Confessions of an immune-compromised health journalist

I’ve been ‘outed’ by the Covid-19 virus.

A combination of feedback about my chemotherapy-compromised immune system from my oncologist and some tough-love feedback from my wife woke me up to my stubborn insistence on living my life the ‘normal’ way.

The oncologist said bluntly that with my borderline blood count, if my kids have friends around on play dates and are infected with any virus, let alone Covid, (just one example), I will die. She shared with us that in her 30 years of practicing she’d never been so challenged with her patients as with the ever-changing circumstances of the Covid threat. I immediately wondered about the millions of HIV– (and immune) – compromised South Africans, (not on ARV’s), a frightening percentage of whom are co-infected with TB. We’re in the same boat. Except that I have the privilege of access to private, funded healthcare, good transport and means.

Rendered conscious

But back to my ‘awakening.’ There’s my much-treasured once or twice per season visit to my favourite trout lake in the mountains above Ceres. A small Swiss-like cabin, sparsely outfitted with a gas stove top, single table and four beds, nestles on its craggy shores. I’ve been going there for 30 years. It’s a familiar, pristine, magnificent environment where I rejuvenate and celebrate nature, tuning into weather and water conditions and entomology to catch and release beautiful trout. Unable to enjoy my beloved past-time since my initial diagnosis with oesophageal cancer, (Stage One), last November, I’ve now settled into my second three-month chemo routine pending a major, hopefully curative op, later this year. With a two-week chemo break every three weeks, my fatigue dissipates somewhat. So, I decided to invite my two best fishing buddies and book the mountain cottage for a long-denied fishing trip. Pre-Covid reaching our shores.

Stop. One of my fishing mates runs a busy quarry near Durbanville with a large labour force. The other is a builder/come handyman in Prince Albert who has his own work team. Picture the lake; wide open nature. Then; tiny cottage, enclosed space. My wife did the maths, not me. I was in desire – and denial. The other day I pulled into a service station to fill up, my wife beside me. I wound down the window to chat to the petrol attendant. My wife asked me what I was doing. I frowned. The two-meter rule! He was closer than that. So, after ordering 95 petrol, I wound the window back up and handed the credit card to my wife, who did the payment on her side. I shook my head. She has literally shut down her social life, PC, (Post Coronavirus). I’m a bit of a hermit, so I hadn’t properly registered her sacrifices on my behalf. Until she took me on about my weak justifications for wanting to continue with my fishing trip.

Don’t panic, but get busy – fast

So, what’s my point? It’s this; for weeks now I’ve been curating coronavirus stories for Biznews; medical experts, economists, epidemiologists, analysts, research. Don’t panic is a universal (and valuable) message, but there’s an underlying, rational, urgent undertone. Get prepared, change your behaviour, up your hygiene, keep your physical distance (elbow-expressed love), we must urgently expand our routinely-burdened hospital capacity (Cyril did the rest by declaring a national disaster). This is where the personal gets political. For 16 years I covered healthcare as the news editor at the SA Medical Journal. I was at the reporting coalface during the AIDS denial years, documenting the victimisation of courageous doctors trying to save as many as they could in the growing flood of patients – without official ARV’s. Mbeki and Tshabalala-Msimang and their faithful deployed health cadres’ denial cost 300,000 lives, according to Harvard University research (2008). Others have since put it higher. The latest coronavirus news is that a medical research team from Barcelona, Spain (see elsewhere in Biznews) has recycled the application of a drug called Hydroxychloroquine to disrupt transmission of the coronavirus. It’s not a treatment or a cure, but anyone who tests positive or manifests symptoms can take this familiar drug (commonly used in Africa as malaria prophylaxis) to weaken the virus. This reduces the risk of the “host” transmitting it to others.

The question today must be that while our leadership is showing sanity and will surely assess the pragmatics of this development with a possible implementation timeline, what kind of denial are we still in? We’re inured to decades of false racial separation that was part of some ideological delusion that we’re different as human beings, resulting in an economic racial divide around which our politics pivot today. It’s most evident in the empty shelves at your local Woolies as panic buying sets in among those with the means to stockpile. The moment the shelves are replenished, those that didn’t stock up do, perpetuating the paucity and spreading panic worse than any virus.

Meanwhile in the townships, people don’t have the luxury of worrying about cancelling an imminent trout fishing trip because they’ll be sharing a confined space with two people with an outside chance of carrying the virus. Let alone stockpile groceries. They live cheek by jowl with HIV and TB, (too often drug-resistant), infected folk, often in their own homes, and travel in crowded taxis, buses and trains. Heaven help us if the coronavirus begins a serious local spread, or if this latest potential intervention doesn’t fly, or takes too long to implement. There is no separation, no matter how hard the apartheid regime tried to engineer it. We each have to take radical responsibility for one another. It took me contemplating my own mortality to get here. Were I not immune-compromised, I’d probably still be in denial. I think the real rub comes when we’re asked to make personal sacrifices, give up something we value, or change familiar, automatic behaviour. It just won’t happen to me. Until it does. Or we need hospitalisation for any reason. My own vital operation is in question as the private hospital my bariatric surgeon works in has just cancelled all elective surgery. It’s getting real folks.

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