Tag Archives: Long Covid

Hospital Acquired Infections and other disasters of the modern age.

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I am home from the hospital for the six or seventh time in the last two months or so. I’ve been in the hospital so much, I’ve actually lost count of my stays and, strangely enough, sick people aren’t that good at record keeping, especially when they are sick enough to be in the hospital. With help from loved ones, I could rebuild the chain of events, but I don’t want to. I’d be just as happy to forget it. Anyway, this morning I tested negative on an admittedly unreliable rapid antigen covid test* on day 3 at home and I will test every other day until day 10 to do my best to make sure I did not pass along a Hospital Acquired Infection (HAI).

My hospital admissions include more than 30 overnight stays and two stays that were a week or more. I think I’m in a pretty good position to talk about the state of masking in our hospitals and where we’re at with Covid in BC hospitals.

But first, I want to note that I have talked to, I’m guessing, over 100 medical professionals during this time. That is a low-ball estimate for sure.** Only one asked me about covid. One. He was an ER doc who saw on my record that I had picked up a paxlovid prescription the day before. (I keep one on hand just in case. My last one had expired and I am  medically complex. For me, it’s like having an EpiPen. Hopefully, I won’t need it.) I explained this to him. No other doctor who took my history, NOT ONE, asked if I had ever had Covid. This seems like a big failing to me. The number of illnesses and diseases they screen for is staggering. But they haven’t asked about the most likely culprit causing people to be ill since 2020. They seem not to know that many people develop Long Covid after their initial infection appears to be over. They don’t seem to know that Covid is a vascular disease that can affect every organ in the body, including the brain, and even our immune systems. They don’t seem to know that Covid can and will complicate anything else we have going on. Why don’t they know this?

Only one of my doctors (I have at least 6 regulars and have seen probably 15 others between emergency visits and other procedures**) masks regularly, but I have seen even him walking around the hospital without a mask. At least he masks when he comes to see me. Some of the covid cautious community have written about why doctors might not mask. Have a look at Jessica Wildfire (OK Doomer) or Tern’s account on X/Twitter. I’m too tired to link to the exact threads. I have also written about it a little here and there. I think I’ve said all I want to say on the matter in an open letter to health care workers and in the second half of my post about Doppleganger. Have a look. I’ll admit, I’m a little obsessed with the issue of masking in health care because my life depends on it. My whole world has been health care for months now. But back to doctors, in short, we all contain multitudes—we are both careless and caring. Doctors too.

I’m not going to vilify the people who have kept me alive. But I will say it is time for some medical professionals to take stock. Many of their colleagues are showing leadership which they should emulate. For example those at the Yale School of Medicine have done tremendous work on understanding Long Covid and doing the job that public health should be doing. Look it up, and their ground breaking study with Dr. David Putrino at Mount Sinai.  And while you’re at it, read some of Eric Topol’s excellent public education work. These will lead you to more resources.

Anyway, the first couple of times I was in hospital, there was a mask mandate in health care settings. It meant I was safer. It was not perfectly enacted. The entry lobby is not well managed. There are still administrators without masks and behind plastic screens. Pure hygiene theatre. But I won’t criticize them for having multiple hand washing stations visible everywhere. It’s a hospital. This is good practice. I would suggest they should add masking signs to all of those.

In all of my hospital visits, I wore a mask (3M aura is my mask of choice) in all public areas, in hallways when porters were ferrying me to multiple tests, in procedures rooms and so on. Porters always wore masks. Good management there. I appreciated it so much. I did not mask in operating rooms, obviously. One would hope those would be reasonably free of harmful viruses or bacteria, and anyway, you can’t mask while intubated. I was unmasked in recovery rooms because I was mostly unconscious and unable to do so. I also did not mask in my own patient room. I was fortunate enough to be in a hospital in which most patients have their own room, at least on the cardiac and complex surgery wards. And, the window in my room opened. I knew I was taking a chance, but how could I possibly mask for a week straight? It’s not reasonable. That’s why everyone else has to mask, so patients can get a break, sleep, breathe easier, and heal.

My last two times in the hospital were after the mask mandate was removed. The first time, I put a sign on my door asking anyone who entered to mask and a nurse was kind enough to leave a box of masks by the sign. Everyone except one person complied, and no one complained. The second time, we were a week further away from the lapse of the mandate. Another sign went up at my door. This time, I got push back. One nurse came in and demanded (the tone was demanding) to know why I wanted people to mask. I looked at her as politely as I could, and  said, “Covid.” One word. She looked disgruntled and said, “But you’re not masking.” Again, I was in my own room. I said, “I just had open-heart surgery and a lobe of my lung removed. I mask outside this room.”  She warned me she could not make anyone else wear a mask. She actually said this with a little glee. But when she came back, she was wearing one, and about 80 per cent of people who came into my room did too. I was not as safe as the time before. But again, I kept my door closed and my window open.

Maybe you’re going to come on here and tell me how to do this. Maybe you’ll tell me my measures are idiotic. Please. I’m tired. I’ve done my best. Knock on wood, I’ve avoided a hospital acquired infection 7 times. That includes MRSA and other plagues of the modern world. (Excuse me while I literally knock on wood.) As for you, you do you. You probably won’t be in your own room in a newer hospital with decent HVAC. If that were me, I would bring in every kind of filter imaginable and mask much more. But ultimately, you have to eat and drink. Masks might slip while sleeping. You can only do so much. That’s why it takes all of us. It can’t be an individual effort.

On my last visit, I noticed in the hallways, procedure rooms and other public spaces that hardly anyone masks anymore. Maybe ten percent of people. I would often get wheeled by Cardiac Short Stay and see twenty or more people sitting in a row of chairs in the hall, all unmasked. They are there for pacemakers and all the procedures that can be done on a heart outside of an operating room. They are still serious procedures and if you’re there, you’ve got a health issue to care about. One way to care about it is to wear a mask. Do it for yourself, if not for me. Maybe I will finally put this issue to rest on my blog. If not, I hope it is because I have an update about how indoor air quality and masks are suddenly being seriously improved in public spaces. A girl can dream.

Meanwhile, Do No Harm BC continues its efforts to bring back mask mandates. Check them out here. Maybe add your voice to the project.

*Re bad RAT tests. It’s impossible for me to find a RAT test in my area of BC that is not expired and rumour has it the government is quietly ending free access to them. I also understand they are increasingly unreliable with the new variants. Why are we not investing in improving this important tool in the arsenal of preventing the spread of covid? Remember, many cases are asymptomatic: the only way you might find out you have it (and therefore take appropriate measures not to spread it) is to regularly test.

** Re my many procedures and doctors. To be clear, my gratitude to the public health system in Canada knows no bounds. Those trying to privatize it are the enemy of the public good, ableist, eugenicist, or worse.

An open letter to my health care providers: you are irreplaceable.

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As you know, I’m in a health crisis. You are one of many professionals who are applying their skills, expertise, experience, and knowledge to helping me get through this. I appreciate you more than words can convey. Your care is the difference between life and death for me.
And I’m worried about you.
Many of you are not taking the pandemic seriously. You act like it is over and talk about it in the past tense. Covid, that is SARS-CoV-2, is a Level 3 biohazard, like tuberculosis. It is spread through the air like smoke. Once you get it, it often presents as a cold or flu, but it is so much more. It is a vascular disease. It potentially affects every part of your body, every organ (including your brain), your blood, and your immune system. It has long-lasting effects that we are only beginning to understand. There are a plethora of peer reviewed studies examining the harm that Covid can cause. For years now, some have suggested Long Covid could be a mass disabling event. It already is. Over three million Canadians have already experienced symptoms of Long Covid. Many people with Long Covid cannot work. The first major study of doctors with Long Covid in Britain reveals it has impacted the respondents’ ability to work and to carry out regular day-to-day activities. Almost one in five said they were no longer able to work because of their post-covid ill-health.
You are around sick people all the time. I urge you to wear a good mask, that is, a respirator. Yes, it would help me, but again, I am also worried about you. You are so important. So few people can do what you do. It takes years of training and practice and hard work. You studied for years to be able to do this. Your knowledge is so needed right now. And you are irreplaceable. Irreplaceable.
I have conversations with those of you who are obviously dedicated to protecting yourselves from Covid. You wear respirators and some of you wear face shields too. I appreciate the care you are taking. Some of you only work nights now or take only occasional shifts. Some of you have left full time employment. This is a huge loss for those of us who need you, but I understand. And I support you. It is safer. As one of you said, you have to protect yourself and your family.
Some of you wear the masks that your employer provides. They are better than nothing, and I appreciate the effort. But often they are not N95. They are not respirators. Maybe your employer, the health region, the hospital, the doctor’s practice, could provide better respirators.
Even though in my region, there is currently a mask mandate in all patient areas in hospitals, everyone behaves differently. Some of you introduce yourself and take a breath, peel off your mask for a second so I can see your face, and put your mask back on. I understand why you are doing that, but you don’t have to. I can see what’s going on in your eyes.
Some of you, particularly those at intake desks, still think being behind a clear plastic barrier is enough. It is not. Air travels over, under, and around these barriers and Covid travels in the air.
Some of you pull down your mask when we get into an important conversation, a life and death conversation, or when you are trying to make sure I understand you. Don’t worry: I can understand you through your mask.
Some of you wear masks in the hospital but not in your offices.
Some of you don’t wear them at all.
Masking is a vital part of infection control. It is a vital part of protecting yourself.
You are irreplaceable to me, as your patient, and to your other patients. There is no one else who knows what you know the way that you know it. No one else has your exact experience.
You are even more irreplaceable to your families and your loved ones. Irreplaceable.
I’m going to say something wild here: I love you. All of you. Even the bossy nurse whose poor mask wearing set the tone for the rest of the medical staff in that unit and left everyone less safe. Even you. You obviously have skills. You were the one who got everyone’s questions. You were the one who knew how everything worked. You are so important. We can’t lose you. Please, wear a mask. You are needed. You are irreplaceable. You are loved.
With gratitude and respect,
Your patient,
Jane