Our society has reopened, but have the medically vulnerable become a “forgotten people”?

Covid 19 has been a challenge for everyone. Two years of uncertainty and at times tremendous fear, has taken its toll. It is understandable therefore to see the jubilant faces of so many, staring out of our newspapers and newsfeeds, as they celebrate our departure from so many restrictions.

But what about the medically vulnerable in this new, reopened society? Where do we fit in? Are we to feel as liberated as everyone else? Or are we, where we have always been, ‘more vulnerable’, only this time not just from Covid variants, but from the new reopening policy too?

You see the sad fact is that Covid has not gone away. It’s just gone a bit more Covid-light and the statistics suggest that if you are the average human being, with your double vaccine and booster shot, that you are most likely to experience Omicron, as a light illness, “like a head-cold”, if at all. Great. But what if you’re not the average human being?

What if you are immunocompromised, or have an underlying condition, like I, and thousands of others do ? My condition is heart failure, which I acquired 10 years ago, at age 38. There are an estimated 90,000+ people in Ireland living with this condition (source Irish Heart Foundation). And that’s just the condition heart failure. What about all the other medical conditions, that were labelled as high risk or very high risk during Covid, like diabetes, cancer, cystic fibrosis, COPD, Kidney disease, obesity? While there is not an official number available as to the size of the ‘medically vulnerable’ cohort in Ireland, a survey called, Health in Ireland (2019), commissioned by the government, reported that 28.1% of males and 27.3% of females in Ireland were living with a long-standing illness… that’s over a million people, with a long-standing illness. Does that mean the medically vulnerable figure could indeed be hundreds and hundreds of thousands, out of an overall Irish population of est. five million? If so, that’s a lot of medically vulnerable people.

While the Omicron variant, is less dangerous, it is more transmissible so presumably that means that our reopened society with its now increased circulation of people and no social distancing, will see a rise in transmission. But unless our medically vulnerable citizens are cocooning, aren’t they more likely to see a rise in their numbers being infected too? And doesn’t that mean by nature of their underlying medical issue, that increased exposure, puts them more at risk, not just of getting Covid, but of ending up in ICU, or worse, of dying?

According to a Time magazine article of January 6,this year, titled, ‘No you should not try to get Omicron’, health correspondent, Jamie Ducharme writes, “But even if Omicron is on the whole milder than other variants, it will still be catastrophic for some people….. Unvaccinated, elderly and medically vulnerable people are at the highest risk…”

Professor Tony Blakely, a New Zealand epidemiologist and public health expert, who works for Melbourne University, has suggested the older populations and vulnerable communities, need to “hunker down”, as the Omicron variant sweeps through New Zealand. But the medical director of the Cancer Society in New Zealand disagrees, citing that there is not enough evidence to date to support advising people stay at home. But do we want to wait for ICU or fatality increases amongst the medically vulnerable to occur before we advise this group to “hunker down” while Omicron is still so transmissible?

I’m not suggesting that we medically vulnerable people should cocoon, I’m just asking for some guidance, or perhaps even some recognition of our existence regarding re-opening, and what science might be indicating is the best thing for us to do in the weeks ahead.

To date, there has been no official advice offered to medically vulnerable people in relation to their circulation since the reopening measures were announced in Ireland, bar the suggestion by Tánaiste (deputy leader) Leo Varadkar that medically vulnerable patients might need an annual Covid vaccine, or our Taoiseach Micheal Martin’s idea that medically vulnerable patients might want to talk to someone about our anxiety around the re-opening, so what are we medically vulnerable patients, actually supposed to do now?

Professor Kingston Mills, from Trinity College, Dublin seems to have summed up Ireland’s lack of guidance to medically vulnerable people, amidst the reopening announcements at the weekend perfectly, when he said, “There’s also the issue about people who have underlying medical conditions who might not respond so well to the vaccines and have been in the fear of their lives for the past two years, living cocooned, and these are the forgotten people in the latest measures”.

Alas, I couldn’t agree more Kingston.

Le grà

Pauline

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