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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

'At Higher Risk': the Immunocompromised and COVID-19

Rebecca Smith
/
KBIA
On Wednesday, March 18, 2020, Kenny Greene was working on a small piece of jewelry. Even before the City of Columbia’s stay-at-home order, he was working “when he wanted” and very aware of COVID-19, as he is immunocompromised due to a kidney transplant. ";s:3:

By now, most people will know that the Centers for Disease Control and Prevention consider older individuals "at higher risk" for serious complications of COVID-19, but there are several other groups that also have higher risk – and are maybe not as obvious to the naked eye. 

Monarch Jewelry is a small shop located in the North Village Arts district. The walls are covered with bright paintings, there are pieces of fine jewelry in a display case, and bits of stones, beads, and even an arrowhead lay on a counter across the room. 

Toward the back of the store – standing next to his workbench and holding a mug of coffee – isKenny Greene, the “unofficial” Mayor of the North Village Arts District.

Kenny and I met up at his shop last Wednesday, March 18, before the City of Columbia issued a stay-at-home order, to chat about something that, he said, some people may not be aware of: He’s immunocompromised.

He said he’s lived in Columbia since the 1970s, is very active in the arts community, is nearing 70 – and he's the recipient of a donated kidney due to benign idiopathic retroperitoneal fibrosis. 

“It cost me a lot of money to learn that,” Kenny joked.

Kenny experienced renal failure and was on dialysis for more than 7 and a half years, but 16 years ago, he received his new kidney, and “I’ve had a compromised immune system since then. I left the hospital with 14 drugs… I’m down to two.”

That’s every day. And those drugs are immunosuppressants, which keep his body from rejecting his new-ish kidney. But those same drugs that protect his kidney, also put him at higher risk for infectious diseases – like COVID-19.

“It’s important that we talk about COVID-19,” Dr. Ashley Millham said. “But It's also important to recognize that most of these groups are also at higher risk for things like pneumonia, and influenza and a lot of other infectious diseases that are present year-round.”

Dr. Millham is the medical director of Columbia/Boone County Public Health and Human Services, and she said there are three main groups of people more at risk when it comes to COVID-19.

Those over the age of 65.

People with underlying health conditions. This includes things like: various disabilities, asthma, diabetes, COPD, chronic bronchitis, heart disease and failure, or a history of heart attacks.

And the third group is sometimes a little harder to recognize because “you can’t always tell someone is immunosuppressed by looking at them,” Millham said.

She added there’s many reasons someone’s immune system may not be firing on all cylinders, and many conditions require immunosuppressants for treatment. This includes things like: inflammatory bowel diseases – Crohn’s Disease or ulcerative colitis – any organ transplant, rheumatoid arthritis and even, sometimes, psoriasis.

“Keeping that in mind, if you’re sick – please stay home,” Millham said. “If you have mild, cold-like symptoms that don’t require going in and getting seen, then taking care of yourself at home and not exposing other people in the community to that illness would be a really kind thing to do.”

And she said this is something she hopes people will consider and continue to do in the future, even once COVID-19 is less of a concern.

Back at Monarch Jewelry, Kenny said he’s not really worried because he hasn’t had an immune system for 16 years, and he’s made it through other high-risk times – like flu season each year.

Since I visited Kenny last week, the City of Columbia has issued a stay-at-home order, which means less people will be out and about, but you could still come in contact with those more at risk – at the grocery store, on the trail or at the pharmacy.

Which means Kenny is still paying attention. He knows his risk factors, has stopped teaching his tai chi classes, and, for now, is just doing what he can.

“I don’t think I can get younger,” Kenny said. “So, I’m just gonna follow the regular standards of good health and go with that… and deal with it, if things get worse." 

Rebecca Smith is an award-winning reporter and producer for the KBIA Health & Wealth Desk. Born and raised outside of Rolla, Missouri, she has a passion for diving into often overlooked issues that affect the rural populations of her state – especially stories that broaden people’s perception of “rural” life.