immune-compromised individuals are embracing layers of covid-related support, protection, and treatment
the pandemic hasn’t been easy for immune-compromised folks, but fortunately, a variety of support, protection, and treatment options are available
4 minute read
mekki macaulay lives with chronic lymphocytic leukemia, a type of cancer of the blood and bone marrow, and is considered immune-compromised by the national advisory committee on immunization.
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the covid-19 pandemic has been challenging for people who are immune-compromised. for these canadians and their families, taking steps to stay safe throughout the pandemic, including in our current reopening phase, requires particular diligence. mekki macaulay of toronto is an example of the one in seven canadians who are immune-compromised. he lives with chronic lymphocytic leukemia (cll), a type of cancer of the blood and bone marrow that affects the lymphocytes – a group of white blood cells that helps the body fight infection. not only are cll patients’ lymphocytes ineffective, but they also multiply when healthy lymphocytes would die, resulting in an accumulation of abnormal lymphocytes in the blood and certain organs and causing complications.
“it’s mostly a geriatric disease, but i was diagnosed in my mid 30s,” says macaulay. “it causes opportunistic infections that show up for no obvious reason.”
as such, having his life disrupted because of his immune-compromised status isn’t new to macaulay. he had to take a year-and-a-half leave from his graduate phd program for treatment when he was diagnosed – but the pandemic has added a whole new layer of disruption. and he knows he’s not alone. following a recent update by the national advisory committee on immunization (naci), those living with cll are now considered immune-compromised due to solid tumour or hematologic malignancies.
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“i’ve had to be extra careful during covid,” says macaulay. his first line of defence has been isolation, which he has been doing for over two years now. it hasn’t been easy. “isolation has taken a big emotional toll on me,” he says. “my circle has shrunk dramatically. it has been hard on my wife as well, as she’s careful to protect me. for the past two-and-a-half years, we’ve only had safe, small, outdoor gatherings.”
macaulay hasn’t been able to go for routine blood testing during the last few months, as the risk is too high. when he does venture out, he wears a half-facepiece respirator – a mask with n95-equivalent filters that looks like a gas mask – for protection. “i look ridiculous, and people point at me, but it’s absolutely necessary,” he says.
macaulay notes that despite the challenges he has faced daily for the past two-plus years, things are even harder for others in the cll community and other immune-compromised individuals. “i have a lot of privilege,” he explains. “i’m male, i’m able-bodied, i’m ambulatory, i’m an athlete, i’m cisgendered, i’m straight, i have a job where i can work from home, and i’m relatively financially stable. during the pandemic, what i was seeing online was that a lot of people like me who are immune-compromised were suffering because they didn’t have that privilege. it really impacted and saddened me to see how much people are suffering.”
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when mekki macaulay, who is immune-compromised, leaves the house, he wears a half-facepiece respirator for protection against exposure to covid-19.
propelled by this knowledge, macaulay founded the donate a mask project canada charity to help ensure that all vulnerable canadians have access to this base level of protection.
besides masking and physical distancing, the immune-compromised community also has other options when it comes to preventing and treating covid-19. macaulay has become a passionate advocate for the immune-compromised community and believes it’s important for immune-compromised individuals to know their options. “covid exposure is like any other disease exposure,” he says. “we want to isolate by default – that’s the best way to stay away from disease. if you have to be exposed, then wear a mask. we have all these layers, including additional prevention and treatment options.”
monoclonal antibodies, vaccines, and antivirals are all medical options that can also be used by immune-compromised people to either prevent or treat covid-19.
vaccines are the primary option for preventing covid-19. they cause the body to produce its own protection (antibodies) against the sars-cov-2 virus that causes covid-19.
in people who have a weaker immune system and are unlikely to be protected by a vaccine or when vaccination is not recommended, monoclonal antibodies can be used in the prevention of covid-19. monoclonal antibodies are proteins that prevent healthy cells in the body from being infected by the sars-cov-2 virus. monoclonal antibodies are not a substitute for vaccination in individuals for whom covid-19 vaccination is recommended.
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for individuals who have tested positive for covid-19, there are treatments available. antivirals are drugs that stop the virus from multiplying, which can help the body to overcome the infection faster and may help the patient get better. monoclonal antibodies are proteins that attach to specific targets of the virus that cause infection, preventing the virus from entering and infecting cells within the body; this may help reduce the risk of the infection getting worse and/or reduce the risk of hospitalization.
like all medical interventions, both prevention and treatment options may cause side effects and may not be suitable for all individuals. side effects can be different for each person, for different medicines and types of treatment.
as the world reopens and restrictions lift, macaulay encourages those who are not immune-compromised to remain vigilant in order to protect their communities. “this disease is a community disease, and it exists because we transmit it in the community,” he says. “every choice that an immune-competent person makes affects those of us who are immune-compromised. we’re all in this together, and we can support each other.”
this story was created by content works, healthing.ca’s commercial content division, on behalf of a canadian healthcare company.
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