Monday, June 20, 2022

COVID didn't kill me

 Ever since the early reports about a new virus in China started coming in during late 2019, I worried about how the virus would interact with CPT2 deficiency. My worries were magnified greatly when I heard two anecdotal reports from others with CPT2 that they had asymptomatic COVID yet ended up hospitalized because viral infections can trigger an episode

I tested positive for COVID on a rapid test on January 18, 2022. At that point I'd had a total of four vaccinations (the regular 2 mRNA vaccines and 2 boosters).

I was barely symptomatic. I had a headache and sniffles. However, because of the known risk of any viral infection to somebody with CPT2 deficiency, I stayed off my feet for a week and drank an ungodly amount of Gatorade.

I recovered quickly, and the only thing that has changed is that I may be slightly more tired. Frankly I think the fatigue is due to things other than long COVID, but who knows.

I'm so grateful I was able to get vaccinated and boosted. It turned what could have been a CPT2 disaster into more of an annoyance than anything else.

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Note that there are many genes involved in CPT2 production. I have two different kinds of mutation, one on each allele. If you have CPT2, it may well involve different mutations, so my experience does not predict your risk of a CPT2 issue with COVID.

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Added 22-06-22: This raises the question about how to deal with COVID going forward. My risk level is pretty much "same as others in my age range" (now that I know it didn't negatively interact with my version of CPT2). I asked myself "what even are you waiting for in order to relax your restrictions?"  I've now had 5 immune events (vaccines + infection), and as far as I know there isn't anything on the way that will be able to outpace the virus' ability to mutate into a version that has pretty good immune escape. I worry a lot about long COVID, less so about acute COVID (because vaccines do mitigate the risk of death down to an acceptable level, and Paxlovid is there to fill in any gaps).

The bottom line is that I can't identify any change that will be a clean demarcation between "be super careful" and "back to normal".  The choice is thus between staying super careful forever and figuring out how I want to live for the next decades. If British Columbia took seriously the risks faced by immunocompromised people and those with chronic illness, I'd absolutely be part of that effort -- it is something I've been doing for years now. However, I don't know how much risk mitigation I'm providing others by being the only person in the grocery store wearing a mask.

Ultimately my conclusion is that (a) I've taken all of the steps I can to reduce my risk of serious injury or death; (b) everybody I'm in regular contact with is low risk (either via vaccination or other factors such as age); (c) given the piss-poor public health efforts in place in British Columbia where I live, any steps I take to protect others (primarily wearing a mask whenever I'm not home) probably only make a de minimis change - if any - in the risk level of those at high risk. 

The logical answer - I think - is that I can relax my protocols significantly, to a level where I'd be ok with those staying in place all of my life. Basically, mask when indoors for more than a few minutes in proximity to somebody at high risk, isolate for 2 weeks if I test positive, and respect any request to put on a mask. 

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