NEW YORK (AP) – The country’s national public health service updated its list on Thursday of which Americans are at higher risk for serious COVID-19 diseases, adding pregnant women and removing age as a factor only.
The Centers for Disease Control and Prevention have also changed the list of underlying conditions that make someone more susceptible to suffering and death. This is how sickle cell disease came on the list. And the threshold for high-risk obesity was lowered.
The changes did not include adding race as a risk factor for serious illness, despite increasing evidence that black people, Hispanics and Native Americans have more infections, hospitalizations and deaths.
Agency officials said the update was prompted by medical studies published since the CDC first listed a list of risk groups. They tried to release the information before Independence Day weekend, when many people may be tempted to go out and socialize.
“For those at higher risk, we recommend limiting contact with others as much as possible, or limiting contacts to a small number of people who are willing to take measures to reduce the risk of (u) becoming infected,” said CDC – director Dr. Robert Redfield.
The same advice applies to people living with or caring for those at higher risk, Redfield added.
Earlier, the CDC said that people at high risk of serious illness were 65 and older; those who live in a nursing home or long-term care institution; and people with severe heart disease, obesity, diabetes, liver disease, chronic kidney disease, chronic lung disease, and conditions that have a weakened immune system.
In the changes, CDC created categories of high-risk and high-risk people.
Those at high risk are those with chronic kidney disease, chronic inflammatory lung disease, obesity, severe heart disease, sickle cell disease, type 2 diabetes and a weakened immune system due to organ transplants. The threshold for obesity concerns was lowered from a body mass index from 40 to 30.
The CDC said that people are at greater risk as they age, but it has removed people age 65 and older as a risk group.
The list of high-risk people includes pregnant women, smokers, and those with asthma, diseases that affect blood flow to the brain, cystic fibrosis, high blood pressure, dementia, liver disease, scarring or damaged lungs, type 1 diabetes, a rare blood disorder that affects thalassemia, and people who have weakened the immune system as a result of HIV or other reasons.
Pregnant women were listed on the same day that a CDC report found they were responsible for about 9% of laboratory confirmed COVID-19 cases in women of childbearing age. About 5% of women of childbearing age are pregnant at any time.
The report found that pregnant women were hospitalized more often, admitted to an intensive care unit at the hospital, and ended up on a ventilator versus young women who were not pregnant. However, there was no clear evidence for a higher death rate among pregnant women.
It is not entirely surprising, said Dr. Denise Jamieson, chair of obstetrics and gynecology at Emory University School of Medicine. Pregnant women have been found to be at a higher risk for other infectious respiratory diseases, probably because the lungs decrease in volume as the uterus grows, Jamieson said.
What’s surprising, she said, is that CDC has not placed pregnant women in the highest risk category.
“For me, this is the most compelling evidence to date that pregnant women are at increased risk,” said Jamieson, who spent 20 years at CDC as a reproductive health expert.
Earlier this week, CDC officials called on a panel of experts to help them identify groups that should be given priority in coronavirus vaccinations if one becomes available and supplies are limited.
Pregnant women could belong to that group. This also applies to certain racial and ethnic groups.
CDC officials shared data with the Advisory Committee on Immunization Practices showing that, compared to white Americans, the number of hospitalizations in the coronavirus was 4 times higher for Hispanics, 4.5 times higher for black people and 5.5 higher for American Indians and Alaska Natives. A recent study in the Atlanta area suggested that being black was just as likely to be hospitalized as having diabetes, smoking, or being obese.
“If we don’t address racial and ethnic groups with a high risk of prioritization, everything that comes out of our group will be viewed very suspiciously and with great restraint,” Dr. Jose Romero, chairman of the expert panel.
“They are groups that need to be moved to the front,” he said.
CDC officials say they expect to come forward with recommendations for racial and ethnic minority groups soon.
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