Tag Archives: immunocompromised during pandemic

Speaking Up for the Immunocompromised

by Jennifer Crystal

I live in a high-rise apartment building with a common laundry room for hundreds of apartments. The long, narrow room is lined with ten washers and dryers, with barely enough space for one person to walk, much less two. My neighbors and I usually do an awkward dance, squeezing behind each other to get to the dryers, or letting someone push their laundry basket past before opening a front-loading washing machine that blocks the way. 

This system worked just fine until the COVID-19 pandemic. In such a tight space, it’s impossible to practice social distancing, so I’ve learned to do my laundry at low-traffic times. If someone else is in the room when I arrive, I wait in the hallway for them to finish before entering. Then, wearing a mask and gloves, I disinfect the machines and hope that no one else will show up before I finish. Sometimes, if another person arrives, they do what I do: give a little understanding wave, and wait at the entrance of the room until I can load my machines and leave. 

Yesterday, I was not so lucky. I was taking my clothing out of the dryer when two neighbors walked in: one masked, one unmasked. Though our building has a rule that residents must wear masks in common areas such as the lobby, the elevator, and the laundry room, many of my neighbors do not follow it. As an immunocompromised person, this makes me terribly nervous. 

I’ve already had COVID-19, but we don’t know enough about individual immunity yet for me to feel confident that I can’t get reinfected. Moreover, despite my overall recovery—I’m still dealing with a lingering cough—I can’t say with absolute certainty that I’m no longer contagious. For my own safety and the safety of others, I wear a mask and assiduously follow social distancing guidelines. 

I hope my neighbors will do the same, but as I learned in the laundry room, I can’t count on that. As the masked and unmasked people neared me with their laundry baskets, I politely asked, Would you mind waiting just one minute while I finish taking my laundry out, so we can stay six feet away from each other?” The masked neighbor looked a little taken aback. She didn’t wait, but she at least decided to load her clothes in a machine that was further away from mine. The unmasked neighbor pushed right past the masked neighbor, close enough to breathe on her, and started loading the dryer next to mine. I stopped what I was doing and backed away, but the only place to do so, without standing right next to the other neighbor, was the corner of the room. Still, I was only a foot or two away from each neighbor. I waited there, cornered until both neighbors finished and left. 

When people don’t wear masks but keep their distance from others, their choice is personal. But when they don’t take this simple gesture and get too close to others, their choice infringes on another’s personal safety. Now that businesses are opening again, immunocompromised people would like to join the outside world, too, but they worry about how they can safely do so. They can take all the proper precautions: wearing a mask, keeping their distance, and washing their hands, but they can’t control what other people do. And if they live in a crowded area, or have to negotiate tight spaces like elevators, the prospect that others aren’t taking the necessary precautions keeps patients locked at home out of fear.

Part of the problem is that the immunocompromised don’t usually have a physical marker that flags them as such. Another high-risk group for COVID-19, the elderly, can usually be easily identified because of their age. People tend to give the elderly a wider berth on the sidewalk. They have designated shopping hours at grocery stores so they don’t need to come in contact with younger, unmasked people. 

For the immunocompromised, especially those who are younger and otherwise don’t seem sick, staying safe isn’t so easy. Others may assume they’re healthy just by looking at them, and not think it’s a big deal when coming close. Even one of the EMTs who took me to the hospital when I first experienced COVID-19 symptoms said, before learning of my underlying conditions, Well, even if you have [COVID-19], you’re young and healthy, so you’ll be fine.” 

Fortunately, I am fine. My recovery from COVID-19 has been slow, but steady, and I was never on a ventilator. Many other people have not been so lucky, and those who haven’t contracted the virus are rightfully scared of what could happen to them if they do. 

When the pandemic first hit the U.S. and shelter-in-place orders went into effect, my plea to healthy citizens was to stay home, not just to protect themselves, but moreover to protect vulnerable citizens. Now, as areas start to reopen, my plea is, by all means, come out and enjoy yourselves—just please do so with the safety of others in mind. Wear a mask, wash your hands, and keep a respectful distance. That person you brush by in the grocery store could be immunocompromised. It could be me.

Additional COVID-19 and Lyme Disease Resources:

Blog: Corona With a Twist of Lyme
Blog: Corona With a Twist of Lyme: Part 2
Blog: Corona With a Twist of Lyme: Part 3
Video: Webinar with Dr. Cameron and Lyme-COVID-19 patient
Letter: GLA CEO Addresses COVID-19 and GLA Community
Letter: GLA Chairman on What We Can Learn from COVID-19 Response
GLA POV: Parallel Pandemics: COVID-19 and Lyme Disease
Blog: Q&A on COVID-19 and Lyme Disease with LLMD

jennifer crystal_2

Opinions expressed by contributors are their own.

Jennifer Crystal is a writer and educator in Boston. Her memoir about her medical journey is forthcoming. Contact her at [email protected].

Lyme Disease Physician Answers Questions About COVID-19

Patient-Doctor Q&A: Lyme Disease and COVID-19

Interview by Alex Moresco

I have spent the last few weeks like many of you inundated and overwhelmed by the sheer enormity of the news coverage about COVID-19. Separating fact from fiction is growing increasingly difficult as panic permeates our community. Typically trustworthy media sources are misreporting the COVID-19 pandemic. As someone living with Lyme disease, POTS and SAD, I sought out factual, science-based knowledge on COVID-19. Toward that end, I recently sat down with Dr. Casey Kelley, an Integrative and Functional Medicine specialist (and LLMD), and the founder of Case Integrative Health, who has been reporting live from Chicago as an Illinois COVID-19 expert on Fox 32, Chicago.

Dr. Casey KelleyDr. Kelley graduated from The Ohio State University College of Medicine and completed her residency in Family Medicine at St. Joseph Hospital in Chicago.  She is a ten-year member of the Institute of Functional Medicine (IFM), a Director on the board of The International Lyme and Associated Disease Society (ILADS), and is a Founding Member of the Academy of Integrative Health and Medicine (AIHM).  Dr. Kelley is also on the faculty at the Feinberg School of Medicine at Northwestern University.

Dr. Kelley answered the following questions submitted by members of the tick-borne disease community.

Q:  First of all, what is COVID-19, and what are the early symptoms we should look out for?

A:  COVID-19 is a new type of coronavirus that is causing mild to severe symptoms in our population. Most people will have a mild form of the illness while some who have underlying medical conditions, those who are over 60,  smokers and those who are immunocompromised are at a higher risk of developing a more severe form of the illness.

Check in with yourself regularly. The most common symptoms to look out for are a fever of 104 or higher, a dry cough and difficulty breathing. Some people are also noting a loss of smell and taste. Less common symptoms include headache and GI upset. Keep in mind, it is also cold, allergy and flu season—if you start to show COVID-19 symptoms, do not panic!

Q:  How is COVID-19 spread so quickly from person to person? Is this virus airborne?

A: As a doctor that is sitting with patients all day, every day, I am constantly seeing respiratory illness. If you have respiratory symptoms it might not be COVID-19, but all respiratory illness is generally contagious so treat this like any other illness and self-quarantine.

COVID-19 can spread through respiratory droplets produced when an infected person coughs or sneezes. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it, and then touching their own mouth, nose, or possibly their eyes. So you are not likely to catch it just from being in the same grocery store with someone who is sick.

Many of my patients have been asking me—does this spread before you show symptoms? Yes, just like with the flu, it is possible to spread the infection before you know you are sick. Just because you feel well doesn’t mean that you cannot transmit the infection.

Q:   As someone with other conditions—like Lyme disease—are there extra steps I should be taking to stay safe from COVID-19?

A: There are certain precautions we can take to stay safe. Remember, do not panic, but be cautious. Avoid contact with people who are presenting COVID-19 symptoms. Stay home and self-quarantine if you feel like you are sick. Avoid public gatherings and practice social distancing, this is how we will keep from spreading the illness faster than our hospital systems can handle. At the most basic level, do not touch your face, do not shake hands, use hand sanitizer with 60% or more alcohol content, and avoid touching things like doorknobs, elevator buttons, and credit card scanners.

Talk to your doctor about ways you can help boost your immune system: supplements, IVs, peptides, etc. One of the most important aspects to treating Lyme disease is boosting the immune system so it can fight off the infection) and protect you from viruses and other illnesses you might come in contact with.

Q:  What should I do if I think that I could have possibly come into contact with someone who has COVID-19?

A: First, assess your symptoms, a persistent fever of 103-104, a dry cough and difficulty breathing could be symptoms of COVID-19. If you feel you are unwell, self isolate and then you should call your doctor to discuss your condition and situation. They can help best determine if you need testing.

Q:  As someone who is chronically ill, and now worried about COVID-19, what are some simple things I can do to reduce my anxiety?

A:  Manage your anxiety and stress (which suppresses your immune system) the best way you can.  Find time to reach out to loved ones, take time for self-care—bubble bath anyone?— gratitude, laughter. These are some of the strongest things you can do to stay safe in this time. Set up a phone call with your therapist if you regularly see one. Try not to consume too much news. Set time limits on how much news you watch day to day, and your anxiety should lessen.

Let’s also touch on the importance of lifestyle and self-care. Get adequate levels of sleep, avoid processed foods, eat foods rich in vitamins and minerals. Exercise if you can and get outside!

Q: With the medical community having to adapt to accommodate the COVID-19 outbreak, what has the greatest challenge been?

A: With COVID-19 sweeping the U.S. our work feels like it has greater purpose— to keep patients safe from the progression of the novel coronavirus, and aid in keeping our hospital systems from becoming overburdened and kept available for the most critical COVID-19 cases. In our efforts, we have moved all of our patients to virtual visits. We have also launched small group visits virtually, so we can aid more patients day to day to support their health and immune function during such a critical time. We are happy to help those who are immune-compromised, at any time.

Q:   If you aren’t considered high risk but do have cold and flu symptoms, what is the best course of action?

A: The best thing you can do is call your doctor and immediately socially isolate yourself. The important thing to remember during this time is that most will recover from COVID-19, but we must protect our immunocompromised friends.

Q:  Generally-  what antiviral and immune support protocols should we be following?

A: Supplemental support is crucial right now and we should all be practicing preventative medicine in the coming weeks. If you want to boost your immune system, I recommend: vitamin A 25,000 IU 1-2x/day (NOT if pregnant or if trying to become pregnant), vitamin D 10,000-15,000 IU daily, vitamin C 3,000-6,000 mg daily (watch for upset stomach as a side effect and if so reduce dose), zinc lozenges, elderberry and anti-viral herbs as directed. As always, this is not meant to be taken as medical advice, so please consult your doctor.

Q:  Is it safe to take walks in the neighborhood while you are working from home and you are considered healthy?

A: Yes, absolutely! Get outside to breathe fresh air! And exercise is necessary for everyone right now, if possible. Please practice social distancing and stay six feet away from others on the sidewalks. But don’t forget to make eye contact and wave hello to people you see.

You can find Dr. Casey Kelley on Instagram and her website.

*If you suspect you may have COVID-19, please call the office of your health care provider.

Related Posts:
Letter from CEO About COVID-19 and GLA Community 
Corona With a Twist of Lyme
Alex Moresco’s Podcast: In The Lymelight

Alex Moresco on StageOpinions expressed by contributors are their own.

As someone who lives with Lyme & other illnesses, Alex Moresco’s mission in life is to help others and better the lives of those living with tick-borne illness. As the co-founder of two separate fundraising events in Chicago, She’s raised over  $350,000 for Global Lyme Alliance.

You can find Alex Moresco on Instagram.