Immunocompromised risk

[treeflowercat]

My perception to date has been that those who are immunocompromised are at extremely high risk of Covid... And the shielding letters and comms to people in that category that have put the fear of god into them have reinforced this.

However, has the risk been overstated to the extent that those who are immunocompromised remain in fear of their lives when actually the risk doesn't actually merit that level of fear?

I've quoted from Prof Francois Balloux, who seems to be a very level head when it comes to Covid, with his summary based on a paper linked to his Twitter account:

"Immunocompromised people are at increased risk of severe Covid. For example the study below found a ~2x mortality increase. This is substantial increase in mortality risk but covid is not an automatic death sentence for the immunocompromised. To provide some context, the excess mortality risk of covid for an immunocompromised person, is roughly in line with being 5-10 years older, having a mental illness or being obese."

Of course, there's a spectrum of immunocompromised conditions, but this seems to suggest that it's not quite as bad as tends to be made out... and this kind of analysis may help those who are immunocompromised to be less concerned, whilst still recognising they remain at greater risk, and feel more able to have a fuller and less isolated life as a result.

I'm on immunosuppressants (eligible for 4 jabs) and I don't disagree. I asked my consultant the change in my risk profile re Covid and he said it was equivalent to smoking a couple of cigarettes a day which seemed reasonable to me. As it is, I have Covid at the moment and I have a banging headache but it's totally fine other than that.

I’m unclear if this is referring to people who are immunocompromised or those who are severely immunocompromised and in the smaller group of people eligible for 4 jabs. Also, there are many unknowns. Lots of people don’t have one condition but have multiple and this increases the complexity. It’s impossible to judge what might happen to me if I got Covid. I’m not cowering in fear, I am curious though.

@treeflowercat, every ECV person is different, making their risk profile also unique. Both my sibling and I are ECV, he much more so than I. I've written about this before, but he has late-stage blood cancer, a bone-marrow transplant, has had pneumonia recently, and has blood clots throughout his body. It is unlikely he would sail through Covid, as much as I would like to think he would.

You cannot make fit an entire group of people into one homogenous box. We are young, old, and in between. Many of us still work. (My brother does!) We may have one condition, or many. We look like you.

There have been some studies around people's perception of risk of covid generally, and they sound that people had a hugely inflated sense of covid risk. One that I remember last year was that about 40% of Democrats and 25% or Republicans thought half of people who caught covid are hospitalized. I saw UK figures as well which I don't remember now and they were also very unrealistic estimates.

So I think it makes sense that people would also over-estimate the risk for the immuno-compromised.

@MangyInseam

There have been some studies around people's perception of risk of covid generally, and they sound that people had a hugely inflated sense of covid risk. One that I remember last year was that about 40% of Democrats and 25% or Republicans thought half of people who caught covid are hospitalized. I saw UK figures as well which I don't remember now and they were also very unrealistic estimates.

So I think it makes sense that people would also over-estimate the risk for the immuno-compromised.

You'd really quote a study like that?

You'd really quote a study like that?

A study like what? It's just standard polling from Brookings which is a serious policy analysis group. And it's not a particularly controversial result, similar attempts to look at this question elsewhere by other groups shows similar sorts of very high risk estimates.

Do you have some particular issue or do you have a problem with looking at people's perception of risk?

Can you not let us come out of shielding to our own schedule? A lot of us are doing our best to adapt and trust in the new treatments (and actually accessing them).

Balloux is a huge minimiser. He proclaims to be a level head but he is not. He gets some things right but distorts others and adds too much weight to “good news” that hasn’t been peer reviewed and often has to be retracted. He is not reliable.

I’d let the immunocompromised make their own informed decisions in line with their personal medical advice.

@MangyInseam

You'd really quote a study like that?

A study like what? It's just standard polling from Brookings which is a serious policy analysis group. And it's not a particularly controversial result, similar attempts to look at this question elsewhere by other groups shows similar sorts of very high risk estimates.

Do you have some particular issue or do you have a problem with looking at people's perception of risk?

@MangyInseam

One that I remember last year was that about 40% of Democrats and 25% or Republicans thought half of people who caught covid are hospitalized.

You didn't quote the source originally, though. Anyway, Republicans are right-wing and on the issue of Covid, many are veering towards the far right. I wouldn't take any poll/study they are quoted in seriously. And no, I don't have a problem looking at people perception of risk - thanks. Would you like to post a source to the study?

@Dishh

I gave the name of the group that did it, it would be easy to look up.

But you have misunderstood the post severely - it wasn't quoting either Democrats or Republicans as authorities on covid. In fact both groups were wrong on that question by orders of magnitude.

That was the point. Regular people overestimate how many people who catch covid are hospitalized. So it makes sense that people would overestimate how many vulnerable people get that sick as well.

Depends what you mean by immunocompromised. The highest comorbidity death rate (above even dementia) is diabetes.

But of course separately it's not just about the initial acute infection. There's the potential longer term damage - heart, lung, brain, and kidney problems, clotting, increased risk of developing various conditions including diabetes, autoimmune illnesses, and dementia.

SARS-COV-2 can lead to somebody becoming immunocompromised.

However, has the risk been overstated to the extent that those who are immunocompromised remain in fear of their lives when actually the risk doesn't actually merit that level of fear

No.

Long Covid means everybody is potentially clinically vulnerable.

@MangyInseam

I gave the name of the group that did it, it would be easy to look up.

That isn't how it works. If you use a source to support you're saying, you quote the reference. You don't expect others to go and look it up.

But you have misunderstood the post severely - it wasn't quoting either Democrats or Republicans as authorities on covid. In fact both groups were wrong on that question by orders of magnitude.

I didn't misunderstand it.

That was the point. Regular people overestimate how many people who catch covid are hospitalized. So it makes sense that people would overestimate how many vulnerable people get that sick as well.

No, it doesn't. That is an entirely different question.

I find this quite tone deaf. We’re not a single group. With intricacies in our conditions and required lifestyles that affect risk (eg I have school aged children - these are my biggest risk factor).

Regarding risk no I’m not panicking based on a misinterpreted letter. I’m going based on what my consultant, a specialist in my condition, tells me. And she tells me to do everything I can to avoid Covid right now. My risk is categorically not the same as a typical person 10 years older. It’s much much higher.

I saw that study too, it was really interesting: www.brookings.edu/research/how-misinformation-is-distorting-covid-policies-and-behaviors/?amp

In December, we asked, “What percentage of people who have been infected by the coronavirus needed to be hospitalized?”
The correct answer is not precisely known, but it is highly likely to be between 1% and 5% according to the best available estimates, and it is unlikely to be much higher or lower. We discuss the data and logic behind this conclusion in the appendix.
Less than one in five U.S. adults (18%) give a correct answer of between 1 and 5%. Many adults (35%) say that at least half of infected people need hospitalization. If that were true, the millions of resulting patients would have overwhelmed hospitals throughout the pandemic.
Democrats are much more likely than Republicans to overestimate this harm. Forty-one percent of Democrats and 28% of Republicans answered that half or more of those infected by COVID-19 need to be hospitalized. Republicans were also far more likely to get the correct answer, with 26% correctly identifying the risk compared to just 10% of Democrats.

That being said I think immunocompromised people are the epitome of people who should feel free to assess their own risk, together with their medical advisors - as they always have in the past. I have a cousin who is on infusions for Crohns and has always been very careful around my kids not to pick up their endless colds because for him they could be very serious.

@MangyInseam

There have been some studies around people's perception of risk of covid generally, and they sound that people had a hugely inflated sense of covid risk. One that I remember last year was that about 40% of Democrats and 25% or Republicans thought half of people who caught covid are hospitalized. I saw UK figures as well which I don't remember now and they were also very unrealistic estimates.

So I think it makes sense that people would also over-estimate the risk for the immuno-compromised.

Perhaps we actually have all the information? This is quite dismissive. The immunocompromised group is a small group so do you really think we haven’t sought individual advice?! I’m now living my life probably as I did pre Covid but I know there is a fair risk to me and I’m noticing an increasing number of people on here who are dismissive without actually understanding.

Thank you for linking the study, @Xiaoxiong. It is interesting!

The immunocompromised group is a small group

Depends what you mean by immunocompromised. Covid deaths are highest in people with diabetes.

They are not a small group.

And of course the initial acute infection stage of Covid is just one concern. The long term damage it can cause means that everybody is vulnerable. Potentially only one SARS-COV-2 infection away from becoming immunocompromised.

@Tealightsandd

The immunocompromised group is a small group

Depends what you mean by immunocompromised. Covid deaths are highest in people with diabetes.

They are not a small group.

And of course the initial acute infection stage of Covid is just one concern. The long term damage it can cause means that everybody is vulnerable. Potentially only one SARS-COV-2 infection away from becoming immunocompromised.

Immunocompromised has a medical, clinical definition.

I’m not suggesting people with diabetes aren’t at risk but what you’re suggesting is silly. When I say “immunocompromised” or “immunosuppressed”, I am using the actual definition.

^^ I am using the definition that identified the 0.5 million U.K. people.

@Tealightsandd

However, has the risk been overstated to the extent that those who are immunocompromised remain in fear of their lives when actually the risk doesn't actually merit that level of fear

No.

I recognise that the immunocompromised aren't a homogenous group, and there will be a spectrum of severity within it.

Given this, and assuming the referenced study and conclusions are valid, it implies that some people who are immunocompromised are actually less at risk than the average 10 years - perhaps most people if some in that group have a very significantly elevated risk.

For a person at the less severe end of the spectrum, their risk may be 5 years less than a typical non-immunocompromised individual, rather than the 10 year average!

Taking a typical immunocompromised person for instance however, if some such person who's, say, 30 years old perceives their risk to be equivalent to a 90 year old, when actually it's more like that of a 40 year old, then surely they have a distorted and perception of excessive risk that would be extremely damaging and limiting?!

I think 'reassuring' people when you don't know their conditions or medication is maybe unwise.

I didn't want to suggest that the
immunocompromised are a homogenous group, and recognise that there are those who are at very much increased risk.

My point is that this study suggests that many aren't actually as extremely highly at risk as tends to be appreciated, and that it would be beneficial for that cohort of those who are immunocompromised to be aware of this if they aren't already as it may revolutionise their lives.