Shielding, But Not Shielded

The number of cases in Coronavirus has jumped by 48 in the last day. This is the highest increase of cases since 23 May.

Shielding may be officially paused since 31 July, I’m continuing to shield as a personal choice, and I want to tell you a bit about the considerations that brings.

Everything my medical team have told me suggests I continue to be at extremely high risk, and given that I spent last autumn/winter constantly in and out of hospital with fevers whose cause we never actually traced tells me I do not want to do anything that forces us to go through that again.

This was supposed to be a good time, and technically, medically, it is. We dealt with the strictures. The Ustekinumab is working probably as well as we can expect it to. I will never get this time back to use the way I was supposed to. I don’t feel good about that. But everything I have read about how Covid-19 works means I’m not prepared to expose myself to other people’s risks.

Autumn/winter really left a mark on me. When I feel cold, I have to ask Remco if he’s shivery too, because I’m still expecting that old thing, whatever it was, to come back. Not knowing what it was means we also don’t know if it ever cleared, or if it’s just lying dormant, quiet only because we stopped using the Hickman line for TPN. I’m lucky I’ve been able, so far, to get away with that.

But the line itself is still in my chest (contributing to my vulnerability re: Covid), because the pandemic hit before we could arrange removal. No reason to think I’ll get rid of it any time soon, because the backlog of ordinary hospital business is now vast. People much sicker than me are being told the surgery they now desperately need won’t happen until next year. The IF team, from what I’ve been told, is holding its breath.

A couple of weeks ago I was lucky enough to get emergency dental treatment, and the trip to the dentist (a five minute car ride up the road, and the furthest I’d been since mid-March) was very revealing. I’d heard local taxis could provide a taxi with a screen between you and the driver on request. Well, it turned out the screen was badly fitted, leaving about an inch of space between me and the driver. But because he had a screen, the driver wasn’t wearing a mask.

I took a calculated risk based on the short journey time and the fact I was wearing a mask – though as we know, the greater part of the protection of masks (outside full-scale medical PPE) lies in preventing stuff being breathed out, rather than in the vulnerable person not breathing stuff in. Seemed safer to walk home after – rainy day, few people (Ballyhack is hiving on sunny days), and I used the side of the street opposite the shops.

However, I’ve realised that taxis aren’t going to be a feasible way to go to hospital appointments. Half an hour (if you’re lucky) each way across town, in a cab where the screen is not adequate to protect me and the driver from each other? There’s a real question here about taxi firms’ duty of care to their staff – I’m talking about being human here, regardless of what kind of contract they’re on.

The point is that a precaution that doesn’t do its job is in some ways worse than nothing, because it gives people a false sense of security. I’m not sitting in a car for a total of an hour with someone unmasked. I’m just not. Would having the window all the way open be enough? I don’t know. Would I stake my life on it being enough? No. I’ve done a lot to stay alive over the years; I know exactly what it’s worth.

And taxi drivers, who sit in their cars with people all day, are unbelievably vulnerable and have no way of knowing what risks passengers have taken – perhaps themselves feeling they have no choice but to work in unsafe conditions. They deserve to be safe.

So my one option – as advised by my team – is using the St. John Ambulance ambulance transport for pickup/drop-off. I’m both exhausted that it’s come to this and deeply grateful that the option exists. It’s also very expensive, even with the substantial discount I got, because they are literally going to sit and wait for me, so it costs what it would cost if a taxi did that. I’m very lucky; I can afford that. Many can’t.

I think we’ve all already made up our minds whether we’re going to wear masks or socially distance or not, so I’m not going to harry you about that, but I write this because I think there’s a perception that everyone who’s been shielding has sallied forth and gone back to normal, and also a perception that we’re all magically not at risk any more, which isn’t the case.

Anyway. That’s the stuff I think about when I read about 48 new cases in one day.