LOVE, LIFE & EVERYTHING ELSE IN THE TIME OF COVID-19

Life is changing radically for many people around the world.

Like most people, I’m worried about contracting Covid-19, the latest or “novel” iteration of the regular coronavirus to be unleashed on the world.

The stress is most evident in the fact that I’ve been itching all day and most days – over most of my body, my scalp, arms, legs and back. It feels like the creepy crawlies have laid siege to my body.

I know there is nothing wrong with me that a loofah sponge and a bit of body cream won’t sort out. And some de-stressing time away from news about the latest developments on infections of and deaths from Covid-19.

But, as a heart transplant recipient with a compromised immune system, I am probably more alert than others to the fact that the world is humanity’s germ-infested home and that I must protect myself from exposure to disease, including Covid-19.

And yet, my interests are not more important than yours, and vice versa, regardless of any demographic feature including our respective medical conditions or comorbidities. Of course, there are many others in our society with a weak immune system. These include those with HIV or TB, or with other conditions, comorbidities, that make them vulnerable should they contract the virus. It includes young and old. Let’s respect that and try to commit more to their well-being.

We cannot condemn people to die because of their demographics – young, old, immuno-suppressed, poor, homeless. We must fight wherever we are, for ourselves and for others. No matter how much we try to limit the risk, we’re all exposed to this insidious virus, and the sooner we can shut it down, the better.

Some of us have relatives overseas, in countries that have been badly affected by the virus; others are far away in the same country. There are doctors and nurses in our families, and others who perform essential services, whom we hope will be safe, despite their exposure.

Some people will remain in denial, believing that they are immune to Covid-19, because of where they live, their social status, their religious disposition.

Government has introduced radical interventions. I am not prepared to sit on the side-lines and simply criticise government efforts in respect of this virus. I will support all those who are doing a good thing to save lives, to lessen the burden of this disease on everybody in our country. I urge you to support these basic measures, radically, so that we all do our bit to stop the spreading of this disease.

As we work towards a common goal, we hope and pray for the worst impacts of Covid-19, which have been felt in many other places, to be avoided or at least ameliorated in our country. But logically and scientifically, South Africa’s trajectory may involve an overwhelmed healthcare system, with very many people being admitted to hospitals and with hundreds, if not thousands, dying.

That, in turn, will result in huge stresses on the frontline individuals who staff our public and private hospitals and clinics. They may be forced to go into isolation away from loved ones for long periods, they may get sick, some may die. All will be subjected to horrendous pressures – the usual on-the-job stresses, now multiplied many fold, and even ethical dilemmas never confronted consciously. (Imagine having to walk away from a patient whom you know cannot be saved, in order to save another or many others.)

The impact on the economy will be felt by all, except the risk-takers who have already put in place plans to reap huge benefits. With that in mind, counting and lamenting each individual cost we may face will not change the collective impact on our country and world.

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In the work up for my transplantation, I was warned that with another person’s heart in my body, I would be more much more susceptible to taking on germs, contracting infections and being very ill with conditions that before might have seemed completely innocuous.

It’s not that I push the memories away, trying to forget what I went through. It’s just that I have become seduced by the normalcy of my post-transplant life, however different it might be from a former life or from how the next person lives.

Ironically, while my body, courtesy of my donor heart, is stronger now than it has ever been, it is also in a constantly weakened state. Even though my new heart is such a big and integral part of me, my body treats it as a foreign object, constantly working to reject it. As a result, I take a daily cocktail of immunosuppressant or anti-rejection tablets. These suppress the body’s ability to fight any foreign organism, including my new heart, by lowering the amount of white blood cells, essential to the immune system.

Adopting a healthy lifestyle and avoiding viral infections such as Covid-19 remain essential for me to stay alive.

But it’s important to understand how this virus is transmitted. It is passed on in droplets and is not airborne – except of course that droplets will pass through the air from someone breathing or sneezing over another. Droplets can enter one’s body through the mouth, nose and eyes and, obviously, through any open wound.

Most of the measures I have been taking since my transplant to avoid infection generally apply specifically to avoidance of the Covid-19 virus as well.

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The best measure to avoid infection is extreme social distancing or complete isolation. After my transplant in October 2016, I was in an isolation ward in an intensive care unit of the hospital for about a week, before being transferred to a single ward in a general section of the hospital.

Once discharged, I was forced to stay at home for at least a month, allowed out only to attend surgical clinics or other essential reason.

Since then, I have been free to live mostly a normal life; my bosses agreed with my heart specialist’s request that I work from home, although I keep in regular touch with the office.

When I do go out, I remain alert all the time when I am in public to the dangers inherent in any situation. I mostly avoid crowds and congested public spaces where I may be forced to have close contact with strangers. Generally, I keep anyone who is not a family member or a trusted friend or associate at a distance.

Keeping a good personal space around me is important. Sometimes it does feel as if I am being unnecessarily rude when I step back from someone I am addressing or hold my hand as a shield in front of my face. I try whenever possible to act in ways which will not patently offend someone, especially given that a stranger will not know my medical condition as the reason why I am keeping a distance.

Unless I find myself in circumstances outside of my normal social environment which require such communication, I rarely tell people of my medical condition, which is strange, I know, but we all want to present as normal a façade as possible, I think. Of course, there are those times when urgent and even uncivil action may be necessary to protect myself. Occasionally, I have smiled quietly when someone else with a medical condition but who is unaware of my condition, sets down stringent rules for a meeting with me. ‘Are you kidding me?’ I muse.

Wherever possible, I do not use public transport including airplanes, trains, and minibus taxis. Air travel is especially a no-no in the current circumstances, locally and internationally.

I also always carry disposable face masks as a last resort to avoid infection, although I have not felt the need to use these in public until just recently and it’s worth considering how effective some masks are compared to others.

With the onset of Covid-19, I go out only when necessary. Of course, it is always difficult to assert that the current excursion is a necessary one, to the shop or to visit someone.

Voluntary isolation within one’s home must be considered to prevent transmission of Covid-19. Eventually, government might need to enforce a ban on moving out of one’s home unless there is a compelling reason to go out – for example, if one works in an essential sector. At that point, state of emergency law will have been imposed and we will have no option but to comply, so best to practice now without any legal imperative.

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Basic hygiene premised on respect for ourselves and each other will remain a critical feature of all phases of this disease.

I wash my hands as often as I need to, in public situations or at home, and especially when I am about to eat. In our modern era, certain places or areas are especially unhygienic, like shopping malls, or stairway banisters, door handles, knobs or turnstiles. I don’t touch these unless it’s necessary. A portable sanitiser in my bag provides extra cover when touching is inevitable.

When the latest flu vaccines are available, I will get the shot and comply with all other protocols passed on by my transplant team, based on the recommendations of infectious disease specialists.

Of course, I am incredibly privileged to have received a donor heart. Because I have medical aid, I have had access to the best healthcare before, during and after my transplant. The cost of the expensive medication which I must take for the rest of my life is also covered by the medical aid scheme. I realise also that, because of my economic status, I can protect myself and manage my exposure to disease much better than someone with different socio-economic circumstances.

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A life-changing experience such as an organ transplant may also provide pointers to how one regards life during and after the Covid-19 pandemic. Our world is changing radically, and it will be a massively wasted opportunity if we do not learn from these changes being forced on humanity by the virus.

I realise that Covid-19 has triggered all the memories I have of being sick before my transplant in 2016, being told I was dying and then hearing there was the slightest chance that I could receive a donor heart.

I am stumped by the emotions which were unleashed in me by the South African government’s decision to send what was in effect a military plane staffed by SAA personnel to fetch South Africans under lockdown in Wuhan, China. It reminded me of the flight which was chartered in 2004 to fetch South Africans stranded in Thailand in the wake of the tsunami.

In both instances, I prayed “bring them home”. I wonder what it says of my psycho-spiritual state today, about the lifelong journey I have been on and the everyday detours I have taken, about the place(s) that I call home and the foreign abodes that I have inhabited, about the people I desire to have around me, when I am on top of the world, and when I am swimming for survival in very deep waters.

I remember, when I was at my lowest point in hospital, with 10 percent of my heart function remaining, asking Belinda not to leave me alone. It was a strange request which I still struggle to explain today; wanting someone, the most important person in my life, to sit, to wait with me for a while, till an end.

This Covid-19 virus will stop lives and will irreparably change others. We may not have the opportunity to sit for a while with another. We must prepare for these eventualities in our families and communities. And we must commit to continuing the fight to live for ourselves and many others.

People of faith may have much to share with us. I am cynical of those, like many Christians I know, who so easily say that God is in control, therefore they and their loved ones will be safe from this calamity and any other, and they must do nothing else but believe. I wonder if your faith may not have been nurtured “for such a time as this”, not to sit in a corner and pray, but to help the world to survive.