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High Risk Adults and COVID-19 with Michael Wolf, PhD, MPH

In mid-March, the early days of Chicago's COVID-19 outbreak, older adults with multiple chronic conditions didn't think the disease would affect them and reported not changing their behaviors, according to the results of a Northwestern Medicine study. Michael Wolf, PhD, who led this study, explains the results and how public health interventions are needed to protect vulnerable populations.


Michael Wolf

"One in five participants in the survey said that their daily routine wasn't changing a lot and that they were not changing plans accordingly, which would include social distancing or other ways to be preemptive."

—  Michael Wolf, PhD, MPH

  • Associate Vice Chair for Research, Department of Medicine
  • Director, Institute for Public Health and Medicine's Center for Applied Health Research on Aging
  • James R. Webster, Jr., Professor of Medicine
  • Professor of Medicine in the Division of General Internal Medicine and Geriatrics
  • Professor of Medical Social Sciences
  • Member of Institute for Public Health and Medicine
  • Member of Northwestern University Clinical and Translational Sciences Institute
  • Member of the Robert H. Lurie Comprehensive Cancer Center

Episode Notes

In early March 2020, as the COVID-19 virus was just starting to spread in the Chicago area, Michael Wolf, PhD, and his research team designed a survey modeled after earlier H1N1/swine flu surveys that had been conducted in 2009. They wanted to understand if high-risk adults in Chicago, with one or more chronic conditions, understood the threat of COVID-19 and if they were taking preemptive steps to protect themselves from the virus. 

The survey was conducted before Illinois issued a shelter-in-place order and when there were mixed messages at state and federal levels about the seriousness of the pandemic. Those surveyed were all part of existing studies conducted by Wolf's team and funded by the National Institutes of Health.

"A lot of these people that we've been doing research with for so long are probably at the greatest risk," Wolf said. "We were wondering if they'd get harmed by the lack of a consistent public health message."

His team sent out about 130 surveys a day for six days and obtained a very large sample of 673 people, which created the cohort for the Chicago COVID-19 Co-Morbidities survey (C3). The majority of participants are 60 years and older, which puts them at higher risk for contracting coronavirus. Two-thirds of these patients had three or more chronic conditions, increasing the likelihood they could have serious complications or death from the disease. Many of them had lung disease, kidney transplants, cardiovascular disease and type 2 diabetes, among other conditions. 

Highlights of the study published in Annals of Internal Medicine:

  • All had concern for COVID-19, but most did not think it was likely at all that they would get the virus
  • One third couldn't name three symptoms of COVID-19.
  • One third couldn't name three ways to prevent the virus.
  • One in five said that their daily routine wasn't changing a lot. 
  • Black adults reported being less worried and perceived themselves less likely to get COVID-19, yet also felt less prepared for an outbreak compared to whites.
  • Those living below the poverty level were also less worried and perceived themselves less likely to get infected compared to those with higher incomes.
  • Individuals with low health literacy also felt they were not likely to get COVID-19 and were more likely to report not feeling prepared for an outbreak. 

Wolf’s team will survey this group several more times and will publish results. They will check to see if these patients can still access their medication with the shelter-in-place order and prescription shortages, how they are handling telehealth visits and the overall impact of the pandemic on their personal physical and mental health - especially given many are not able to be seen in person or to get routine blood work or other tests done. They will also use electronic health records to see if any of these patients were diagnosed with COVID-19.

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Continuing Medical Education Credit

Physicians who listen to this podcast may claim continuing medical education credit after listening to an episode of this program.

Target Audience

Academic/Research, Multiple specialties

Learning Objectives

At the conclusion of this activity, participants will be able to:

  1. Identify the research interests and initiatives of Feinberg faculty.
  2. Discuss new updates in clinical and translational research.
Accreditation Statement

The Northwestern University Feinberg School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement

The Northwestern University Feinberg School of Medicine designates this Enduring Material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure Statement

Michael Wolf, PhD, MPH, disclosed financial relationships with Amgen, Luto, Merck, AB Imbev Foundation, Eli Lily, Sanofi, Pfizer, Inc. Course director, Robert Rosa, MD, has nothing to disclose. Planning committee member, Erin Spain, has nothing to disclose. Feinberg School of Medicine's CME Leadership and Staff have nothing to disclose: Clara J. Schroedl, MD, Medical Director of CME, Sheryl Corey, Manager of CME, Jennifer Banys, Senior Program Administrator, Allison McCollum, Senior Program Coordinator, and Rhea Alexis Banks, Administrative Assistant 2.

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