High Risk from Covid
“Exactly how worried and careful should I be about Covid now? How ‘high risk’ do my disabilities actually make me, and what can I do to protect myself at this stage of the pandemic?”
Recent discussions about Covid-19 in disability and chronic illness communities have mostly centered on external forces like government policies, CDC recommendations, workplace practices, and how politics and social forces have shaped the shifting responses to the pandemic. These continue to be essential topics. But their understandable intensity seems to have left practical advice on individual self-protection, from an experienced disability standpoint, a bit neglected.
The most noticeable high risk disabled and chronically ill people speaking out on public platforms express a good deal of fear and anger. They aren’t so much afraid and angry at Covid itself, but at the growing feeling of being left behind, even left to die, by a society that nearly across the board seems to be “done” worrying about Covid, regardless of worrying new variants and their possible consequences. It has felt this way since March 2020, but in some ways it seems worse now, more lonely and uncertain.
True, various authorities that have in the past at least taken the pandemic seriously are cautiously reassuring about the newest variants. As a July 7, 2022 New York Times article states, “The C.D.C. says there is so far no evidence that BA.4 or BA.5 is inherently more severe than other Omicron subvariants.” However, it also points out that the new variants spread more easily and are somewhat more resistant to vaccines, and that “when more people become infected, the number of people hospitalized because of the virus may also rise.”
The CDC itself continues to recognize that disabled and chronically ill people are at higher risk of hospitalization and death from Covid-19. When infections increase, even when they are comparatively benign for most, disabled people are in more danger.
Yet so far, there is little evidence of any sort of renewed public effort to reduce infections, or even to do much to protect high risk people. Vaccines are still important, but it’s unclear how much disabled and chronically ill people can rely on them as their only protection.
What can people with disabilities and other chronic conditions do to protect themselves, by themselves, if they can no longer expect much in the way of public cooperation? What are disabled people already doing? What can those who previously didn’t think of themselves as “at risk” do to minimize their risk today — short of total isolation?
Here are some things for disabled or chronically ill people to consider. But first a few important caveats.
These should be seen as notes for consideration, not medical advice. Everyone should consult a doctor if they possibly can before deciding on a definite strategy. And these ideas are meant to help individual disabled people. They are separate from the public health and policy goals that are aimed at some kind of justice for broader disability communities.
Now to begin with some questions …
First, are you in fact at higher risk? The CDC has its more or less official criteria. But that leaves many disabled and chronically ill people in a vast gray area of uncertainty, with little to go on but past experience and gut instinct. To harness those experiences and sharpen those instincts, disabled and chronically ill people can ask themselves a few practical questions:
- Am I usually more vulnerable than most people to catching infections?
- Does my disability or chronic condition make illnesses that most people handle fairly easily much worse for me?
- Am I forced to spend a lot of time indoors with lots of other people — such as in a nursing home or crowded indoor workplace?
- Do I have to interact with people very closely every day — such as home care providers or family?
- Are the people around me taking precautions, like getting vaccinated, tested, and wearing masks — or are they very much “done with Covid?”
- Am I fully vaccinated myself, if possible, and up to date on boosters I might be eligible for?
- Am I wearing a high quality mask when I go into public indoor places or very crowded outdoor events?
- What is the current daily or weekly rate of COVID infection in my county?
These questions can help disabled and chronically ill people get their bearings. The next thing is to start taking common-sense action.
Get vaccinated if you haven’t already, and get booster shots when they are due. Even if they can’t guarantee zero risk from Covid, they are still likely to reduce your risk and help lessen the severity of Covid if you get it.
If you can, wear a high quality N95 or KN95 mask whenever you are in public indoor spaces — like classrooms, workplaces, stores, offices, churches, etc. Masking can also be a good idea in outdoor events with a lot of closely interacting people, like concerts or festivals. And unlike earlier in the pandemic, supplies of these kinds of masks aren’t too hard to get.
If you really can’t wear a mask or take a vaccine due to a disability or other condition, discuss with your doctor what that means for you, and how you can take other precautions to minimize your risk as much as possible
Ask people you have close contact with on a regular basis to wear high quality N95 or KN95 masks when they are around you. This may include family, friends, coworkers, and personal care providers. If they resist your request, explain how your conditions or situations put you at higher risk. Ask them to do it for you — for your health and your peace of mind.
Regularly check a variety of COVID-19 stats and risk assessments for your county Here are two sites that provide new data every day:
When you visit these sites, be sure to look not just at the CDC’s color-coded risk assessments, but also the daily rate of transmission or new infections. An area listed as Low Risk, (Green) by the CDC, may actually have a somewhat high transmission rate, maybe quite high. And remember that low or medium risk for most people can still mean high risk for people with disabilities, depending on their medical conditions, disabilities, or other situations.
Talk to your doctor and any specialists who deal with your disabilities or chronic conditions. In plain, direct language, ask them how they think you should handle Covid risks going forward. Don’t be discouraged or upset if they don’t have much to tell you. Doctors are still learning about how Covid works and how it affects people with different conditions and disabilities. But don’t avoid asking these questions. And don’t be afraid to press your doctors to think through how Covid might affect you, personally, with your specific conditions and medical history taken into account.
Make a plan with your doctor, pharmacist, family, friends, and caregivers if you have them, for what you will do if you test positive for Covid. Discuss access to the best treatments for you, and how to get them as quickly as possible. Make sure to think through any practical barriers connected with your particular disabilities, like accessible transportation, clear communication, and information and instructions you can easily read and understand.
In consultation with your doctor, think about deciding on a daily transmission rate low enough in your area for you to feel comfortable without a mask in places like stores and restaurants. In other words, how low will Covid rates need to be in your area before you will feel more or less safe? And how high will transmission rates need to go in a surge before you will go back to your protection practices?
Make sure to get your free COVID-19 test kits. You can order them online — or call: 1-800-232-0233, TTY 1-888-720-7489.
For a variety of information, visit the COVID.gov website, a one-stop resource on COVID-19 testing, treatment, and assistance, searchable by county.
Finally, don’t give up entirely on forceful advocacy for more robust public health measures — even event cancellations or mask mandates — if and when things get especially bad again in your community.
Plenty of disabled and chronically ill people may not feel they are at higher risk at all. Some of them may be right. But being dismissive isn’t the same thing as being brave. And neither denial nor bravery is of any use in avoiding or coping with Covid.
More responsible and apolitical policy and social attitudes towards Covid could probably make it easier for high risk people to weather the storm. But it should be clear by now that they can’t count on others to prioritize their safety. Covid really doesn’t seem to be going away. Anyone with any possible high risk factors should be looking honestly at their situations and making the prudent, sustainable plans they can manage with the resources at hand. Some steps make sense for everyone. But individual disabled people’s plans and practices should fit their own specific needs, whatever anyone else thinks or does.
