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Living With Immunosuppression During The Coronavirus Outbreak

AILSA CHANG, HOST:

Right now Americans are working on how to negotiate daily life in the cloud of the coronavirus, but for those who have a compromised immune system, each decision is all the more fraught, since one misstep could prove deadly. We're joined now by Kevin Brennan. He has psoriatic arthritis and a compromised immune system. And in recent weeks, he has taken a lot of precautions to protect himself from COVID-19. And he shared his concerns in an op-ed this week in The Washington Post.

Welcome.

KEVIN BRENNAN: Thank you.

CHANG: So for those people who aren't familiar with what psoriatic arthritis is, just give us an idea of what it's been like the last few weeks for someone like you, who's just trying to figure out how to avoid getting sick right now.

BRENNAN: Well, my immune system is dysfunctional, and it has been for a long time. And its original dysfunction started the attack on my joints, which is what inflammatory arthritis does. And then over time, there was a discovery of medications that allowed my immune system to be suppressed, which put the arthritis in check. And knowing that I have an immune system that's suppressed, I was very worried that I was more exposed to the virus. I get a flu shot every year. You know, it's important to be protected, so it's been really on my mind.

CHANG: But this medication that you receive that limits the pain you feel from the arthritis, it weakens your immune system, so you have this choice whether to have a weaker immune system or to feel a lot of pain. Is that right?

BRENNAN: Well, I do. My physician actually explained to me - because that was the question I asked this week was, should I get off of my medicine? Is that going to help my rheuman (ph) system rebound? And what he told me was, actually, it's sort of a double-edged sword because I could develop a serious flare, which means my immune system goes back to attacking my joints and ignores foreign invaders like the coronavirus. So I'm kind of in a dilemma because if I get off the medicine, I might be in just as bad a shape as if I stay on it.

CHANG: So what kind of steps are you taking right now to take extra precautions because of the coronavirus?

BRENNAN: You know, I'm taking the steps that everybody should take. And I think that's the important message that I'm trying to deliver to folks. I mean, you wash your hands, engage in proper social distancing. Do the things that you need to protect yourself and your loved ones. You don't have to - you know, right now, that I'm not contemplating extraordinary measures. That might seem extraordinary, which is why I've gotten looks from people, but I think there are very common-sense things that we all should be doing to protect ourselves and our loved ones.

CHANG: Well, what does that look like in your house? Just paint me a picture of all these different precautions that you are taking in your daily life now.

BRENNAN: I think the biggest challenge is having small children and, you know, making sure that they are vigorously, you know, washing their hands and for a longer period of time. We've found that we - doing handwashing in public places, but we're not as vigorous about it at home.

So we're really making sure that we do that. We're making sure that we wipe down door handles and handles in the refrigerator, anywhere where, you know, you're having lots of touching, and making sure that when we're out - you know, we do basic tasks, but we don't do unnecessary social tasks. And we do keep, you know, a 3 to 6-foot distance between folks that we see.

My daughter is actually going to do her cross-country tryouts, and we debated whether or not to let her do that today. But it's very important to her. And we've had to impress upon her that she can't hug her friends after she runs the meet. She's got to keep a distance. And she says, look, Mom, I'm 11. And I'm going to do the best I can, but I can't promise you anything.

CHANG: I mean, it sounds like, you know, you're doing a lot of the responsible things that medical professionals have been recommending. But this is all very real for you. For a lot of people, it's still very abstract, and they're just beginning to adopt these recommendations. But for you, this could be life or death.

BRENNAN: Yeah, that's right. And, I mean, it's - there's things you can do right now. There's things that are out of your control that you try not to let get the best of you. And you really have to think about being in the mindset of this isn't just today where we're going to have to practice these things. It could be months that we're practicing these.

And, you know, I think it's really important to try to address your mental health and making sure that you're in a place that you can, you know, you can endure through this long period of time where you're going to be in a period of uncertainty and anxiety. And you can only do so many things. There is no magic wand that you can wave yet that's going to, you know, protect us from this. And so you're going to have to be in a place where you're strong mentally to continue these practices and operate in a period of uncertainty.

CHANG: Do you find it insensitive or maybe even offensive that there are people out there who think a lot of this conversation about taking all these precautions is just straight-up panicking, that it's all overblown? Is there a part of you that's getting angry listening to that thread of conversation right now?

BRENNAN: No, I'm actually encouraged. I mean, after I wrote the piece, you know, I got a lot of comments from folks I know and from strangers who said, you know, I didn't know that you were immunocompromised. And I didn't think about the steps that I should take. And I didn't think about folks that were vulnerable and at risk. This, you know, helped change their mindset. I'm not interested in sort of engaging in pandemic-shaming.

I just think it's important that folks understand, I mean, Americans have through, you know, a great many challenges, and we've rallied through them. And I think this is just another time for us to do that. And so it's an opportunity to educate folks about the challenges that this community faces. And I have every confidence that folks are going to meet it with compassion and kindness and American resourcefulness.

CHANG: Kevin Brennan is a member of the Arthritis Foundation's National Advocacy Board.

Thank you very much for joining us today.

BRENNAN: Thank you very much. Transcript provided by NPR, Copyright NPR.