Frequently Asked Questions
Our own Chief Medical Officer Dr. Rizzo answers frequently asked questions about COVID-19 from individuals living with chronic lung disease.
Have a question not addressed in our FAQ? Contact our Lung HelpLine at 1-800-LUNGUSA for one-on-one support, or submit your question online.
COVID-19 is a respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), a type of virus that is novel, or new, to humans. Spread person-to-person when people sneeze, cough, sing, talk or even breathe, it carries the potential for mild to severe illness, which may include pneumonia and lung damage in some people who become infected.
Everyone is at risk for getting COVID-19 if they are exposed to the virus. People with serious underlying health conditions, including COPD, lung cancer or lung transplant recipients, are more likely to have worse outcomes if they become sick with COVID-19.
Risk of severe illness from COVID-19 increases with age.
Individuals of any age who have serious underlying medical conditions, particularly if not well controlled, such as serious heart conditions, COPD, cancer, type 2 diabetes, kidney disease, sickle cell, obesity with a body mass index (BMI) over 30, and those who have weakened immune systems from solid organ transplant are at greater risk for severe illness.
In addition, people with the following conditions might be at increased risk for severe illness: moderate to severe asthma, cystic fibrosis, pulmonary fibrosis, smoking, and many others.
Individuals who are asymptomatic have been exposed to the coronavirus but they do not have symptoms of COVID-19 so they don’t know they are infected. This is particularly troubling because if you are sick you will stay home, but if you don’t know you are sick, you could be spreading the disease to others without realizing it. Staying home as much as possible, maintaining at least six feet distance from others when in public and wearing a cloth face covering help protect others in case you are an asymptomatic carrier.
Across the country, medical offices are opening back up for non-urgent appointments. If you have a previously scheduled appointment coming up or a new, non-urgent concern, I recommend you contact your healthcare provider to discuss if a virtual or in-person appointment is preferred.
If you are experiencing any symptoms that could be COVID-19 (shortness of breath, chest tightness, dry cough) be sure to communicate that by phone with the healthcare provider. Do not take public transportation to the appointment, wear a cloth face covering and follow any other advice your doctor provides.
This is a good question. There is a lot of talk in the news about antibody testing, a blood test that checks for proteins (antibodies) specific to this disease that helped fight off the illness. This tells us if you have previously been infected with the novel coronavirus. We do not know if these antibodies provide protection, and for how long, from getting infected again. We will have to wait and see if the antibodies make individuals immune to the virus moving forward.
There are two kinds of tests available for COVID-19. The one you are asking about tests for current infection – a viral test that is usually obtained by way of a nasal swab. The two main reasons to get tested are if you’re having symptoms that could be COVID-19 or have been exposed to a person confirmed to have COVID-19. These results may help your doctor determine how you should be treated and also become important in tracking contacts to decrease the spread of COVID-19. In most instances you will need a prescription or order from your physician. Contact your healthcare provider if you feel you should be tested to discuss your concerns.
The lungs are a major target of COVID-19. When the virus is inhaled into the lungs, it invades the tissues, causing inflammation and breathing problems. If the infection gets worse it can develop into pneumonia. In a small number of severe cases, patients can develop acute respiratory distress syndrome (ARDS) that will require them to be placed on a ventilator for oxygen. If too much of the lung is damaged and not enough oxygen is supplied to the rest of the body, respiratory failure could lead to organ failure and death. The recovery rate and complications from severe illness caused by COVID-19 will vary person to person but there may be some long-term damage to the lungs. Long lasting lung health consequences are still being studied.
Most children with COVID-19 are asymptomatic or have mild symptoms, though there have been reports of youth hospitalized with severe illness and sadly, some deaths have been reported. There is a new body of evidence looking at a small sub-set of children who are experiencing symptoms of Multisystem Inflammatory Syndrome in Children (MIS-C) that is associated with COVID-19. This is a troubling new development that the medical community is researching. COVID-19 is a disease that has never been seen in humans before and we are constantly learning and adapting recommendations based on new information. For now, the best advice I can give you is to continue staying home, wearing a mask, maintaining social distancing, washing hands and distancing yourself from individuals who are ill. And I encourage you to be in contact with your healthcare provider regarding any new symptoms you or your children may develop.
At this time there is no vaccine to prevent COVID-19. It’s hard to say exactly when a vaccine will be available and how long immunity will last. Across the globe, researchers are fervently working and collaborating to safely and quickly develop a vaccine that protects against COVID-19. Read more about vaccination in our blog.
The CDC recommends individuals wear a cloth face covering when out in public and unable to maintain at least a six-foot distance from others, such as in a grocery store, to further reduce the transmission of the virus. Commercial masks, such as N95 masks, are not recommended as they are urgently needed by healthcare providers caring for sick individuals. Check out our steps to help yourself get used to wearing a cloth face covering in public.
As the surgeon general stated, the recommendation of wearing cloth face coverings is to protect others from your respiratory droplets when cough, sneeze or talk because we know that people with little to no symptoms can unknowingly spread the disease. The cloth covering is not being recommended as a way for you to decrease getting infected—the main way you protect yourself is avoiding others who are sick, maintaining social distancing, washing your hands frequently and not touching your face (nose, mouth, eyes) and cleaning regularly used surfaces and objects with disinfecting products. Read more about masks in our latest blog.
While secondhand smoke and secondhand e-cigarette (vaping) emissions are proven causes of a variety of lung health and other diseases, in the case of coronavirus the real danger is from the smoker. Secondhand smoke is of two types—side-stream and mainstream.
Sidestream smoke comes off the lighted end of the cigarettes themselves and carries the toxins and carcinogens into the air to cause exacerbations of asthma and COPD and are known causes of lung cancer. Mainstream secondhand smoke is what is exhaled by the smoker after they puff. This smoke not only contains the toxins and carcinogens as above but it also contains respiratory droplets from the smoker that may carry the COVID-19 virus. Therefore, not only are individuals potentially spreading virus by not wearing a mask, they are blowing these droplets to the people around them who may potentially get infected. I recommend maintaining social distance of at least six feet from individuals to reduce the risk of spreading COVID-19, including from individuals who are smoking or vaping.
People who have been exposed to the new coronavirus and who are at risk for coming down with COVID-19 should practice self-quarantine. Health experts recommend that self-quarantine lasts 14 days. Two weeks should provide enough time to know if they will become ill and be contagious to other people. Self-quarantine involves using standard hygiene and washing hands frequently, not sharing things like towels or utensils, staying home, not having visitors and staying at least six feet away from other people in your household, preferably in a separate room with a separate bathroom. Once your quarantine period has ended, if you do not have symptoms, follow your doctor’s instructions on how to return to your normal routine.
It’s a good idea to wipe down surfaces and objects that enter your home using an alcohol (at least 70%) or bleach-based solution to remove germs. If the newspaper arrives in a plastic bag, carefully remove the bag and throw it away. Then, after you touch the paper, thoroughly wash your hands. The CDC has guidance on how to clean and disinfect your home should you have a suspected or confirmed case of coronavirus in your home.
Even though businesses are reopening, COVID-19 is not gone. I continue to recommend staying home as much as possible, especially if you or a family member are at higher risk for severe illness from COVID-19. If you are still weighing travel options, please consult the CDC recommendations for travel within the United States or internationally. You can also read our latest blog dedicated to travel during the pandemic.
Anybody who is sick should be kept away from others, especially a high-risk individual. In fact, the high-risk individual should additionally contact his/her healthcare provider for advice. The high-risk individual should talk to their doctor about what is happening, monitor themselves for symptoms and share any concerns that might warrant getting tested. It is important to distinguish between the flu and COVID-19 because if it’s the flu, there is treatment for that. If it’s COVID-19, the sooner you get diagnosed, the quicker the necessary medical support can begin.
High Risk Groups
Anyone with a compromised immune system, which includes people with autoimmune disease, on chemotherapy or living with an organ transplant, should be more stringent on staying home and other preventive measures such as hand washing, social distancing and disinfecting. Additionally, you should contact your healthcare provider to determine an individual action plan based on your specific situation.
First, check out our steps to help yourself get used to wearing a cloth face covering in public. There are many different types of face coverings with a variety of fabrics, designs, straps and fits may make one mask more comfortable than another.
Individuals living with chronic lung diseases may be asymptomatic (no symptoms) carriers of COVID-19 who can go on to infect others and should wear cloth face masks when in public areas. When my patients ask about not wearing a face covering, I review options with them and reiterate why wearing a mask is important to stop the spread of COVID-19. And I tell them if their lung disease is so severe that it makes breathing with a cloth face covering difficult then they are certainly at increased risk of severe illness from COVID-19 and really need to remain home and distanced from others.
Cigarette smoking and vaping are linked to lung inflammation, as well as reduced lung and immune function, all which can increase the likelihood of complications if exposed to COVID-19. Therefore, long-terms smokers and e-cigarette users have a higher risk of developing chronic lung conditions and serious infections associated with severe cases.
Air pollution can make the COVID-19 pandemic worse for some communities. Since it is a disease affecting the lungs, people who live in places with more pollution could be more vulnerable to severe illness.
A tough question indeed. COPD, for example, is a high-risk disease for readmission to the hospital. So, the best things to do is stay home and on your maintenance medications. If you absolutely must be out of your home, maintain social distance, avoid sick people, wear a cloth face covering, watch the air quality and keep your hands clean. Stay in contact with your healthcare provider about any change in symptoms. There’s no good answer other than following your treatment plan as prescribed.
Treatment and Medication
Do not use disinfectants on or in your body. The use of disinfectants should be applied as directed for cleaning surfaces, not people. The Environmental Protection Agency has a list of over 400 cleaning products that have been tested to disinfect surfaces against the virus that causes COVID-19.
Pulse oximeters are not recommended for otherwise healthy individuals. They are indicated for individuals with lung or heart disease who receive supplemental oxygen as a way to monitor and adjust their prescribed oxygen therapy.
Many individuals use a nebulizer to take inhaled medications at home and it is safe to continue doing so.
However, if you have suspected or diagnosed COVID-19, you should speak with your healthcare provider about additional precautions to take when using your nebulizer.
It’s generally advised to continue taking your current medications to maintain optimal health. Having a poorly controlled chronic condition may put you at increased risk of severe illness. If you have any concerns about the medications you are currently taking they should be directed to your healthcare provider.
Contact tracing is a decades old public health strategy to reduce diseases from spreading. If someone you have been in close contact with tests positive for COVID- 19, you will be contacted by public health workers with next steps. You will be asked to stay home and maintain social distance from others until 14 days since the date of exposure. You will need to monitory yourself for symptoms of COVID-19 and report any changes of health status immediately. You will remain in constant communication with your healthcare provider and the public worker throughout as they support you during this time and will help determine when home isolation may end. Read more about contact tracing in our latest blog.
Opening Up Guidelines
The benefit is that you don’t have to go out in the public. If possible, pay by credit card so you don’t have to interact with the delivery person. They can just leave it at the door. There are benefits to this method if you can afford it. Don’t forget – after bringing in your groceries or deliveries – wash your hands.
It depends. Healthcare providers are following national and local guidance of when to open facilities based on a number of factors. As facilities slowly open up, prioritization is made for individuals who would most benefit from services considering that individual’s physical and emotional wellbeing. I recommend speaking with your doctor about when it makes sense for you to resume appointments.
The recommendation to stay home and limit the spread of the virus hasn’t changed in spite of recent openings. Re-opening doesn’t mean the virus is gone from your community. I encourage you to utilize takeout or delivery options to support local diners and restaurants. Many stores are offering no-contact curbside pickup or delivery options. Consult your local and state agencies for the latest public health guidance for your area, especially if you are considered among those at high risk for complications if you get infected.
If you decide to venture out, it is important to maintain social distancing of at least six feet from others, wear a cloth face covering for the protection of others, and wash your hands often. Do NOT go out if you are experiencing symptoms that might be COVID-19 (short-of-breath, chest tightness, cough, fever).
Page last updated: August 5, 2020