Doctors thought she had the worst case of pneumonia they had seen, but for Helen Black, that misdiagnosis led to an accurate one: stage four metastatic breast cancer that had spread to her lungs, causing one to fill with fluid and collapse in March 2017.

She had a port placed and started chemotherapy just days later.

Chemotherapy was draining, and after losing all of her hair and a lot of her energy, Black started on a new medication called Ibrance in fall 2017. A key side effect of the intensive drug treatment, which works to stop the spread of cancer cells, is a lower white blood cell count.

Black discovered this unfortunate fact during recent flu seasons, when she had to be meticulous about not shaking hands with people and sanitizing her own religiously.

Last year, she had to quarantine for a few months to reduce her risk of catching the flu, with her low white blood cell count.

Just three years after her diagnosis, a pandemic has forced Black, who is considered immunocompromised, back indoors – but this time with more urgency than in a typical flu season.

While her most recent scans showed no evidence of cancer, Black has started to quarantine again, as COVID-19 spreads across Washington.

The mother of nine children, three of whom are still living at home, with a part-time job at the Arc in Spokane, Black is a busy woman.

She works with individuals with intellectual and developmental disabilities to know their rights and help them navigate housing, criminal justice and other systems and programs, at both the state and federal level. A week ago, Black made a choice to ask her children to stay home from school and to keep herself home from work in order to keep their risk for contracting COVID-19 low.

She prepared to juggle both homeschooling and working from home, emailing teachers and getting permission from the Mead School District to do so.

Gov. Jay Inslee had the same idea, however, when he announced that all schools would close for six weeks, banned gatherings of more than 50 people and closed restaurants, bars and other businesses through the end of the month.

The Black family is now at home, and Helen’s husband, who has been helping with shopping and other errands that require leaving the house, is back at work at the railroad. Every time he comes home, he sanitizes and changes his clothes immediately, she said. Her son, who lives at home, also has underlying health conditions, including cardiac, lung and respiratory issues.

“Honestly, I’m terrified of this because of the history with my lungs,” Black said. “And I am scared for my son because he has a very tiny, compromised airway.”

The novel coronavirus does not lead to severe illness for the majority of people who get it. However, for people like Black who are immunocompromised, or her son who have underlying heart or lung conditions or other diseases, COVID-19 can be devastating.

People with such conditions and those over the age of 60 are encouraged to take extra precautions as the virus spreads, but the global effort to stop COVID-19’s spread will also require those who are not at high risk to take appropriate precautions and distance themselves from others.

“People have this mindset of, ‘Well, that’s not my problem,’ ” Black said. “It isn’t your problem, you’re right, this has no impact on you, but for those of us – and there are many of us – we’re counting on you to be a member of this community and do your part, just like you would want another one of the community to do their part for your loved ones.”

Black is not letting visitors into her family’s home, and she has canceled her physical therapy appointments. She still needs to go to the doctor semi-regularly, however, for blood draws and to get her port flushed. She plans to take extra precautions at the doctor’s office when she goes, perhaps by wearing gloves and not touching anything in the office, and she is thinking of calling ahead of time to see if she should wear a mask.

Black’s health care providers have told her to thoroughly and regularly wash her hands, avoid crowds and not allow people who are sick near her.

“Right now, if somebody showed up at our door, we wouldn’t let them in. We just can’t risk it right now,” Black said. “There’s just so much we know about this virus, and especially with the history of my lungs, we’re not going to risk that. And with my treatments, we don’t know how my body is going to respond.”

She said seeing the increase in cases and deaths in Washington is scary to watch. Washington has nearly 1,200 confirmed cases of COVID-19 and 66 reported deaths as of Wednesday evening. And limited testing capacity at a federal level has stymied local health officials’ ability to understand how widespread the virus is in Eastern Washington.

Black hopes the coronavirus pandemic will bring awareness to the broader community about how many people of all ages are immunocompromised or at increased risk for falling ill.

“We are always, always on guard. We are always less likely to offer a hand when meeting or greeting somebody. It’s not because we are OCD, it’s because we are living with a disease that puts us at risk,” Black said. “And the biggest thing for me is, I’ve been saying to people: This is what I live with every day.”