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PSA for #publichealth authorities & reporters working on #COVID2019.

Please think about people who are old, living with chronic illness and/or immunocompromised by medication.

They read/hear/watch your announcements, press conferences and news stories. They’re #Audience. 1/x

As you know, people who are old, living with chronic illness or immunocompromised by medication (POCII) and are infected by the COVID-19 virus have an elevated risk of slow recovery, complications and death. This routine context appears in most guidance and news stories. 2/x

So far, so good. But since POCII with #COVID19 are isolated, and unlikely to be professionally engaged with this pandemic, there’s a danger of marginalizing them in public discourse. The standard account of their relationship to the virus is unsatisfactory. 3/x

Some messages from officials and words in the news media treat POCII as an afterthought. They appear as a class of people near the end of writings. The context is usually differentiation between POCII and the rest of the population, whose prognosis with COVID19 is better. 4/x

When POCII die from COVID19 conplications, the terms used to indicate their vulnerability are generic - underlying conditions, complex medical problems, serious or chronic illness, or other vague expressions. So far, stories and announcements seldom specify the condition. 5/x

Why do I say this vagueness is unsatisfactory? Because when a POCII reads such writings, their natural reaction is to wonder whether the victim’s situation was the same as theirs. Was it Parkinson’s? Lupus? Immunosuppression from chemotherapy for cancer? 6/x

POCII with certain conditions may not have a clear idea of whether they are at elevated risk of complications from COVID19. For example, multiple sclerosis (MS), is caused in part by immune system dysfunction, but people with MS are not necessarily immunocompromised. 7/x

People with MS are immunocompromised if they are being treated with drugs that target cells involved in immune response. (For more, see mssociety.ca/resources/news….) Otherwise their risk of COVID19 infection or complications is similar to that of a healthy person of the same age. 8/x

#COVID19 deaths unfortunately will keep occurring. It’s important to POCII to know the cause, which will either reassure them or make them more vigilant about their own situation. The same goes for anyone with a POCII friend or relative. Details help people make decisions. 9/x

There’s also no reason to relegate POCII to the position of afterthoughts, as if their age, #Disability, incapacity or vulnerability makes them somehow less important or relevant to the story than others. As if they are closer to death anyway, with fewer life-years to lose. 10/x

In fact, POCII should be at the centre of the #COVID19 story. People of all ages may be vulnerable to infection because of cancer chemotherapy or other treatments. They are our parents, grandparents, children, sisters and brothers, aunts and uncles, friends and colleagues. 11/x

POCII are more likely to be infected by any virus or bacteria, and in conditions like MS any infection will make the chronic illness worse, so for them prevention is a serious matter. Respiratory-system viruses pose a special problem for people whose lungs aren’t optimal. 11/x

If the lungs have constricted passages or the breathing muscles around them are weak, they may not be able to cough well and expel the fluid that collects during infection. That can lead to pneumonia that lingers, and pneumonia is a major cause of death among POCII. 12/x

So please, #publichealth authorhties and reporters dealing with #COVID19, make an effort to name “underlying conditions” when reporting deaths or vulnerability. And please be careful to write and speak about POCII without adding to their anxiety by using generic boilerplate. 13/x