Coronavirus and the immunocompromised – Why people who have autoimmune arthritis are at an advantage with COVID-19

For the first time in a very long time, I am at an advantage.  It was the same a few weeks ago when fire was ravaging Canberra.

Panic.  All around me people are panicking. 

People worrying about extremely unlikely scenarios and ignoring the actual likely threats.  People buying enough toilet paper to last them until 2030 but leaving non-perishable food on the shelves.  People stockpiling, selfishly emptying the shelves of the supermarkets and taking more than they could possibly need, so that people who really need toilet paper, or other daily essentials, can’t get any.

Doing everything wrong, basically.  Turns out a world-wide pandemic brings out the worst in some people.

As someone with autoimmune arthritis, I’m better off. 

Wait, shouldn’t I be worse off?  Doesn’t having autoimmune arthritis make me more susceptible to the coronavirus?  Doesn’t COVID-19 kill the elderly and the immunocompromised?

Yes.  Yes, it does.  But I am NO MORE likely to catch COVID-19 than anyone else. The problem is IF I catch the virus, I am more likely to experience the severe disease course, possibly even die.  And still I say, I am better off than the masses who are counting their toilet paper stash.

Here’s why.

People with autoimmune arthritis are not prone to panic

I am used to facing health crises.  Over the last few years I have had to deal with potentially life threatening diagnoses, co-morbidities and complications on a regular basis. 

At first, it’s hard not to panic. To not go straight to “I’m dying, HELP ME!” and run around in a flap.  But the more experience you have had with making life altering decisions about your health, the better you get at it.  You realise panicking doesn’t help and is in fact seriously counterproductive.  Anxiety gets in the way of logic, and so I have learned meditation techniques that allow me to calm myself and focus.  So that I can assess the situation logically and free of fear. 

Whether the situation is a high-risk surgery or a brand-new virus that the world has never seen before, the process is the same.  Gather all the available (science based) information, assess my risk level, assess my risk aversion, and then decide on a course of action.

For me, COVID-19 is just another situation to assess. 

Note: Everyone’s situation is different. Your location, your age, your general health, your disease severity, your co-morbidities, and the medications you are on are ALL factors that are unique to you and affect your personal risk level.

I have been watching the Wuhan virus, as it was first known, since mid-December.  When the first news stories and videos of Wuhan were hitting the internet I believed that this was the pandemic that the scientists have been warning us about for over a decade.  I figured this was serious, and I scanned the news daily, hoping I was wrong.  When China quarantined 60 million people I hoped for containment.  And the virus started hitting mainstream news, and the great Australian Toilet Paper Shortage of 2020 was born.

It’s easy to sit back and laugh at the panic merchants, but I empathise.  The toilet paper panic is a clear sign that there are a lot of frightened people out there, who for whatever reason aren’t accessing the appropriate information.  I think our government is doing an excellent job of keeping the information flowing and providing advice on what to do, and yet people are not hearing the message.  It’s a sign that the government needs to put together a public health awareness campaign and be even more clear about what the correct courses of action look like.

But more than that, there are very real problems with this kind of panic-buying behaviour.  I’m at a loss as to why people feel safer with three trolleys full of extra soft three ply in their possession, but the result is that there are a lot of people who have run out of toilet paper, and can’t buy any!  IF we extrapolate to other essential supplies, panic buying must be halted. 

On the upside, the memes hitting the intertubes are hysterical. 

When panic hits, logic goes out the window. 

When I saw what was happening in China, I decided to buy a little extra.  Since January, I have been buying a few extras at every grocery shop. Non-perishables.  Canned goods, rice, beans, some snacks…crackers, chips. Even some chocolate and lollies.  I’ve stocked the freezer.  I have paracetamol and ibuprofen and a stocked first aid kit (I had that anyway).  I have bleach and disinfectant.  Basic preparations, enough supplies in case we need to be quarantined at home for four weeks.

Back in January, family members were laughing at me, telling me I was being silly.  They’re now running out to get their supplies, picking at what’s left, while I don’t have to.

I also spread the expense of the extra supplies over 6-8 weeks, because when you live on the poverty line you can’t just splurge on a month’s worth of food.

This was what I chose to do to calm my anxiety.  I have mobility issues, and I’m recovering from major surgery.  I needed to stock the house and freezer anyway, for the surgery recovery. I just bought a few more things in case there’s an outbreak in my part of the world, and it makes me feel more in control, and less concerned.  My kids are both highly anxious and I explained it to them the same way. They both feel more comfortable knowing we don’t have to leave the house for four weeks if the shit hits.

I didn’t buy anything that I wouldn’t normally buy.  If we never need to isolate, then we will just use the extra groceries up over coming months.  They are all non-perishable.

I feel better knowing that if there is person-to-person spread in my little part of the world, then I am ready. I do not have to go out into the community, and we are easily able to stay home and I will not have to contact anyone who has the virus.

Having said that, I have NOT been panic-buying. I have not bought ridiculous amounts of food. I have not emptied the shelves and prevented other people from preparing their own pantries.  While we’re looking after ourselves, we have to still look out for others as well.

I watch the news daily and keep up with the numbers.  Where I am in the world right now, Canberra, Australia, the panic and the fear (and the fear mongering) are much more harmful than the virus itself.  As of today, there has only been one case in the ACT and that case was detected many days ago.  There have been no further cases, and there is no evidence of community spread in my little part of the world.  We are very safe here right now. But the situation changes daily.

2. I am very health literate

I spend a lot of time with doctors, talking about health. I’m familiar with the terminology, I know how the health system works, I know Australia has no surge capacity and why we need to slow the spread of COVID-19.  I know what SARs is, I know about the yearly flu risk and I know what a coronavirus is.  I know what COVID-19 does to the human body, how it progresses, and I know what pneumonia is.  I know there’s no vaccine and there won’t be for at least a year. I know my personal risk is higher than most due to my immunosuppressant mediations, and I know how to protect myself should there be an outbreak close to me.

I read lots of doctors’ blogs and websites aimed at medical professionals.  I speak ‘doctor’ and I can interpret the information without having to google too many big words. 

The average person sees a doctor once every few years and doesn’t have the same level of health literacy.   Toilet paper hoarding is a clear sign that people who are less informed are scared and need to be informed and reassured.  Hopefully a public health campaign will fill in some gaps and calm the stock-piling.

I’m used to practicing infection control

The advice for preventing infection with COVID-19 (or anything else) is to:

• Wash hands frequently for at least 20 seconds with soap or hand sanitizer.
• Sneeze and cough into tissues or your elbow.  Throw away any tissues immediately, and wash your hands right away.
• Don’t touch your eyes, nose and mouth with your hands.
• Clean and disinfect surfaces regularly.
• Stay home if you are sick to avoid infecting others.
• Practice social isolation if there is an outbreak in your area.
• Protect those who are at highest risk of getting sick (aged and infirm, immunocompromised people).

This is the standard advice that we all heed every flu season.  As someone who has been immunocompromised for well over a decade, I’m very used to practicing good infection control.  This is just normal for me.  I don’t have to change much of anything.

I’m used to being house bound

I have been mostly housebound for two years.  I’m watching people complain about not being able to go out, and having events cancelled that they wanted to go to. And they just seem a little petty to me.  A lot of people still think that the novel coronavirus is a media beat up, and nothing to really worry about, which blows my mind.  Given that attitude, they are very unhappy about mass gatherings of more than 500 people being banned. They are annoyed at concerts and Grand Prix and fireworks being cancelled.  They’re flapping about and getting pissy because the idea of being shut in at home is very unappealing to them.

Whelp. Welcome to my world.  I’m used to being at home. I’m used to being alone. I’m used to being socially isolated. I’ve learned to survive and thrive with just my own company.  I’m not at all worried about staying home for a month and having no social contact.  That’s just game on for me.  And social distancing is just fine as well.

So I guess COVID-19 isn’t as big a deal for me as it is for a lot of people, in terms of changing my daily routine to avoid catching it.  The changes make sense to me, and many of the recommendations are business as usual for me.

I am concerned though.  I am doing everything I can to avoid COVID-19 because if I DO catch it, I could be one of the fatalities.  Which means I’m very motivated to keep practicing infection control and social isolation. And I’m very motivated to convince others to take the coronavirus seriously as well.