Dealing with a Chronic Disease During the COVID-19 Epidemic

Chronic diseases, or conditions that require ongoing medical attention, can limit daily acitivity and enjoyment. These illnesses, such as heart disease, cancer, and diabetes, are some of the leading causes of death and disability across the world. Having a long-term illness can cause stress and anxiety, especially if symptoms are rapidly changing or other problems arise. For many though, constant treatment and monitoring are part of a routine schedule. But how does the introduction of a new virus, such as the virus causing COVID-19, impact those living with chronic diseases? Dr. Christian Lemm, a medical doctor with Beijing United Family Hospital's Center for Family Medicine and Integrative Health Care, provides some insights on the potential impact of COVID-19 on managing chronic diseases and how to stay healthy during this time.   

Does having a chronic medical condition put someone at increased risk of getting COVID-19?

So far we do not know if those living with a chronic medical condition may get the infection easier than a person with no chronic medical condition, but it is to be assumed that chronic medical conditions that lead to a reduced immune defense, like diabetes mellitus or diseases being treated with drugs to suppress our immune system (long-term steroids or immune modulating drugs as used for some chronic or chronic recurrent inflammatory diseases or autoimmune diseases (e.g. Rheumatoid arthritis, Ankylosing spondylitis), make a patient more vulnerable to getting the infection. Also an unhealthy lung (e.g. chronic obstructive pulmonary disease (COPD), asthma, other lung diseases) might make it easier for the virus to penetrate our defense barrier).

Does having a chronic medical condition put someone at increased risk for getting severe symptoms or COVID-19 related outcomes?

Yes. This is something that seems to be the case when the experts look at the outcomes data and statistics of the infected patients up to this point.  

How can someone with a chronic condition avoid the COVID-19 disease? Are there specific precautions they should be aware of?

It is the same for these patients as for all the other patients. Wear a suitable (surgical or medical N95) mask whenever going outside of your home. Wash and disinfect your hands regularly and frequently. When out of your own home, avoid crowds or small closed spaces/rooms. Do not touch your eyes and face when outside or do so only after disinfecting your hands. Try to have your chronic illness under control as much as possible (e.g. good blood sugar control if you live with diabetes, good symptomatic control of asthma or COPD). Lead a healthy lifestyle with enough fluids (preferably water), healthy food, and enough sleep.

Should someone with a chronic condition continue to take their medication for their condition? What happens if their prescription runs out or they are unable to refill a prescription?

Yes, absolutely. The patient should continue taking their medication for their chronic condition. If the prescription runs out, the patient can contact the hospital and ask for a doctor to call the patient back in order to discuss if the medication can be prescribed during these times with just a telephone follow-up, or if there is an urgent need for the patient to have any tests done that cannot wait for the next few months, until the situation regarding the Coronavirus outbreak has hopefully improved.

Are there any contraindications from COVID-19 treatment that may impact those living with a chronic disease? Or vice versa, does medication for certain chronic diseases interact poorly with COVID-19 treatment?

At the moment there is no proven treatment for COVID-19, specifically. All specific treatment regimens are currently in a trial phase and it might take some time to get reliable results of effective treatment options.

Should someone with a chronic disease keep his or hers regularly scheduled appointments? Or should these be postponed?

Again, this can be discussed with a doctor over the telephone. For the patient with a chronic disease who has a regularly scheduled follow-up appointment, it is advised that she or he calls the hospital and asks for a call back from a doctor from the department she or he was going to visit in order to discuss if follow-up in person is needed at this time. 

What should someone with a chronic condition do if he or she begins to feel sick?

This depends on the symptoms. If the symptoms are severe or indicate urgency, like a possible heart attack, acute appendicitis, or other emergency, the patient can call the hospital emergency telephone number or go to the emergency room, where she or he will be triaged by our healthcare professionals.

If the patient has some milder symptoms of illness then again, a telephone call with a doctor is recommended to evaluate if a patient needs to be seen in the hospital or other recommendations might be helpful.

Is there any other advice you would like to give to someone with a chronic condition during this unique time?

Try to stay positive even if there are a lot of inconveniences at the moment, and try to adhere to your chronic disease treatment plan in order to have this chronic disease controlled as much as possible during this time. And take the precaution measures/advice seriously. 

Dr. Lemm is an experienced Family Medicine physician, with over 20 years of medical experience. Our Family Medicine team of physicians consists of experienced family doctors, general practitioners, and internal medicine doctors from around the world. They are specially trained to provide comprehensive medical care for infants, children, and adults of all ages, addressing the needs of the whole person; body, mind, and spirit, to help each client reach their wellness goals. To make an appointment with Dr. Lemm or one of our other Family Health physicians, please call our 24hr service center at 4008-919191.