Still, immunocompromised people face an elevated risk. At Henderson’s hospital, about 20% of people hospitalized for COVID-19 are vaccinated — most of them have a health condition that makes them susceptible.
Diabetes, for example, is known to affect immune function, Henderson explained. “White blood cells, which are the basis of fighting infections, don’t work the same way in diabetics,” he said.
Diabetes was listed as an underlying condition in 15% of COVID-19 deaths nationwide.
As the state and nation look to turn the page on the pandemic, these patients, as well as older residents, have to be more vigilant in keeping up with boosters and wearing masks, Henderson said.
“The pandemic has always been about the vulnerable. In terms of the havoc that it’s wreaked, it has been about the elderly, the medically vulnerable and now those who are unvaccinated,” Henderson said.
Andy Imparato, director of Disability Rights California, said that unlike conversations around vaccine distribution in which advocates were able to provide input, they were not invited to discuss the state’s SMARTER plan, a blueprint released last week that will set the stage for the next phase of the pandemic.
The plan sets preparedness goals that state officials say will help them quickly respond and adapt to changing conditions, including new variants. But the 30-page document mentions people with underlying medical conditions only to emphasize that they should continue to use masks and stay up-to-date on their shots.
Under the state’s existing guidelines, vaccinated people can go maskless in most public places. People who are unvaccinated must still wear a mask in all public settings, although throughout the pandemic, the rules have rarely been enforced, mostly leaving it up to businesses to decide whether to check vaccination status. And even then, vaccinated people can still transmit the virus.
High-risk individuals can’t live in a bubble. People with health conditions or disabilities, for example, often depend on others for assistance. Many people with heart disease or diabetes have to venture out into the world to work.
“We want the state to recognize those who, even after they have been vaccinated, are at high risk,” Imparato said. “We recognize that the state is trying to balance competing demands, including keeping business afloat and helping people resume their lives, but we don’t want it to happen prematurely.”
The state is also expected to soon set a date for when masks will be able to come off inside schools.
The imminent end of indoor masking at schools concerns Garza-Silva, who teaches middle school film appreciation for the Los Angeles Unified School District. In a sign of loosening protections, the district announced Friday that it is lifting its outdoor mask mandate.
Her students, she said, are very understanding of her immunocompromised condition and are good about wearing masks in the classroom. She keeps windows and doors open for better airflow, but doesn’t know what will happen when masks are no longer required in schools.
“Our principal has been very supportive, and maybe it will be OK for students to wear masks at least for my class, I really don’t know,” she said.
Earlier this month, a Placer County high school teacher, who was fully vaccinated but had suppressed immunity from prescriptions treating his autoimmune disorder, died from COVID after returning to the classroom.
Looking to the future
One hopeful sign is that therapeutics, like remdesivir, are now much more widely available than they were before — although during the omicron surge, supply still struggled to keep up with demand, said Dr. Shira Abeles, an infectious disease specialist at UC San Diego Health.
Also, another recently approved drug known as Evusheld, can be used as a preventive measure, before infection, for those at highest risk, although supplies are still quite limited.
Liber, who lives in San Diego, said one of her friends who also is high risk was treated with monoclonal antibodies when they caught COVID, “but there’s no guarantee it’ll be available if I need it.”