No Simple Answers on Re-Entering the World

Ask these three questions to assess the risk of COVID-19 for you and your children, says Dr. Kate Sullivan, an immunologist and adviser to the Immune Deficiency Foundation.

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Dr. Kate Sullivan on returning to work and school

For months now, Dr. Kate Sullivan has been the immune deficiency community’s go-to expert for advice about COVID-19. In partnership with the Immune Deficiency Foundation, she has delivered regular YouTube updates that go into depth about the novel coronavirus and specific risks immune-compromised patients could face.

But in her most recent video, Sullivan said what many primary immunodeficiency patients want to know now is: Is it safe to go back to work or send my kids to school in the fall?

The New York Times recently attempted to shed some light on those questions for the general population by asking more than 500 epidemiologists which activities they would do now – and which they wouldn’t. Would they hug a friend, dine out at a restaurant or take a flight? Results were mixed.

Sullivan, Chief of Allergy and Immunology at the Children’s Hospital of Philadelphia, said there are no simple answers to these questions, particularly for people who have immune disorders. Rather, she suggested getting comfortable with “a more nuanced idea of risk management.” And she offered three guidelines for making decisions:

1. What is the community prevalence of COVID-19 and the rate of infection in your area at the moment? This was her No. 1 variable, Sullivan said. It doesn’t matter what happened in New York if you don’t live in New York and you’re not traveling to New York. (In the U.S., state health departments are often a good place to start if you want to know the status of your local community and how it’s trending. You also can track state-by-state data at this CNN link.)

2. What is the capacity for infection prevention among the people you’ll be with and at the places you’ll be visiting? How rigorous will a school, sports team or workplace be in enforcing masks, hand-washing and social distancing? Can people follow those rules? When the question is about kids, the age of the children involved will be a factor, she said.

“That’s going to be a lot harder to pull off for a group of 2-year-olds than it is for a group of 12-year-olds or a group of 20-year-olds,” Sullivan said.

3. What do you know about your specific, personal risk? With 400+ different primary immune diseases, that means knowing whether your specific disease makes you more susceptible to serious illness from COVID-19. About that, the jury is still out, Sullivan said.

But PI patients have an opportunity to contribute to the research because the IDF has launched a patient survey, she said. The goal is to collect the experiences of patients who get COVID-19 to understand better how the illness affects people with different PI diseases. The survey launched in March and was borne out of necessity, the IDF says on its website.

“If we do not do it and do it now, no one will,” the group said. “We have a tremendous opportunity to make a difference and IDF can’t do this important COVID-19 research without you.”