Age is one of the most significant factors in determining risk of severe illness from the coronavirus disease (COVID-19).

While current evidence suggests that individuals with well-managed T1D are NOT at higher risk of contracting COVID-19, what if you are among those who are at a higher risk of severe illness: someone with T1D who is over the age of 65, or who has consistently elevated blood sugar levels or someone with T1D of any age who has another serious underlying medical condition? What should you do to protect yourself?

Below, we share advice from T1D experts as well as the CDC’s recommendations for higher risk populations.

Be vigilant about social distancing  

People who are at higher risk of severe illness need to stay at home and avoid close contact with others as much as possible. Unfortunately, for older adults, this includes not seeing your grandchildren in person, as they are more likely to be asymptomatic COVID-19 carriers.

“Children seem very unlikely to get symptoms,” said Dr. Anne Peters, director of the University of Southern California Clinical Diabetes Programs and a practicing physician, as shared in an interview with JDRF’s colleagues at Beyond Type 1.  “It’s not that children are unlikely to catch it. It is unlikely that children will show signs of infection. One of the problems is they can be secret vectors of this—they can be asymptomatic—and…spread through sneezing, coughing and spit.”

“That is what is behind a recommendation to try to allow your grandparent-generation—people over 70, unless you’re providing actual direct care to them—to [keep away from] your children, who are very likely to be the ones who are infected and not showing any symptoms,” said Dr. Mary Pat Gallagher, director of pediatric diabetes at the Pediatric Diabetes Center at Hassenfeld Children’s Hospital at NYU Langone during a JDRF Facebook Live event. “The aim is to protect the population that’s most at risk for requiring hospitalization and having a severe outcome.”

Other smart social distancing practices include:

• Going to the store or pharmacy when it is less likely to be crowded. Numerous stores have set aside “senior hours” so that their older customers can shop more safely with fewer people in the store.
• Taking advantage of Telehealth options to continue seeing your physicians.
  • If you haven’t used telehealth before and it is an option for seeing your physician, JDRF has shared some tips—including a how-to video with a JDRF staffer who has T1D and has used telehealth.

If you have a family member who lives with you or is your caretaker who could expose you to COVID-19, they need to pay close attention to their behaviors and daily routines.

“The person with whom I live is 75 years old and he has diabetes. I can’t get him sick. And it’s not because of the diabetes, it’s because he’s 75 years old,” Dr. Peters said. “So, I am just insanely careful. We’re lucky enough that we have our own bathrooms—bathrooms are a point of spread. If you share a bathroom, decontaminate. You don’t want to share towels; you want to keep everything separate.”

Dr. Peters added, “I’m in a high-risk position because I’m seeing patients all day. So, now I actually go to work in a set of scrubs. When I come back, and before I do anything, I take off the scrubs, throw them in the washing machine, run upstairs and take a shower. So, I decontaminate myself. And as soon as you’ve done that, you can be in the same house just fine. Let’s not contaminate each other!”

Dr. Gallagher emphasized it is critical that no one 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.”

Follow the CDC’s precautions for higher risk populations

These include much of the same advice for lower risk populations: washing your hands often, not touching your face and regularly cleaning and disinfecting frequently touched surfaces in your home, which include everything from countertops to doorknobs, light switches, and cabinet door handles.

A full list outlining precautions for higher risk populations is on the CDC website.

What about bringing things into the house, such as take-out food? During the Facebook Live event, Dr. Gallagher said that takeout food was safe, but that people may want to consider taking some extra precautions with it.

“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,” Gallagher said.

Dr. Gallagher 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.

Have a care plan in place in the event that you do get sick

It is vital to be ready for the worst, even if (hopefully) you never experience it.

First, you should talk to your health care provider team while you are healthy—especially if you have other medical conditions.

“If you have another condition in addition to type 1 diabetes, you want to be in touch with doctors for that condition,” Gallagher said. “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.”

You should also have all of your doctor’s phone numbers on hand—including how to reach them at night, on weekends and holidays (summer is fast-approaching with Memorial Day, July 4^th and Labor Day).

Other steps include:

• Ensure that you have diabetes medical supplies on hand and have access to refills.
• Stock your cabinets with food and beverages to help you manage your T1D and stay hydrated.
• Familiarize yourself with what you would need to bring to the hospital and with different hospital protocols.

Find complete guidance for all three of these steps on our coronavirus page.

Try your best to manage your stress levels

Even though parts of the nation of have been living in quarantine for a little more than one month now, the stress of it all is often overwhelming.

While stress can have an adverse effect on anyone’s health, it can be especially troublesome for people living with T1D.

“Stress can cause negative outcomes with our diabetes care,” said Dr. Nicole Johnson, JDRF Senior Director of Behavioral Health and Psychology Research, who also participated in a JDRF Facebook Live event.  “You need to take care of yourself, so you are able to take care of your diabetes and of the diabetes that exists in your family.”

Johnson advised that doing all you can to protect you and your family—namely, connecting with your physician(s) and following the CDC recommendations—can help ease your mind.

Johnson also advised that it is important to do all the things that keep you healthy and help manage your T1D.

This includes eating, exercising and sleeping well.

“End your day on a positive note. If you go to bed feeling anxious, you are more likely to have disrupted sleep which is not wise for anyone, but especially for someone living with a medical condition.”

She recommended turning off the late-night news and instead reading a book or listening to music.

“Do something that makes you feel grounded, connected, peaceful.”

For more ways you can manage your stress levels, consult JDRF’s full list of tips from Dr. Johnson as well as tips from the CDC for managing stress during the pandemic.