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Dealing with Covid
Feb. 5th, 2023 02:48 pmI've felt for a some time that it might be worthwhile to take stock of how I'm managing Covid.
---Precautions
Miriam and I are isolating as much as we can. For my part, since I'm not working, the only times I leave the apartment are for outdoor stuff like a dog park, or essentials like picking up our curbside grocery order. Since the last time we did a sort of threat assessment together last month, I've been going to Costco much less frequently and stopped "fun" trips like thrift stores entirely.
Miriam works from home but has to be physically present at an hour-long meeting once a week. Other than that, she may occasionally go to a store with me, but mostly doesn't. I'm also not really going to stores anyway, so that's moot.
In the last month or so, we've had one person at our apartment: a friend who has been in the hospital for some time. I think we all needed to see each other after that ordeal. They are fully vaccinated, and we all masked other than while eating dinner, which we did in turns in a spare bedroom with a window open to the outside while no one else was in the room.
That's the extent of our in-person contact with people other than each other.
When I do share indoor space with other people, such as at Costco, I use an Airgami mask, which is the most breathable one I have yet tried and has a NIOSH-tested filtration efficiency of 99.07%, even though it has not been given an official N95 or similar rating because the process is expensive. I'm considering trying some N100 respirators for fit. I have purchased materials necessary for at-home qualitative fit testing of respirators, but have not set that up yet, nor ordered a variety of respirators to try it with.
---Status of Covid
This is hard because things change so much and so frequently.
The current variants seems to be highly contagious, even compared to previous versions that were highly contagious in comparison to yet earlier variants. Testing and reporting is also much less common and thorough than it was in earlier days of the pandemic, and using official reports for decision-making requires inferences that I don't feel like I have knowledge or expertise for. There is a local, weekly update that monitors Covid in municipal wastewater, but the provincial, conservative, government is also not willing to fund much of anything regarding Covid so the abilities of those doing the monitoring is limited.
It seems like the current variants also are less likely to cause severe infection, hospitalization, or death. But how much less likely in absolute terms is something I don't understand.
I have tried, off and on, to read through what information is out there from places like the WHO or the CDC, but it's difficult for me to make heads or tails out of how the information they have affects my and Miriam's personal risk. I really wish that health experts would give some advice for people who are living in places where almost nobody seems to give a damn about Covid but who are still trying to avoid it. I am badly in need of expert advice and don't really know where to find it in ways that I can understand and interpret.
---Physical Health
Personally, I'm fine. I suspect that, if I were to catch Covid, I'd still be fine. As noted, recent variants are less likely to cause severe illness or death, and for most of my life I've been someone who seldom gets sick and usually fights off colds and viruses pretty quickly. My concerns for my own health are based primarily on not having any health coverage here. The odds seem to be small, but if I *did* get sick enough to need hospitalization, I don't have a way to pay for it and would probably bankrupt us. That said, I still have some concern about potential long Covid, especially cognitive disability.
I'm much more concerned for Miriam. She's been dealing with a cluster of serious health problems since near the time we moved to the Netherlands three years ago. Serious chronic pain, brain fog, trouble sleeping, respiratory problems, and more. We're still not sure what the underlying cause is, but we think it's something auto-immune related. Lately, she's been thinking that this might have been long Covid all this time. She got sick for a little while around the time of that move, when her symptoms started and before Covid tests were available and before there was much understanding of the nature of this pandemic.
If she has long Covid and is reinfected, could that make things even worse? If it isn't long Covid but she has auto-immune problems of another kind, would Covid be extra dangerous for her? Since long Covid could actually be the virus triggering latent auto-immune disorders that were already there as potential problems, could it make them worse? We don't know.
---Mental Health
This has been hellish for my mental health. Some context:
Through my whole life I've had pretty serious social anxiety. In the '90s, I would read about how shy people had found amazing ways to interact in ways that felt safe to them via this internet thing, and I was envious. Even mediated through text, talking to people was too scary. I've had some better times here and there, but for the two years I was in the Netherlands, my social anxiety combined with feeling like I was a nuisance to everyone around me because I didn't know the language made going out so scary that I often couldn't even walk to a shop down the street for groceries.
I think some -- even a lot -- of that might have been gender dysphoria related. In the last year, since more fully embracing my transition, some of that anxiety has gone away. I have found a community here that I want to be part of. I want to go to events: hang out at a local brewery on trans night, join people for thrifting trips, even just meeting up with them for metaphorical coffee (I hate coffee) to get to know them as I've been invited to. I want to make friends, even go on dates, and just be the me I never got to be for most of my life. I have a lot of internalized ageism about this, feeling like if I don't get out and do these things that I've never really done much of now, I'll be too old to do them.
In short, I feel like the life I have wanted since I was a lonely little girl who thought she was a boy is being teased in front of me, just out of reach.
What I'm trying to do instead is just...not have hope. Not short term or long term. Maybe things will change, but if I don't hope that they will, there's less chance of my mood crashing for days every time I find out there's some event I want to go to and can't. And for some time, that's what was happening: I'd see an event being planned and have two days of depression.
Even the processes of researching this little essay and writing about Covid are seriously distressing. I'm forced to once again think about all of the things I so very much want to do, and contemplate the possibility that it may take years before I can do them safely. Writing this brings some of that hope to mind again, just for me to have to squash it again and that hurts.
I sometimes wonder if I'm off in paranoia land. It's hard not to have those thoughts when most people are out living their pre-pandemic lives and I feel like they see me as some kind of bunker-dwelling survivalist. For a span of time, I was taking more precautions than a person I know who is an organ recipient and is on immunosuppressants, and that feels really strange. With new variants of Covid that are more problematic though, said friend is back to being as restrictive as we are, which really sucks.
And knowing that there are people in that situation gives me ethics concerns about all this too, and that is a serious factor in my decision making. I don't want to be part of making normal existence out of reach for high-risk people. Every single person who is out there not masking, not vaccinated, is one more reason why people who are at high risk are forced to isolate themselves. It's another thing that keeps me from going to events with any significant number of people: I don't want to be yet another infection vector for at risk members of the public, and every large event I go to increases my risk to other people I may be around later. Were I dictator, either public masking plus vaccinations and boosters would be mandatory, or large public gatherings would be illegal.
---Requirements to loosen restrictions
What I need is more certainty. Not certainty in an absolute sense: no one can tell me that my partner and I will not suffer long-term debilitating illness or death. But certainty in the sense of just knowing what my risk is. How likely is it that I will end up with long Covid if I'm infected? How risky is it for Miriam to have Covid, potentially for the second time? Some data suggests that disability from Covid infection is cumulative, and more likely with additional infections, but more research is needed.
"More research is needed" is at the core of all of this. I just don't know how much risk there is. Not knowing how much risk means, to me at least, that I don't want to accept that risk to me and my partner. And research takes time. Sometimes it takes years.
It would also help a lot if most people would get their god-damned vaccinations and boosters and wear their fucking masks, but clearly that's too much to expect. Because of that, I have to assume that everyone I come into contact with outside the apartment has been exposed to someone with Covid or has Covid themselves.
---Precautions
Miriam and I are isolating as much as we can. For my part, since I'm not working, the only times I leave the apartment are for outdoor stuff like a dog park, or essentials like picking up our curbside grocery order. Since the last time we did a sort of threat assessment together last month, I've been going to Costco much less frequently and stopped "fun" trips like thrift stores entirely.
Miriam works from home but has to be physically present at an hour-long meeting once a week. Other than that, she may occasionally go to a store with me, but mostly doesn't. I'm also not really going to stores anyway, so that's moot.
In the last month or so, we've had one person at our apartment: a friend who has been in the hospital for some time. I think we all needed to see each other after that ordeal. They are fully vaccinated, and we all masked other than while eating dinner, which we did in turns in a spare bedroom with a window open to the outside while no one else was in the room.
That's the extent of our in-person contact with people other than each other.
When I do share indoor space with other people, such as at Costco, I use an Airgami mask, which is the most breathable one I have yet tried and has a NIOSH-tested filtration efficiency of 99.07%, even though it has not been given an official N95 or similar rating because the process is expensive. I'm considering trying some N100 respirators for fit. I have purchased materials necessary for at-home qualitative fit testing of respirators, but have not set that up yet, nor ordered a variety of respirators to try it with.
---Status of Covid
This is hard because things change so much and so frequently.
The current variants seems to be highly contagious, even compared to previous versions that were highly contagious in comparison to yet earlier variants. Testing and reporting is also much less common and thorough than it was in earlier days of the pandemic, and using official reports for decision-making requires inferences that I don't feel like I have knowledge or expertise for. There is a local, weekly update that monitors Covid in municipal wastewater, but the provincial, conservative, government is also not willing to fund much of anything regarding Covid so the abilities of those doing the monitoring is limited.
It seems like the current variants also are less likely to cause severe infection, hospitalization, or death. But how much less likely in absolute terms is something I don't understand.
I have tried, off and on, to read through what information is out there from places like the WHO or the CDC, but it's difficult for me to make heads or tails out of how the information they have affects my and Miriam's personal risk. I really wish that health experts would give some advice for people who are living in places where almost nobody seems to give a damn about Covid but who are still trying to avoid it. I am badly in need of expert advice and don't really know where to find it in ways that I can understand and interpret.
---Physical Health
Personally, I'm fine. I suspect that, if I were to catch Covid, I'd still be fine. As noted, recent variants are less likely to cause severe illness or death, and for most of my life I've been someone who seldom gets sick and usually fights off colds and viruses pretty quickly. My concerns for my own health are based primarily on not having any health coverage here. The odds seem to be small, but if I *did* get sick enough to need hospitalization, I don't have a way to pay for it and would probably bankrupt us. That said, I still have some concern about potential long Covid, especially cognitive disability.
I'm much more concerned for Miriam. She's been dealing with a cluster of serious health problems since near the time we moved to the Netherlands three years ago. Serious chronic pain, brain fog, trouble sleeping, respiratory problems, and more. We're still not sure what the underlying cause is, but we think it's something auto-immune related. Lately, she's been thinking that this might have been long Covid all this time. She got sick for a little while around the time of that move, when her symptoms started and before Covid tests were available and before there was much understanding of the nature of this pandemic.
If she has long Covid and is reinfected, could that make things even worse? If it isn't long Covid but she has auto-immune problems of another kind, would Covid be extra dangerous for her? Since long Covid could actually be the virus triggering latent auto-immune disorders that were already there as potential problems, could it make them worse? We don't know.
---Mental Health
This has been hellish for my mental health. Some context:
Through my whole life I've had pretty serious social anxiety. In the '90s, I would read about how shy people had found amazing ways to interact in ways that felt safe to them via this internet thing, and I was envious. Even mediated through text, talking to people was too scary. I've had some better times here and there, but for the two years I was in the Netherlands, my social anxiety combined with feeling like I was a nuisance to everyone around me because I didn't know the language made going out so scary that I often couldn't even walk to a shop down the street for groceries.
I think some -- even a lot -- of that might have been gender dysphoria related. In the last year, since more fully embracing my transition, some of that anxiety has gone away. I have found a community here that I want to be part of. I want to go to events: hang out at a local brewery on trans night, join people for thrifting trips, even just meeting up with them for metaphorical coffee (I hate coffee) to get to know them as I've been invited to. I want to make friends, even go on dates, and just be the me I never got to be for most of my life. I have a lot of internalized ageism about this, feeling like if I don't get out and do these things that I've never really done much of now, I'll be too old to do them.
In short, I feel like the life I have wanted since I was a lonely little girl who thought she was a boy is being teased in front of me, just out of reach.
What I'm trying to do instead is just...not have hope. Not short term or long term. Maybe things will change, but if I don't hope that they will, there's less chance of my mood crashing for days every time I find out there's some event I want to go to and can't. And for some time, that's what was happening: I'd see an event being planned and have two days of depression.
Even the processes of researching this little essay and writing about Covid are seriously distressing. I'm forced to once again think about all of the things I so very much want to do, and contemplate the possibility that it may take years before I can do them safely. Writing this brings some of that hope to mind again, just for me to have to squash it again and that hurts.
I sometimes wonder if I'm off in paranoia land. It's hard not to have those thoughts when most people are out living their pre-pandemic lives and I feel like they see me as some kind of bunker-dwelling survivalist. For a span of time, I was taking more precautions than a person I know who is an organ recipient and is on immunosuppressants, and that feels really strange. With new variants of Covid that are more problematic though, said friend is back to being as restrictive as we are, which really sucks.
And knowing that there are people in that situation gives me ethics concerns about all this too, and that is a serious factor in my decision making. I don't want to be part of making normal existence out of reach for high-risk people. Every single person who is out there not masking, not vaccinated, is one more reason why people who are at high risk are forced to isolate themselves. It's another thing that keeps me from going to events with any significant number of people: I don't want to be yet another infection vector for at risk members of the public, and every large event I go to increases my risk to other people I may be around later. Were I dictator, either public masking plus vaccinations and boosters would be mandatory, or large public gatherings would be illegal.
---Requirements to loosen restrictions
What I need is more certainty. Not certainty in an absolute sense: no one can tell me that my partner and I will not suffer long-term debilitating illness or death. But certainty in the sense of just knowing what my risk is. How likely is it that I will end up with long Covid if I'm infected? How risky is it for Miriam to have Covid, potentially for the second time? Some data suggests that disability from Covid infection is cumulative, and more likely with additional infections, but more research is needed.
"More research is needed" is at the core of all of this. I just don't know how much risk there is. Not knowing how much risk means, to me at least, that I don't want to accept that risk to me and my partner. And research takes time. Sometimes it takes years.
It would also help a lot if most people would get their god-damned vaccinations and boosters and wear their fucking masks, but clearly that's too much to expect. Because of that, I have to assume that everyone I come into contact with outside the apartment has been exposed to someone with Covid or has Covid themselves.
