Most of the time, the voices in Keris Myrick鈥檚 head don鈥檛 bother her. They stay in the background or say nice things. But sometimes they get loud and mean 鈥� like when a deadly pandemic descended on the world.
鈥淚t鈥檚 when things go really, really fast and they seem overwhelmingly disastrous. That鈥檚 when it happens,鈥� said Myrick, who was diagnosed with schizophrenia 25 years ago. 鈥淭he attacking voices were calling me stupid. 鈥� I literally had a meltdown right here in my house. Just lost it.鈥�
She was able to calm herself and quiet the voices, and as the pandemic wore on, she kept them at bay by keeping busy: continuing her work for a foundation, hosting a podcast, and writing a children鈥檚 book. She managed, but she worried about other people like her.
鈥淧eople with schizophrenia were not actually deemed as 鈥榯he priority vulnerable population鈥� to be served or to be addressed in the same way as people who had other chronic health conditions and who were over a certain age,鈥� said Myrick, who lives in Los Angeles. 鈥淪o we kind of got left out.鈥�
This omission occurred even as new data published in JAMA Psychiatry showed that people with schizophrenia were as likely to die from covid-19 as the general population. Their risk of death from the virus is greater than it is for people with diabetes, heart disease, or any other factor aside from older age.
鈥淧eople鈥檚 initial reaction to this was one of disbelief,鈥� said Katlyn Nemani, a New York University school of medicine neuropsychiatrist and the study鈥檚 lead author.
Some researchers initially questioned whether the disparate death rates could be explained by the often poor physical health of people with schizophrenia or their difficulty accessing health care. But Nemani鈥檚 study controlled for those factors: All the patients in the study were tested and treated for covid, and they got care from the same doctors in the same health care system.
Then studies started rolling in from countries with universal health care systems 鈥� the U.K., Denmark, Israel, South Korea 鈥� : a nearly three times higher risk of death for people with schizophrenia. A from the U.K., published in December 2021, found the risk was nearly five times as great.
鈥淵ou have to wonder, is there something inherent to the disorder itself that鈥檚 contributing to this?鈥� Nemani asked.
The immune dysfunction that causes severe covid in people with schizophrenia could be what drives their psychotic symptoms, Nemani said. This suggests schizophrenia is not just a disorder of the brain, but a disease of the immune system, she said.
Although researchers had already been , the data from the pandemic has shed light on it in a new way, opening doors for discoveries.
鈥淭his is a really rare opportunity to study the potential relationship between the immune system and psychiatric illness, by looking at the effects of a single virus at a single point in time,鈥� Nemani said. 鈥淚t could potentially lead to interventions that improve medical conditions that are associated with the disease, but also our understanding of the illness itself and what we should be doing to treat it.鈥�
In the long term, it could lead to new immunological treatments that might work better than current antipsychotic drugs.
For now, advocates want the data about risk to be shared more widely and taken more seriously. They want people with schizophrenia and their caretakers to know they should take extra precautions. Earlier in the pandemic, they had hoped people with schizophrenia would get vaccine priority.
鈥淚t鈥檚 been a challenge,鈥� said Brandon Staglin, who has schizophrenia and is the president of , a mental health advocacy group based in Napa Valley.
When he and other advocates first saw Nemani鈥檚 data in early 2021, they started lobbying public health officials for priority access to the vaccines. They wanted the Centers for Disease Control and Prevention to add schizophrenia to its list of high-risk conditions for covid, as it had done for cancer and diabetes.
But they heard crickets.
鈥淚t doesn鈥檛 make any sense,鈥� Staglin said. 鈥淐learly, schizophrenia is a higher risk.鈥�
In several other countries, including the U.K. and Germany, 聽for vaccines from the beginning of the rollout in February 2021. In the U.S., though, it wasn鈥檛 until people were getting 聽2021 that the CDC added schizophrenia to the priority list.
鈥淲e were happy when that happened, but we wish there had been faster action,鈥� Staglin said.
It鈥檚 always like this with mental illness, said Myrick.
鈥淚t鈥檚 like we have to remind people,鈥� she said. 鈥淚t鈥檚 just sort of, 鈥極h yeah, oh right, I forgot about that.'鈥�
This story is part of a partnership that includes , , and KHN.