ALS as a COVID-19 Comorbidity and Unvaccinated Caregiver Risks

A man with amyotrophic lateral sclerosis (ALS) has died from COVID-19 after contracting the virus from his unvaccinated caregiver. Some diseases can increase the risk of developing severe COVID-19 and are known as comorbidities. The existing disease may make it harder for the body to fight against the COVID virus.

Paul Kirsch, 65, was fully vaccinated against COVID-19 in April, but was still careful about getting the virus, his wife, Emily Kirsch, told The Oregonian. He only met with a select group of vaccinated friends and family, and he made sure to keep their gatherings outside, Emily said.

But the person hired to help take care of Paul wasn't vaccinated against the virus and contracted it in late August. Paul started to show symptoms not long after, Emily said, and died of the virus on September 5. "Although Paul was fully vaccinated, ALS complicated his recovery from COVID," his obituary reads. It also includes this message: "Paul would encourage anyone who can to 'please get vaccinated.'"

ALS as a COVID Comorbidity

ALS is a rare neurological disease that mostly impacts the nerve cells that are responsible for controlling voluntary muscle movements, like chewing, talking, and walking. There is no cure for ALS and no effective treatment to stop or reverse the disease. Symptoms get worse over time.

While the Centers for Disease Control and Prevention (CDC) does not list ALS as a condition that increases a person's risk of severe complications from COVID-19—known as a comorbidity. However, data from the U.S. Department of Veterans Affairs shows that veterans with ALS are three times more likely to die of COVID-19 than veterans without the condition.

Risk From Unvaccinated People

Many health organizations have COVID-19 vaccine mandates in place for healthcare workers, including caregivers, but it's often a company-specific policy. Some states also mandate vaccinations, but not all. Oregon, where Paul lived, requires that healthcare workers be fully vaccinated by October 2021, but the rule does not include home caregivers, the type Paul had.

Paul couldn't walk or talk due to having ALS. In April 2020, he started using a device that helped him use his eyes to pick out words and letters that he could say out loud. His caregiver, Amy Balderas, spent eight hours a day feeding him, taking him to the bathroom, and showering him. While Balderas wore a mask all the time, Paul did not.

Emily told The Oregonian that Balderas was the only caregiver who refused to get vaccinated against COVID-19 because she worried that there could be long-term health effects. But Paul decided to keep her on because she was good at her job and had been caring for him for three years, Emily said.

Balderas told The Oregonian that she woke up with body aches and a fever on August 20, 2021; Paul developed symptoms a few days later. Balderas said she had spent time with five friends and visited a chiropractor's office the week before she was infected, but she's not sure how she contracted COVID-19.

Paul began having trouble breathing and needed to go to the ER later that week. He was tested for COVID-19 and moved to the intensive care unit because of his condition. His condition got progressively worse, and Emily remembers telling him, "If you need to go, the good Lord's waiting for you." She said a tear rolled down his cheek and raised his eyebrows to indicate "yes." He died the next day.

Emily said she was originally angry at Balderas but eventually realized that her husband made the choice to keep her on. Balderas now says she is considering quitting her career. "It was very devastating to find out he had passed," she told The Oregonian. "And then to feel, like, 'Oh my gosh, what if I did give it to him?'"

Despite her experience, Balderas says she still does not plan to get the COVID-19 vaccine.