By: Sony Salzman
The current COVID-19 pandemic has triggered fear, stigma, and discrimination, all too familiar to people living with HIV. For healthcare providers treating people with HIV, this means not only the added burden of managing the outbreak among their patients, but also an opportunity to alleviate panic.
At the annual Conference on Retroviruses and Opportunistic Infections (CROI 2020), John T. Brooks, MD, a medical epidemiologist with the Division of HIV/AIDS Prevention at the U.S. Centers for Disease Control and Prevention (CDC), took the opportunity to remind attendees that stigma is one of the greatest dangers to public health during an infectious disease epidemic.
"He encouraged everyone to use our rich collective experience with HIV to help combat anti-COVID-19 stigma," Brooks said.
In addition to processing the revived trauma of the early HIV/AIDS panic, people living with HIV may need to start preparing for what will happen if this new epidemic appears in their community, Brooks noted.
This new coronavirus is a close relative of SARS (severe acute respiratory syndrome, which caused a global outbreak in 2003). It produces a short-lived illness known as COVID-19 that manifests like the flu and usually clears up after a few weeks, although it can cause more severe symptoms and even death in some people. It first appeared in China and quickly spread to more than 100 countries, including the United States. (Brooks noted that people of Chinese descent have been inappropriately targeted and stigmatized because of the new virus's origins in China.)
At the time this article was published, more than half of the U.S. states had reported cases of COVID-19. Major cities such as New York, San Francisco, Seattle, and their surrounding areas are already experiencing significant outbreaks, and experts predict that the virus is almost certain to spread to the rest of the country.
During a special session at CROI 2020, Brooks gave attendees an overview of what we know about COVID-19 so far and offered specific recommendations for clinicians to convey to people living with HIV, many of whom may be considered at high risk of acquiring COVID-19 due to demographic and other health factors.
“COVID-19 has spread around the world with remarkable speed,” Brooks said. The virus appears to be highly contagious, and its symptoms are difficult to distinguish from the common flu. For that reason, many people who develop COVID-19 symptoms may be asked to stay home.
Although estimates vary, "the case fatality rate is likely to be between 0.5 and 3.5 percent," Brooks said. "That means COVID-19 could be five to 35 times more deadly than seasonal flu."
Data so far indicates that the virus is more dangerous among people with underlying health conditions, as well as among people over 60. Brooks noted that "the CDC estimates that 50% or more of people with HIV are over 50 years old."
This, along with an underlying persistent viral infection, means that "all people with HIV should take precautions against this new virus," Brooks said.
According to Brooks, all Americans should be prepared to obey "social distancing" orders from their local public health officials, which will likely include measures such as keeping children home from school, avoiding public transportation, and possibly self-isolating for days or weeks.
For people living with HIV and their healthcare providers, this means:
• Ensure a supply of medicines for at least 30 days at all times.
• Keep vaccinations up to date, especially flu and pneumonia vaccines.
• Establish a plan for providers and their patients to stay in touch, including telemedicine options, if they are isolated or quarantined.
• Discover how people living with HIV can stay in touch with friends and family using remote technology, which will help keep spirits up while isolated or quarantined.
HIV care providers are uniquely prepared for this moment. In particular, those who lived and worked during the early years of the HIV epidemic can help remind others—patients and the general public alike—that stigma is one of the greatest enemies of public health.
Providers are also in a position to reinforce ways in which people living with HIV can take steps now to protect themselves and their loved ones from potential harm, and they can do so without demonizing people already living with and recovering from this novel coronavirus.
From: https://www.thebodypro.com/article/covid-19-cdc-recommendations-hiv-clinicians