Many people diagnosed with chronic illnesses do not consider themselves 'at risk' for COVID-19 infection

In parallel with the surveys, the project’s researchers are conducting interviews with people in Denmark about how they are experiencing the corona crisis, and what it means for their well-being. In particular, we are asking how people are managing the crisis in general and the lockdown in particular. These interviews enable us to learn about the immediate effects of the current situation on people’s behaviour, mental health, and well-being, and thus to analyse the possible consequences (e.g., on social relationships, health, finances, etc.). At this time, we have interviewed 32 adult residents between the ages of 24 and 83 from various areas of the country. Each person has been given a pseudonym, and we have removed any identifying features from their quotes so that they cannot be recognised.

We specifically interviewed 18 people who have been diagnosed with a chronic condition. According to the Danish health authorities, certain chronic illnesses may be associated with an increased risk of a prolonged or severe course of infection (and even death) from COVID-19. We wanted to learn whether these people consider themselves as having a higher risk for infection, and how they are managing this risk.

 They comply with the precautions

When Alice (age 75) was asked whether she is in a high-risk group due to having type 2 diabetes, she answered, “Noooo – not especially.” She also does not consider herself to be at risk because she self-isolates, which she is comfortable doing. Jane (age 65), who has both Parkinson’s disease and essential thrombocythemia, recognises herself as being in a high-risk group, but was not concerned about this. She and her husband had adapted their usual routines to minimise the risks, e.g.: “We’ve decided that I won’t go shopping – my husband does that.”

Living life like ‘ordinary’ people

Johan (age 64) has type 1 diabetes and rheumatoid arthritis. He said, “I’m in a risk zone, so I really should stay home all the time, not go out and shop, and not go to visit my parents or anything. But I haven’t. I’ve been doing things like most ordinary Danes who don’t have anything wrong with them. (…) I haven’t done anything extra, even with the illnesses I have”.

They are used to assessing their own risk

When asked who she thought is in danger of being infected, Heidi (age 24) answered: “People with chronic illnesses, infants, elderly people”. But with regards to her own risk due to having epilepsy, she explained: “I’ve carefully investigated whether [my condition] puts me more at risk of becoming infected or very ill from [the virus], and there’s no connection at all. So, after I researched it and learned that it didn’t make any difference, then I didn’t think about it anymore”.

Morten Skovdal and Amy Clotworthy from the project’s qualitative team state:

These interviews indicate that many people diagnosed with chronic conditions are used to actively practicing risk-reducing behaviours, and many were already complying with the public-health advice related to the COVID-19 pandemic; i.e., physical distancing and hand hygiene. Even if they did consider themselves to be more susceptible to COVID-19 infection, their sense of control over their chronic condition(s) means that they do not see themselves as having an increased risk, and they continue to live life like ‘ordinary’ people.

This suggests that ‘chronic illness’ is not one homogeneous category because people with specific conditions are used to managing their individual situation. These people have been labelled by the government and health authorities as being part of a ‘high-risk’ group, but it seems that they feel a need to ‘unlabel’ themselves. Rather than instituting blanket policies and enforcing precautions that follow a ‘one-size-fits-all’ approach, the Danish health authorities should evaluate the risks posed to people with specific conditions on a more individual basis. They should also consider people’s different capacities to assess and manage their own risk.