Updated as of Wednesday, August 5, 2020
Positively Aware and TPAN are committed to keeping our community and staff safe. Our main concern is that everyone, particularly people living with HIV, takes the necessary precautions to protect themselves and their loved ones. Following is some general information and a list of resources that we’ve compiled from multiple sources that we hope you’ll find useful. Check back at PositivelyAware.com frequently as we continue to update this information. The CDC website and HIV.gov/coronavirus also have information that is continually being updated. The U.S. Dept. of Health and Human Services updated its Antiretroviral Guidelines and issued Interim Guidance for COVID-19 and Persons with HIV on March 20.
What is a coronavirus?
Coronaviruses are a large family of viruses that usually cause mild respiratory illnesses such as the common cold. The virus (SARS-CoV-2) that causes the disease (COVID-19) is currently spreading around the world, and was officially declared a pandemic by the World Health Organization (WHO) in March. At least six other types of coronavirus are known to infect humans, with some causing the common cold and two causing epidemics: SARS in 2002 and MERS in 2012. SARS-CoV-2 is a new coronavirus that was not identified in humans before December 2019, and is thought to have originated in bats.
Who is at risk?
Some people are at higher risk of getting very sick from this illness. This includes:
- Older adults
- People who have serious chronic medical conditions such as:
- Heart disease
- Lung disease
What are the symptoms?
Most cases are mild, but reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.
The following symptoms may appear 2–14 days after exposure to the virus:
- Shortness of breath or difficulty breathing
- Repeated shaking with chills
- Muscle pain
- Sore throat
- New loss of taste or smell
How is it spread?
The virus is thought to spread mainly from person-to-person.
- Between people who are in close contact with one another (within about 6 feet).
- Through respiratory droplets produced when an infected person coughs, sneezes or talks.
- These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
- Some recent studies have suggested that COVID-19 may be spread by people who are not showing symptoms.
Maintaining good social distance (about 6 feet) is very important in preventing the spread of COVID-19.
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads, but we are still learning more about this virus.
When to Seek Medical Attention
If you develop any of these emergency warning signs* for COVID-19 get medical attention immediately:
- Trouble breathing
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning to you.
Call 911 if you have a medical emergency: Notify the operator that you have, or think you might have, COVID-19. If possible, put on a cloth face covering before medical help arrives.
Recommendations for people with HIV:
- Ensure you have an ample medication supply
- 30-day supply at all times
- Keep vaccinations up to date
- Influenza, pneumococcal
- Establish a plan for clinical care if you become isolated/quarantined
- Telemedicine options
- Physician online portals
- Maintain a social network, but remotely
- Social contact helps us stay mentally healthy and fights boredom
At this time, the Chicago Department of Public Health recommends that people living with HIV follow the same guidance as the general population and do not need to take additional precautions (See: Preparedness Checklist for Individuals and Households), unless individuals are considered higher risk (See: Guidance for People at Higher Risk). Those at higher risk include:
- Persons over 60 years of age.
- People, regardless of age, with underlying health conditions including cardiovascular disease, diabetes, cancer, heart disease, or chronic lung diseases like COPD.
- People, regardless of age, with severely weakened immune systems.
According to the CDC, "At the present time, we have no specific information about the risk of COVID-19 in people with HIV.
“Older adults and people of any age who have a serious underlying medical condition might be at higher risk for severe illness, including people who are immunocompromised. The risk for people with HIV getting very sick is greatest in:
- People with a low CD4 cell count, and
- People not on HIV treatment (antiretroviral therapy or ART).
"People with HIV can also be at increased risk of getting very sick with COVID-19 based on their age and other medical conditions."
In a special session on COVID-19 at CROI 2020 in March, John T. Brooks, U.S. Centers for Disease Control and Prevention, in his presentation “Global Epidemiology and Prevention of COVID-19,” spoke about high-risk groups:
“Persons with medical co-morbidity and advanced age are at increased risk for severe illness and death. In the Chinese data I showed previously, persons with cardiovascular disease, diabetes, or chronic respiratory disease had a case fatality rate greater than 5%.
“Unfortunately, there aren’t data at the present time about persons who are immunocompromised, whether by medical therapy or acquired infection. But for persons with HIV, we think the risk for severe illness would be greater for persons at lower CD4 cell counts and who aren’t virally suppressed [have undetectable viral load], since we’ve seen the same pattern in other intercurrent illnesses in people living with HIV. Nonetheless, all persons with HIV should take precautions against this new virus about which we’re still learning a lot. And I want to note that CDC estimates that equal to or more than 50% of people with HIV are over 50 years old.”
The New York Times recently reported that "immunocompromised people with compromised immune systems are especially vulnerable to respiratory infections. That group includes those who have autoimmune disorders such as lupus and arthritis, those who have had organ transplants, patients undergoing chemotherapy and other cancer treatments, and anyone who is taking steroids as treatment.
"People with H.I.V. are not on the list as yet, however. With powerful antiretroviral drugs, many now have immune systems strong enough to stave off infections, said Dr. Monica Gandhi, an infectious disease expert at the University of California, San Francisco.
"There is some very preliminary evidence that certain H.I.V. drugs in wide use may help slow the coronavirus."
While studies are underway, the CDC says that “until more is known about the effects of these medicines on COVID-19, people with HIV should not switch their HIV medicine in an attempt to prevent or treat COVID-19.”
What can I do now to prepare?
Wash your hands and cover your cough. Really. It sounds basic, but washing your hands frequently, with soap and water, or alcohol-based hand sanitizer, is one of the best ways to stop the spread of respiratory viruses, including cold viruses, influenza viruses, and novel coronavirus. Teach your children to wash their hands before and after eating, before and after using the bathroom, and any other time their hands become dirty. Wash for 20 seconds (you can sing Happy Birthday twice; 20 seconds is longer than you think). Cover your cough or sneeze with a tissue, then throw the tissue away and wash your hands.
Try not to touch your face. Viruses enter your body through your mouth, nose and eyes; touching your face with unwashed hands is one of the best ways they spread.
Stay home as much as possible if you are sick, unless you need to seek medical care. This is always important, especially during cold and flu season, but it will be the most important thing you can do to help stop the spread of COVID-19 if it begins circulating in the community. If you or your child has a fever, you should not be at work or school. If you have bad cold or flu-like symptoms, please stay home and keep your germs from spreading to others.
Get a flu shot. It’s not too late to get a flu shot, if you still haven’t gotten one this fall or winter. Everyone who is at least 6 months old should get a flu shot every year, unless directed otherwise by their doctor. It is certain that anyone who is infected with influenza and COVID-19 at the same time will become much sicker. This is an easy step that can help protect you and those around you. Go to your doctor, pharmacy, or in Chicago, www.ChicagoFluShots.org to learn where to get a flu shot.
Review your family’s health, now, and reach out to your doctor as needed, to make sure you are as healthy as you can be. We know that most people who have been infected with COVID-19 have mild disease and recover fully, but we also know that people who have underlying health conditions, like heart and lung problems and diabetes, are more likely to become seriously ill if they are infected with COVID-19. Now is the time to make sure your underlying conditions are as controlled as possible and that you are as healthy as you can be.
Make sure you have the medications you need and are taking all of your medications as prescribed; check in with your doctor if needed and make an up-to-date list. If you or your children have asthma or COPD, for example, make sure you have a non-expired inhaler at home. If you have diabetes or hypertension or heart disease, make sure you have all of your medications at home and are taking care of your health. Do the same for any of your other health conditions. Try to eat well, drink enough water, and get enough sleep; this helps build a healthier immune system. Try to exercise at least 30 minutes every day (walking or gentle exercise counts!); this builds healthier lungs and hearts. Think now about what helps you relax when you are feeling stressed (meditation, prayer, calling a friend) and try to make it part of your daily routine.
Think ahead about your prescription medications. Ask your doctor, pharmacist, or insurance company whether you can get an extra 30 days of your prescription medication to have on hand at home, and/or set up home delivery of your medications. Nearly half of Americans take at least one prescription drug. In a health emergency, it’s best if healthy people don’t need to visit the pharmacy for routine medications
Reach out now to build your social circle and share contact information. Being connected to people around you is one of the most important things you can do to prepare for, respond to, and recover from an emergency. It helps with mental health and physical health during times of community stress.
We know people are more likely to help one another in times of community stress when they have been regularly involved in each other’s lives. Think especially about members of your community who may need more help and get to know them. Knock on your neighbors’ doors and learn about who lives around you, especially those who are elderly, live alone, have a disability or a chronic disease, are pregnant or have young children, care for older people or people with special needs, or depend on electric-powered medical equipment. Think about those who may have trouble paying for food and basic needs. Attend community events. Nurture connections with family, friends, places of worship, schools, and volunteer organizations. Think about who needs to be on your own emergency contact list, but also think about whether you could build connections and be on a contact list for your friends and neighbors. Think now about how to potentially share childcare or eldercare responsibilities; think now about who you might turn to for support if anyone in your family is ill or needs more help at home.
Think ahead about having some basic supplies on hand at home. This is not to raise alarm and is not specific to COVID-19 planning; having these items at home is good practice for being prepared for any unexpected events in life. You don’t need to stock up for months; just think about what you and your family might need if you were staying home as much as possible for up to two weeks. You may never need these supplies, but having them on hand can also help with your peace of mind. Thinking ahead means you can start purchasing these things now, as your budget allows.
Keep some basic sanitation and hygiene items at home, like soap, hand sanitizer, antibacterial wipes, garbage bags, and toilet paper.
Keep some basic first aid supplies at home, like an inexpensive digital thermometer, gloves, and bandages. Over-the-counter medications are also helpful, including pain and fever relievers (Tylenol/acetaminophen or ibuprofen, including children’s versions) and medications to help relieve coughs, colds, or diarrhea.
If you have special medical supply needs, try to have at least 30 days of supplies on hand (oxygen supplies, catheters, syringes, blood test monitors and strips, etc.).
Ensure any medical equipment you use is in good repair. This includes oxygen equipment, nebulizers, and CPAP machines. It includes hearing aids, glasses, or assistive technologies. If you use a cane, crutch, walker, or wheelchair, ensure it is in good repair.
Think about having nonperishable or canned food on hand, including if there are people in your family who need special foods (infants, people with dietary restrictions). Basics like rice, beans and peanut butter are inexpensive and keep well.
Think about the non-food items you regularly purchase at the pharmacy or grocery store and try to have at least two weeks’ of supplies on hand (basics like toilet paper, toothpaste, menstrual supplies, condoms, batteries for hearing aids, and contact lens solution).
Think about pet supplies (including pet medications), childcare supplies, and baby supplies like diapers.
Stay up-to-date with trusted health information sources.
- For the latest on coronavirus in Chicago, go to the Chicago Department of Public Health website at www.chicago.gov/coronavirus
- CDC website www.cdc.gov/coronavirus
- Updated Guidelines from DHHS: Interim Guidance for COVID-19 and Persons with HIV
- IDSA: COVID-19 Special Considerations for People Living With HIV
- HIV.gov/coronavirus: Coronavirus (COVID-19) and People with HIV
- General COVID-19 fact sheets and posters from the CDC in English, Spanish, and Simplified Chinese: https://www.cdc.gov/coronavirus/2019-ncov/communication/factsheets.html
Positively Aware: COVID-19 update for PLHIV
Positively Aware: COVID-19 and HIV Q&A with Dr. David Wohl
Lambda Legal & The AIDS Institute: Know Your Rights: HIV & COVID-19
Here’s a helpful article from CNN on keeping desk/work areas clean
Positively Aware: The Lifesaving Power of Connection by David Fawcett
"Coronavirus: Wisdom from a Social Justice Lens." www.healingjustice.org/podcast/corona
Positively Aware: "Love The One You're With: Sex and Pleasure in the Time of COVID-19"
Syringe Services and Harm Reduction Provider Operations During the COVID-19 Outbreak (PDF) (Also available online in Spanish)