Coronavirus: 'I've got an underlying health condition - and yes, I'm scared'

Those of us with existing medical conditions are even more worried about coronavirus, writes Nicole Mowbray. Photo / 123rf

COMMENT:

If you're firmly in the grip of Coronavirus mania… join the club.

Most of you can, though, console yourselves with the fact that, for 80 per cent of people, Covid-19 - if contracted - will be relatively mild.

However, the outlook is rather different, and far less reassuring, for those of us with a pre-existing health condition. And we're not all aged or infirm.

Fifteen or so years ago when I was about 25, I was diagnosed with an inherited genetic heart condition called hypertrophic cardiomyopathy. It affects one in 500 people in the UK, often from childhood or their teenage years, but if untreated and unmonitored, the condition can, for some, lead to sudden cardiac arrest - as footballer Fabrice Muamba, unfortunately, experienced in 2012.

Mine is an aberration, no one else in my family has it and I am thankful to have no symptoms. Aside from a life-saving implantable cardioverter defibrillator (ICD) which lives in my chest in case of any dangerous heart rhythms, to all intents and purposes I live a completely normal life.

But not at the moment. Every time someone tragically dies, the nation practically holds its breath until it is proclaimed that they had "an underlying condition". The subtext is a barely disguised; "see, it's only the 'weak' that are going to die! Relax everyone else, this probably isn't going to happen to you!" Cue almost audible exhale of breath.

Of course, it's understandable that people want to mitigate the fear spread by this illness in the general population. But for anyone with a medical condition, news like this does exactly the opposite. And let's not forget, the list of issues that increase your risk of complications runs the gamut from the sickest cancer and transplant patients through to those with relatively common issues.

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It's a stress that's getting increasingly impossible to bear. In online support groups, young people are likening the spectre of the illness to waiting for a colossal hurricane to hit. Many of us are already avoiding public transport, large gatherings, working from home and having a lower threshold of suspicion with any symptoms.

Perhaps the anxiety can be best illustrated by a trip to the shops, an everyday task that's turned into a game of Russian roulette. Touching a door handle, then forgetting and touching your face is enough to trigger a wave of anxiety. Every nearby cough feels like small arms fire in this epidemiological war. … How much of this is anxiety and how much of this is an actual danger is impossible to know, and that is part of the problem.

Conflictingly though, many of us are also made to feel as if we're overreacting by family members, colleagues or friends. I have personally experienced incredulity over my cancelling meetings in central London, or not wanting to shake hands or kiss on the cheek…

And there's panic for partners too. My (healthy) husband feels a huge responsibility to not give me the virus, so has taken the decision to work from home - with me - for the past week instead of taking the tube to his office. We both spent hours yesterday tracking down an elusive vial of the pneumococcal vaccine for me, privately after the Cardiomyopathy UK charity recommended people with my condition get vaccinated if possible (nationally, NHS stocks are low).

Many of us have read online comments in which people have parroted opinions such as "it's natural selection" or the virus "might help the country in the long term by picking off the old and weak". Cheers guys. For the record, many of us are neither. So please be kind and remember, people with pre-existing conditions we can do nothing about are no less scared of dying of this virus, and no more deserving of that fate than you are.

Victoria Lambert: What the experts say

So far, all the UK citizens known to have died due to Covid have had co-morbidities such as hypertension or lung disease and type 2 diabetes, or complications due to ageing.

It's not surprising then that anyone with a chronic ailment will be feeling increasingly nervous and those fears should not be lightly dismissed, says Professor Jon Cohen, Emeritus Professor of Infectious Diseases, Brighton and Sussex Medical School.

"Older people, and especially those with pre-existing or underlying conditions, are more at risk," says Cohen. "This is in part because they have less reserve to cope with the stress of an infection, and partly because natural immunity wanes as we get older."

Cohen points out that as a specific example, coronavirus causes a respiratory illness: "This places greater stress on the heart, so people with pre-existing heart disease will find it harder to deal with a serious respiratory infection."

Dr Andrew Freedman, Reader in Infectious Diseases, Cardiff University, agrees, adding: "Other conditions such as chronic heart failure and kidney disease are also associated with a reduced reserve and less favourable outcomes to infection."

The respiratory link is also a concern for anyone with asthma, says Jessica Kirby, Head of Health Advice at Asthma UK.

"Unfortunately, if people with long-term lung conditions like asthma get coronavirus, it can be more severe."

She adds: "The best thing you can do is to ensure your asthma is as well-managed as possible – which means taking your preventer inhaler every day as prescribed, and keeping your reliever inhaler with you all the time so you can use it if your symptoms get worse."

For anyone living with diabetes, the coronavirus can cause more severe symptoms and complications, says Dan Howarth, Head of Care at Diabetes UK, but no one should panic.

"If you routinely check your blood sugar at home," says Howarth, "you'll probably need to do it more often – at least every four hours, including during the night."

One piece of good news is that children seem to be able to cope with viruses like this much more easily. This should come as some comfort to new parents and women who are pregnant. Kate Pinney, a midwife with the baby charity Tommy's, says the most important thing is to try not to worry.

Thorough hand washing can help slow the spread of the virus. Photo / 123rf

"There is currently no evidence that Covid-19 causes serious problems in young babies,' she says, "but if your baby has a temperature of 38C or more, get them checked."

Some pregnant women will be worried that the virus may have an impact on their unborn child.

"This is a new virus," says Pinney. "We are just beginning to learn about it and there is not currently a lot of evidence about the effects on pregnant women. For most people, the impact of the virus is relatively mild, similar to flu."

Another group who may feel concerned are people with cancer and their families, as having cancer and treatment can weaken people's immune systems.

For example, chemotherapy can stop the bone marrow from making enough white blood cells which are part of the immune system. While this is most likely to happen during a course of cancer treatment, the effects can last for some time afterwards.

Types of cancer that affect your immune system like leukaemia or lymphoma can also lower the ability to fight infection. This means the symptoms of any infection can be much more severe and may become dangerous.

Perhaps one of the most worried cohorts of the population will be those with underlying mental health issues such as anxiety or obsessive-compulsive disorder for whom fear of catching the virus could be as painful as the actual symptoms.

Anxiety is a normal emotion to experience from time to time, says Dr Martina Paglia, clinical and counselling psychologist and clinical director of the International Psychology Clinic.

"However," says Paglia, "some people's relationship with worries can become an all-encompassing part of their life." So with the xoronavirus outbreak, she points out, "they might immediately worry that they will surely catch the virus and die. These worries become uncontrollable and irrefutable."

She suggests trying relaxation techniques and attention training. Taking conscious control of your breathing (slowly breathing in and out to the count of six) and focusing your mind on the here and now and what you are experiencing through your senses (sight, touch, hearing, smell, taste) can help you calm down.

Paglia also recommends exercise: "Exercising produces endorphins, which give you that feel-good boost that can help in relaxing your mind and keeping it calmer."

Lastly, she says we all need to have a think about our daily lifestyle: "Our mental health is in sync with our physical health.

"Start to make healthy choices to help your mind and body stay healthy. These include drinking plenty of water, avoiding nicotine and alcohol, and eating healthy food."

What all of us can do – regardless of risk factors is to think ahead. Jessica Kirby explains that, "As the virus is predicted to spread further in the UK, the next step in slowing down the spread would be people taking steps to reduce their contact with others, for example by discussing arrangements for working from home with your employer and avoiding large gatherings of people."

And that's advice that applies to us all, however, well we feel at the moment.

New border measures have been set in place in New Zealand from March 16. Travellers arriving in New Zealand are now required to self-isolate for 14 days.

The Ministry of Health advises washing hands often, avoiding personal contact, not sharing personal items, and staying home if you are feeling unwell.