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As a new strain of coronavirus (COVID-19) swept through the world in 2020, preparedness plans, masking policies and more public policy changed just as quickly. WVXU has covered the pandemic's impact on the Tri-State from the very beginning, when on March 3, 2020, Ohio Gov. Mike DeWine barred spectators from attending the Arnold Sports Festival in Columbus over concerns about the virus, even though Ohio had yet to confirm a single case of COVID-19.

'The fear is real' for immunocompromised people navigating COVID in maskless, unvaccinated communities

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The Harts meet the newest addition to their family with Isaac on the far left, Henry (the baby), Alex, Tracy, Zachary and Christopher.

The CDC last month eliminated guidelines for masking and social distancing for most people. It was a move pushing people back to normal after nearly two years of pandemic precautions. But those who are immunocompromised are left in the dark about when they can safely rejoin "normal."

In Kenton County, 16-year-old Isaac Hart is just getting home from a field trip to see a Cyclones hockey game. It's one of the first times he's been allowed to be around a crowd of strangers in nearly two years. His dad, Zachary, says the decision to let him join his classmates in person wasn't easy because Isaac is immunocompromised. He has Down syndrome, a congenital heart defect, and Crohn's disease.

"There's not a simple answer. And sometimes people you know, they're going to do things that might be riskier, because they got to go to work and their kids got to go to school," Zachary said. "And so you're always kind of evaluating that risk. We don't have the perfect situation where you could just be home all time, and I don't know we would want to do that anyway. I think there's a lot of downsides to that, too."

A 'right to be a part of the world'

Isaac is pretty good about wearing a mask and his parents kept him home from school until he was vaccinated. He also missed a few weeks of school earlier this year when the omicron variant surged. But his parents know he can’t mask and stay socially distanced forever.

"He has a right to be a part of the world just as much as anybody else, and so what are things we can do to make that a little bit easier?" Zachary said. "I don't necessarily have the answers for that."

About seven million Americans are immunocompromised, according to the American Medical Association. When the CDC released new masking guidelines last month, there wasn't a lot of detail about what those people should do.

CDC Director Rochelle Walensky said during a news conference Feb. 25, "Those who are immunocompromised or have underlying health conditions, those who have disabilities, or those who live with people who are at risk — those people might choose to take extra precautions regardless of what level their community is in."

Zachary says Isaac's doctor offered similar suggestions but it wasn’t very helpful.

"It was like, was he gonna have to wear it forever? Is there ever going to be a point where he doesn't need to do that?"

'It has changed life drastically'

The answer is complicated.

Dr. Tahir Latif is a University of Cincinnati Professor of Clinical Medicine in the Division of Hematology Oncology. He works with patients who are at such high risk of infection they can't eat fresh fruit or vegetables. They can't have flowers in their hospital room. All of those things could cause an infection.

"You can understand why the recommendation is confusing, because this situation may be different for any individual time point," he said. "And then, as a physician, you have to balance some quality of life you want to live. Living means you interact with people ... you take part in group activities and things like that. On the other hand, you have to balance it with the risk of catching COVID, or risk of catching the infection, which is really a very, very difficult thing to do."

He says for those who are healthy, getting vaccinated, keeping hands clean, and wearing masks around immunocompromised people might be all they can do to keep others safe.

"Other than that — meaning other things the immunocompromised person can do — is to get the vaccine, get the booster shots, get their fourth shot, and also talk to their physicians about these antibodies if it's indicated for them. But short of that, I don't think we have anything else that we can do," he said.

Latif says immunocompromised people could have to take extra precautions indefinitely. It'll be up to them to do risk assessments, weighing what activities they find meaningful and what they'll have to give up.

"I think it has changed their life drastically. There's no doubt about it. And the fear is real."

'It's people you know'

Zachary Hart says he knows he can't expect the general public to keep masking and social distancing forever. But he asks people to see beyond political divides and get vaccinated. It could be the difference of life and death for people like his son.

"The reality is, any person could get something at any time, or they could become immunocompromised and be in that situation," he said. "So I think people want to act like 'Well, that's somebody else.' And it's not. It's people you know, it could be you."

Hamilton County and many Northern Kentucky counties have lower COVID-19 rates than just a few weeks ago. But immunocompromised people like Isaac, young children who can't be vaccinated, and others at high risk of COVID-19 complications, are still living through the pandemic. New variants are also cropping up, each with characteristics that pose deadly risks to everyone.

On the two-year anniversary of the pandemic, WVXU is looking back at how COVID-19 has changed the city and the people who live within it. See those stories here.