April 22, 2020 / BY ALICE PARK AND JEFFREY KLUGER
Lianne Kraemer knows she’s in a precarious position. She has stage-4, terminal breast cancer that has spread to her brain. To keep it from penetrating further into other organs, she’s currently on chemotherapy, which weakens her body and puts her at high risk for a number of health problems—including infectious diseases like COVID-19.
Soon after public health officials identified SARS-CoV-2 virus as the cause of a previously unknown illness in the Hubei province of China, doctors realized that the novel coronavirus seemed to zero in on certain demographics: older people, as well as those with existing chronic diseases and weakened immune systems like Kraemer, 43. “From very early on, I felt vulnerable and scared,” she says. “People were saying ‘everybody don’t worry, this will only affect the sick people.’ I felt vulnerable and expendable.”
Now another specter threatens Kraemer’s already tenuous hold on health. If she develops COVID-19, and needs intensive care and help from a ventilator to breathe, she might be denied access. “With my diagnosis of metastatic terminal breast cancer with brain metastases, doctors will go, ‘Wow, she’s on her way out anyway,” she says. “The fact that I could go to the emergency room with COVID-19 and they might deem me not worthy of care is mind-alteringly terrifying.”
Anywhere from 3% to 19% of COVID-19 patients will wind up in an intensive care unit (ICU), often requiring ventilators to breathe. The number of COVID-19 cases in the U.S. is, as of writing, nearing 1 million, which means roughly 150,000 additional patients for the country’s already-stressed ICU system. If the flow of patients continues to outpace the supply of ventilators, doctors will be making heart-wrenching decisions about how to distribute those precious few devices.