You Don't Always Know Who Is High Risk

States are racing toward reopening and more of us are planning to go back to work and resume some of our normal activities, but nothing about the coronavirus itself has actually changed. It’s as virulent and deadly as ever, and even if the risk that hospitals will be jammed with high-risk patients is lower, the risk to those patients is no less serious if they get infected—and there’s no way to tell at a glance who is high risk and who is not. The person you pass in the grocery store, the neighbour from down the street, the co-worker you’ve collaborated with numerous times: they could all be at a high risk for developing COVID-19 complications without you ever knowing.

A recent example is a lawmaker in Pennsylvania, Brian Sims, who is immunocompromised because he recently donated a kidney, but who only heard about his potential exposure to COVID-19 a full week after his colleague’s diagnosis. Looking at Sims, you might not guess he is in a high risk category; he appeals healthy and strong, but the virus doesn’t care about optics. Situation’s like Brian’s should serve as a stark reminder that we can never fully know another’s health situation, which means we need to be careful to constantly monitor our own behaviour in order to keep from exposing others to risk.

More Americans are at high risk than you realise

An estimated 92 million American adults are at risk for developing COVID-19 complications. Of these 92 million, 51 million are at risk because of their age. Another 41 million are at risk due to asthma, chronic lung disease, liver disease, diabetes and other conditions that leave a patient with a compromised immune system.

That is a lot of people walking around with conditions that put them at increased risk. Of the people you know—your neighbours, your colleagues, your friends—there are undoubtedly some, if not many, who are high risk. Even more might be living with a high-risk person.

These people are also under no obligation to tell you their health status so that you can act more carefully around them. They aren’t obligated to tell you they have an autoimmune disorder, or that they are going through chemotherapy or that they have a rare genetic disorder. They aren’t required to tell you about their asthma, their diabetes, or anything else relating to their medical history. No one should have to share deeply personal facts about themselves in order to be treated with care.

Patient confidentiality exists for a reason, not least of which is that no one should be required to share intimate details about their own medical history. At best, talking about it is awkward and uncomfortable. At worst, it can lead to discrimination.

So treat everyone with care

So what does this mean? This means we need to treat everyone with care, regardless of what we think we know about them. It’s not enough to assume that since a person looks healthy, they aren’t high risk. Instead, we have to work on doing everything we can to protect others while allowing them their privacy. That means washing your hands, maintaining physical distance, wearing a mask, and giving others every opportunity to protect themselves, without judgment.

Respect others’ privacy. If someone says no to an outdoor physical distancing meetup or shows extreme caution when it comes to staying safe, it’s not our place to question them, judge them for “overreacting” or to demand an answer about why they are being so careful. Navigating a pandemic means adjusting to new rules of social interaction and etiquette, but doing all you can to keep others’ safe shouldn’t be a bridge too far.