COVID-19 FAQ For The Pulmonary Hypertension Community2020-09-03T12:03:30-04:00

COVID-19 Frequently Asked Questions for the Pulmonary Hypertension Community (updated 9/3/2020)

As communities adapt to the COVID-19 pandemic, the Pulmonary Hypertension Association (PHA) continues to address questions and concerns from the pulmonary hypertension (PH) community. PHA provides the most recent Centers for Disease Control and Prevention (CDC) guidance to help the community make decisions about safety precautions and daily activities.

Visit the CDC website and PHA’s COVID-19 page for current information. It is important to understand potential risks and take precautions to protect yourself and others because there is no way to ensure zero risk of transmission.

Symptoms

Q: What are symptoms of COVID-19?2020-09-01T12:03:51-04:00

A: COVID-19 symptoms can include fever or chills, cough, shortness of breath or difficulty breathing, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting and/or diarrhea, according to CDC. Some may be a result of PH, but worsening symptoms might be warning signs. You don’t have to be sick or have symptoms to spread the virus.

Emergency warning signs include difficulty breathing, shortness of breath, severe chest pain and blue lips. This list isn’t all-inclusive.

Q: How do I know if my breathing issues are due to PH or COVID-19?2020-09-01T12:07:52-04:00

A: Symptoms of COVID-19 can be difficult to distinguish from your PH and from other viral infections, especially during cold and flu season. You know your symptoms and PH best. Significant worsening symptoms might be warning signs of COVID-19.

Q: What should I do if I think I have COVID-19?2020-09-01T12:10:51-04:00

A: If you have these or other severe and worrisome symptoms, call your doctor or EMS immediately. Notify the 911 operator that you think you might have COVID-19. If possible, cover your mouth and nose with a mask before medical help arrives.

If you have COVID-19 symptoms and want to be tested at a clinic, urgent care or emergency room, contact your PH health care team. In some places, COVID-19-specific testing sites and stand-alone respiratory clinics evaluate non-urgently ill people who might have the virus. Your health care team will work with you on how to proceed.

Safety

Q: Are people with PH at greater risk for COVID-19 virus infection?2020-09-01T12:20:13-04:00

A: According to the CDC, there is no evidence to suggest that people with underlying health conditions are at higher risk of becoming infected with the COVID-19 virus. However, there is evidence that people with underlying health conditions, including all types of heart and lung diseases, have a higher risk of developing serious illness from the COVID-19 virus if they become infected.

A recent research study through PHA-accredited PH Care Centers (PHCC) suggests the risk of COVID-19 virus infection in PH patients might be similar that of the general population. However, outcomes aren’t well established for people with PH who contract COVID-19. Additional studies are needed to fully understand the impact of COVID-19 on PH patients.

Q: What everyday safety precautions should I take to prevent infection?2020-09-02T13:55:59-04:00

A: People with PH and those close to them should continue taking precautions to keep themselves healthy and follow CDC guidelines for those at higher risk:

  • Stay at home as much as possible to reduce your risk of being exposed. The best way to prevent COVID-19 infection is to avoid being exposed to the coronavirus.
  • Keep space between yourself and others, and stay at least six feet apart from others. Look for physical barriers or visual reminders such as plexiglass screens, markings or arrows on the floor, or chair arrangements to help you keep your distance from others. Outdoor activities are safer than indoor activities. It is easier to stay six feet apart from others outdoors, as well as maintain good air flow for virus clearance.
  • Avoid large crowds or heavy traffic areas.
  • Limit close contact with other people, especially those who are sick.
  • Frequently wash your hands with soap for at least 20 seconds or use hand sanitizer with at least 60% alcohol content.
  • Avoid touching your face, especially your eyes, mouth and nose.
  • Cover your mouth and nose with a cloth face cover when in public and around others outside of your household. Continue to keep six feet between you and others while wearing a face cover. Cloth face covers aren’t a substitute for social distancing. The COVID-19 virus is thought to spread from person-to-person through respiratory droplets when an infected person sneezes, coughs or talks.
  • Monitor your health for COVID-19 symptoms, and take your temperature if symptoms develop. Stay home if you are sick. Follow CDC guidance if you have COVID-19 symptoms.

The best way to lessen the impact of COVID-19 is to slow the spread of the virus to others. This will ensure the healthcare system doesn’t become overwhelmed. It also will allow researchers time to develop vaccines or treatments for the infection. If you are sick with COVID-19, stay home and away from others until you have no fever for 72 hours (without the use of fever-reducing medicine) and for at least seven days since your first symptoms. Additional information can be found on the CDC website.

Remember: The more people you interact with, the closer the contact and the longer the time you interact, the greater your risk of COVID-19 virus infection. Some people might be infected but don’t have symptoms. It’s not known how often people without symptoms transmit the COVID-19 virus to others.

Q: Should I wear a mask?2020-09-01T12:30:26-04:00

A: The CDC recommends everyone wear a mask in public settings and when you’re around people who don’t live with you.

Q: What type of mask or face covering should I wear?2020-09-02T17:19:10-04:00

A: Recent clinical and laboratory studies have shown that cloth masks or face coverings can provide an extra layer of protect to prevent respiratory and aerosol droplets from traveling through the air to other people. Researchers are studying the effectiveness of various kinds of mask in preventing virus transmission.

CDC doesn’t recommend masks with exhalation valves or vents, which permit exhaled respiratory droplets to escape through the opening. N-95 respirators are considered critical supplies and should be reserved only for healthcare workers and medical responders.

Instructions to make cloth masks are available on the CDC website. Try several types of masks to find which is most comfortable for you.

Q: How will using nebulizers, inhalers or oxygen therapy impact COVID-19 transmission?2020-09-02T16:41:56-04:00

A: Person-to-person transmission is thought to be the main way the way the COVID-19 virus spreads. While it’s unknown whether aerosols from some procedures, such as high flow oxygen delivery and nebulizer administration, spread infection, devices used at home aren’t thought of as great a concern.

Continue to use your prescribed oxygen therapy or nebulizer for respiratory medications, and don’t stop any treatment without consulting your PH health care team. If have suspected or diagnosed COVID-19, speak with your healthcare provider about taking additional precautions when using your nebulizer.

Don’t share equipment with others or reuse old supplies. Discard cannulas after 30 days as directed by the manufacturer. Consider using your nebulizer in a room by yourself away from other household members. Wear a cloth mask over your cannula when in public to protect against COVID-19 infection and spread.

Q: Am I at risk of getting COVID-19 from food?2020-09-02T10:58:19-04:00

A: Coronaviruses are thought to spread from person to person by respiratory droplets. COVID-19 is a new disease, and we are still learning about how it spreads. There is no evidence that suggests COVID-19 is transmitted through food. Wash your hands with soap and water for at least 20 seconds before eating as part of a regular food safety routine.

Q: Can I contract the virus by touching mail?2020-09-02T10:59:15-04:00

A: Although the virus can survive for short periods of time on some surfaces, health experts consider it unlikely that the virus spreads through mail or packaging products. While it might be possible to get COVID-19 if you touch packaging or other materials contaminated with the virus, then touch your mouth, nose, or eyes, that isn’t thought to be the main way coronaviruses spread. It is good practice to wash your hands after receiving deliveries and mail and routinely clean frequently touched surfaces.

Learn more about the current understanding of how COVID-19 can spread  on the CDC website

Work and School

Q: Is it safe for me to go to work?2020-09-02T07:55:28-04:00

A: Adults with PH should try to work remotely whenever possible. You should consider the infection rate in your community, health of household members, financial situation and job type if you decide to go into your workplace. PH patients might be eligible for protections under the Americans with Disabilities Act (ADA), such as reasonable accommodations to perform the essential functions of their jobs. Find out more information about working with PH, including your rights.

Refer to your state or local government for specific restrictions. Ask your care team about your specific risk factors. They can help you determine appropriate courses of action.

Q: With many schools reopening, it safe for my child to go back to school?2020-09-02T13:47:34-04:00

A: While distance learning is the safest option to prevent COVID-19 infection, some school districts and state governments have decided to open schools. Discuss measures to reduce infection risk of infection and distance-learning options with teachers and school administrators.

The CDC  and the American Academy of Pediatrics provide guidance for school re-entry policies. Find federal guidance on school responsibility for students with disabilities during COVID-19 here.

Consider the infection rate your community and other factors to determine whether your child should attend school in-person. Those factors include your child’s:

  • Health (and that other household members), such as PH or other preexisting health conditions.
  • Age (K-12 or college).
  • Ability to practice physical distancing.
  • Ability to learn independently.

Other factors include:

  • Work and financial situation.
  • Childcare options.
  • Access to school meal programs.
  • Opportunities for social-emotional support.
  • Available academic instructional format (i.e. class and school size, virtual learning options).

Consult the CDC’s Decision-Making Tool for Parents and Guardians to help weigh your options.

Find federal guidance on school responsibility for students with disabilities during COVID-19 here.

Discuss your decision with your PH care team and ask how to reduce the risk of COVID-19 infection for you, your child and other members of your household.

Q: I’m worried that someone I live with might get infected because of their work or other circumstances (e.g. spouse works in a medical setting or a profession in frequent contact with others). What should I do?2020-09-02T11:16:33-04:00

A: To reduce the risk of spreading the virus, that person might want to change clothes before entering the house, keep potentially contaminated shoes outside, sanitize hands before entering the house, wash potentially contaminated clothes in hot water, and shower before interacting with other household members.

Q: What do I do if my family member gets sick?2020-09-02T11:17:03-04:00

A: The CDC provides guidance on reducing the risk of infection when someone in the house is sick. That includes separating the sick member of your household in a room away from others in your home, with a separate bathroom when possible. Do not share linens/towels and food. Discuss your concerns with your PH health care team and ask whether they recommend additional precautions.

Medical Appointments and Clinical Trials

Q: Is it safe for me or a family member to have in-person doctor visits or non-emergency medical procedures?2020-09-01T12:56:39-04:00

A: PH patients should continue regular care regimens recommended by their PH health care teams. Routine PH clinic or non-emergency doctor’s visits can be conducted through telemedicine (telephone, videoconferencing, etc.) appointments.

It is important to continue to manage and control your PH. Certain in-clinic treatments and monitoring may be necessary. Patients with newly diagnosed or worsening symptoms might benefit from in-person PH clinic visits. Ask your PH health care team when to opt for an in-person clinic visit or a telemedicine visit.

If you go to a hospital or care facility outside of where your PH health care team is located, have the health care providers reach out to your PH health care team for guidance and recommendations. Bring all your PH medicines and supplies with you.

For additional guidance on telemedicine, see the “PHA Connects: Preparing for a Telemedicine Appointment” videoDownload the worksheet.

Q: What should I do if I am participating in a clinical trial?2020-09-01T12:58:48-04:00

A: If you are participating in clinical research, contact the research team about your clinical trial visits. While some research studies are temporarily pausing new patient enrollment, many clinical trials are making changes to allow you to stay in the study while limiting in-person visits and/or relying on telemedicine visits.

Treatment

Q: Are treatments available for COVID-19?2020-09-01T13:16:47-04:00

A: There  are no antiviral medications recommended or licensed currently by the FDA for COVID-19. And there is no evidence that PH medications provide a protective or curative benefit for COVID-19.

However, scientists and pharmaceutical companies are developing and evaluating promising therapy and vaccines. Patient care and management of COVID-19 symptoms and complications continue to improve, including antiviral and steroid treatment regimens for hospitalized patients.

As with any non-prescription or over-the-counter medication, there is a high potential for interactions with PH medications. Or these agents could have a direct effect on the heart or lungs. See the latest COVID-19 information from the FDA here.

Q: What risks are associated with medication for pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) when infected with the COVID-19 virus?2020-09-01T13:19:05-04:00

A: The use of PAH and CTEPH medications hasn’t been studied in PAH or CTEPH patients who contract COVID-19. Stopping or modifying your medication isn’t recommended because that could make your PAH or CTEPH worse. Talk about medication concerns with your PH health care team.

Q: Should I worry about running out of medicine or supplies?2020-09-01T13:23:15-04:00

A: The CDC recommends that you maintain enough medicine and supplies for several weeks in case you need to stay home for prolonged periods of time. There is no indication that PAH prescriptions and refills will be disrupted.

PHA isn’t aware of any manufacturing disruptions of PH medication caused by COVID-19. Current information of the impact of COVID-19 on access to PH therapies, supplies, oxygen and lab tests can be found here.

There may be shortages throughout the United States of some supplies and other medications. Consult the FDA’s drug shortage database about specific medications. PHA is monitoring the PAH medication and supply availability throughout the pandemic.

Q: What do I do about routine tests for refills?2020-09-01T13:27:32-04:00

A: Certain PH medications may require blood and/or urine tests to refill your prescription. If you are concerned about going to the hospital for tests but are short on medication, contact your PH care provider and/or specialty pharmacy. Your specialty pharmacy might require home visits for some medications. Most have temporarily halted home visits, but speak to your healthcare provider and specialty pharmacy about changes in services.

Q: What about herbal or vitamin supplements?2020-09-01T13:29:16-04:00

A: Don’t take herbal supplements, high amounts of vitamin supplements or any “antiviral cures” without consulting your PH care team. Herbal therapies should be viewed as drugs and can be harmful.

COVID-19 In Your Community

Q: How is COVID-19 affecting my community?2020-09-01T19:06:11-04:00

AJohns Hopkins University, the CDC, and state and local government entities provide updates on infection rates, stay-at-home orders and reopening.

Q: My city/state is reopening. What does that mean for people with PH?2020-09-01T13:44:26-04:00

A: The CDC has added additional guidance to consider as communities begin to reopen. That includes recommendations to stay safe while running errands, dining outside your home and participating in social activities. See the CDC’s updated frequently asked questions about COVID-19.

Managing Stress and Anxiety

Q: COVID-19 has caused a lot of anxiety for me and my family. What can I do?2020-09-01T13:48:24-04:00

A: PHA is here to help! The “Living with PH” section of PHA Classroom provides resources to learn about coping, diet and nutrition, and exercise to help manage stress.

You might feel lonely or isolated because of social distancing. PHA encourages you to use its many platforms to reach out to other people with PH. Connect with another patient or caregiver, call 800-748-7274 or download an overview of PHA’s virtual support resources. CDC provides information on coping with fear and anxiety caused by the COVID-19 outbreak.

Q: How do I stay up to date about new developments?2020-09-02T13:48:54-04:00

A: Our understanding about COVID-19 is evolving. It is important to regularly check websites from the CDC, PHA, reliable news organizations and state health departments.

Talk with your PH health care teams about your health risks and safety measures to protect yourself from COVID-19 infection.

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