For Immunocompromised, It’s Tricky to Go ‘Back to Normal’

Mask mandates are lifted. Crowds are gathering for sporting events, concerts and graduation ceremonies. People aren’t required to stay 6 feet apart. This return to semi-normalcy is cause for celebration for most healthy people, especially those who are vaccinated, boosted and exercise a little caution.

But for people whose immune systems are weak, letting down their guard against COVID-19 and other infectious diseases is much riskier. A COVID-19 infection could land them in the hospital—or worse—because their bodies can’t effectively fight the virus.

These include people who are recovering from or being treated for cancer, diabetes, HIV/AIDS, and those who have had organ or stem cell transplants. People with uncontrolled high blood pressure, asthma, obesity, and pregnant women and people older than 65 are also at higher risk.

And while vaccination is still protective, the immunocompromised do not generally create as many antibodies in response to the shot as other people. That means immunocompromised people can’t rely on the vaccine to keep them healthy the way people with fully functioning immune systems can.

Justin Yopp, PhD, who counsels people experiencing serious illness, says the “collective spirit of looking out for each other” from early in the pandemic has waned, leaving immunocompromised people in a tough position.

“Now, with COVID being less prevalent, and with many people being vaccinated, all those extra protective measures are becoming an individual choice,” Dr. Yopp says. “But when you are immunocompromised, you may have the disconcerting feeling that others are not as concerned about the virus as you are.”

Dr. Yopp offers the following advice for immunocompromised people wondering how to protect their physical and mental health during this stage of the pandemic.

Think About Your Risk Tolerance

The hardest part about these calculations for immunocompromised people is that no one can tell you for sure what you should or shouldn’t do to stay safe. Obviously, a total lockdown keeps you from getting COVID-19, but it could also harm your mental wellness and relationships.

The key is to try to establish your risk tolerance, Dr. Yopp says.

“What, for you, are healthy, ‘normal’ steps to live your life while exposing yourself to a potentially life-threatening virus?” he says.

People at high risk of infection can continue to wear masks in public if that helps them feel comfortable. They can continue social distancing and avoiding large crowds, especially indoors. They might decide that some events, such as a family wedding or a favorite band’s farewell concert, are worth attending—if they wear a high-quality mask the whole time.

There is no right answer, Dr. Yopp says. You try your best. Some may choose to stay home, but isolation can be risky, too.

“People are social creatures,” Dr. Yopp says. “We’ve all lived isolated lives for the past two years, and we’ve had to reassess what feels safe. It’s hard to find that balance between our physical health and our mental health.”

Your doctor can help you figure out what’s right for you, he adds.

Talk to Your Doctor About Risks and Benefits of Going Out

“I’d urge people who are immunocompromised to have an honest discussion with their doctor, nurse practitioner or nurse navigator about how cautious they need to be,” Dr. Yopp says. “Find out what they recommend. It may be that your doctor doesn’t think some activities are as risky as you might fear.”

Because of the benefits of being around others, Dr. Yopp encourages people to find out what risks feel acceptable to them. Maybe you can be around one person beyond your “bubble.” Or you can attend a small group gathering outside.

“Don’t restrict yourself to always thinking ‘I can’t,’” he says. “Find spots where it feels safe enough to take calculated risks.”

Work with Your Child’s Pediatrician to Balance Physical and Mental Health

Parents of immunocompromised children are also in a tough spot, trying to safeguard their children’s health while allowing them the fun of childhood.

“As hard-wired as we are to protect ourselves, we’re even more protective of our children,” Dr. Yopp says. “It’s worth noting, though, that there is an increasing mental health crisis among children. No doubt, it predates the pandemic, but it’s been magnified over the past two years.”

Being with peers in person—not just through social media or on a screen—is incredibly important for children, he says. They need to be around other children to learn social and emotional skills. Having someone to talk to and play with builds self-esteem and creativity.

If you are worried about your child’s risk of getting COVID-19 from being around others, talk about your concerns with your child’s doctor. You might be able to find ways to protect them and still allow them to be kids; outdoor activities and masks are potential options.

“A lot of children have suffered from being so isolated,” Dr. Yopp says. “We don’t want to protect our children so much that we cut them off from socialization opportunities. Talk to your child’s doctor to understand how big the risks might be and what you can do to minimize them and still allow your child time with peers.”

If you’re worried about your risk of COVID-19 infection, talk to your doctor about what you can do to stay safe while balancing your mental health needs. If you need a doctor, find one near you.