What does it mean to be “at risk”?
Dr. Stephan Haney
As we weigh how to renew worship within the four walls of Laurel Heights UMC, our first priority is the continued protection of those most at risk of infection. Ironically, the most serious obstacle in protecting the vulnerable is personal denial . . . denial that the risk may actually apply to us. What follows is one approach to answering the question: “Am I at high-risk if I become infected with COVID-19.”
Each of us live our lives with risks: risk of having a car accident, risk of having a heart attack, risk of getting COVID-19. Risks are things that endanger us—our health, our lives, and our happiness. We cannot avoid risks entirely, but we can improve our odds by managing our behaviors. There is a risk of being struck by lightning. The odds are that 1 in 700,000 people will be struck in the U.S. this year. But you can greatly improve those odds for yourself by staying out of the open during a thunderstorm. In fact, with prudent actions, you can be virtually certain that you will not be struck by lightning. Behavior matters. It matters a great deal.
That side of risk management seems obvious enough. We can minimize our risks by avoiding the actions that expose us to them. Concerned with an auto accident—drive more carefully. Concerned with heart disease—quit smoking, lose weight, manage your hypertension. Anxious about getting a contagious disease —well . . . we know now more than ever before how to minimize that . . . isolate yourself, avoid contact with those who are potentially infected, become germ phobic.
But the most pressing question at this moment is: “How can we get on with our lives without putting ourselves at unnecessary risk of contracting COVID-19?” The first step in answering that question is an objective look at what our individual risks are. Some diseases can be relatively benign for most of the population and, yet, fatal for a small segment of that same population. Measles is a good example of that. If you are old enough, you will remember a time when measles was pandemic. Measles is highly contagious, and before vaccines, we viewed it as an inevitable childhood experience—an unpleasant one, but not generally serious. We tried to protect infants and the very young from exposure, because they were the population most at risk of serious consequence and death. Even today with vaccines available, 180,000 lives were lost worldwide in 2018 to measles.
In many ways, COVID-19 is reminiscent of that time. Like measles, COVID-19 is highly transmissible, with a contagion rate 2-3 times greater than seasonal flu and comparable to that of smallpox. Like measles, COVID-19 is more of an inconvenient disease for most people rather than one of serious consequence. But like measles, the risk for those who are vulnerable can be grievous. So who are those most vulnerable to serious infection and death to COVID-19? The Centers for Disease Control (cdc.gov/coronavirus) has a long list of conditions that put us at higher risk (see the table at the end), but we sometimes have a hard time believing our own conditions are serious enough to matter. We tend to curate our own health conditions in ways that suit our purposes best. One objective way of answering who is at greatest risk is to ask, “Who would be most at risk of dying if they got pneumonia and were hospitalized, irrespective of COVID-19?” You can answer that question intuitively: those with serious underlying diseases and the elderly.
If you feel that pneumonia would be a serious health risk for you, then COVID-19 is particularly dangerous. If you are at extreme risk, consider continuing to shelter at home until a COVID-19 vaccine is available or until an effective treatment is discovered. In any case, weigh the benefit of each public outing versus the risk of exposure. When we do go out, we can minimize our risk of exposure to COVID-19 by following the new norms for public and private behavior: social distancing, avoiding close contact with others who could be contagious, washing hands frequently, disinfecting commonly touched surfaces, and avoiding large public gatherings. We can minimize our risk to others by: wearing a mask in public; minimizing physical contact; and staying home if we feel ill, have respiratory symptoms (coughing, sneezing, difficulty breathing), have a fever, or have been possibly exposed. Good compliance with these guidelines can greatly reduce the risk of exposure, but a small risk is encountered each time we venture into the public. No one can tell you what you should do, because only you can weigh the benefit of an activity versus its inherent risk.
As we begin this transition from isolation to renewed contact, your behavior will largely define your risk of COVID-19 infection. If you are at high risk according to the CDC, or if hospitalization from pneumonia would prove life threatening for you, continued virtual worship services might be prudent. We will miss you in the sanctuary, but you will remain close to our hearts until conditions allow your safe return.
Those at High Risk for Severe Illness from COVID-19
|– People 65 years of age or older.
– People who live in a nursing home or long-term care facility.
– People of all ages with underlying medical conditions, particularly if not well controlled, including:
= People with chronic lung disease or moderate to severe asthma.
= People who have serious heart conditions.
= People who are immunocompromised.
Many conditions can cause a person to be immuno-compromised, including:
+ Cancer treatment.
+ Bone marrow or organ transplantation.
+ Immune deficiencies.
+ Poorly controlled HIV or AIDS.
+ Prolonged use of corticosteroid and
other immune weakening medications.
= People with severe obesity (body mass index [BMI] of 40 or higher)
= People with diabetes
= People with chronic kidney disease undergoing dialysis.
= People with liver disease.