Living with diabetes or leukaemia in endemic Covid-19: How high-risk individuals can continue to protect themselves

In a world where many have resumed pre-pandemic activities, Mr Jimmy Ong remains cautious. 

The 72-year-old retiree, who currently lives with his youngest son and is a grandfather to five, has lived with Type 1 diabetes for 43 years. This puts him in a vulnerable category of individuals who are immunocompromised or have an impaired immune system, and require extra precautions against Covid-19. 

Throughout the pandemic, he recalls having to significantly change his health management and daily living, which took a toll on his well-being. 

“I had to be extra careful about how I live my life, including avoiding crowded places, continuously wearing a mask, and limiting how often I see my friends and family to protect myself,” says Mr Ong.

Risks for the immunocompromised 

Dr Leong Hoe Nam, infectious disease specialist at Mount Elizabeth Novena Hospital, says that while vaccination is the body’s primary defence, as many as 50 per cent or more of immunocompromised individuals may not be able to mount an immune response.

This includes those who have underlying health conditions or are taking immunosuppressive drugs for medical conditions such as blood cancers, and those undergoing active chemotherapy, dialysis or an organ transplant. These conditions can lower immunity and reduce the ability of white cells to fight the infection.

Since 2017, Singapore has over 53,000 immunocompromised patients¹, of which about 25,000 are on active chemotherapy², says Dr Leong. For these individuals, their risk of hospitalisation and developing severe complications such as pneumonia or organ failure is eight to 10 times higher than that of a healthy individual, he adds.

However, Dr Leong says that some immunocompromised patients may be medically unsuitable for the Covid-19 vaccination or may not mount the same level of protective response from the vaccines.

He explains: “Vaccines, which usually contain a weakened form of the organism, are given to train your body to fight against the virus or bacteria.

In immunocompromised people, as their bodies may not be able to manufacture these antibodies, they are still at high risk of hospitalisation and severe complications if they were to contract Covid-19.”

Therapy options for additional protection

Like Mr Ong, Mr Ting Chew Thai is another immunocompromised individual. The 74-year-old retiree was diagnosed with leukaemia at the end of 2021 and had to undergo a bone marrow transplant (BMT) in early 2022.