We are excited.  There are two vaccines being distributed- albeit in very spotty fashion.  At least one more (the Johnson & Johnson version) is about to be submitted for FDA approval- to be followed shortly thereafter by the Oxford/Astra-Zeneca choice.  Hopefully, by the end of this year, the pandemic will be over.

But, in the meantime, there’s a whole population that has been glossed over.  We know our older citizens (of course that means older than I!) are at risk for COVID-19.  And, we also know that folks who managed to survive to or beyond octogenarian status are our biggest risks.

Except, they are not.  Really.

Oh, sure, octogenarians are at a big risk.  But, folks on dialysis?  SARS-CoV-2 has chosen them as its prime targets.  The numbers seem to be 1 in 30 die of COVID-19.

Keep in mind that half the folks on dialysis are 40 y of age or younger.  Moreover, they have young families!  So, learning that one of these younger folks on dialysis is 4X more likely to succumb to COVID-19 than an octogenarian, should shake up your thinking that it’s just older folks at risk for COVID-19.

Part of the reason for this heightened risk is because COVID-19 interferes with blood clotting.  Or, it could be due to inflammation of the kidney blood vessels (akin to how the disease inflames the lungs in “normal” patients), which leads to the dreaded cytokine storm (elevated immune response).   Moreover, once a renal patient contracts COVID-19, it takes significantly longer for them to recover from the disease- assuming they don’t succumb (the short-term mortality rate for dialysis patients is at least 20%!).

It’s why dialysis clinics were among the first to demand universal masking of patients and staff, to effect universal screening and testing of patients. After all, the clinics average a 3 foot separation  among stations- not 6 feet.  And, these patients are virtually immobile for four hours at a clip in that same location.  Not to mention that a good percentage of the patients are transported to and from the clinics via shared-ride services.

Yet, not one developed nation has escalated the priority for vaccines to include these patients.

Come on, Joe!  You, too, Tony!   Let’s take care of the 750,000 folks at dire risk.

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