Denisse Takes's world is small these days. She lives in Burbank, Calif., and makes a living by producing songs from her living room, playing games online with friends, and occasionally walking her dog.
She sees no one except for her husband, who donated his organ in order to give her a compatible donor.
Her immune system is kept from rejecting the organ by the medication that suppresses it. She went to the emergency room with a cold because of her bad body. She thinks Covid-19 would kill her.
The isolation and depression amplified by the rest of the world have taken their toll.
Millions of Americans with weakened immune systems, disabilities or illnesses that make them especially vulnerable to the coronaviruses have lived this way since March 2020, sequestering at home, keeping their children out of school and skipping medical care rather than risk exposure to the virus. Politicians and public health experts talk about the value of their lives in a way that they see as diminishing.
As Year 3 of the Pandemic approaches, with public support for precautions decreasing and governors of the most liberal states moving to shed mask mandates, they find themselves dealing with exhaustion and grief, and they are willing to accept them as a return to damage.
I can still see your world, but I live in a different world, and I'm vulnerable because of it.
She lives alone, eats almost every meal alone and scrolls through social media alone, but she gave up on social media altogether.
More than seven million adults in the United States, or 3 percent, are characterized by health professionals as immunocompromised because of a disease, medication or other treatment that weakens their body's immune response, meaning that diseases such as Covid-19 can be more deadly.
More than 10 million Americans have at least one medical condition that puts them at risk for Covid. Many live with little worry, while others at higher risk feel the need to stay out of society.
When he received a heart transplant in June 2020, he hoped for a better outcome. He thought a transplant would give him more freedom after years of hospital stays. He hasn't been to school or a restaurant since early 2020 and hasn't seen his family or doctors since the beginning of the year.
"If I could go to school, that would be cool, I can't go anywhere except the hospital," he said.
He takes drugs to stop his body from rejecting the heart, so his doctors have told him to act like he is not. His siblings wore masks to school last month, making them stand out in their conservative community, where roadside signs urge people not to get a coronaviruses vaccine.
His parents said they had received hate mail for asking neighbors to wear masks or get vaccinations, and some of the same neighbors who prayed for him when he needed a transplant.
In states such as New York, Illinois and California, mask mandates have been rolled back, which is causing stress for vulnerable Americans who fear that the rest of the country is not taking precautions to keep them safe. The Centers for Disease Control and Prevention said last week that it was too soon to abandon masks because of the potential impact on vulnerable people, but on Wednesday the agency indicated that it would soon issue new guidelines.
The dean of the School of Public Health at Brown University said that having everyone mask indoors is not a long-term strategy. She said that we need to make sure that we have more stringent protections in place in places where people don't have a choice.
Keeping infections low is the best protection in the long term. She said that vaccinating almost everyone would help, but millions of Americans wouldn't, and not enough funding has been forthcoming for improved ventilation systems in public places.
The fear and anger felt by many high-risk Americans burst into public view last month in response to remarks from the C.D.C. director. She told ABC News that 75 percent of those who died despite being vaccine free had at least four comorbidities.
Imani Barbarin, who has several conditions that put her at high risk, created the #MyDisabledLifeIsWorthy on social media to draw attention to the government's approach.
We just want to survive this, and we have seen a complete disregard for our needs.
Dr. Walensky apologized to disability advocates in a meeting and promised that senior C.D.C. officials would meet with them regularly. Julia Bascom, the executive director of the Autistic Self Advocacy Network who was in the meeting, said the comment reflected a familiar attitude: that people with disabilities are just inevitably going to die.
The backlash led the Biden administration to re-examine its approach to people with vulnerabilities, according to the senior policy adviser for equity on the White House Covid-19 Response Team.
He pointed to recent guidance from the Department of Health and Human Services saying that patients cannot be deprioritized on the basis of disability. He said the administration would announce more actions this week.
Government officials and the health care system can help vulnerable people without asking the rest of society to take precautions indefinitely, according to experts.
An assistant professor of health law at the University of Denver suggested using federal Pandemic Relief money to upgrade the air quality in businesses and schools, and make prophylactic antibody treatments such as Evusheld widely available to immunocompromised people.
It would be frustrating to have states fail to protect people at higher risk, and then try to frame things as an individual-individual trade-off between people who want to maintain mask requirements versus removing them.
After the health secretary announced that the United States would double its order of prophylactic antibodies, Ms. Cain said that she felt like her only chance was to regain a semblance of normal.
She said it was disappointing to see elected officials or other people in power minimize or miss the severity of the crisis.
In rural Missouri, a 12-year-old namedAaron spends his time in online classes, playing games with friends, and making videos of himself trying spicy foods. His friends keep asking when he will come back to school, but he knows it won't happen soon.
The loss of support from his parents continues to sting.
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