End of lockdown didn’t mean end of isolation for immunocompromised

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Professor Grigg said some of his patients had gone six months without seeing anyone, other than their doctors and nurses.

Also, those with compromised immune systems continue to be profoundly over-represented in coronavirus hospitalisations during the Omicron outbreak and are far more likely to end up severely ill, he said, even if they have been vaccinated.

Several of his vaccinated patients, who have blood cancer, including a young mother in her 30s, have ended up seriously ill after contracting the virus, developing severe pneumonia or requiring oxygenation.

“It’s just incredibly distressing to see that happen to your patients when they’ve done everything they can to protect themselves,” he said.

Melbourne doctor and president of the Royal Australian College of General Practitioners Karen Price said some people, particularly those with underlying health conditions, were now so accustomed to approaching COVID-19 with caution that they were “almost agoraphobic” (a condition which can include an irrational fear of leaving the home).

“There’s a lot of lonely people,” she said. “We certainly see those people in practice that haven’t seen anyone for months. It’s indescribable that despair.”

Others are taking a pragmatic approach, trying to avoid getting COVID-19 while they might have contact with a vulnerable family member, or before a special event such as a wedding – attempting to bring a level of control to a pandemic that has taken so much control from people.

Dr Price said choices about the level of risk people were willing to accept were often difficult because, while there were clear risk factors for more severe COVID-19, such as being unvaccinated, obesity, old age and pregnancy, it was impossible to predict how any individual would be affected.

Doctors including Melbourne oncologist Cameron McLaren said the “let it rip” approach to Omicron had failed the most vulnerable people in the community, including the immunocompromised and the elderly, who were left scrambling for booster shots and rapid antigen tests.

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He said others, including some of his patients undergoing hormone treatment therapy, were confused and anxious about what they should do.

Ms Ferugia started wearing a mask everywhere before they were mandated. Before being vaccinated, she frequently stopped working her job at a supermarket whenever coronavirus cases surged. She still avoids crowded places and stays home as often as she can.

But her worst fears were realised last month, when she was infected with the virus. She was not well enough to line up at a testing clinic and unable to secure enough rapid antigen tests.

“It made me feel confused and scared,” Ms Ferugia said.

‘We couldn’t stay in lockdown forever, but I feel like the government has opened up without really thinking about people like me.’

Kathrine Ferugia

Weeks later she still feels the lingering effects of the virus, including a persistent cough and crippling fatigue.

“We couldn’t stay in lockdown forever, but I feel like the government has opened up without really thinking about people like me. The way they have lifted restrictions has been quite severe.”

Also trying to avoid COVID-19 is engineer Monica Russo, who is heavily pregnant with her second child.

She enjoyed a relatively normal Christmas with her family, but when case numbers kept rising, and the impending birth got closer, she decided the risk of getting COVID-19 was too high to continue socialising with all but a small circle of close family members and stopped frequenting cafes or restaurants.

Monica Russo and her 20-month-old son Leon are both in isolation at home.

Monica Russo and her 20-month-old son Leon are both in isolation at home.Credit: Scott McNaughton

Ms Russo said she was told that if she entered labour while carrying the virus, she’d have to stay in a COVID-19 ward, wouldn’t be able to have her husband with her for the birth and would be largely separated from her baby – bar breastfeeding – until she was cleared of the virus. That’s a scenario the Camberwell mum wants to avoid.

The family is in a privileged position where they can largely shut themselves off from the world, with Ms Russo and her husband both able to work from home.

The couple also plan to pull their 20-month-old son out of childcare two weeks before his sibling is due to arrive.

“We’ve basically cancelled any social gatherings, and that includes a wedding in the family that we chose not to attend,” she said. “Everyone was sad, but nobody was angry. I think everyone understood why we’re doing what we were doing.”

There is an early suggestion that the vaccine’s effectiveness wanes quickly for immunocompromised people, even after a third dose, amid mounting research that organ transplant recipients and those with blood cancers may need a fourth or fifth dose.

Professor Grigg said the Austin hospital had already commenced a fourth-dose program for its immunocompromised patients.

But he said the most crucial action all Australians could take was to get their booster shot as soon as possible to slow transmission of the virus and create a crucial layer of collective protection for the immunocompromised.

‘People have a community responsibility to have the third dose.’

Professor Andrew Grigg

“People have a community responsibility to have the third dose, not just for their own health, but for the health of people who are otherwise going to be stuck at home and scared of going out,” he said.

“It doesn’t diminish the risk entirely, but it means people are less likely to be infectious, at least for longer periods of time.”

Cancer Council chief executive Todd Harper said there had been a sharp surge in people calling the organisation’s helpline as coronavirus cases hit tens of thousands of new infections a day this year.

More than 650 people called in the first three weeks of January. Of those, more than 20 per cent expressed emotional distress about feeling increasingly isolated.

“We’re really worried about the uncertainty for them,” Mr Harper said. “Cancer patients are telling us of significant levels of distress and not being able to access the usual support networks during a very difficult period.”

Australian infectious disease physician Sanjaya Senanayake said he felt the federal government had moved too quickly from “very cautious to zero caution”.

“What we needed was to have that bundle of COVID-safe measures in place, particularly as people gathered for Christmas before Omicron took off,” he said.

But Professor Senanayake said he always urged his patients to find the joy in life, noting the mental health implications of isolation were profound.

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Taking precautions, including getting booster shots, investing in high-quality face respirators, such as N95s, meeting up with friends and family outdoors and requesting close friends and family clear themselves with a rapid tests before catch-ups all reduce risk.

“I think it is so important to realise that you can do things to keep yourself safe, and you can have a life,” he said.

The Cancer Council is pushing for vulnerable individuals – including people with cancer – to be given priority access to COVID-19 tests and booster vaccine shots.

The council’s support and coronavirus information line can be reached on 13 11 20.

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