Thursday, March 19, 2020

Immunomodulated and Uninsured during COVID-19

I am at-risk, uninsured, and afraid.


Prior to moving to Ontario at the beginning of this month, before my employer-provided health insurance reached its end, I met with my doctors and messaged my pharmacy to request a three-month supply of my 11 different prescriptions. Back in November, when my husband and I began entertaining the idea of moving to Canada, the first thing I did was start requesting quotes on health insurance. After the fifth insurance company rejected my application for coverage based on "extensive preexisting conditions", I decided to give up.

So now my husband and I sit inside an Airbnb apartment--a handbag full of 11 five-inch tall pill bottles of antimalarials, muscle relaxers, antidepressants, supplements, and pain medications hanging on the bathroom door handle--waiting to move into our new apartment next month. I wake up at 7:00 every morning, because taking care of the horses at my new stables is not a job that can be "Closed Until the Virus Blows Over" like the rest of Ontario, and pray that my "preexisting conditions" stay under control until the months leading up to our qualification for free public health care are completed.

Every day, operating hours are shortening for the few essential businesses that still maintain (monitored) open doors, and we don't even have proper Canadian IDs yet, let alone insurance or official jobs... A huge source of my anxiety sits in our failure to yet receive our "Virtual Visas" from our new bank to our post office box, which will be the only way for us to purchase anything online from our Canadian accounts, as physical debit cards are only usable in physical stores. Every restaurant in the province has closed their dining rooms, allowing only drive-thru or online ordering, so our current payment situation has us using a lot of gas trying to find affordable meals and purchasing a lot of TV dinners at the unnervingly-crowded supermarkets.

Today, I ventured to the grocery store to restock what meager supply of home-eating we can reasonably store in the small kitchen of our temporary housing. Upon parking, the sudden reality of my situation hit me in the form of a panic attack, as both my immunocompromised and uninsured statuses began flashing behind my closed eyes. Up until today, Dallin had accompanied me during all my public outings, and had been taking conscious measures to open doors, touch handles, and make any necessary contact with others so that I would not have to. Having left him at our apartment to finish his work on commissions, I hadn't thought grabbing the handle of the shopping cart would send me into such a panic.

Since the Canadian Prime Minister's declaration of the country's State of Emergency, I have reassured myself that, while we do not qualify for Canada's free public health insurance for another two months, there are several free/reduced-cost clinics within the city of London where either Dallin or I could receive basic medical care should we need it. However, with the COVID-positive count in Ontario rising above 250, with five cases already reported in our city alone, the cost per day of inpatient rooms in the downtown hospital occupied my thoughts over any cost a community health center might present. After a fervent prayer, I entered the grocery store, pushing the cart with the sleeves of my sweater covering my hands, I felt as if I shouldn't inhale too deeply. Of course, as with many other stores across the globe, the toilet paper and fresh meats aisles were bone-dry and many signs were posted restricting certain goods to "Two Per Customer". After quickly collecting the few items we needed while focusing all of my attention on not touching anything unnecessarily, I sped through the checkout line and to my car, where I felt the irrational need to immediately replenish my lungs with clean air. Upon arrival to my home, I am hesitant to share that I broke down in fear of potentially needing to repeat this process for the unforeseeable future.

Social distancing and self-isolation may seem unnecessary or inconvenient.
Mandated closures and cancellations may seem extravagant or overprotective.
These protect the elderly, the young, the immunocompromised, the sick, the pregnant.

Invisible illnesses exist all around you. One in seven children in the US have asthma or other breathing disorders. 13% of adults have some form of lung disease, which exponentially increases the chances of complications should they contract COVID-19. I belong to the 7% of the world's population living with an autoimmune disease, which leaves our immune systems weak and susceptible to diseases such as this, and no one could know this by looking at me.

I'm sure I looked like a nervous wreck wandering through The Real Canadian Superstore with almond milk, latex gloves, and TV dinners in my cart, holding my breath, and clutching the cart by my sweater sleeves. I know that, even should I contract this virus or even be hospitalized as a worst-possible-case-scenario, I will survive and eventually recover. The fear of the unknown weighs heavily on me, but the significance of finally being able to maintain my illness at a manageable level in the months leading up to our move and the impending global health crisis is not lost on me. Small and simple things are bringing me comfort every day amidst the surrounding panic; things as little as the medication I have been on for three years being listed as one of the possible therapies showing positive results in those being treated for COVID-19, or realizing that I have gone several days without a specific pain that used to be continuously present, or scrolling past an article depicting a contribution of goodwill and kindness during this difficult time.

Even after all of this, I do not regret our move to Ontario from the US. Even having only been here for a few weeks, we have already had multiple impressions of comfort in our decision to immigrate. We are full of gratitude towards our family, friends, and the divine interventions that made our move possible. We feel that we were truly inspired to make the decisions we did, and that London has many great things in store for our future here.

May we all continue to be kind, and may we all consider our less-fortunate neighbors in this hour of need.



"Undifferentiated connective tissue disease (UCTD) is a systemic autoimmune disease. This means the body’s natural immune system does not behave normally. Instead of serving to fight infections such as bacteria and viruses, the body’s own immune system attacks itself. In UCTD, autoimmunity may cause the immune system to attack specific parts of the body resulting in a variety of problems. The phrase “connective tissue disease” is used to describe the diseases of the immune system that are treated primarily by rheumatologists. These represent systemic autoimmune diseases that often involve the joints, cartilage, muscles, and skin. They can also involve any other organ system such as the eyes, heart, lungs, kidneys, gastrointestinal tract, bone marrow, nervous system, and blood vessels. Examples of connective tissue diseases include lupus, scleroderma, rheumatoid arthritis, Sjögren’s syndrome, myositis, and vasculitis. There are many people who have features of connective tissue disease; however, they do not fulfill the diagnostic criteria established for any one disease. In such circumstances, they are often considered to have “undifferentiated” connective tissue disease. Over time, people with UCTD may evolve into one of the more specific connective tissue diseases, such as lupus, Sjögren’s or scleroderma."