A Reality Check.

What immunocompromised people have been doing since they were diagnosed vs what you are being asked to do during the SARS-CoV-2 aka Covid-19 pandemic 

Covid19

To prevent the spread of COVID-19:

• Clean your hands often. Use soap and water, or an alcohol-based hand rub.
• Maintain a safe distance from anyone who is coughing or sneezing.
• Don’t touch your eyes, nose or mouth.
• Cover your nose and mouth with your bent elbow or a tissue when you cough or sneeze.
• Stay home if you feel unwell.
• If you have a fever, a cough, and difficulty breathing, seek medical attention. Call in advance.
• Follow the directions of your local health authority.
• Avoiding unneeded visits to medical facilities allows healthcare systems to operate more effectively, therefore protecting you and others.

Immunocompromised people all the time

• Vaccinate except for those that are not contraindicated by their condition (such as live vaccines)
• Health care providers and caregivers should make sure their own immunizations are complete and up-to-date. Of particular importance include varicella-zoster virus, measles, mumps and rubella and annual influenza vaccines. 
• Health care facilities must have infection prevention and control policies and procedures in place to mitigate the risk of infection transmission to anyone, regardless of immune status
• Hand hygiene - essential for all day-to-day activities including, but not limited to:
• Before eating or preparing food
• After urinating or defecating
• After touching body fluids or excretions or items that might have had contact with human or animal feces (e.g., clothing, bedding, toilets) 
• After touching plants or soil
• After collecting or depositing garbage
• After being in any environment outside the home or visiting a public place
• After touching animals
• Exercise proper respiratory etiquette and meticulous hand hygiene. 
• Avoid contact with individuals known to have a respiratory illness, especially when they are symptomatic. 
• Notify the treating physician at the first signs of respiratory illness during influenza season. 
• Inform the medical team when there is influenza illness within the household.
• Minimize exposure to crowded environments, such as shopping malls, during influenza/respiratory virus season.
• Avoid primary or secondary exposure to tobacco smoke.
• Avoid risk of exposure to fungal pathogens by:
• Minimizing exposures to construction, excavation and renovations sites, where fungal spores (e.g., Aspergillus) can thrive
• Minimizing  inhalation of fungal spores from plants and animals (i.e. in farms, barns or pigeon coops, or from mulching, turning compost piles or cave exploration),
• Not smoking marijuana.
• Waterborne illnesses
• Not drinking tap water in Canada when ‘boil water’ advisories are in effect.
• Drinking only bottled or boiled water when travelling to regions with suboptimal sanitation.
• Not drinking well water unless the source is properly screened and monitored by health authorities.
• Not drinking water directly from rivers, streams, lakes and ponds.
• Not using hot tubs, which have been associated with infections such as Pseudomonas folliculitis, Legionella pneumophila infections, and mycobacterial infections. 
• Cleaning abrasions with water from a safe source. 
• Avoid swimming in water that may be contaminated. 
• Waterborne pathogens can enter through skin abrasions, or the respiratory tract if aspirated.
• Foodborne illnesses
• All milk, fruit and vegetable juices should be pasteurized.
• Avoid cheeses produced from raw or unpasteurized milk, especially soft and semi-soft varieties (e.g., Brie, Camembert, and blue-veined cheeses).
• Avoid raw meats, seafood and eggs. 
• Lettuce and all other raw vegetables should be washed thoroughly, even when they are labelled as prewashed.
• Avoid cross-contamination when preparing foods. 
• Keep cooked and raw foods separate and use different cutting boards or surfaces for raw and cooked foods.
• Animal or pet exposures
• Animal-associated pathogens of particular concern to immunocompromised children and youth, because they are more vulnerable and can get very ill, include: 
• Bartonella spp., 
• Bordetella bronchiseptica, 
• Campylobacter spp., 
• Capnocytophaga canimorsus, 
• Chlamydia psittaci, 
• Cryptosporidium spp., 
• Giardia lamblia, 
• Mycobacterium marinum, 
• Pasteurella multocida, 
• Rhodococcus equi, 
• Salmonella spp., 
• Toxoplasma gondii, 
• Zoophilic dermatophytes 
• Measures to reduce risk of contracting an animalborne infection include the following:
• A prospective pet should be thoroughly evaluated by a veterinarian before being placed with an immunocompromised person, 
• An ill pet should be seen by a veterinarian immediately.
• Consider the type of pet and specific risks for infection:
• Reptiles (snakes, iguanas, lizards and turtles) and frogs carry high risk for Salmonella, and should be avoided.
• Chicks and ducklings can also transmit Salmonella infections.
• Rodents, but especially the common house mouse, can transmit lymphocytic choriomeningitis virus. 
• Young cats can transmit Bartonella henselae infections (cat-scratch disease).
• Cats can transmit Toxoplasma gondii. 
• Puppies, kittens and chicks can transmit Campylobacter infections.
• Fish tanks may be associated with waterborne pathogens e.g., Mycobacterium marinum.
• Avoid contact with ill animals, especially when they have mouth lesions.
• Avoid cleaning birdcages, bird feeders or litter boxes, and any contact with animal feces. When this is not possible, wear disposable gloves and a standard surgical mask and be sure to wash hands thoroughly after removing gloves.
• Avoid contact with or cleaning aquariums. When this is not possible, wear disposable gloves and be sure to wash hands after removing gloves. 
• In addition to the above precautions, some general principles apply universally:
• Wash hands with soap and water after contact with any animal or pet, and especially after visits to a petting zoo or farm.
• Avoid contact with stray animals.
• Raccoons are a source of Bayliascaris procyonis (raccoon roundworm). Places where racoons visit should be inspected for stool and regularly cleaned.
• Travel advice
• Immunocompromised people should be individually evaluated for destination-specific travel risks. 
• Special attention to protective vaccines
• Hand hygiene in airplanes or areas of public transit, 
• Immunocompromised individuals should travel with a personalized ‘health passport’ that lists their medications and immunizations, describes their condition, and provides their health provider’s contact information. 
• Prevent insect bites
• Immunocompromised individuals should be protected against arthropod-borne illnesses
• West Nile virus
• mosquito or tick-borne illnesses
• Precautions include using DEET 
• dressing protectively 
• using mosquito netting where mosquito-borne infections are endemic.
• Safer sexual practices
• Safer sexual practices help reduce the risk of sexually transmitted infections
• cytomegalovirus (CMV), 
• hepatitis B and C, 
• herpes simplex virus (HSV), 
• human immune deficiency virus (HIV), 
• human papillomavirus (HPV), 
• syphilis.

So when you think about it, the restrictions you are currently living under during this Pandemic are fairly easy to comply with. You have an endpoint for these restrictions, immunocompromised people do not.

As someone who is immunocompromised and has contracted a number of the illnesses listed here, I can tell you that 7 months is a long time to live with pneumonia brought on by mycobacteria. Please consider others around you before you decide to ignore the recommendations.

Some information gathered from the Canadian Pediatric Society.