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June 26, 2020

'I fear I'll be isolating for years': What it's like to be at high risk of severe Covid-19

Daily Briefing

    David Andelman—executive director of the Red Lines Project and a 75-year-old, lifelong asthma patient—is at high risk for complications and death if he develops Covid-19. And although states have lifted stay-at-home orders and relaxed social distancing guidelines, Andelman fears that he and millions of Americans like him will be locked down for the rest of their lives, he writes in an opinion piece published by CNN.

    Advisory Board's take: 3 ways you can limit the effects of social isolation

    'A long way from … normal'

    At 75 years old, Andelman's age puts him at high risk for developing a severe case of Covid-19, the disease caused by the new coronavirus. And with "lifelong asthma" and 30% lung capacity, "I'm likely a goner if I get [Covid-19]," he writes.

    So to protect himself from the virus, Andelman for the last three months has lived in isolation in a "cabin in the woods in northeast Pennsylvania." The time has allowed him to "reflec[t] on some hard, and very sad, facts of life," Andelman writes, for both him "and others in [his] position" as the coronavirus continues to spread throughout America.

    For instance, Andelman writes, even as New York—his home state for about 50 years—has begun easing measures that officials had put in place to curb the new coronavirus' transmission, he doesn't feel he'll be able to return to his New York City apartment any time soon. In fact, Andelman writes that he "recently arrived at the disturbing conclusion that [he] may be unable to return to [his] apartment, or visit [his] family in Paris, for years."

    But that's a reality for him and hundreds of millions of other Americans at high risk of developing a severe case of Covid-19, including the more than 50 million Americans who are older than 65, 121 million who have heart disease, 25 million who have asthma, and 34 million who have diabetes, according to Andelman.

    And it's not just people who are at high risk of becoming seriously ill or dying from Covid-19 who are considering a more sheltered existence, Andelman writes. He notes that a recent New York Times poll of 511 epidemiologists revealed that more than 50% of respondents planned to wait up to a year before once again eating in a dine-in restaurant, working in a shared office, or sending their children to school, day care, or camp. In addition, nearly two-thirds of respondents said they would delay attending sporting events, concerts, and plays for another year, and more than 40% said they would wait more than a year to go "to church or synagogue" or "atten[d] a wedding or funeral," Andelman writes.

    Ultimately, Andelman writes, "for most … life is a long way from returning to normal" because of Covid-19's risks.

    Could a vaccine lead to a better life?

    Andelman writes that, until there's a vaccine against the new coronavirus vaccine or a treatment for Covid-19, "the risks of death simply outweigh any of the pleasures of [his] daily pre-Covid life."

    But even if researchers develop a vaccine, Andelman fears he and other high-risk Americans still would be fated to a life of isolation.

    According to Andelman, some researchers are questioning whether a potential coronavirus vaccine will be effective enough to protect people against the virus. For instance, he notes that yearly influenza vaccines typically reduce a patient's risk of developing a severe case of the flu by between 40% and 60%, according to CDC, but they do not provide complete protection. And for asthmatics, who already have damaged lungs, researchers are wondering whether that level of efficacy would be high enough to adequately lower patients' risk of experiencing severe symptoms of Covid-19, Andelman writes.

    According to Paul Stoffels, chief scientific officer at Johnson & Johnson, the efficacy target rate for a vaccine against the new coronavirus is 70%, Andelman writes. "But even if it reaches that level, do I really want to roll the dice on a 3 in 10 odds of contracting a disease that will almost certainly prove deadly?" he asks.

    'Is this my life until the end?'

    Andelman writes that, particularly as states scale back measures intended to curb the coronavirus' transmission, "there must be millions of" high-risk Americans like him "asking themselves, is this my life until the end? Must we feel marginalized as our friends and relatives return to work and pick up their lives?"

    But although he is missing "friends and relatives … and the ability to watch [his] 7-year-old grandson grow up in person, rather than on the end of a Zoom call," he concludes that the best thing he and others who are at high risk for severe Covid-19 can do right now is to continue self-isolating.

    "Life will not emerge for many of us," he writes, though he notes that he and others going through this difficult time are "hardly alone" (Andelman, CNN, 6/23).

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