Wednesday, December 2, 2020

When strong young people get COVID19 - twice

This post is by Chelsea Chisholm. I (Andrew) saw it on Facebook and felt it had important implications for us all. Hence, I asked Chelsea if we could tweak it for the blog.

This is a post I wrote on social media in order to try to address the rampant misinformation that I saw spreading throughout my networks back home in Canada. Full disclaimer- I'm not a disease expert, I'm a postdoc working in the domain of ecology and evolution based in Switzerland. This post was never meant as a commentary on research around Covid. It was meant to provide a personal example of my experience with Covid after being in one of the worst-hit zones in Europe two times now. The audience was people I know, particularly young people who are excellent at both ignoring health advice and being vectors for the pandemic. I hoped it would cut through the lies and confusion and convince a few people to start taking precautions while providing them with some resources they could look to for information. As far as Facebook rants go it's a long one. Nevertheless, I have had nothing but calm and generally positive comments in response, even from people who had previously posted conspiracy theories about this pandemic. So for once social media doesn't suck.

Covid update 2.0: Masks & Small Gatherings

This post was initially aimed towards my friends and family back in Canada, as I see a lot of confusion and anger running riot on social media back home. For those of you who don't know, Michael (my husband) and I contracted Covid back in February/early March. I wrote a social media post then, detailing what it felt like to go through it and asking people to consider others' safety during the pandemic. I experienced some fever and chest pain, which disappeared after a week. Michael had only a slight dry cough, but soon after developed a case of pericarditis, or inflammation of the pericardium, the sack that surrounds the heart. He spent a month with chest pain akin to a mild heart attack, a lot of this time in bed, and was then put on strict orders not to stress his heart for another four months after his inflammation kept returning. Our doctor's main concern was that he would develop myocarditis, an inflammation of the muscle of the heart which can cause permanent damage. We slow biked our way through spring and luckily his heart healed. Michael ran an ironman in September after his recovery. I say this not to show that you can bounce back from Covid, but simply to point out that the man was fit. He was not in an at-risk group for Covid. He had no pre-existing conditions. He was 34.

Fast forward 7 months to October. Throughout the summer Michael and I needed to socially distance as much as possible to prevent catching another cold or flu that could trigger his pericarditis. But as he started to feel better, and as the summer had seen such low case numbers in our region, we made the decision to start seeing a few more people. This was around the time that weather was cooling off, sending more people indoors and cases skyrocketing, so I would say this was a poor decision on our part. Keep in mind that "seeing a few more people" meant expanding our bubble from ~2 to 6. Because a few of those extra people were not limiting their interactions with others, our bubble actually went from 2 to many, and they showed up for dinner at our place infectious (but not yet showing symptoms). We caught Covid again, and for those of you who are wondering, it was not easier the second time around. Michael had a raging fever, was in bed for a week, and after eight weeks now his smell and taste are still gone. His heart rate has been all over the place, making normal things like a short run difficult. And as for me, I was diagnosed with pericarditis, the same thing Michael had during our Covid 1.0. I've been told to lay off strenuous exercise for 6 months and I've yet to go for more than a short walk/run since my diagnosis 8 weeks ago (it still hurts, and simple things like walking uphill are physically exhausting).

Cases this past week in Switzerland were in the top five worst in the world per capita, and we've now entered a second (soft) lockdown. Doctors will start triaging patients, choosing who gets to have an ICU bed and who is sent home because there simply isn't enough space. My family doctor has had to move to the hospital to assist the ICU doctors. This is in one of the richest countries, with one of the best medical systems, in the world. I've watched debates around the pandemic rage back and forth in Canada. It's the same thing that happened here and continues to happen through the lockdown. Cases are rising steadily in Canada, just as they did here. The funny thing about exponential growth is that things seem under control until they are not. It will get much worse in the coming weeks. I am not a medical doctor, but I am a scientist, and the stuff I do know a little about, the data, is troubling. I'm going to ignore the usual arguments, that this is the same as the flu (it is definitively not) and that it only affects the elderly (sorry grandparents?), and focus on the demographic that seem to vocalise the most around the pandemic. Studies vary but thus far suggest that 5-10% of people aged 18-50 who contract coronavirus will suffer long-term symptoms. This ignores other categories of people who are more at risk due to pre-existing conditions or age, in which case the probability would be higher. You might look at that and say that's quite a low risk. Think of it this way. If cases continue to rise, as they did in Switzerland, one or two (young) people who catch Covid out of every twenty are likely to experience long-term symptoms. That means someone in your friend group, a few people in your family, a few people at work. We've seen this happen already as a lot of our work colleagues and friends have been laid out with Covid, with some still not back to work or working at half capacity. A few of these people may even go on to have permanent damage that they will have to live with for the rest of their lives. It could be us. We don't know, and that's even scarier.

From what I read online, people are upset about the infringement on their rights and freedoms, either through the cancellation of social activities or the requirement to wear a mask inside. The worst is when I see people calling the pandemic a hoax. I don't want to get in a screaming match over social media, I've seen enough of that already, and honestly, it's heartbreaking (no pun intended). For those of you who have questions about what Covid is like, or whether it is real, or whether it is indeed worse than the flu (yes), I'd be happy to talk about our own personal experiences, if only to put a face to this. I am also happy to share resources about what measures appear to be working to reduce spread (see the bottom of this post).

The pandemic is hard, and some of us are luckier than others, as I'm sure a lot of struggling small business owners will attest. But I would say almost all of us reading this post are pretty well off compared to the rest of the world. We have access to medicine or live in a place where self-isolating is possible. And many of us are being asked to do our part through very simple actions, like limiting our gatherings and wearing a mask to the grocery store so that elderly people can feel more safe shopping for food. While masks are not 100% effective (neither is birth control, I might add), they help to reduce the risk of spreading the virus from you to others. These things are not that hard, and are the least we can do to help reduce the load on the many doctors and nurses who are working tirelessly to save others during this time.

And if this feels like too big of an ask, I'd suggest reflecting on how good you must have it, that wearing a mask in a store is your biggest hurdle in life right now...


For those of you who want resources, here's an excellent graphic on how masks can work to reduce spread:

Here's a dashboard created by Nat Geo which does a really nice job of illustrating your risk of Covid in different environments (public transport, bars, restaurants, etc.). This shows that mask-wearing during your day to day (transport, shopping) can really help to protect you and others. It also shows that the longer you are in a room with someone (public/private gatherings), the more likely you are to catch it, even if everyone is wearing masks, so limiting indoor gatherings is really important.

A recent paper that suggests limiting small gatherings, shutting schools and increasing availability of PPE are the most effective measures that governments have taken thus far to reduce the spread of the virus.

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