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COVID-19 A ‘Double Whammy’ For At-Risk People With Existing Health Conditions

People with pre-existing health conditions or who are immunocompromised are finding ways to cope.
People who have diabetes have an increased risk for some infections, according to Diabetes Canada.
dragana991 via Getty Images
People who have diabetes have an increased risk for some infections, according to Diabetes Canada.

Leslie Bank is in “fight or flight” mode.

The 34-year-old was diagnosed with Type 1 diabetes 15 years ago, and developed health anxiety five years ago. Bank has used clinical psychology and cognitive behavioural therapy to control her mental health. She had a healthy pregnancy in December, and has been practising social distancing since then because she was worried about cold and flu season.

But she says the spread of COVID-19 is triggering her strongest fears. She’s worried about getting sick, running out of medical supplies, having trouble managing her blood sugar or not being able to access medical care.

“I can’t shut off the panic, which makes it even harder to manage my disease,” Bank, who works for a hospital foundation in London, Ont., told HuffPost Canada in an email. “The fear is no longer in my head, it’s everywhere around me.”

Leslie Bank and her husband, Devan.
Leslie Bank
Leslie Bank and her husband, Devan.

She doesn’t think she could survive COVID-19, calling her diabetes a “double whammy”: the novel coronavirus can be deadly for a healthy person, but managing her blood sugars, she’s also at risk of developing diabetic ketoacidosis, which is also life-threatening.

Bank has tried to keep a sense of control by stocking up on medication, supplies and other emergency items, but she still worries about running out.

“I desperately want everyone to start social distancing or even self-isolation — my life depends on it — but it’s tough to accept that I can’t control the actions of others,” she said.

WATCH: Dr. Theresa Tam, Canada’s chief public health officer, says the community spread of COVID-19 is growing. Story continues below

People with pre-existing health conditions, including high blood pressure, heart disease, lung disease, cancer or diabetes, are more at risk of developing a serious illness from COVID-19, according to the World Health Organization. In Canada, about 6.8 per cent of people had diabetes in 2008-09, according to research by the Public Health Agency of Canada, and one in five Canadians live with hypertension.

In addition to being more susceptible, people with existing health conditions and the immunocompromised face further challenges, in relying on other people to responsibly social distance to slow the spread of the virus.

They also rely on the internet, and each other, to create a sense of community and find ways to get through this pandemic together.

“It’s no question this is an extremely trying and stressful time for all people —whether you have any pre existing physical or mental health problems [or not],” Ingrid Söchting, a clinical psychologist and clinical associate professor at the University of British Columbia, told HuffPost Canada.

For people who are struggling, Söchting recommends trying to differentiate the voice of anxiety from your rational, reasoning voice through talking to a trusted friend or family member, or writing in a journal.

“It's no question this is an extremely trying and stressful time for all people.”

- Ingrid Söchting

“When we get very emotionally worked up or feel something very intensely, it’s very important to not begin to sort of draw conclusions or develop belief about what’s really going on around [us]” and instead label the feeling and let it pass, Söchting said.

She said people at heightened risk should be extra kind to themselves right now, and find calming activities that work for them, such as puzzles, listening to music or working with their hands.

Alexandria Gold, 10, had a liver transplant when she was five-months old.
Courtesy Jessica Gold
Alexandria Gold, 10, had a liver transplant when she was five-months old.

Jessica Gold’s daughter turned 10 the last day of school, before the Ontario government announced schools were closing because of COVID-19. They had dinner with extended family at a restaurant, sitting at a table in the corner. When the family came home, they decided that was it — no more outings or friends visiting.

Gold’s daughter Alexandria was born with biliary atresia, a condition that affects an infant’s liver. She had a liver transplant when she was five-months old and now takes daily immunosuppressants. For Alexandria, a common cold could last up to three weeks, or involve severe symptoms like a higher fever or a cough that turns into pneumonia.

Gold recalls first hearing about the cases of COVID-19 in China. She immediately believed it would come to Canada.

“It’s terrible for healthy people, or it could be. What’s it gonna be like for her?” she remembers wondering.

“My daughter needs to be kept away from people that have colds and illnesses — chickenpox would put her in the hospital. So I can only imagine what this virus could do to her.”

Gold, a Hamilton-based legal assistant, has been able to work from home, and her husband has been taking vacation days to be at home. Alexandria’s school is close to her house so there are lots of kids around, but Gold isn’t letting her meet up with any friends in-person, offering FaceTime chats for play dates instead.

If her daughter plays outside, as soon as she comes inside she washes her hands. When Gold goes grocery shopping, she wears rubber gloves and disposes of them in a garbage bin outside and she wipes down packages and lets them sit before opening them.

“I can only imagine what this virus could do to her.”

- Jessica Gold

Alexandria doesn’t quite understand what’s happening, but if she’s playing on the driveway and sees other people outside, she’ll come back into the house. “So she gets it, but she doesn’t get it,” Gold said.

Her daughter isn’t on social media, but plays some online video games that have a chat window. Alexandria comes to her mom with questions from what other people have said online. In one chat, someone posted, “Can people die from this?”

She had to tell her daughter, “unfortunately, yes” but emphasized that it’s not a clear-cut answer.

Gold has found it helpful to post in Facebook groups for other people who have had transplants, to find out how other parents are handling the situation. She also uses the groups to gauge what other people are doing. “Sometimes I go on other people’s pages and look, and I’m like ‘OK, they’re the same scenario as us. And they’re in their backyard and they’re having fun. Why can’t we also [do that]?’”

To other people who have an existing health condition that puts them more at risk, or are caring for someone with one, Gold wants to send a message: be selfish, and take the steps you need to take to be safe, regardless of what other people say.

“You need to think of yourself and protect those that you can protect,” she said. “The rest of the world is unpredictable — you don’t know what your neighbour is doing. So as long as you protect yourself, then you’ll at least know that you did everything you could control. The rest is up to the rest.”

CORRECTION: A previous version of this story said Gold’s husband is working from home. He is actually using vacation days to stay home.

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