Talking to an Expert on Coronavirus Disease

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Mary Pat Gallagher MD

JDRF invites leading type 1 diabetes (T1D) expert to talk about the chances of contracting COVID-19, who is at greatest risk of getting severely ill, and what people with well-controlled T1D should do to stay healthy.

“I am pretty much doing COVID-19 and diabetes 24/7 these days,” said Mary Pat Gallagher, MD, director of pediatric diabetes at the Pediatric Diabetes Center at Hassenfeld Children’s Hospital at NYU Langone.

A good thing, too, as the demand for information about T1D and COVID-19 continues to grow.

“What we know about COVID-19, it seems that we are all equally susceptible,” Dr. Gallagher said.

“COVID-19 is a respiratory virus. It is very similar to viruses that cause the common cold which we’ve seen – all of us – all of our lives. But this one is novel. It’s a novel corona virus. And it’s causing some severe disease. None of us is immune to this because it’s brand new. We are all susceptible.”

Dr. Gallagher shared this information and more during last Friday’s JDRF Facebook live Q & A event, which you can watch below. (Note: Due to fluctuating internet connection, the live stream reflects some audio drop out.)

During the event, Dr. Gallagher answered several live questions from the audience. We share the top themes below.

6 Key Takeaways

1. Older people (70 and above) seem to be at the greatest risk

“If you are older, it looks as if the disease is more severe, regardless of whether you have other medical conditions.”

“People over the age of 70 are at the highest risk. And then it goes down in a sort of stepwise fashion, each decade.”

“The good news for people who are under 20 is that while it’s not zero risk, it’s VERY low. And that’s regardless of whatever other conditions you have.”

“We know from our friends in Europe and through the International Society of Pediatric and Adolescent Diabetes is that we will definitely expect to see the kids doing well with type one diabetes.”

“In Italy that’s their experience. They are not seeing a higher rate of serious illness in children with type 1 diabetes versus children without type one diabetes.”

“So that’s really good news I hope that that’s very reassuring to people. I feel that that’s reassuring to me, I’ve been very pleased to know that that’s the case.”

2. Symptoms differ from person to person

“The most common symptoms are sore throat, fatigue and fever, Gallagher said. But, symptoms typically do not show up until 4-5 days after someone has been infected.”

“During those 4 to 5 days you’re infectious, unfortunately.”

“The most common (symptom) is little dry cough – but not everyone has to have a cough.  And it seems like the illness can progress from the first day when you start feeling sick to the 5th to 8th day when people feel the sickest.”

“Younger people seem, at least 50 percent of the time, to have some gastrointestinal symptoms. Diarrhea is fairly common in younger people . . . and vomiting.”

3. We should not underestimate the rate of potential spread

COVID-19 is “a very infectious virus,” Gallagher said. “It is not as infectious as measles, which is super super infectious, but it’s more infectious than influenza. So, it’s very easy to get it when you’re around other people. It’s also a little more serious than influenza – more people who get it go to the hospital.”

“The most important piece is that it’s brand new and zero percent of the population is immune.”

“Ninety percent of us are going to be fine when we get it, but if 10 percent of the population of the United States needed to be hospitalized at the same time, there wouldn’t be enough beds, and there wouldn’t be enough equipment.”

4. People with well-controlled T1D should do what everyone else is doing to stay healthy

Dr. Gallagher urged that everyone in the T1D community closely follow recommendations from the Centers for Disease Control and Prevention on how to stay healthy.

“You’ve been seeing this from day one – be sure everyone try not to touch your face – and wash your hands, wash your hands, wash your hands! Use hand sanitizer. And social distancing. Try to eat well. Try to get enough sleep, stay hydrated.”

“If you have another condition in addition to type 1 diabetes, you want to be in touch with doctors for that condition. If you have immunosuppressants that you’re taking, if you have inflammatory bowel disease, or if you have severe hypertension or severe lung disease, then you want to be in touch with your nephrologist, your pulmonologist  people who can help you talk about how you can protect yourself.”

She said the pandemic poses particular challenges for people not able to work remotely, and thus not able to apply social distancing. She reminded T1D listeners that anyone in this situation may consider seeking special accommodations under the Americans with Disabilities Act, which also aims to protect those with diabetes.

She referred to a sample employee letter posted by the American Diabetes Association. “This encourage employers to allow their employees with type 1 diabetes – or perhaps people who have children with type 1 diabetes – to modify their work schedules or their workplace or just be able to work remotely to minimize exposure.”

5. Takeout food is safe, but take extra precautions

“My understanding is that heat will help destroy the virus. But most people are recommending that if you get takeout, you take it out of the containers, you throw those containers away, you wash your hands thoroughly and disinfect them. That’s probably safe enough.”

She urged everyone to remember that COVID-19 can live on surfaces for several days, so it is important to keep your home clean and take extra care with anything you bring in from the outside.

6. Success is about “flattening the curve”

“Ninety percent of us are going to be fine if we get it. But if 10 percent of the population of the United States needed to be hospitalized at the same time, there wouldn’t be enough beds and there wouldn’t be enough equipment.”

“We just can’t have 10 percent of the people in our country needing to be hospitalized at the same time.”

“So success – I’m sure you’ve all seen this – is about flattening the curve, slowing things down. I know that’s distressing because this is going to go on longer and longer. But that should be considered success – that this is taking several months instead of just overwhelming the hospital system in the next few weeks.”