Maintaining social distance and voluntarily quarantining yourself is part self-interest, part altruism. As the coronavirus pandemic continues to spread, the lives it is claiming are not always, generally speaking, young and healthy ones. People have been told repeatedly that their efforts to stay well or stay well away from others will not only benefit them, but protect the lives of the more vulnerable people around them, like older adults and people with serious, long-term health challenges. For those vulnerable populations, self-isolating is doubly vital.
Trouble is, for many people with preexisting medical conditions, holing up at home isn’t an option. If they’re in the middle of a course of chemotherapy or due for a liver transplant or even just pregnant, doctor’s visits can’t be postponed indefinitely. Instead, their medical needs will draw them straight to where they are most likely to encounter a person suffering from Covid-19: the hospital. Understandably, people are worried, especially now that hospitals are looking at canceling nonemergency surgeries and setting up makeshift respiratory units.
Like much of the internet, Facebook groups and subreddits for people with serious medical conditions are buzzing with coronavirus concerns, but with an urgency that is considerably more concrete and specific. One question dominates all forums: What am I supposed to do? With medical—and governmental—guidance in short supply worldwide, most people are doing what everyone else is: talking about it, looking for answers. Some cling tight to their mantras about washing their hands and avoiding travel.
Some bemoan their doctors’ vagueness. Some crack dark jokes. “I’m not particularly worried,” one Reddit user writes on r/cancer. “If I die a horrible death from coronavirus, that means I'll avoid a horrible death from cancer.
Kind of a lateral move, there. ” Some just want to commiserate. Fear is spreading fast. Nearly all of the concerned people who spoke to WIRED said they’ve only grown more anxious in the past week, as countries like Italy have gone on lockdown and the number of coronavirus cases worldwide has surpassed 125,000.
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“I dismissed the news and the projections for the first month or so. I read encouraging information about there being little chance of vertical transmission from infected mother to newborn, so I tried to put it out of my mind,” says Lindsay Vranizan, a pregnant woman living in New York City. ”It was when I started to grasp the impact this could have on the health care system that I started to get distressed. ” As that system reaches what experts call surge capacity, hospitals could very well run out of beds, so for Vranizan, her two biggest worries are where she’ll be able to deliver and what her newborn might be exposed to.
Others, like B, a 24-year-old terminal cancer patient in Yorkshire, and Thom Greene, who lives in London and is on immunosuppressants for a kidney transplant, are facing the fact that they’re in less-talked-about vulnerable groups. Because much of the news about Covid-19 has focused on its impacts on people over 60 and those with conditions like heart disease or lung disease, susceptible young people with illnesses that may not be visible or obvious to others are often put in compromised positions, even by their peers. “I'm 34, which isn't old, and I feel like people aren't getting the fact that I am at risk,” Greene says. “I worry that people aren't taking precautions because they themselves are likely to be fine.
” Read all of our coronavirus coverage here. Because of their concerns, Greene and others are avoiding public places, but especially hospitals and doctor’s offices, often at their own risk. “I am in end-stage liver failure due to stage four cirrhosis and primary biliary cirrhosis and am waiting for transplant,” says AK, who lives in the United States and, like many people WIRED spoke to for this story, asked not to be identified. “I have to have monthly blood work done to monitor my condition, and I haven't gotten it done in either February or March because I'm worried about going to any medical facility.
” Is that risky? Absolutely. But so is going to the doctor.
““I've been told to self-quarantine.”
I'm anemic due to my condition and already have issues getting enough oxygen to my organs,” AK says. “Catching any virus or bacteria that could potentially inhibit my ability to receive oxygen could be disastrous. ” AK is trapped between two potentially deadly gambles. Even for people whose treatment has yet to be directly impacted by the spread of coronavirus, simple hospital logistics are a looming threat, especially after reports of doctors being forced to make heartbreaking triage decisions in Italy.
“I know that if I caught the virus, I would likely require hospital assistance in order to survive it. I also know that I would be considered a patient not worth saving, due to my illness, and a doctor might refuse to save my life,” says B. “I understand the logic behind these choices, but as someone who might only have a year left to live, it is extremely scary to know that I might lose even that one precious year. ” B is currently unable to avoid hospital visits and has resorted to using hand sanitizer every five minutes while there.
“People around me were coughing, and I don’t have a face mask,” B says. Hospitals and doctors are doing what they can to allay these fears, but it’s difficult to give definite answers or solutions in the face of projections and hypotheticals. “At the moment, I am really confused about [how to go] about my life,” says Greene, who has had trouble even getting hold of a doctor. Nearly everyone’s care team gave vulnerable patients the same advice they would anyone, with a few caveats.
“All of my transplant professionals tell me the same thing,” says Brooke Thomas, a heart transplant recipient in Florida who is on immunosuppressants. “’If you develop a cough, come to the hospital. Otherwise operate as normal. ’" For all of these patients, online communities have offered solace, to a point.
“[r/Transplant] is the only community I can relate to online really,” says Greene. “Whilst it’s helpful to some extent, it is still all very confusing. ” Others echoed Greene’s sentiment. “A few months ago I was asking people roughly how many shoe sizes I could expect to go up,” Vranizan says of the pregnancy-focused online communities she participates in.
“Now I go to those same sites to commiserate with people feeling similarly overwhelmed and ill-equipped, blow off steam, maybe make a joke about the waking nightmare of it all. When it comes to this outbreak, nobody really knows a whole lot more than anyone else! ” Hospitals are working to make sure their facilities are as accessible and safe for patients as possible, whether they’re seeking care for Covid-19 or in need of some other medical treatment. “The key with keeping healthy people safe is really just ensuring that we are taking appropriate measures with those who are sick,” says Tim Pfarr, assistant communications director for the Washington State Hospital Association.
“We tell anyone who has symptoms and needs medical care to call a hospital first, to make sure they get into the hospital in a safe manner. ” Safe, in this case, means being greeted by staff wearing protective gear, and getting escorted through an entrance that is away from other patients. Many hospitals, from Mount Sinai in New York City to the Seattle Children’s Hospital, have implemented new, coronavirus-specific rules for patients and visitors, most limiting visitor numbers to just two. At Vranizan’s hospital, only partners and grandparents are permitted in the labor and delivery ward.
Some doctors are warning patients about even more serious restrictions. “My OB has already let me know that if the situation escalates and there aren't beds available, I may have to push my [scheduled induction] date back until there are beds free,” says Sarah, a pregnant woman who lives in central California. At the moment, planning and waiting and warning is all any responsible doctor can really do for people like Sarah. Their frustrations are understandable, but utterly inevitable.
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