Coronavirus (COVID-19) and Diabetes *Updated 10/1*
If you have seen the news, you will know that there is a global pandemic of CoronaVirus. The number of cases and deaths from this exponentially spreading virus is climbing every single day. The media is consistently reporting that both the elderly and those with "underlying health conditions" are very high risk for developing complications. Diabetes just so happens to be at the top of this list.
Okay, so how concerned should people with diabetes be, and how should they prepare? Here is what we know from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO)
First, What is coronavirus (COVID-19)?
Coronaviruses are a very large family of viruses that are common in animal species, and it is very rare for them to infect and spread to humans. Unfortunately, that is what has happened in the case of COVID-19, which began last year as an outbreak in Wuhan, China, and linked to a market selling seafood and live animals. It has since spread and become a global pandemic.
The first deaths from the coronavirus began late February, they were reported in Washington state and were a man and a woman who were older than 50, but no other information about their health condition prior to the coronavirus has been released.
The biggest problem with this virus is that it has an extended incubation period that can be from 2-14 days, according to the CDC. This means that you can be exposed and infect others for days or weeks before you show any symptoms.
There have been over a dozen states — including California, Illinois, Michigan, and Nebraska — that have received CDC approval for a coronavirus test that is administered and processed in 4 days.
The CDC is currently on high alert and expects this strain to spread throughout the United States. They are advising Americans to prep themselves for "significant disruption in their daily lives."
Even with the amount of time and money being put into research for a vaccine and a treatment, it might take up to a year before there is a working version that can be made in sufficient quantities.
Now let's Discuss Your risk of Coronavirus and Diabetes
Not just for coronavirus, but with any viral infections, people with diabetes face greater risks. This is going to remain true for the COVID-19 virus as well.
The recommended safety precautions are similar to the regular flu, things like frequent hand washing, and covering coughs or sneezes with a tissue. There is not a recommendation for people to use face masks if they are not infected. The ADA also encourages people with diabetes to follow the CDC's Guidance.
People with diabetes are at higher risk for things like the flu, pneumonia, and now COVID-19; this happens because when someone's blood sugar levels fluctuate or are consistently elevated, there is a lower immune response. This makes it easier for people with diabetes to get sick and have more complications. There can also be an underlying risk of exacerbated illness simply by having diabetes, even if glucose levels are in range.
The Journal of the American Medical Association reports that there is a higher fatality rate among those with preexisting conditions:
- 10.5 percent for cardiovascular disease
- 7.3 percent for diabetes
- 6.3 percent for chronic respiratory disease
- 6.0 percent for hypertension
- 5.6 percent for cancer
Virus precautions for everyone
It is good for everyone to attempt to follow the general recommendations for protecting against this infection. They include limiting exposure to people who are sick, washing hands often with soap and water for a minute, and making sure you are up to date with your vaccinations.
It's advised that you keep your hands away from your eyes, nose, ears, and mouth as these are the most common entry points for infections like this to enter the body.
The CDC is emphasizing that if you think you might be sick, or you may have been exposed, stay home from work or school.
This recommendation has faced a lot of criticism, though. It is very difficult for many people to afford bills if they have to miss work for illness. Because of this, many companies are implementing a "work from home" policy that will help employees to navigate the issues that we are facing with COVID-19.
Precautions for People with Diabetes
The majority of doctors are advising that people with diabetes do all that is possible to limit exposure to others, take basic hygiene seriously, and as a precaution, focus on blood glucose control.
If you or a loved one gets sick with any type of flu or cold-like illness, the first step is to make sure it's not the flu, since that is much easier to treat. The main thing too look for is a progression into pneumonia. If this occurs, then get support and treatment as fast as possible, since this is what makes this virus especially dangerous.
People with diabetes are often more prone to dehydration, especially with elevated blood sugars. When fighting the flu or cold, it is very important to stay hydrated. It has been advised that diabetics stock up on water and sugary drinks like Gatorade that can provide electrolytes and energy in case of an emergency or in situations where food can become scarce.
Here are some specific reminders for people who have diabetes:
- Be OCD about hand washing, and it is important to be very compulsive about that.
- Get the flu shot; it is beneficial to prevent the flu.
- Be cautious around people who have signs of respiratory illness, who are coughing, sneezing, etc.
- A humid environment is also beneficial; it is easier for germs to get into your nasal passages when they are dried out due to dry air.
There is a higher risk for diabetics to contract the virus if they have an A1C in the 9-10 range. But the risk is significantly lower for people who have A1C's in the 6-7s.
The next biggest issue is controlling blood sugar if you do become ill; if your blood sugar numbers are high, you are helping the virus. If you can keep your blood sugar numbers in check you will have a much better chance and fighting the infection, or not getting it all together.
What about stockpiling diabetes supplies?
There is a general consensus that this outbreak is causing people to question their level of disaster preparedness. There is a need for improved emergency and disaster planning; most people are very poorly prepared for any type of disaster scenario.
In situations like this, many people are reminded of how vulnerable they are when living with diabetes. Anyone with diabetes is reliant on the manufacturing and distribution of insulin and glucose monitoring supplies. With about these supplies, most diabetics will have a very hard time surviving, especially when it comes to life-sustaining insulin.
It is a good idea to have extra supplies on hand at all times, and it is a safer idea to have at least two months worth of supplies. But for some people, this is an expense that cannot be afforded; that's why it is a good idea to research relief efforts in your area. You can also talk to your doctor about the best methods to get around these barriers if it is ever needed.
Thankfully, many of the medtech and pharma companies are proactively tackling awareness and disease preparation related to the spread of COVID-19.
What About Diabetes Product Shortages?
It is much too soon to tell if there will be any sort of product shortage because of this ongoing pandemic.
There have not been any reports of supply chain issues for diabetic products and supplies. But with media-induced panic and fear, issues might arise if people begin to horde supplies and put extra strain on the supply chain.
There has, however, been a warning by the FDA that medical product supply chain issues could materialize. They are aware that this outbreak will likely affect the supply chain for all medical supplies, and even result in shortages of critical medical products.
Only one of the major U.S. insulin manufacturers, only Eli Lilly has issued a formal statement. They are assuring customers that they "don't anticipate shortages for any of our products, including all forms of insulin."
Meanwhile, there are still many other companies that are involved in diabetics supplies, and few, if any, have issued statements about the overall impact that this pandemic will have on their individual supply chains.
Responses to #COVID19 and Social Media
There have been numerous different sides to how people are responding to this threat. Some people are taking it seriously and doing their best to stock up on supplies and inform others, while many are brushing it aside as nothing more than the typical flu season preparedness that happens every year.
It is important to stay up to date on what is happening in the world as this outbreak is a very fluid process, and many on Twitter have shared some interesting updates and strategies.
In a situation like this one, it is important to follow a few simple guidelines like:
- Refill insulin & key supplies prescriptions ASAP.
- Update my primary care doctor's contact info.
- Review basal/bolus rates, and create a sheet for someone else to follow in case you cannot operate the pump.
- Wash hands your dirty hands!
The Stark Truth
The situation is very fluid, with leaders around the world calling for various levels of shut down and quarantine. It is critical to stay up to date on what is happening in your area and be prepared to ride out this situation for the next week weeks if not a month.
If you can, stock up on basic supplies, as well as any medical supplies you might run short on. If you don't use them now, you will inevitably use them in the long term.
Yes, this current pandemic is scary, but there is not a need to begin hoarding supplies and putting an undue strain on the supply chain. The best things you can do is be prepared for the next month, and follow the basic guidelines for hygiene and social distancing that the CDC has put out