Updated January 24, 2022, to include the importance of getting vaccinated.

When it comes to severe illness, even death, from COVID-19, African Americans bear an unjust burden. Studies show a death rate from COVID-19 at least two times higher than white people. Latinos and Native Americans aren’t far behind.

In Richmond, Va., 17 out of 20 deaths are African American, according to Danny Avula, M.D., director of the Richmond and Henrico health districts.

In terms of hospitalization, the Centers for Disease Control and Prevention reports that:

• Non-Hispanic Black people have a hospitalization rate approximately 5 times that of non-Hispanic white people.
  
  
• Non-Hispanic American Indian or Alaska Native people have a rate approximately 5 times that of non-Hispanic white people.
  
  
• Hispanic or Latino people have a rate approximately 4 times that of non-Hispanic white people.

It’s not that Black, Native American and Latino populations have a biological basis for their disproportionate infection rate or poor outcomes. A wide range of socioeconomic factors place them at an unfair disadvantage when it comes to health. In terms of COVID-19, this disadvantage comes in the form of chronic heart and lung disease, diabetes and obesity.

Socioeconomic factors are hard to change on your own. You may work in a job that exposes you to lots of people, such as health care or retail. You may rely on crowded public transit because you can’t afford a car. You may share your home with several family members, making it hard to social distance. Or your neighborhood may lack grocery stories with healthy food choices, taking a toll on blood sugar and weight.

If you are African American, Latino or Native American and have a chronic health condition, is there anything you can do now to protect yourself from infection, severe illness or death from COVID-19? Are there better ways to manage your health?

We spoke to several VCU Health experts for their advice on managing chronic conditions that can affect your response to COVID-19.

Chronic heart disease

If you’re 65 or older and have chronic heart disease, especially coronary artery disease, high blood pressure (hypertension) or heart failure, you’re at greater risk of severe COVID-19 symptoms if infected and you may be sicker longer.

It’s extremely important that you get vaccinated and boosted. Practice social distancing and frequent hand-washing, says VCU Health cardiologist Jeremy Turlingon, M.D. , who urges you to also wear a face mask covering your nose and mouth to reduce your risk of contracting — and spreading — COVID-19.

“Get plenty of rest, eat a good, healthy diet and continue to take your medications as directed,” Turlington says.  This applies whether you’re trying to avoid getting COVID-19 or you already have it.

Take your medications

“Early on there were concerns about taking ACE inhibitors or ARBs (angiotensin converting enzyme inhibitors and angiotensin-II receptor blockers), but there is no increased risk of complications in taking these medications,” Turlington said.

If you do get COVID-19, having chronic heart disease doesn’t necessarily mean you’ll be hospitalized or suffer complications. Many people with chronic heart conditions who get COVID-19 can manage at home, Turlington notes.  “The vast majority of patients are minimally affected, including heart patients.”

Study your symptoms

Many COVID-19 symptoms are the same as those of chronic heart conditions, such as rapid heartbeat, chest pain and shortness of breath. You may already be experiencing these symptoms, Turlington states. “It doesn’t mean you have COVID-19, but could be related to your underlying heart condition.”

If your symptoms worsen or are somewhat unusual, though, call your primary care doctor or cardiologist and ask for recommendations about testing or other means of managing your condition. If you feel you may be experiencing a medical emergency, call 911 and seek emergency care.  Don’t delay treatment.

Chronic lung disease

“Chronic lung disease increases your risk of contracting COVID-19 and developing complications,” says Patrick Nana-Sinkam, M.D.,chair of the VCU Division of Pulmonary and Critical Care Medicine.

African Americans are at higher risk for developing smoking-related lung diseases, such as chronic obstructive pulmonary disease (COPD), at a younger age and with lower tobacco exposure. COPD, which includes emphysema and chronic bronchitis, can lead to severe illness including respiratory failure in people with COVID-19.

African Americans are also at higher risk for developing asthma and sarcoidosis, both of which may increase risk for complications secondary to underlying lung disease or use of immunosuppressing drugs. 

If you have chronic lung disease, get vaccinated and boosted. Social distancing, frequent handwashing and wearing a face mask in public are essential. Limit your exposure to people who have a greater chance of contracting the disease, if you can. Follow your treatment regimen and refrain from making any changes on your own. Always ask your doctor. Your goal should be maintaining the best lung function you can at all times.

Follow a healthy lifestyle

Nana-Sinkam advises people with chronic lung disease to maintain healthy habits such as weight control, healthy eating, smoking cessation, regular exercise and ample sleep. 

Because you’re staying home more often, have at least a 30-day supply of your medications on hand and avoid triggers that can make your symptoms worse. Call your doctor if you feel sick or have other health care concerns.

Type 2 diabetes

“People with type 2 diabetes are at higher risk of complications from COVID-19, so we strongly encourage them to follow all recommended guidelines for wearing masks, frequent handwashing and social distancing,” said VCU Health endocrinologist Trang Le, M.D., a specialist in type 2 diabetes.

Members of the African American, Latinx and Native communities may be at higher risk of more severe illness from COVID-19 because they have a higher rate of type 2 diabetes and obesity, Le said. “This is an excellent opportunity for patients to work on goals that will not only reduce their risk of COVID-19 severity but will improve their diabetes, weight status and overall health.”

Le offers this advice for those with type 2 diabetes:

• Pay extra attention to maintaining healthy blood sugars. High blood sugar makes it harder for your body to fight infection. During this time of COVID-19, check your blood sugars more often. Your doctor may need to adjust your medications.
  
  
• See your doctor from home. Telehealth offers you the opportunity to visit with your doctor using your cell phone or computer. This is an excellent way to keep in touch with your health care team without risking exposure to the virus.
  
  
• Focus on healthy meal choices. Losing just a little weight can have a major impact on your blood sugar. Cut back on carbohydrates and add more fruits and vegetables to your meals — especially the vegetables. Pay attention to portion size. Avoid snacking out of boredom and drink plenty of water. The American Diabetes Association has an excellent website on healthy meal choices, www.diabetesfoodhub.org.
  
  
• Get moving. Simply walking can help keep your blood sugars in a healthy range. Try walking for 10-15 minutes after meals. This can make a big difference in how your body handles your blood sugars after eating. It will also boost your mental health. Walk outside in uncrowded areas and wear your face mask, as per social distancing guidelines.

Obesity

Some people who have obesity don’t realize they have diabetes, notes VCU Health weight loss specialist Susan Wolver, M.D. Waiting until you test positive for COVID-19 is not a good time to find out.

If you have obesity, losing even a little weight now may be helpful in preventing a more serious case of COVID should you get infected. 

COVID-related lifestyle changes can be unhealthy

You may have already changed some of your behaviors due to the pandemic, Wolver notes. These include social distancing, working from home, frequent handwashing and wearing a face mask. But some of your other behaviors may lead to weight gain.

Be on the lookout for the following behaviors and guard against them:

• Food as stress relief. The threat of COVID-19 may leave you anxious. Are you turning to food for comfort? Are you turning to sweets? Open your refrigerator and look inside. Sodas, sweet tea and juices are high in calories, as are cookies, cake and ice cream. Cut back on foods that increase your blood sugar. Studies show that better blood sugar control leads to better COVID-19 outcomes.
  
  
• Sheltering in place. You may be afraid to leave your house or apartment for fear of exposing yourself to the coronavirus. Do you find yourself sitting for hours on end? Prolonged sitting can be bad for you because it increases insulin resistance — how well your body uses carbohydrates. So take time to move. Go up and down the stairs. Go outside and walk. Grab some weights. Do some squats. Increasing your physical activity will help decrease your blood sugar, reducing your risk of diabetes. There are many free videos on the internet that can help guide you, no matter what your level of fitness.
  
  
• Social isolation. Feeling lonely? Visit friends and family by phone, Zoom or Facetime. Don’t replace your friends with your refrigerator. If you’re tempted by too many sweets and snacks at the grocery store, try home delivery.
  
  
• Working from home. Are you easily distracted? Do you find yourself walking by the refrigerator more often than not? If you’re working from home, mimic your office environment and pack your lunch. Instead of “grazing,” learn to cook healthy meals. Articles and videos are online.
  
  
• Pay attention to your mental health. Make sure you get plenty of sleep and exercise. Focus on feelings of peace and wellbeing. Connect with nature — go out for a walk, as long as you practice social distancing.Meditating is great for stress relief, and there are many free apps and internet resources you can use.

Sickle cell disease

Sickle cell disease is a chronic condition that does have a biological base, mainly affecting Black Americans. If you have sickle cell disease, your immune system is weaker than those of other people. This increases your risk for severe complications if you get COVID-19. Notes Wally R. Smith, M.D., the Florence Neal Cooper Smith Professor of Sickle Cell Disease at VCU: The best way to prevent complications is to keep from getting infected in the first place.

Smith offers this advice for people with sickle cell disease:

To limit your risk of getting COVID-19:

• Get vaccinated and boosted.
• Stay at least 6 feet from others (social distancing).
• Wash your hands with soap and water for 20 seconds or use hand sanitizer with at least 60% alcohol.
• Avoid touching your eyes, nose, mouth and face.
• Avoid being close to people who are sick, coughing or sneezing.
• Greet one another from a distance (no hugs or handshakes).
• Disinfect frequently touched objects and surfaces.
• Cover your cough or sneeze with a tissue, then immediately wash your hands.

When sheltering at home, stock up on supplies

The best way to avoid exposure to the coronavirus is to stay home as much as possible (“sheltering in place,” or “self-quarantine”). If you need to see your doctor, opt for telehealth visits using your cell phone or computer.

Continue taking your prescribed medications (Hydroxyurea, glutamine, penicillin, folic acid, Voxelotor, Crizanlizumab, Deferasirox, and any others). These will help keep your body in the best possible condition to fight off infection.

Plan ahead:

• Have plenty of medication refills on hand, as well as over-the-counter medications and supplies, such as tissues. Some drug stores offer home delivery.
• Have a thermometer to take your temperature.
• Stay in touch with others by phone, text or email. You may need to ask for help from friends, family or neighbors if you become ill.
• Decide who will watch your children, other loved ones or your pets if you become too sick to care for them.

Continue your transfusions

“There is no evidence that COVID-19 is transmitted through blood, but there is still a lot we do not know,” Smith said Continue all of your treatments unless your doctor says otherwise. If you’re worried about going in for your transfusions, ask your doctor about the risks of missing them and ask about alternatives.

If you have a fever, call your doctor.

First, use a thermometer to be sure you really have a fever. Don’t panic. Lots of different infections can cause a fever, Smith points out. This does not mean you have COVID-19.

If you do have a fever, call your doctor right away. Don’t rush to the emergency room (ER). Some ERs are crowded right now, with long waits. ERs are also seeing patients who may have COVID-19. Your weakened immune system puts you at greater risk of catching the disease. Go to the emergency room only after you explore other options.

Call 911 if you have:

• A lot of difficulty breathing
• Unusual persistent pain or pressure in your chest
• New confusion or inability to wake up easily
• Darkening of your lips or face

If you test positive for COVID-19:

Not all people with sickle cell disease and COVID-19 require hospitalization, Smith points out. If you have only a fever and mild symptoms, you may be able to manage your condition at home. If you have severe pain or respiratory distress, though, you may need to be hospitalized.

Stay connected with your local sickle cell organization

Trusted websites include:

• Sickle Cell Disease Association of America
• OncSCDVoice
• Centers for Disease Control and Prevention: Coronavirus Disease 2020: People with certain medical conditions

Other conditions

For information on managing other conditions during the COVID-19 pandemic, please visit our page on specific conditions and COVID-19.

For information on how we’re keeping our hospitals, clinics and emergency rooms safe if you need care, please see “Steps we’re taking to improve your safety."

Check for COVID-19 symptoms