COVID-19: Potential Implications for Individuals with Substance Use Disorders

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19).

As people across the U.S. and the rest of the world contend with coronavirus disease 2019 (COVID-19), the research community should be alert to the possibility that it could hit some populations with substance use disorders (SUDs) particularly hard. Because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape. People with opioid use disorder (OUD) and methamphetamine use disorder may also be vulnerable due to those drugs’ effects on respiratory and pulmonary health. Additionally, individuals with a substance use disorder are more likely to experience homelessness or incarceration than those in the general population, and these circumstances pose unique challenges regarding transmission of the virus that causes COVID-19. All these possibilities should be a focus of active surveillance as we work to understand this emerging health threat.

NIH has posted a compilation of updates for applicants and grantees, including a Guide Notice on administrative flexibilities and accompanying FAQs.

SARS-CoV-2, the virus that causes COVID-19 is believed to have jumped species from other mammals (likely bats) to first infect humans in Wuhan, capital of China’s Hubei province, in late 2019. It attacks the respiratory tract and appears to have a higher fatality rate than seasonal influenza. The exact fatality rate is still unknown, since it depends on the number of undiagnosed and asymptomatic cases, and further analyses are needed to determine those figures. Thus far, deaths and serious illness from COVID-19 seem concentrated among those who are older and who have underlying health issues, such as diabetes, cancer, and respiratory conditions. It is therefore reasonable to be concerned that compromised lung function or lung disease related to smoking history, such as chronic obstructive pulmonary disease (COPD), could put people at risk for serious complications of COVID-19.

Co-occurring conditions including COPD, cardiovascular disease, and other respiratory diseases have been found to worsen prognosis in patients with other coronaviruses that affect the respiratory system, such as those that cause SARS and MERS. According to a case series published in JAMA based on data from the Chinese Center for Disease Control and Prevention (China CDC), the case fatality rate (CFR) for COVID-19 was 6.3 percent for those with chronic respiratory disease, compared to a CFR of 2.3 percent overall. In China, 52.9 percent of men smoke, in contrast to just 2.4 percent of women; further analysis of the emerging COVID-19 data from China could help determine if this disparity is contributing to the higher mortality observed in men compared to women, as reported by China CDC. While data thus far are preliminary, they do highlight the need for further research to clarify the role of underlying illness and other factors in susceptibility to COVID-19 and its clinical course.

Vaping, like smoking, may also harm lung health. Whether it can lead to COPD is still unknown, but emerging evidence suggests that exposure to aerosols from e-cigarettes harms the cells of the lung and diminishes the ability to respond to infection. In one NIH-supported study, for instance, influenza virus-infected mice exposed to these aerosols had enhanced tissue damage and inflammation.

People who use opioids at high doses medically or who have OUD face separate challenges to their respiratory health. Since opioids act in the brainstem to slow breathing, their use not only puts the user at risk of life-threatening or fatal overdose, it may also cause a harmful decrease in oxygen in the blood (hypoxemia). Lack of oxygen can be especially damaging to the brain; while brain cells can withstand short periods of low oxygen, they can suffer damage when this state persists. Chronic respiratory disease is already known to increase overdose mortality risk among people taking opioids, and thus diminished lung capacity from COVID-19 could similarly endanger this population.

A history of methamphetamine use may also put people at risk. Methamphetamine constricts the blood vessels, which is one of the properties that contributes to pulmonary damage and pulmonary hypertension in people who use it. Clinicians should be prepared to monitor the possible adverse effects of methamphetamine use, the prevalence of which is increasing in our country, when treating those with COVID-19.  

Other risks for people with substance use disorders include decreased access to health care, housing insecurity, and greater likelihood for incarceration. Limited access to health care places people with addiction at greater risk for many illnesses, but if hospitals and clinics are pushed to their capacity, it could be that people with addiction—who are already stigmatized and underserved by the healthcare system—will experience even greater barriers to treatment for COVID-19.  Homelessness or incarceration can expose people to environments where they are in close contact with others who might also be at higher risk for infections. The prospect of self-quarantine and other public health measures may also disrupt access to syringe services, medications, and other support needed by people with OUD.  

We know very little right now about COVID-19 and even less about its intersection with substance use disorders. But we can make educated guesses based on past experience that people with compromised health due to smoking or vaping and people with opioid, methamphetamine, cannabis, and other substance use disorders could find themselves at increased risk of COVID-19 and its more serious complications—for multiple physiological and social/environmental reasons. The research community should thus be alert to associations between COVID-19 case severity/mortality and substance use, smoking or vaping history, and smoking- or vaping-related lung disease. We must also ensure that patients with substance use disorders are not discriminated against if a rise in COVID-19 cases places added burden on our healthcare system. 

As we strive to confront the major health challenges of opioid and other drug overdoses—and now the rising infections with COVID-19—NIDA encourages researchers to request supplements that will allow them to obtain data on the risks for COVID-19 in individuals experiencing substance use disorders.

This content is also available in Spanish - COVID-19: Las posibles implicaciones para las personas con trastornos por consumo de drogas.


Additional Links

For those with questions about how their state justice systems are adjusting operating procedures in response to COVID-19, The Marshall Project is tracking changes as they occur. Also, the Vera Institute of Justice has developed guidance for justice system adjustments to COVID-19. 

Dr. Nora Volkow, Director

Here I highlight important work being done at NIDA and other news related to the science of drug use and addiction.

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Comments

 Methadone clinic

I took a picture this morning of the methadone clinic near my house. There was 100 people lined up on top of eachother. It’s bullshit. The Ma Dept of Health won’t give them take homes. You should see this place. It won’t let me post the picture here.

In reply to by Anonymous

 Although we do not yet have

Although we do not yet have any direct data on the implications of methamphetamine use for COVID-19 illness, it is worth noting that methamphetamine constricts the blood vessels, which contributes to pulmonary damage and pulmonary hypertension. This may put methamphetamine users at increased risk.   

 Alcoholism

I live with a chronic long term alcoholic.
I am a smoker, amphetamine user, looking after my alcoholic.
Very Very scary

 Residential treatment

Also, on 3/16/20, the Substance Abuse and Mental Health Services Administration issued guidance to opioid treatment programs to provide take-home medication for longer durations for many patients during the pandemic, reducing the need for frequent clinic visits. They also recently released Virtual Recovery Resources for Substance Use and Mental Illness.

This is not an answer. I work intake at a residential treatment center. We are still doing business as usual. I am very conflicted and as long as my administration is telling us to keep working and accepting patients I am going to keep doing that or until I get sick and have to stay home. But my administration is not going to tell us to stop taking patients. What am I supposed to do? Stand my ground and say no or trust that I’m doing what I’m supposed to be doing and helping addicts get the help they need?

 We certainly understand your

We certainly understand your concerns.  We expect the SAMHSA guidance to help some people with substance use disorders, but as you point out, others need more intensive treatment.  We are all trying to do our best for each other, and to stay healthy at the same time.  We appreciate and thank you for what you are doing to take care of people who need it.

 lapsed sobriety related to anxiety & social support

I believe that the significance of anxiety and of withdrawing social support is not being addressed. These issues are at least, if not more, important than lung disease in the issues of substance abuse.

 Please see this blog post

Please see this blog post from the Director of the National Institute of Mental Health - Coping With Coronavirus: Managing Stress, Fear, and Anxiety. There are resources to help support recovery in these difficult circumstances; for example, virtual meetings of mutual support groups (e.g. SMART Recovery, AA, and NA) are available to those with access to the internet.  The Substance Abuse and Mental Health Services Administration issued guidance to opioid treatment programs to provide take-home medication for longer durations for many patients during the pandemic, reducing the need for frequent clinic visits.  They also recently released Virtual Recovery Resources for Substance Use and  Mental Illness

 Por ahora la información más clara que he leído

Muchas gracias por la información compartida, así como por los comentarios que se han publicado, son de gran ayuda. Porque es la experiencia real ante esta contingencia, no solo los que no tienen casa son afectados, tengo casa, pero no tengo sueldo por esta situación que estoy viviendo. Se reafirma el virus, como el uso y abuso de las redes sociales, para crear más pánico y lidiar con una psicosis colectiva.

 Chances of survival of going through withdrawal and covid 19

Was wondering if I caught the virus and I was a suboxone user for 9 years now on very minimal doses , now I’m sick in the hospital going through withdrawal symptoms because I’m guessing you can’t take suboxone when your sick , 1. Will the doctor still give me my doses if I have it if I’m sick and fighting for my life in the hospital or 2. Make me go through withdrawal and covid 19 at same time , if so I have a feeling I won’t make it out alive if I’m going through both at same time , please help

 Hartford CT MMT Program and Social Distancing

My daughter goes into the Fishfry Street Clinic in Hartford CT every morning g for Methadone dosing. Apparently the State came in and laid down tape strips on the floor every. six feet to keep people apart but as the line of bodies winds outside the facility they all pack together like sardines in the cold morning air. They must be allowed to take home dosages during this emergency or they are going to spread this disease amongst their families and the general population.

 There are resources to help

There are resources to help support recovery in these difficult circumstances; for example, virtual meetings of mutual support groups (e.g. SMART Recovery, AA, and NA) are available to those with access to the internet.  Also, on 3/16/20, the Substance Abuse and Mental Health Services Administration issued guidance to opioid treatment programs to provide take-home medication for longer durations for many patients during the pandemic, reducing the need for frequent clinic visits.  They also recently released Virtual Recovery Resources for Substance Use and  Mental Illness

 Ethical considerations for drug screening

Our state is a Shelter in Place status.How do we ensure we are doing accurate risk assessment without drug testing? Almost everyone in our program is precontemplative or at the very least ashamed about their use of drugs and alcohol and minimize or deny their use. The cross contamination of Fentenyl in the drug supply is dangerous. Liquor stores are open-treatment centers are not able to meet with them. Benzodiazapines and "fake xanax" 100 x's stronger than real xanax is in the supply. How can we accurately assess and advise clients who are using drugs without an accurate objective tool like drug screens. Our state health authority told us we are not supposed to require drug screening-even if we took precautions and did not require patients to come to the clinic. Our fear is more people are going to die from drug overdose, alcohol poisoning and drunk/drugged driving than a virus. I honestly don't know what to do at this point. Individual safety vs. Possible risk to public from virus spread vs. Risk to public for collateral damage due to drunk/drugged driving and overdose deaths.

 We share the very serious

We share the very serious concerns you raise, especially the frustration that as we are starting to make progress in deploying various strategies to reduce overdose deaths and other adverse substance use outcomes, we will lose ground as result of the COVID-19 virus and some of the measures being employed to contain it.   Our sister agency (SAMHSA), and many of our constituent groups and professional organizations are trying to help by providing links to virtual resources to help those with SUD access treatment and recovery meetings.  These are posted on our COVID-19-resources page

 Kratom

As you know Kratom is from SE Asia and vicinity.I take Kratom in a daily basis for severe pain . Having left Big Pharma and shadows of addiction 3 yrs ago. Kratom saved my life. Now I need to know can my plant carry this virus on itself thru drying and packaging to me? I have Hep B and C...another reason I stopped the pharma drugs....Is there a possibility of exposure? I have just ordered my new supply of Kratom that will arrive within a week and there is massive outbreak of virus as of this question...Do I have to be more worried ( as if I'm not worried enough) Thank you .

In reply to by Anonymous

 Unfortunately we don’t have

Unfortunately we don’t have enough information to be able to answer your question as it relates to kratom. The CDC’s current information on risk of transmission from food products shipped through the mail states that: “In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.”

 Data on COVID-19 mortality and age

I heard the surgeon general suggest on Monday the 23rd that the slight majority (53%) of hospitalizations for NY residents being aged 18-49 years might be due to increased levels of vaping in that age group. While I wonder about almost anything from this administration, I wondered if NIH has actual data on demographics and mortality...you know science.

 MAT Take Homes

A certain clinic in WV REFUSES to give out more than one take home EVERY OTHER DAY, despite being shown SAMHSA guidelines. People are being staggered alphabetically on alternating days. Only 3 people are allowed inside, but you stand outside with 20+ people who DO NOT CARE about social distancing. The clinic staff catches an attitude. They said SAMHSA guidelines weren't "Federally mandated". They obviously don't know that a federal mandate is an order a state has to comply with to receive grant money i.e.....The Americans With Disabilities Act, The Clean Air Act.... It's no surprise that this is pandemic protocol for the state with the highest rate of overdose deaths, and a moratorium on any new clinics. There are only 9 in the entire state of WV. Who can I contact to make someone do something about this before I contract COVID 19?This is NOT FAIR to anyone in long term recovery with major mental health issues. I keep reading about Ohio and how SAMHSA followed their lead. Can Ohio's people call WV's people and tell them to stop needlessly endangering people's lives.

 The real CAUSE of the virus.

What I am wondering is if the smoking of illegal drugs....heroin or meth....is the actual CAUSE of the damage to the lungs, which has enabled a "sleeping", or dormant, virus, to emerge into the forefront. I recently read of an autopsy on a person, who was found, at autopsy, to have lung cancer. Also, at that autopsy, was found the corona19 virus, heretofore as found to be asymptomatic in the individual. Can the "saving" of these people who OD with Narcan really be perpetuating this virus, enabling it to be expelled (breathed) on others. These OD have stopped breathing for a reason. Maybe those who have OD'd and died should have their lungs microanalyzed for this sleeping giant.

 We have known for many years

We have known for many years that opioids suppress respiration and that this can result in overdose deaths.  The impact of the COVID 19 virus on individuals who also use opioids is one of our concerns, as discussed in the blog. However the origin of the virus, like several other respiratory viruses (SARS, MERS), is thought to have jumped species --likely from bats--to infect humans.  There is no evidence that it is caused by smoking illegal drugs.

 SUD employees in non-patient care roles - telework during COVID?

I was wondering if you or SAMHSA are going to issue an advisory on telework for employees at residential SUD facilities who are in non-patient care roles. It is worrying that facilities are still having these staff (ex: billing, compliance, marketing, etc) perform their jobs in-house rather than letting them telework. It is safer for the patients and for our nurses/techs to reduce the number of people in the building. Staff in non-patient care roles are being unnecessarily exposed to COVID due to shared lobbies, hallways, elevators, etc. Many facilities aren't spacious enough to allow for continuous social distancing, so staff/patients are within coughing distance in stairwells, dining halls, etc. With the shortage of ICU beds & ventilators nationwide, it's important that anyone who can do their job remotely is allowed to work from home. SUD patients often have autoimmune conditions or pre-existing respiratory conditions that make them especially vulnerable to COVID. For every employee who is allowed to work from home, the less chance patients have of contracting it. While the CDC and state governments are "encouraging" telework, many SUD facilities still are not making it available to those in telework-compatible positions. We cannot count on facilities to do the right thing...we have to mandate it. The lives of employees and patients are being put at risk because there is currently no formal order for telework. Please hold facilities and agencies accountable before it is too late.

 Suboxone

I am on Suboxone and I to think Suboxone could eliminate the coronavirus . I do not hardly ever get sick at all.Im worried I could have the virus and not know it.

 There is no evidence or

There is no evidence or reason to believe that suboxone would have any effect on contracting or expressing the coronavirus.

 active heroin addict in home

I have my 84 year old immunocompromised mother living with me, my grandson, who is 8, my husband and my adult 30 year old active heroin addicted daughter living in our home. She is trying to go out and score. I do not want to let her back into our home after having contact with possible infected persons. What options do I have? She is not amenable to treatment at this time. Am I legally able to ban her from our home?

 What I think.

I think it doesn't matter whether or not people use drugs or tobacco this is killing way too many people. Infecting thousands and thousands more. The peak isn't until May the expected worse time is in July. At the rate everyone is going, still living day to day as they would without the virus. My kids don't even get to go outback and play because I've had a son die from pneumonia it sucked I would never wanna go through that again nor wish it upon anyone else. But its happening everyday now and its happening rapidly. I think the whole US should be shut down while we have the stimulus checks going out get ready stock up what you need then lockdown for 15 to possibly 20 days. NO LIFE OUTSIDE THEIR HOUSES AT ALL. Having strict rules and consequences for not doing so like ok you don't want to listen lock them up for 15 to 20 days. We're way smarter then this we can figure out some type of plan to stop this thing obviously the vaccine is 100 thousands of deaths too many and 100's of thousands of deaths to come before its even figured out.
THERE IS NO CURE, WE ARE NOT IMMUNE...

How hard is that for people to understand how many more people are going to be infected and die before you finally get it...

 Cannabis usage and the virus

Grouping Cannabis usage with much harder drugs that can actually kill you and saying all of the drugs mentioned carry the same increase is getting the virus and having more serious outcomes is incorrect. Cannabis usages do not mean you will be homeless and a threat to others is ridiculous.

The problem with Vaping is because of the additives added to the vape liquid, not the THC. And smoking cannabis will not cause the spread of the virus if social distancing is used.

 Meth cures/prevents influenza type illnesses

Meth kills brain cells, fuels tooth decay, loads the body with toxins and weakens the heart, muscles and immune system. But the otherwise body-wrecking drug may also have flu-fighting properties, new research suggests.

A group of scientists from the National Health Research Institutes in Taiwan set out to study how methamphetamine interacts with influenza A virus in lung cells. Previous research has suggested that chronic meth abuse makes individuals more susceptible to pathogens such as HIV. The team wanted to investigate how the drug might reduce users' resistance to flu viruses.

They took cultures of human lung epithelial cells, exposed them to different concentrations of meth and then infected them with an H1N1 strain of human influenza A. By 30 to 48 hours after infection, the meth-treated cells had a much lower concentration of the virus than the control group, the researchers reported. What's more, this reduction occurred in a dose-dependent manner, meaning the more meth, the less the virus reproduced.

"We report the first evidence that meth significantly reduces, rather than increases, virus propagation and the susceptibility to influenza infection in the human lung epithelial cell line," wrote the researchers, led by Yun-Hsiang Chen.

No doctor would recommend that you take up a meth habit to fight the flu this winter, but the researchers said their study could help find other, safer compounds that have the same effect.

 Although we do not yet have

Although we do not yet have any direct data on the implications of methamphetamine use for COVID-19 illness, it is worth noting that methamphetamine constricts the blood vessels, which contributes to pulmonary damage and pulmonary hypertension. This may put methamphetamine users at increased risk.

 Second Hand Fumes

Is there data or research that shows whether or not second hand smoke from cigarettes or fumes from vaping can carry the covid-19 virus?

 There is no evidence that

There is no evidence that exhaled aerosol from vaping devices or secondhand smoke can carry a virus, but virus-containing droplets exhaled from someone infected can remain suspended in the air and inhaled by others, similar to secondhand smoke or vapor.

 South Eastern Ontario, Canada

On March 16, 2020, our addiction and mental health community services office closed our offices and began providing only phone contact for our clients. Our groups were cancelled a week or more prior to our offices closure. From my own perspective, phone contact appears to be working well with my clients. They appear to appreciate the phone contact, and to be able to help support them through this difficult time. We also extended take home carries by 7 and 14 days to all registered clients in our suboxone program. Prevention is key, and I have found that many of my clients who do not have access to cable TV and/or radio, were not well informed about the Covid crisis.

 Same Old Persecution of Pain Patients

Once again, chronic pain patient are being lumped in with substance use disorder patients. They are vastly different. Talks more about them overdosing than the virus' effects. Same old ignorant nonsense based on falsely used statistics perpetuated by a government that was already killing off chronic pain patients deliberately.

 Statistical Increase in Substance Abuse

Considering stress levels and the fact that people may not have an incentive for being sober since many workplaces are closed is it possible that we see an increase in substance abuse due to this outbreak?

 Yes we know that stress if a

Yes we know that stress if a major contributor to drug use and to relapse, so we are all concerned about this possibility.  This is why it is so important to maintain connections to those we care about and to encourage those in recovery to take advantage of virtual resources.

 Suboxone refills in NY

I take Suboxone and am slowly reducing my dosage. I also have, like many, depression, anxiety and OCD. I’m also obese, have hypertension, upper respiratory issues and live with my elderly mother who has underlying conditions. I’ve been taking the orders NY has put in place VERY seriously. We have not gone beyond our property for 3 weeks.
When I realized I would need to leave to go in for my Suboxone refill, I began to panic. Then, I went to SAMHSA’s website and read how prescribers could now use telehealth, including just the phone, to prescribe Suboxone.
However, when I called my doctor’s office 3 days ago to check if he was doing phone sessions, I was told yes, but not for his Suboxone patients. I still needed to go there. I immediately broke down and emphasized to him how the rules had been modified but he wouldn’t budge.
So now, the day before my appointment, I am in a complete state of panic and debating if it’s worth it or if I should just suffer from withdrawals instead. It’s beyond frustrating that this is even an issue for anyone when exceptions to the rules of prescribing Suboxone are there for any doctor to use. And I would think a doctor who is VERY close to NYC would absolutely utilize those rule exceptions.
Do you think these new guidelines will ever become mandatory for prescribers, especially since the Covid-19 numbers aren’t even close to where they will be?

 We do not know if this

We do not know if this recommendation will become mandatory, but I would encourage to stay in touch with your physician, provide the information that SAMHSA has published on their website, and not try to withdraw on your own from a medication that is working for you.

 Short of breath

I'm on suboxone and anxiolytic for years. Feeling slight tightness in chest. Any way to get O2 levels without going to dr. For pulses. Supposed to go back to dr in a week or so. Thinking about self quarantine, will that effect my ability to get new Rx for controlled substance?

 Would advise you to contact

Would advise you to contact your physician.  SAMHSA and the DEA have loosened the rules for prescribing controlled substance, allowing more use of telemedicine.  But these are just recommendations, and different practices are choosing whether/how they want to implement them.  See https://www.cchpca.org/telehealth-policy/online-prescribing 

 IV meth use/ contaminated meth?

Does anyone know if the virus could be contaminating meth by the possibility of infected people handling the meth that's distributed to buyers, users. Could the virus even survive on it And for how long? And is use of meth by IV any worse or better than smoking it.

 We do not have any

We do not have any information about the spread of the virus through handling of methamphetamine; however, many infectious diseases can be spread by IV users sharing equipment, even if not needles.  Moreover, we know that this virus can remain infectious on many surfaces for hours or days after contact occurs.  We also know that methamphetamine constricts the blood vessels, which contributes to pulmonary damage and pulmonary hypertension. This may put methamphetamine users at increased risk regardless of their mode of administration.

 Desoxyn cures Coronavirus

METHAMPHETAMINE IS THE CURE FOR CORONAVIRUS!! SOMEONE PLEASE DO THE RESEARCH! It is already approved by the FDA and available in a pill form that is prescribed for ADHD and called DESOXYN!

 At this time, there is no

At this time, there is no evidence to suggest that methamphetamine is a cure for COVID 19. 

 What about the ones that don

What about the ones that don't have a doctor and have been on methadone and xanax for many years and were receiving it from a doctor. We recently moved and my former doctor recently passed away..how am I supposed to get my medications with this pandemic and doctors not being open..please help

 Physicians are seeing

Physicians are seeing patients; many are conducting telehealth appointments.  The DEA has also relaxed some of its restrictions for prescribing controlled substances, allowing for use of telemedicine.  I know it will be difficult starting over with a new physician in the current environment, but if you have your health records documenting your prior treatment, or if they can be retrieved electronically, that should help you resolve this problem.

 COVID19 Opioid Withdrawal

THIS article needs to be on the news. And there needs to be a committee devoted to exploring and mitigating the dangers of people experiencing withdrawal from their usual supply of narcotics, be it illicit or prescribed. The fact that drug withdrawal affects the immune system is well documented, and the first and most enduring symptoms of opioid cessation are consistent with flu-like ones, (including respiratory irritation from severe coughing/sneezing, and greatly increased nasal/bronchial moisture levels), which presents a potent window for opportunistic pathogens to take hold as well. This means that blocking access to normal means of "medication" is essentially creating an entire unnecessary sub-group of sick individuals. I wonder what percent of the affected population is represented in this niche? It seems fair to assume that there is a significant risk, given the levels of opioid-addicted citizens in our country, no? As well, the fact that there is a tremendous amount of coughing and sneezing from those so afflicted, (considerably more than the average respiratory virus), means that there is also a correlation to an increased spread of pathogens all around. And, unfortunately, as several have pointed out, a large percentage of these poor souls aren't apt to practice great illness hygiene, to boot.
Interestingly, though, in recent years, there have been potential anti-viral therapeutic uses for opioids discovered, and scientists would do well to keep this possible avenue in mind- at this time, we can't afford to overlook anything that may help!

 Photo

Will the user who mentioned the photo of lines for the local methadone clinic PLEASE send that to news sources? Please oh please! The plight of this population is so often overlooked by mainstream society, and it would do everyone well to have their eyes opened a little!

Thank you!

 Treatment

Why don't we just multiply the antibodies found in recovered patients and give them to the whole population?