keep up the good work. If you, like me, have underlying health conditions, we need to step up and do all the right things now.
If you have questions about any of your health issues, discuss them with your provider. Many are offering telehealth options right now if you are uncomfortable with visiting the office in person. Do not delay seeking medical attention for your underlying health conditions out of fear of COVID-19. It would be much better to get those issues addressed than to show up too late.
Until next time…live healthy!
Kimberly Alton, RD, CSSD, LD, is the
director food and nutrition services at
Carolina Pines Regional Medical Center.