'High anxiety' for immunocompromised individuals as Ontario lifts more COVID-19 restrictions

Alex Pangman was born with cystic fibrosis and has also had a lung transplant, a procedure that requires immune suppression to prevent rejection.

Pangman, who is immunocompromised, says that her suppressed immune system alongside other comorbidities makes the thought of getting COVID-19 "pretty much a death sentence."

As Ontario prepares to gradually lift COVID-19 restrictions, Pangman says she's scared.

"This has been very, very lethal in people like myself," Pangman told CBC News. 

"So, it's very scary to know that just going out to the grocery store could be a very critical matter for me."

The last couple of years for me have been full of quite a bit of fear and trepidation.- Alex Pangman

Starting Tuesday, people living in Ontario will be able to gather in indoor settings with no capacity limits and with no need to show proof of vaccination, unless businesses choose to ask for it.

While variants of COVID-19 continue to spread, Pangman said she and other immunocompromised individuals live in constant fear.

"The last couple of years for me have been full of quite a bit of fear and trepidation, quite lonely because my immune suppression and health means that I really need to stay very tightly bubbled. It's been an anxious and worrisome time," she said.

"It's millions of Canadians who aren't able to enjoy those freedoms and who aren't going to be able to enjoy them for the foreseeable future. It's pretty lonely and it's troubling for myself as a woman in my 40s, I should be out there making my mark on the world, doing my craft. I can't. I can't work the way I used to," the jazz singer said.

Double-lung transplant recipient Derek Clark said January was a frightening time for him after he was infected with COVID-19.

"Obviously it's high anxiety, because you don't know how COVID is going to affect your body. It's different for every organ transplant individual or immunocompromised person, so a lot of anxiety," he told CBC News. 

"Fortunately, I had done a lot of research, and I'm aware of what other transplant patients have gone through. Many have actually unfortunately had COVID, but what's important is that you get the treatment and you have to get the treatment within seven days of symptoms. If you don't, then there could be potentially complications. So, I was able to get the treatment within 48 hours of testing positive."

Both Clark and Pangman are hopeful about an antibody therapy called Evusheld, a pre-exposure preventative for COVID-19.

'Vaccines do prevent COVID'

The Canadian government has signed an agreement with pharmaceutical company AstraZeneca to procure 100,000 doses of Evusheld, which is under review by Health Canada for use in specific high-risk patient populations, such as people who are immunocompromised.

"The reason it's critical is that many organ transplant patients, including myself, have no antibodies or T-cell response. Vaccines don't work," said Clark, who's had four doses of the COVID-19 vaccine. 

"So, a vaccine is like a recipe with instructions to target a specific virus. My body doesn't understand those instructions, so it's not going to make any difference if I get a fifth or sixth dose of the vaccine. What I need are man-made antibodies to fight COVID. And so that should have been approved months ago."

Dr. Deepali Kumar, director transplant infectious diseases at University Health Network, said it's difficult for immunocompromised individuals to get back to normal. She noted its frustrating that there is not a way to protect those who have had their vaccine but haven't responded to it or built up antibodies.

If you do end up being COVID positive and you are immunocompromised, contact your health-care provider right away because there are now early therapies that are very effective in preventing severe disease.- Dr. Deepali Kumar, director transplant infectious diseases, UHN

With the province opening up, Kumar said there are a few things that immunocompromised people can do to lower their risk. 

"Preventing COVID is the number one way to help yourself. So, continue to wear masks as things open up, continue to surround yourself with people that are fully vaccinated," she told CBC News.

"Vaccines do prevent COVID even in the Omicron wave, and so it is very important to have that bubble around you."

Kumar said that as things open up there will be a higher risk for people who are susceptible to getting COVID, so keeping rapid tests at home is important in the event that they start to exhibit symptoms. 

"If you do end up being COVID positive and you are immunocompromised, contact your health-care provider right away because there are now early therapies that are very effective in preventing severe disease," she said.

Cardiologist and epidemiologist Dr. Christopher Labos said everyone has a role to play in protecting immunocompromised individuals.

He said that following public health measures is not just to protect yourself, but to protect the people around you. 

"Even if you are young and healthy and you would be okay if you caught COVID, you have to think about what would happen if you were to pass COVID on to somebody else, and you have to realize that there are a lot of people in society that are not young and healthy," he told CBC News. 

"We have older people, we have people with pre-existing medical conditions, we have people who are immunocompromised, and some of what we do has to be done keeping them in mind and realizing that it's not just about your own personal individual risk, but it's about the risk of all the people around you too."

Labos said loosening too many restrictions too fast will create a fairly high risk environment, especially for people who have pre-existing medical problems.