People at Higher Risk and Special Populations
Older people and people of all ages with severe underlying health conditions – like heart disease, lung disease and diabetes, for example – seem to be at higher risk of developing serious COVID-19 illness.
People at Higher Risk for Serious Illness from COVID-19
DC has information for other special population, who at this time are not considered high risk of developing serious COVID-19 illness, but are at increased risk of severe illness from other infectious diseases. These include pregnant women and children.
Information on COVID-19 and Pregnant Women and Children
There is not currently information from published scientific reports about susceptibility of pregnant women to COVID-19. Pregnant women experience immunologic and physiologic changes which might make them more susceptible to viral respiratory infections, including COVID-19.
There is no evidence that children are more susceptible to COVID-19. In fact, most confirmed cases of COVID-19 reported from China have occurred in adults. Infections in children have been reported, including in very young children. There is an ongoing investigation to determine more about this outbreak. This is a rapidly evolving situation and information will be updated as it becomes available.
Talking With Children About Coronavirus Disease 2019
Questions about Pregnancy and Coronavirus Disease 2019
Interim Guidance on breastfeeding for a mother confirmed or under investigation for COVID-19
Q: What is the risk to pregnant women of getting COVID-19? Is it easier for pregnant women to become ill with the disease? If they become infected, will they be more sick than other people?
A: We do not currently know if pregnant women have a greater chance of getting sick from COVID-19 than the general public nor whether they are more likely to have serious illness as a result. Pregnant women experience changes in their bodies that may increase their risk of some infections. With viruses from the same family as COVID-19, and other viral respiratory infections, such as influenza, women have had a higher risk of developing severe illness. It is always important for pregnant women to protect themselves from illnesses.
Q: How can pregnant women protect themselves from getting COVID-19?
Pregnant women should do the same things as the general public to avoid infection. You can help stop the spread of COVID-19 by taking these actions:
• Cover your cough (using your elbow is a good technique)
• Avoid people who are sick
• Clean your hands often using soap and water or alcohol-based hand sanitizer
You can find additional information on preventing COVID-19 disease at CDC’s (Prevention for 2019 Novel Coronavirus).
Q: Can COVID-19 cause problems for a pregnancy?
A: We do not know at this time if COVID-19 would cause problems during pregnancy or affect the health of the baby after birth.
Transmission during pregnancy or during delivery
Q: Can COVID-19 be passed from a pregnant woman to the fetus or newborn?
A: We still do not know if a pregnant woman with COVID-19 can pass the virus that causes COVID-19 to her fetus or baby during pregnancy or delivery. No infants born to mothers with COVID-19 have tested positive for the COVID-19 virus. In these cases, which are a small number, the virus was not found in samples of amniotic fluid or breastmilk.
Infants
Q: If a pregnant woman has COVID-19 during pregnancy, will it hurt the baby?
A: We do not know at this time what if any risk is posed to infants of a pregnant woman who has COVID-19. There have been a small number of reported problems with pregnancy or delivery (e.g. preterm birth) in babies born to mothers who tested positive for COVID-19 during their pregnancy. However, it is not clear that these outcomes were related to maternal infection. A: We do not know at this time what if any risk is posed to infants of a pregnant woman who has COVID-19. There have been a small number of reported problems with pregnancy or delivery (e.g. preterm birth) in babies born to mothers who tested positive for COVID-19 during their pregnancy. However, it is not clear that these outcomes were related to maternal infection.
Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation For COVID-19
This interim guidance is intended for women who are confirmed to have COVID-19 or are persons-under-investigation (PUI) for COVID-19 and are currently breastfeeding. This interim guidance is based on what is currently known about COVID-19 and the transmission of other viral respiratory infections. CDC will update this interim guidance as needed as additional information becomes available. For breastfeeding guidance in the immediate postpartum setting, refer to Interim Considerations for Infection Prevention and Control of 2019 Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings.
Transmission of COVID-19 through breast milk
Much is unknown about how COVID-19 is spread. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza (flu) and other respiratory pathogens spread. In limited studies on women with COVID-19 and another coronavirus infection, Severe Acute Respiratory Syndrome (SARS-CoV), the virus has not been detected in breast milk; however we do not know whether mothers with COVID-19 can transmit the virus via breast milk.
CDC breastfeeding guidance for other infectious illnesses
Breast milk provides protection against many illnesses. There are rare exceptions when breastfeeding or feeding expressed breast milk is not recommended. CDC has no specific guidance for breastfeeding during infection with similar viruses like SARS-CoV or Middle Eastern Respiratory Syndrome (MERS-CoV).
Outside of the immediate postpartum setting, CDC recommends that a mother with flu continue breastfeeding or feeding expressed breast milk to her infant while taking precautions to avoid spreading the virus to her infant.
Guidance on breastfeeding for mothers with confirmed COVID-19 or under investigation for COVID-19
Breast milk is the best source of nutrition for most infants. However, much is unknown about COVID-19. Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and healthcare providers. A mother with confirmed COVID-19 or who is a symptomatic PUI should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast. If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant.
Frequently Asked Questions and Answers: Coronavirus Disease-2019 (COVID-19) and Children
See information on COVID-19 and pregnancy and neonates.
Q: What is the risk of my child becoming sick with COVID-19?
A: Based on available evidence, children do not appear to be at higher risk for COVID-19 than adults. While some children and infants have been sick with COVID-19, adults make up most of the known cases to date. You can learn more about who is most at risk for health problems if they have COVID-19 infection on CDC’s current Risk Assessment page.
Q: How can I protect my child from COVID-19 infection?
You can encourage your child to help stop the spread of COVID-19 by teaching them to do the same things everyone should do to stay healthy.
• Clean hands often using soap and water or alcohol-based hand sanitizer
• Avoid people who are sick (coughing and sneezing)
• Clean and disinfect high-touch surfaces daily in household common areas (e.g. tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks)
• Launder items including washable plush toys as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry from an ill person can be washed with other people’s items.
You can find additional information on preventing COVID-19 at Prevention for 2019 Novel Coronavirus and at Preventing COVID-19 Spread in Communities. Additional information on how COVID-19 is spread is available at How COVID-19 Spreads.
Q: Are the symptoms of COVID-19 different in children than in adults?
A: No. The symptoms of COVID-19 are similar in children and adults. However, children with confirmed COVID-19 have generally presented with mild symptoms. Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported. It’s not known yet whether some children may be at higher risk for severe illness, for example, children with underlying medical conditions and special healthcare needs. There is much more to be learned about how the disease impacts children.
Q: Should children wear masks?
A: No. If your child is healthy, there is no need for them to wear a facemask. Only people who have symptoms of illness or who are providing care to those who are ill should wear masks.
People at Risk for Serious Illness from COVID-19
If you are at higher risk of getting very sick from COVID-19, you should:
• Stock up on supplies.
• Take everyday precautions to keep space between yourself and others.
• When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
• Avoid crowds as much as possible.
• Avoid cruise travel and non-essential air travel.
• During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.
COVID-19: What Older Adults Need to Know
Jay Butler, Deputy Director for Infectious Diseases at CDC, describes preventative measures to help protect older adults from COVID-19.
AARP’s Coronavirus Information Tele-Town Hall
Experts share information about COVID-19 and how to protect yourself.
CDC and other federal experts presented at an AARP tele-town hall event held on March 10, 2020 discussing prevention and care for older adults.
Who is at Higher Risk?
Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:
• Older adults
• People who have serious chronic medical conditions like:
○
○ Heart disease
○ Diabetes
○ Lung disease
If a COVID-19 outbreak happens in your community, it could last for a long time. (An outbreak is when a large number of people suddenly get sick.) Depending on how severe the outbreak is, public health officials may recommend community actions to reduce people’s risk of being exposed to COVID-19. These actions can slow the spread and reduce the impact of disease.
If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of getting sick with the disease.
Get Ready for COVID-19 Now
• Have supplies on Contact
○ hand your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time.
○ If you cannot get extra medications, consider using mail-order for medications.
○ Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.
○ Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.
• Take everyday precautions
○ Avoid close contact with people who are sick
○ Take everyday preventive actions
■ Clean your hands often
■ Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
■ If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
■ To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
■ Wash your hands after touching surfaces in public places.
■ Avoid touching your face, nose, eyes, etc.
■ Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
■ Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
■ Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.
• If COVID-19 is spreading in your community, take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus.
○ Stay home as much as possible.
■ Consider ways of getting food brought to your house through family, social, or commercial networks
• Have a plan for if you get sick:
○ Consult with your health care provider for more information about monitoring your health for symptoms suggestive of COVID-19.
○ Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, etc. if you become sick.
○ Determine who can provide you with care if your caregiver gets sick
Watch for symptoms and emergency warning signs
• Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call your doctor.
• If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs*:
○ Difficulty breathing or shortness of breath
○ 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.
What to Do if You Get Sick
• Stay home and call your doctor
• Call your healthcare provider and let them know about your symptoms. Tell them that you have or may have COVID-19. This will help them take care of you and keep other people from getting infected or exposed.
• If you are not sick enough to be hospitalized, you can recover at home. Follow CDC instructions for how to take care of yourself at home.
• Know when to get emergency help
• Get medical attention immediately if you have any of the emergency warning signs listed above.
What Others can do to Support Older Adults
Community Support for Older Adults
• Community preparedness planning for COVID-19 should include older adults and people with disabilities, and the organizations that support them in their communities, to ensure their needs are taken into consideration.
○ Many of these individuals live in the community, and many depend on services and supports provided in their homes or in the community to maintain their health and independence.
• Long-term care facilities should be vigilant to prevent the introduction and spread of COVID-19. Information for long-term care facilities can be found here.
Family and Caregiver Support
• Know what medications your loved one is taking and see if you can help them have extra on hand.
• Monitor food and other medical supplies (oxygen, incontinence, dialysis, wound care) needed and create a back-up plan.
• Stock up on non-perishable food items to have on hand in your home to minimize trips to stores.
• If you care for a loved one living in a care facility, monitor the situation, ask about the health of the other residents frequently and know the protocol if there is an outbreak.