Light at the End of the Tunnel?

The gaps between posts are getting gradually longer and I have little excuse as I've been at home since March save for a brief, COVID-secure, sojourn to Dorset (UK, South Coast) in September. Fortunately my day-job  is intact for the moment and I've avoided COVID (except possibly last Easter - see previous post). So now in the UK we are fortunate to have a vaccine roll-out in progress although who gets which vaccine and when is hard to predict. Broadly speaking, the elderly and those who look after them in a care-setting are high up the list. I haven't been contacted to get a jab yet - the so-called "clinically extremely vulnerable" are in the fourth priority group of nine in recent advice which I notice has just been withdrawn. (In case there is any doubt, yes I will be getting the vaccine at the earliest opportunity.)

Hot off the press is some updated advice to the UK government on vaccine priorities. The full document is here: advice on priority groups for COVID-19 vaccination, 30 December 2020. Some interesting extracts for "clinically extremely vulnerable" people  i.e. including CLIPPERS patients being treated with steroids and/or steroid-sparing immunosuppressants include:

"the overall risk of mortality for clinically extremely vulnerable younger adults is estimated to be roughly the same as the risk to persons aged 70 to 74 years"

 "Many individuals who are clinically extremely vulnerable will have some degree of immunosuppression or be immunocompromised and may not respond as well to the vaccine. Therefore, those who are clinically extremely vulnerable should continue to follow government advice on reducing their risk of infection."

 "Consideration has been given to vaccination of household contacts of immunosuppressed individuals ..." (but until evidence is accrued ) "... the committee is not in a position to advise vaccination solely on the basis of indirect protection."

"Once sufficient evidence becomes available the committee will consider options for a cocooning strategy for immunosuppressed individuals, including whether any specific vaccine is preferred in this population."

So it sounds like the case for vaccinating immuno-suppressed people early is being strengthened and they are considering whether to also vaccinate other members of those households if there is evidence that the vaccines also reduce transmission. They also don't know which vaccine if any is a better fit for vulnerable groups. So no magic bullets yet and of course the UK government does not have a brilliant record for "following the science" whatever they may say publicly. Fingers-crossed for 2021.

Read other articles in this series at Living With CLIPPERS.


Living With CLIPPERS by Bill Crum is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

Life in Lockdown

The daily "commute"

The UK is emerging from coronavirus lockdown - too soon? - and as one of the "clinically highly vulnerable" due to immunosuppression I have been advised (the UK government *advises* the vulnerable rather than instructing them) not to even leave the house for the last 3 months. Having carried out my own risk assessment I decided that it was better for my sanity and physical well-being to take a daily walk around the nearby park and field. Some days a bit of planning is required to avoid dog-walkers but going before work (I'm working at home) means there's very few folk about. So far so good and a world away from my usual two-train journey into and across London. Whether I ever go back to that commute is a discussion for another day, but work are currently saying we shouldn't expect to be back in the office this side of Christmas - I won't argue with that.

The future is a bit less certain for us "shielders" as we continue to be at risk with the virus in circulation. The big question is how much risk? I may be classed as vulnerable but I am not unwell or unfit so who knows how I would deal with COVID? An effective vaccine may be the only way to get some certainty while the virus is still around. There are many teams working on different kinds of vaccines including a trial currently in it's early stages at Imperial College in London. Vaccines which rely on live virus (not the IC one) may not be suitable for people like me despite their likelihood of  being most effective. For the time being it's a case of keeping my head down until the picture is clearer.

Like many others in the UK I've had a couple of bad viruses this year already. One was cold-like and knocked me out for two weeks plus at Christmas. I had another around Easter - not sure how I caught that! - which was more sore-throat and cough. No temperature on either occasion but had some episodes of breathlessness including one particular evening at Easter where my heart was pounding and I couldn't get to the kitchen and back without panting. Were either of those COVID - I've no idea but they weren't classic symptoms and I wasn't tested. When they get the antibody tests sorted out I will try and get tested just to see .... in any case it currently isn't known whether a positive antibody response guarantees resistance. We continue to live in interesting times. Stay safe!

Read other articles in this series at Living With CLIPPERS.


Living With CLIPPERS by Bill Crum is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

Did something happen?

It's a thumbs up from me

It's been longer than I thought since I last wrote something here. This reflects that in my life, as far as CLIPPERS goes, not much has changed. Still taking the tablets, still deciding in conjunction with my neurologist to keep taking the tablets, still wondering if I will always be taking the tablets.

But probably for me and everyone else reading this blog, something has changed. The emergence of SARS-CoV-2 (the virus) and COVID-19 (the illness) looks like it will affect most people in some way even if they don't catch it. I'm not going to speculate wildly about COVID-19 but one thing I know: people with compromised immune systems are more at risk and I am one of those people. Actually maybe I know more than one thing; my understanding is that people like me are not more likely to catch it, so we can take steps to reduce our exposure, and we not certain to have a more serious illness - it's all about risk. Still, I don't like playing games where the odds are biased against me and this seems like one of those situations.

I had already been mulling whether to work from home more (I'm lucky because I can) and at what point I should do this. I travel to work on several different kinds of public transport, which are often busy, in a city with rising numbers of cases, and the government estimates there may be up to 10 times more cases than they know about. My employer has been proactive though and issued a statement yesterday saying that anyone classed as vulnerable by Public Health England should work at home from now on. So that decision has been taken out of my hands and I feel relieved if somewhat daunted at the prospect of being at home for several months. 

There are lot's of unknowns still. The UK government is in a "delay" phase of managing COVID-19. Paraphrased this means: (i) "we can't stop it spreading, so we will slow the spread so as not to overwhelm the health services" (ii) "we will protect the vulnerable in the hope that enough other people build up resistance to stop it spreading further". Whether or not (ii) will be effective is the big question. All we can do is keep calm and carry on. And wash our hands relentlessly.

Read other articles in this series at Living With CLIPPERS.


Living With CLIPPERS by Bill Crum is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.