Immunocompromised Vs COVID-19

My views living as an immunocompromised individual towards COVID-19.

“And those who were seen dancing were thought to be insane by those who could not hear the music.”

I try to live as much of a “normal life” as I can, however define “normal”. Normal is an illusion we as a society have created to filter out the odd or different and pinned to a word. In this case to a group of people that fall under the general population and believe their standard actions of day to day routines are acceptable without judgment, they obtain common sense, and settle for an average regular run of the mill, simple homely lifestyle.

We’ve done a poor job at filtering out these people.

“As what is normal for the spider is chaos for the fly.”  

The spider in this case represents the majority of healthy individuals and the fly are the individuals that live with an invisible disability, immunocompromised, the elderly, someone living with a health complication, “the ill”. 

But in a case with Corona-19 raging through our country, I’ve put myself into total isolation since I was released from the hospital earlier this year. I can’t take a chance of being infected with this virus as the damage could and probably will do is kill me. In the past I have been very susceptible to viruses and had my fair share, more than once: Avian Influenza (H5N1), Swine flu (H1N1), Influenza A and B, all causing severe damage to my lungs- I can no longer afford.

In fact I am still trying to recover from my last few hospital admissions and they were almost three months ago. This isn’t how I imagined living my life- did any of us? I need these precautions, I didn’t go through two double lung transplants, complicated by the fear of some irresponsible individual spreading a virus that could be harmless to themselves, while lifetaking to myself. So at this time I am living in total isolation.

I first heard about SARs COV2 in the beginning of December 2019, as I was in the hospital with a lung infection. After coming across this article I warned my mom and friends that this virus would turn into something huge. It did take some time for the world to experience what was at China’s front door; we have become neighbours in battling and containing COVID-19.

Living as the “Fly” it is easy to be dismissed as a group of people you don’t know much about nor are visually not recognizable. I have been immunocompromised all my life due to living with cystic fibrosis (CF). This became more serious after my first lung transplant in March 2002, because of my disease my lungs lost their ability to function so much so that I had to depend on someone else’s life to end for mine to continue and begin all over again.  But living with Cystic Fibrosis Related Diabetes (CFRD) also causes an immunocompromised issue. Making me a “HIGH RISK” person.

DIFFERENCE OF COVID-19 AND CORONAVIRUS

You have probably heard Coronavirus, SARs COV2 and COVID-19 used a lot lately and are wonder if they are the same thing, what’s the differences and where did they get the names from. So let’s clear this up.

920x500_covid19_2d_microscopy

Coronaviruses contain different strains of viruses, such as COVID-19, the common cold, SARs and MERs.  When visioning Coronaviruses under a microscope they look like little crown like spikes on their surface. This is also where the Coronavirus gets its name from the Latin corona, meaning “crown” or “wreath”, also The Sun’s Corona, “A Fiery Halo”. When looking at the coronavirus you will see what looks like a fiery halo covered in these frown spike like pins.

The virus called SARs COV2; however, once it enters a human it is called COVID-19.  The virus causes more symptoms and has more tricks up its sleeve making it harder to fight off, with it’s different genetics and properties signs of what we’re going to be looking for if you’ve been incontact or been infected with are:

-High temperature: average body temp is 36.5C-37C temperature should be checked if hot on forehead, chest or upper back area.

Flu like symptoms: sore throat, coughing and fatigue.

Shortness of breath 

Dry cough

Some may also experience

-Aches and pain

-Nasal congestion

-Runny nose

-Headache

If experiencing these symptoms you should self isolate and contact your doctor, failing that call the designated helpline for your area regarding COVID-19 screening. It is also recommended to wear a facemask if experiencing symptoms. 

Please avoid just showing up at hospital emergencies unless instructed as the hospitals are becoming overpopulated. There are still other health issues happening, heart attacks, strokes, babies. Unless you hare having issues with; mental health, breathing and heart issues, can’t hold down any food or water, increase in sleeplessness, heart attack like signs or any extreme health issues try to refrain from going. 

Everyone should begin going to CDC.gov or Who.int website, and check with the local public health information page to remain up to date.

BACTERIA VS VIRUSES

Bacteria is a living organism that has its own self contained system for eating and using up energy, they’re a lot like human life forms. They are microscopic, and as long as food and water are available, can replicate by themselves. It’s -single celled, and can be found everywhere. They can be dangerous, such as when they cause infection, or beneficial, as in the process of fermentation (beer and wine) and that of decomposition. Examples of bacterias include: E Coli, Dysentery/ The Runs, Hemolytic syndrome, TB, and Pneumonia.

Viruses are much smaller than bacteria and aren’t considered, by most scientists, to be a living organism because they don’t make their own energy, a virus isn’t able to replicate without a host. Viruses go into living cells to make more viruses. Think of them as tiny little machines that exist to do one thing, that is too hijacking a host. They can infect all types of life forms, from animals and plants to micro-organisms, including bacteria and archaea. Both bacteria and viruses can survive on surfaces, but as long as there are nutrients for the bacteria to live off of they will live longer. Some viruses can live on surfaces longer than others.

Example: HIV can’t live on surfaces longer than a matter of seconds but COVID-19 can live on surfaces for about nine days. Examples of a virus included: Flu, Chicken-pox, Polio and Coronaviruses

WHAT WOULD HAPPEN IN THE LIKELIHOOD I GET COVID-19

In my case right now if I contacted COVID-19, I would become the one in six people who get COVID-19 that become seriously ill and develop difficulty breathing and likely would die. Patients that are affected by the virus can drop/lose up to 20-30% of their lung function, I currently don’t even have 20-30% lung function on a good day. 

There is a lot more at stake for transplant patients like myself. People don’t always understand that what gives the sniffles to them, could potentially kill me. Living with a transplant is always about keeping a balance between rejection and infection. I need to take enough of my medication to prevent organ rejection. But I can’t take too much of this medication because that would leave a higher risk of getting infections. If you looked at me during these 18 years you would have no idea I am still immunocompromised. Leaving me open to higher risk of infections, in fact I’ve contacted my fair share of viruses crossing from H1N1, H5N1 and multiple times of Influenza A & B never fully recovering each time. During each of my transplants there have also been outbreaks of SARs (2002), and my second transplant during swine flu (2009-2010). Making me well aware of the stakes that these viruses pose to high risk people. 

Immunocompromised individuals are people that have gone through battles with their health issues and continue to do so, these people have survived. These people consist of transplant recipients, cancer patients, autoimmune diseases, HIV and more. We are all not hidden away in our homes and hospitals despite popular beliefs, we go to battle against these diseases and continue to every day. For this reason, we try to live everyday lives and enjoy what we have left and live more at ease. Many of us work, go to school, and have families, errands to run, work to be on time for, educational goals to pursue and life events to attend just like anyone else. Our body defenses are always on the prowl for germs and other foreign organisms, leaving us always on the alert for someone near or far, sneezing/coughing or even touching/brushing up on surfaces. Everyday I pay further attention to where germs live avoiding potential infections or viruses as if my life depends on it; because it actually does actually does though. Living with cystic fibrosis, CFRD and being a lung transplant recipient these kinds of attacks from bacteria, or viruses usually mean spending more than my share of my life inside a hospital. Never recovering back to the same baseline. 

One difficulty of COVID-19 is it’s carriers can be asymptomatic as well as symptomatic, making it difficult to be contained and bringing the importance of the recommended volunteer self isolation.

Asymptomatic infection: Which means that the person can have the ‘germ’ in their body, but they don’t have any symptoms or they have very mild symptoms and don’t present as ill. The particular “germ” can be transmitted by coughing or sneezing, for example, and the person may transmit the infection to someone else without knowing it and without having any symptoms themselves. 

Symptomatic infections: The subject becomes symptomatic; in other words, feeling the symptoms which can also be transmitted from person to person. As for viruses that cause colds, people can in fact transmit these viruses with mild or minimal symptoms themselves. In this case, they’re considered asymptomatic carriers still. They usually don’t have the virus in their system for a prolonged period of time, though.

CLEANING COVID-19

COVID-19 is spread from respiratory droplets, eg: liquid that comes out of your lungs, and something that you may not necessarily see. It’s spread through coughing, sneezing and talking out loud. As these particles spread out and land on surfaces, getting picked up by others in close contact, up to 6’ radius can be infected due to these respiratory droplets, which is why it’s really vital to keep cleaning surfaces and hands where people are coughing, sneezing and brushing up, as people can be asystematic from the virus not knowing what they are spreading. 

I’ve been told that most store locations have been sold out of hand sanitizer and Lysol wipes but there has been plenty of soap and spray Lysol cans left. Please keep in mind that hand sanitizer will clean your hands but soap is more effective against COVID-19 than hand sanitizer. Hand sanitizer is just more convenient as you can take it with you making it more portable where running water and soap is not accessible and that Lysol in a spray bottle is just as effective as the wipes. Although Antibacterial wipes will kill most bacterial cells and some viruses living on surfaces. COVID-19 cells scream and cry when it comes to soap or high percentage rates of alcohol higher than 70%. NO your typical drinking alcohol is NOT strong enough to kill viruses/bacteria, the alcohol percentage count needs to be at least or higher than 70%.  As well, antibacterial wipes, Lysol and soap will kill surfaces with COVID-19, but some viruses can live against antibacterial wipes that have some sort of antibiotic properties that will only work on bacterial surfaces and not viruses. So stick to the Lysol and Soap when cleaning. 

Please remember to wash hands for 20 seconds more often than you normally would, whenever you’re in and out of your home/ clean high touch surface areas, keyboard, phone, remote controls, and try to prevent touching your face.

 

HOW I DEAL WITH “GERMS” AND “THE PUBLIC”

I’ve learned to second guess everything and need to act as if nothing in the public is clean, if it helps imagine that everything is covered with “shit”, which is how I think it. After receiving a lung transplant at the age of 16 in 2002, I’ve always needed to take in hand extra precautions to prevent getting sick. As to the everyday public I look like a “normal” individual or you can look at it as an invisible illness.

I avoid large gatherings and learn to shop or go out during off peak times, when it is less crowded and gives myself more space to breathe freely. If I can, I try to avoid public transit and if I must take it, clothing becomes my skin, I use my sleeves in the summer and gloves in the winter to hold onto anything that could possibly be a feeding ground for germs.  I try to sit or stand near a vent or opened windows allowing air movement, but mostly I will drive myself or take an uber avoiding close contact with unknown crowds. While flying I travel with a mask, wipe down my area and keep my hands in my pockets to prevent me from touching anything in public as well my face. But mostly I try to avoid those situations as much as possible. I wash my hands all the time, as well as when posible am very particular where I eat and when possible watch when my food is being prepared. I try to spend limited interaction with toddlers/ kids as they are huge carriers for spreading germs. Kids are like drunk frat party buses full of college spring breakers but instead of drunk they’re covered in germs. Yeah no thank you, keep those runny noses, goopy eyes, airborne sneezes/ coughs away no matter how cute you may think your child is, they’re a breeding ground for some kind of infection/virus to me. I chose my life over a playdate.  Hand washing becomes a thing as if it’s cool, don’t forget your thumbs. And if not hand sanitizer is your sidekick. You learn to act as if every day is the cold/ flu season when out in public.

Think of it this way, how most of you are feeling or fearing from COVID-19 is an everyday life for me due to living with CF and being an organ recipient.  

As of March, 11. 2020 the WHO announced a pandemic against SARs COV2/ COVID-19 

DIFFERENCE BETWEEN PANDEMIC, EPIDEMIC AND OUTBREAK

OUTBREAK

Small, but unusual. By tracking diseases over time and geography, epidemiologists learn to predict how many cases of an illness should normally happen within a defined period of time, place and population. An outbreak is a noticeable, often small, increase over the expected number of cases. Imagine an unusual spike in the number of children with diarrhea at a daycare. One or two sick kids might be normal in a typical week, but if 15 children in a daycare come down with diarrhea all at once, that is an outbreak. When a new disease emerges, outbreaks are more noticeable since the anticipated number of illnesses caused by that disease was zero. An example is the cluster of pneumonia cases that sprung up unexpectedly among market-goers in Wuhan, China. Public health officials now know the spike in pneumonia cases there constituted an outbreak of a new type of coronavirus, now named SARS-CoV-2. As soon as local health authorities detect an outbreak, they start an investigation to determine exactly who is affected and how many have the disease. They use that information to figure out how best to contain the outbreak and prevent additional illness.

EPIDEMIC

Bigger and spreading. An epidemic is an outbreak over a larger geographic area. When people in places outside of Wuhan began testing positive for infection with SARS-CoV-2 (which causes the disease known as COVID-19), epidemiologists knew the outbreak was spreading, a likely sign that containment efforts were insufficient or came too late. This was not unexpected, given that no treatment or vaccine is yet available. But widespread cases of COVID-19 across China meant that the Wuhan outbreak had grown to an epidemic.

PANDEMIC

International and out of control in the most classical sense, once an epidemic spreads to multiple countries or regions of the world, it is considered a pandemic. However, some epidemiologists classify a situation as a pandemic only once the disease is sustained in some of the newly affected regions through local transmission.

To illustrate, a sick traveler with COVID-19 who returns to the U.S. from China doesn’t make a pandemic, but once they infect a few family members or friends, there’s some debate. If new local outbreaks ensue, epidemiologists will agree that efforts to control global spread have failed and refer to the emerging situation as a pandemic.

HOW CONTAGIOUS IS COVID-19

A contagious rate is based off of something called a R0 pronounced (R-nought) rating. When a new disease emerges, health organizations turn to a number to gauge whether the outbreak will spread. It’s called the basic reproduction number. R0, and through useful for decision makers, it’s a nightmare for public communication. In brief, R0 is the average number of people who will catch the disease from a single infected person, in a population that’s never seen the disease before. If R0 is 3, then on average every case will create three new cases. But even though it seems incredibly straightforward, it’s hard to calculate and tricky to interpret.
R0 is important because if it’s greater than 1, the infection will probably keep spreading, and if it’s less than 1, the outbreak will likely peter out. So it offers vital information to organizations and nations as they consider how to respond to an outbreak, such as the one the world is currently experiencing.

On average COVID-19 has a R0 of 1.4-4.8 when not in isolation. Meaning that 1.4-4.8 people will be infected when in contact, SARs in 2002-2003 had a R0 of 1-272. Whereas something like Measles has a R0 of 12-18. The difference of SARs was that symptoms were quicker to develop (2-7 days), whereas COVID-19 symptoms can take up to at least 5-10 days to see or feel any symptoms. That’s why it is asked to self isolate when traveling across borders or if you come in contact with someone that is infected.

At this time we don’t know when the slowdown of contamination COVID-19 will be as SARs eventually slowed down. A Good job of containing this outbreak is going to look like we overreacted. Because the situation didn’t get too bad, one way of containing this outbreak is “contact tracing” to see how and where someone has been or interacted with if it is found out they’ve been infected with COVID-19. It helps to monitor as well contact people that would have been in close proximity and make it a possibility to warn those to look out for symptoms and to self isolate. This method is used with measles, STIs and more. It’s important to move fast as it’s important to stay on top of people that are infected and have others tested. Travel bans are good and bad at the same time, they are good as they prevent people from bringing in the virus but there are still going to be people that will slip out and lie about it if question making “contact tracing” failing to inform others.

It is important to be educated about the virus, allowing people to know how the virus is spread, what are the symptoms and how to avoid/ prevent contamination. 

No, a flu shot is not going to save you from getting COVID-19 because they are only for an estimated strain of influenza vaccines designed for very specific strains of viruses.

It is also important to know that vaccines and antibiotics are very different. Where antibiotics work towards fighting off bacteria only. But don’t think a flu shot is useless in this time of COVID-19. It’s important for flu shot as it is less likely to get the flu making it easier to filter out the flu over COVID-19.

A COVID-19 “Vaccine” is not available at this time and will take time for production, dispencement and test to see if it’s safe in humans. So it is important we do everything possible at containing COVID-19. As there has been more community cross contamination of the virus in the US.

More people have gotten the virus in the US than from overseas contact, also currently more people have gotten the virus from traveling to Egypt and Italy then traveling to China and South Korea combined all based on documented cases. 

Resulting in higher spike numbers of contamination and a higher curve on the charts.

You probably keep hearing we need to “Flattening the curve” and this is so true. It is so important if we want to contain this virus as “flattening the curve” will help slow down the access to the health care system, it’s the difference between a mob entering or a few people entering a building at once. We can’t overcrowd our health care centers or workers as they only can manage so many people at once and have limited equipment that is accessible. These health centers still need to attend to other health issues that need to be taken care of.


The short animated video by Juan Delcan and Valentina Izaguirre, husband-and-wife team shows a row of matchsticks lined up like dominos. Breaking the chain stopps the blaze, much the way that social distancing will keep more people from catching COVID-19.

THINK ABOUT OTHERS

Take time to think about all the people that will be harder hit from COVID-19 due to not social distancing/self isolating. If you can work from home and still get paid, do so. Also think about your community, as schools close, kids’ food programs shutting down become hungry/ donate to food banks, don’t forget that the blood banks still need blood so if you’re healthy donate. If you’re young and healthy see if there are “at risk people” in your neighbourhood that could use help ie: getting groceries, drugs, running small errands. So they don’t have the risk of going out and becoming infected. 

You no longer are required to provide a doctor’s note if you are sick. We need people to self isolate in order to help flatten the curve. In the last week the protocols have increased rapidly. All restaurants, bars, cinemas, tourist attractions, concerts, day cares, have closed. Coffee shops are only for pick-up, grocery stores are allowing on-line shopping and drive through pick-up. Senior shopping hours are being offered to reduce the risk of close contact.

We all have to be vigilant– there is no time to waste. The news sadly has reported that several seniors and long care homes have cases of COVID-19. As much as you love your aged parents, visits are now dangerous. Face-timing, outside window encounters should now be the new for of communication. Although this will cause stress and unhappiness, we need to focus on the short term in order to appreciate the long term results.

Around 1.4 million people who are most at risk from coronavirus will be told to ‘stop all social contact’ from Monday (March, 23.2020) in the US. Mr. Hancock said people including cancer patients and severe asthma sufferers should “take themselves away from all social contact from Monday onwards for 12 weeks”. At present, anyone with an underlying health condition such as those who usually receive an NHS flu jab, people with weakened immune systems and anyone over 70 is told to be “particularly stringent in following social distancing measures”. The group includes those with particular underlying health conditions, who are most vulnerable to getting complications from Covid-19, and is not defined by age.

It includes:

-People with cancer who are undergoing active chemotherapy or radiotherapy

-People with cancers of the blood or bone marrow such as leukaemia who are at any stage of treatment

-People with severe chest conditions such as cystic fibrosis or severe asthma (requiring hospital admissions or courses of steroid tablets)

-People with severe diseases of body systems, such as severe kidney disease (dialysis)

-People who have received an organ transplant and remain on ongoing immunosuppression medication.

The request in some countries and mandatory self distancing/ isolation isn’t just for your safety and health it’s also for the high risk group. If we don’t comply with social distancing/ Isolating, the longer we’re going to have to keep practicing this. It may be a request for some, but for others it is a necessity for survival. 

Quite a few people that are immune suppressed are on a fixed income and can’t afford a doomsday shopping, or the energy. These are the individuals that need to be reached out to. Call them, shop for them, make some meals, we will get through this keeping kindness in mind. This is a time to not panic but be considerate.  While shopping take only what you need, think of others, I have no idea where all the toilet paper has gone. Call your family and friends, check up on them. We are all in this together

MENTAL HEALTH

Naturally people are feeling anxious and fearful. Covid-19 has totally rearranged our world. We are now in unchartered country and it can be terrifying. Thousands have been laid-off, business’ have closed, financial fears have escalated especially with the critical drop in the stock market.

As most have been asked to self isolate loneliness will begin to set in as self isolation can feel that way. The virus may be a global threat but keep in mind majority people won’t be seriously threatened. 

Some will even feel the effects of “Ruminating” while being isolated. We need to learn how to function in a new un-normal. To combat this; turn off push notifications from news sites, limit the amount of news listened to, watched or read. If causing a negative effect pick a couple times a day to be updated on what you may need to know regarding the virus. Studies show that people feel best in the morning and then gradually taper off through the day. Consider making it a breakfast time routine to follow up on. 

Go “outside” meaning low density population areas eg: your own yard, hiking trails that have little to no traffic, low risk areas to spread and transmit the virus. Remember to wash your hands when getting home, even a shower won’t hurt. 

At the moment we need to self isolate from everyone outside of our family that we live with. No play dates, no coffee moments, no get together with friends. We need to be vigilant otherwise the consequences will be catastrophic. It is important that you don’t cut yourself off entirely, we’re in the era of technology, use it to your advantage: face timing, skype, have a virtual group game night. Try to focusing on small positive thoughts, keeping a healthy mental state in times like these are crucial, take care of yourself and practice positive personal care during these times.

HOW I FEEL ABOUT COVID-19

For the past few months I have been watching, feeling fearful yet telling myself to keep calm, as those tiny red dots on the map of the world cases began to multiply, getting bigger and covering more ground.

It has caused more concern in my life, as well making difficulty due to the need to halt most hospital/tests appointments for my transplant assessment. There is also fear, I can’t afford contacting this virus. My current health is already difficult to deal with at this time. There is no more room for me to jeopardize with my lung function. As I said before because of my disease my lungs lost their ability to function so much so that I had to depend on someone else’s life to end for mine to continue and begin all over again not once but twice, I’ve never wanted to put these gifts I’ve received to waste. Living in a bubble lifestyle is very self limiting. Undergoing a transplant meant avoiding the need to live a life in a “sterile bubble” to stay healthy.

I can take the precautions public health officials are advising, I listen to what health care providers are saying about how to avoid exposure to COVID-19. I can’t always avoid other people naive/irresponsible, complete disregard for others, or lack of proper hygiene. Some may think I’m being over dramatic because I may be young but I am not considered healthy. Besides maybe keeping hand sanitizer near or remembering a yearly flu shot, you probably move through life without much alarm that you’re surrounded by germs all the time. You have the peace of mind of knowing that your immune system will help keep you healthy or at least protect from getting too sick. Not myself nor the high risk people, infact how the general public fears COVID-19 is how a CF/ transplant patent, and “high risk”  feels everyday.

Just to make this point clear in case people haven’t realized it yet. The longer we don’t comply with social distancing/ Isolating the longer we’re going to have to keep practicing this. It may be a request for some, but for others it is a necessity for survival. What most of you are experiencing with the fear of COVID-19 is my everyday life, the extra planning and thinking how to complete your day without being in contact with germs. It can be difficult and mentally challenging, and fearful. But we also need to live our lives so be smart, take precautions, self isolate and most importantly wash your hands!

I am not a health expert so take my words with a grain of salt. But I have had my share of hospital life and need to stay informed with issues as such for my own health.

End of the day this is going to be a medical question as we will need a vaccine or treatment. There is a need for a drastic restructuring to our society that will rely on people changing their behavior making decisions, in the trust of everyone else around them who continues to self isolate when needed to.     

We need to collectively thank the health professionals, grocery store employees, pharmacist, scientists working on development of a vaccine, most importantly the individuals helping others and those in self isolation and practicing proper social distancing. My heart goes out to those that have contacted this virus or lost a loved one due to this virus.

REMEMBER WASH YOUR HANDS & PRACTICE SAFE SOCIAL DISTANCING/SELF ISOLATION

“Normal is nothing more than a cycle on the washing machine.”

One Comment on “Immunocompromised Vs COVID-19

  1. Thank you for this post Dan, thinking of you and others for whom this virus is what more than asocial nuisance – will promise to do everything we can to try and promote social distancing, staying home and for gads sake was you f’ing hands!!! Stay safe my friend xx Frankennurse

    Liked by 1 person

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