LOS ANGELES — For Giancarlo Santos, holiday parties are typically a free-for-all of revelry, with friends and family spilling into every corner of the house, and Christmas decorations twinkling everywhere.
This year, Santos will get to enjoy the decorations as he receives treatment for an aggressive type of cancer called diffuse large B-cell lymphoma. But holiday celebrations at his home in Chino, California, will be strictly limited to his wife, Michelle, and their three children, who will be wearing masks and maintaining a safe distance from their 46-year-old father.
“I’m not normal; this is all abnormal,” Santos said from his hospital bed at Cedars-Sinai Medical Center in Los Angeles. His children “are ready for the pandemic to be over — hanging out with friends, going out, taking kickboxing classes,” he said. But they’ve met him halfway, getting vaccinated and wearing masks to protect their dad, whose disease has left his immune system unable to protect him from COVID-19’s deadliest ravages.
If only everyone in his life were willing to do the same.
Almost three years into the pandemic, many Americans have decided that the health emergency is over. In late October, when the polling organization Morning Consult gauged Americans’ concern over COVID-19, only 11% said they considered it a “severe health risk” within their communities.
But for patients whose immunity is weakened or destroyed by medicines or disease, “it’s not over,” said Dr. Akil Merchant, an oncologist who oversees Santos’ care at Cedars-Sinai.
Indeed, for these Americans, the pandemic has taken a turn for the worse.
The omicron strain that is generally considered mild has dealt a significant blow to people with compromised immune systems. Two therapies that have been a mainstay of protection for these patients are no longer believed to be effective against two of the most dominant subvariants, BQ.1 and BQ.1.1 That leaves them with only two effective medications should they get sick.
That, in turn, puts them at the mercy of those around them as COVID-19 cases and deaths are ticking upward, mask use is falling, and updated booster shots are going unclaimed.
In a world that’s moved on from precautions, “they’re on their own,” said UCLA infectious disease specialist Dr. Otto Yang.
That’s not entirely new: Influenza and respiratory syncytial virus have long put these patients in peril as well, but Americans have never been asked to don masks or get vaccinated to help protect them against the viruses that cause those diseases.
Getting Americans to forfeit their perceived freedoms to protect the vulnerable has always been a big ask, said Johns Hopkins University bioethicist Jeffrey Kahn.
“We’re more oriented toward individual rights,” he said.
But even if there were broad support for collective measures to protect the immunocompromised, the coronavirus itself hasn’t cooperated, Kahn noted.
At the start of the pandemic, for instance, near-universal vaccination was touted as a way to protect the medically fragile by surrounding them entirely with immune people. That goal of creating “herd immunity,” however, has been put out of reach by a virus that continues to undermine vaccines’ protection.
