Everyone’s immune system slips up sometimes. But this doesn’t mean you’re immunocompromised.

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One of the most important goals during state-mandated physical distancing and stay-at-home orders is to protect vulnerable populations from COVD-19 — particularly those who have long-lasting medical conditions that might be considered high risk because their immune systems can’t fight off the new coronavirus as effectively.

The Centers for Disease Control and Prevention (CDC) states that chronic heart, lung, and autoimmune conditions are common risk factors that weaken a person’s immune system. But the CDC also states, “Many conditions can cause a person to be immunocompromised.”

If you have a chronic condition that isn’t stated on the CDC’s list, how will you know if you are immunocompromised? Most importantly, how will you know which steps to take to protect yourself?

This guide is designed to help you understand if you or a loved one might be immunocompromised.

Let’s start by breaking down the word.

“Immuno” refers to your immune system. It’s the immune system’s job to first detect harmful bacteria or viruses and then to fight them off. “Compromised” means that this system isn’t working as it should or needs to in order to keep you safe.

The National Institute of Allergy and Infectious Diseases states that our immune systems are incredibly complex, which is why it’s harder to understand what makes a person immunocompromised.

Everyone’s immune system slips up sometimes by letting in viruses or bacteria. But this doesn’t mean that everyone is automatically immunocompromised.

Think of your immune system as a coffee filter. You want to eventually have that steaming, rich mug of morning energy, but you don’t want the gritty particles from the coffee beans to end up in there. That’s what the filter is for — to let the good materials through and keep the other stuff out.

If the coffee filter is your immune system, the desirable drink is the strong and healthy cells that you want. But sometimes, the filter doesn’t keep all the undesirable tastes and textures out of your coffee. This causes the development of infected and unhealthy cells.

When your immune system can’t filter out the bacteria or viruses — or if there’s simply too many to filter at once — your body responds by feeling sick.

Certified physician assistant Annie McGorry spoke to Healthline on her experiences working with immunocompromised patients during the pandemic.

“In a ‘normal’ person, when their body detects something that is foreign, such as a bacteria or a virus, the immune system should immediately kick into action,” McGorry told Healthline.

“However, when a patient is immunocompromised, their immune system is not able to function at its full capacity, and therefore, it takes much longer for that patient’s body to adequately fight off the infection, which is why when immunocompromised patients fall ill, they — more times than not — have a more serious, longer-lasting infection.”

McGorry works as a certified physician assistant at a private rheumatology practice in New York state — one of the hardest hit areas of COVID-19 at the time we spoke.

When we asked about certain characteristics that you can look out for to see if you are immunocompromised, she shared that her patients who are immunocompromised usually:

  • get sick more often
  • are sicker longer
  • typically have more severe illness symptoms

“On a ‘regular’ day, [immunocompromised patients] often still do not feel their best,” she explained.

So what does this mean for you? If you find yourself getting severe colds and/or flus often and you’re unable to recover as fast as others around you — including that co-worker who definitely didn’t wash their hands after coughing, for example — you might be immunocompromised.

McGorry told Healthline that the best way for you to assess if you are immunocompromised is to take note of your symptoms and communicate with a trusted healthcare provider.

“Know what medications you are on,” McGorry added, saying that the side effects of particularly strong medications can also weaken your immune system without you knowing it.

The truth is that the CDC and medical professionals aren’t exactly sure the extent of just how many chronic conditions cause weakened immune systems.

Specific to COVID-19, the CDC warns people to assume they are immunocompromised or at least more susceptible to this virus if they:

  • are over the age of 65
  • are undergoing cancer treatments
  • aren’t up-to-date with vaccines, or can’t safely be vaccinated
  • are currently living in a long-term care center or nursing home
  • habitually smoke
  • have diabetes
  • are being treated for serious heart conditions
  • are currently living with other autoimmune disorders, like HIV or lupus
  • have moderate to severe asthma

Healthline experts add that people with immunodeficiency disorders are at greater risk of various infections.

Some immunodefiency disorders are conditions you are born with, while others can develop later in life. People with immunodeficiency disorders may need medical treatments or vaccines to help their immune system work.

McGorry builds off of this list, saying, “A lot of autoimmune diseases that we treat in rheumatology take a toll on the patient’s immune system, such as systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis, scleroderma, etc.”

“And it is not simply just the fact that the patient has an autoimmune disease, but also what types of medications they are placed on in order to adequately treat and control the disease state.”

For those with autoimmune disorders, the immune system is often hypersensitive or overactive to what it perceives as dangerous viruses or bacteria but often isn’t actually harmful. In these situations, the immune system attacks itself.

McGorry also explained to Healthline how DMARDs (disease-modifying antirheumatic drugs) that patients with autoimmune disorders often need to take for treatment might suppress their immune systems even further.

“Taking these medications comes with the price of suppressing the natural immune response, leaving the patient more susceptible to infection, in order to prevent life threatening complications of autoimmune diseases,” she said.

“It is a complicated and complex balancing act between side effects of the medications and treating the disease state efficiently and adequately.”

If you believe that you might be immunocompromised, have one of the conditions that puts you at higher risk, or have had a healthcare professional diagnose you as immunocompromised, here’s what you need to know about being immunocompromised during the COVID-19 pandemic.

First, it might feel really scary to know or think that you are immunocompromised. Many immunocompromised people live with anxiety about falling ill under normal circumstances. Add a highly transmittable, highly dangerous virus on top of this, and you’ve got a recipe for stress — rightfully so!

Make sure that you’re not only taking care of yourself physically with the suggestions below but also emotionally with online therapy and self-care practices.

Many immunocompromised people are also (virtually) turning to each other with hashtags like #HighRiskCOVID. Safely stay connected with your community of other immunocompromised people, if you can, and remember that you’re not alone.

Remember to practice all suggestions in compliance with CDC guidelines and your healthcare provider’s specific recommendations. Healthline experts suggest that if you are immunocompromised, you should:

  • Be fully vaccinated (including boosters) against COVID-19.
  • Stay away from large crowds and poorly ventilated spaces. If you’re financially, socially, and geographically able to, try to take advantage of delivery services for food, groceries, and medications. When you need to leave the house, be sure to protect yourself with the other suggestions on this list.
  • Wear a mask (as long as it is safe for you to do so), and ask for the people you commonly come in contact with to wear masks as well.
  • Make sure to wash your hands. Even though touching surfaces isn’t the main way the virus spreads, washing your hands still lowers your risk of infection.
  • Avoid touching your face when you are in public areas. Wait until you’ve had a chance to thoroughly clean your hands.
  • Practice social or physical distancing. In fact, stay as far away from people as you possibly can manage. Research from the World Health Organization and the CDC shows that COVID-19 can spread from person-to-person through sneezing, coughing, and speaking. The virus can also remain suspended in indoor air for up to 24 hours.
  • Increase ventilation when you need to be indoors with others, if it’s possible to do so. One way to do this is by opening windows.
  • Have a plan for rapid testing, in case you are exposed to COVID-19 or develop symptoms. Talk with your doctor about how to get home tests or access to testing.
  • Ask your doctor if you’re a candidate for COVID-19 treatments. According to the CDC, these include oral antivirals, pre-exposure prophylaxis (PrEP), and monoclonal antibodies.

The CDC also recommends taking specific precautions based on low, medium, and high community levels of COVID-19. The COVID-19 Community Level tool allows you to look up your county to find out the community level in your area.

If your community level is medium, the CDC recommends that immunocompromised people should talk with their doctor about wearing a mask or respirator indoors.

If your community level is high, the CDC recommends that everyone wear a mask indoors.

All of these elements are essential to maintaining your health during the pandemic, especially if you are immunocompromised. But remember that, even if you are not immunocompromised, it is extra important that you practice all of these precautions and more.

“It is not just the immunocompromised people who need to be cautious, it is everyone that they will be coming into contact with as well,” McGorry advised.

She made sure to remind Healthline that so many people — especially in New York state, where she works — can carry the virus without having any symptoms whatsoever.

“So, if you know or live with someone who is immunocompromised, you too need to go above and beyond with your social distancing protocols,” she said. “It may be ‘annoying’ or ‘frustrating’ for some people, but it is necessary in order to protect your loved ones who did not choose to be immunocompromised.”

Aryanna Falkner is a disabled writer from Buffalo, New York. She’s an MFA-candidate in fiction at Bowling Green State University in Ohio, where she lives with her fiance and their fluffy black cat. Her writing has appeared or is forthcoming in Blanket Sea and Tule Review. Find her and pictures of her cat on Twitter.