COVID-19 & You
Howard Brown Health Confronts the Coronavirus
Howard Brown Health (HBH), a leader in LGBTQ healthcare in the Midwest since 1974, has taken proactive steps to protect the patients who visit their eleven clinics in Chicago and some easy steps that anyone can follow to ensure that they’re protecting themselves from the Coronavirus.
Coronavirus, also known as COVID-19, is a respiratory illness that can spread from person to person. The virus that causes COVID-19 was first identified during an investigation into an outbreak in Wuhan, China, in 2019. The virus is spread by respiratory droplets, which may travel as far as six feet from someone who is sneezing or coughing. Close contact with an infectious person, such as shaking hands, or touching a doorknob, tabletop or other surfaces touched by an infectious person, and then touching your nose, eyes, or mouth, can also transmit the virus. People in close contact with infected people are at greatest risk of exposure, e.g., health care workers and those who share a living space with people who are infected.
A&U’s Hank Trout interviewed Howard Brown Health’s Chief Clinical Officer Magda Houlberg, MD, about the virus and its effect on people living with HIV.
Hank Trout: I’ve read and heard that the Coronavirus which leads to COVID-19 is more similar to the flu virus than to HIV. Is that true?
Magda Houlberg, MD: Yes, the novel 2019 coronavirus, now called severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2 and influenza “the flu” virus both are infectious respiratory illnesses. Influenza and SARS-CoV-2 both can cause fever, cough, body aches, fatigue; sometimes vomiting and diarrhea. They both can be mild or severe, even fatal in rare cases. They both can result in pneumonia. They also share a similar route of transmission. Both can be spread from person to person through droplets in the air from an infected person coughing, sneezing or talking. SARS-CoV-2 might be spread through the airborne route but that is unclear. Influenza can be spread by an infected person for several days before their symptoms appear, and SARS-CoV-2 is believed to be spread in the same manner, but we don’t yet know for sure. Neither virus is treatable with antibiotics, which only work on bacterial infections.Both may be prevented by frequent, thorough hand washing, respiratory hygiene, staying home when sick and limiting contact with people who are infected. HIV differs from this because of the mode of transmission——so it isn’t transmitted as a respiratory illness
If the symptoms of COVID-19 are similar to the symptoms of the flu, how can someone infected tell the difference? Or does detecting the virus require special testing?
Yes, there are tests that identify if the respiratory illness in a patient is COVID-19 versus influenza, “the flu.” The testing technology for the virus MERS-CoV detection is not widely available and testing is being organized mainly through health departments and under the direction of the CDC. Blood testing——also known as serology testing——is used to detect previous infection (antibodies to MERS-CoV) in people who may have been exposed to the virus and had an immunologic response. In general, the flu is very common and is much more likely.
Does the virus affect people who are HIV-positive differently from the general population? Are the symptoms more severe in HIV-positive patients? Are there symptoms found in HIV-positive patients that do not occur in the general population?
We don’t know yet. Initially it appears that HIV positive patients are not more susceptible to MERS-CoV.
I’ve also read and heard that some of the antiretroviral therapies that many of us are on are somewhat effective in thwarting the virus. Is that true?
They are studying both the antiviral medications we use for influenza, and antiviral medications we use for HIV in patients with COVID-19 to see if they improve outcomes but it is unclear right now.
If someone who is HIV-positive develops flu-like symptoms and/or thinks they might have been exposed to the virus, what steps should they take immediately and long-term?
For any flu-like illness, Howard Brown Health would recommend talking to a healthcare provider and getting advice if you are safe to stay at home and let it run its course. Influenza is very common, so generally in the case of the flu if your symptoms started more than five days ago antiviral flu medication wouldn’t be helpful but it would need to run its course. MERS-CoV is not common at this point, so it would be unlikely. At this time if someone was hospitalized, they might test for MERS-CoV if there is no other explanation for a severe respiratory illness. Wearing a mask when you are ill to protect others, practicing good respiratory hygiene practices, and staying home if you are ill and appear stable are all good practices.
Other than washing our hands thoroughly often during the day, what other steps should HIV-positive folks take to prevent contracting the virus?
Washing hands is still the best defense! Right now, the focus in the U.S. is on avoiding travel to areas where MERS-CoV is more common but outside of that most of this is going to be driven by common sense measures.
In the absence of an effective treatment for COVID-19, do you expect the mortality rate among HIV-positive folks to be higher or the same as in the general population?
Right now, the jury is out on this. Those who are medically frail and have multiple chronic conditions such as diabetes and heart disease and those that are elderly are more likely.
For more information and to stay updated about protecting yourself from the coronavirus, please log on to https://howardbrown.org/coronavirus-faq/
Hank Trout, Senior Editor, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a forty-year resident of San Francisco, where he lives with his husband Rick. Follow him on Twitter @HankTroutWriter.