Introduction by Hampus Eckerman: My mother wrote an opinion piece for one of our Swedish newspapers about her bout with the corona virus.
I’m getting kind of scared for all older fans out there, in Sweden there’s a lot of older people still going outside, shopping as usual, because they feel so healthy, so this article hopefully could scare some people to be more careful.
People of My Generation – Beware The Corona Virus Like The Plague!
- First published as an opinion piece in the Swedish newspaper Dagens Nyheter, March 29, 2020.
By Ingrid Eckerman: “I’m not scared – I’m healthy!”, say people from my generation and continues to socialize.
I’m also healthy, but I got the corona anyway. I didn’t die. I didn’t have to stay in intensive care for two months. I haven’t even had a high fever. Thus, a rather mild infection.
For ten days, the temperature has fluctuated around 38 degrees Celsius (100F). I have slept around 20 hours a day. I pull myself up on the bedside, waiting for the world to stop. Need support to be able to get up, taking hold in the furniture. I walk like a cripple – the hip part of my body seems to have crumpled. After a few steps comes the breathlessness, perhaps a bout of coughing. My body has aged 20 years.
Dressing is for me a great effort that requires an immediate return to bed. With pepping and prepping, I get my body to accept some basic food, a fruit, some ice cream, for pure survival purpose.
Everything has become heavy. The laptop must be carried with two hands. How should I be able to water the flowers? Getting up from the chair requires extra effort. Hair falls off in tufts.
Now on the twelfth day I begin to see the light in the tunnel. The temperature drops slowly, I’m not as deathly tired. I have felt hunger. Managed to get through both a shower and changing the bed sheets.
But I dare not take out anything in advance. It feels like there has been a war in my body, and the battle is not over yet. There is some small virus behind the sternum waiting for a weakness in my immune system. There is a risk of setbacks.
Now comes the convalescence, the recovery, built up during quarantine to be safe and infection-free before I meet others.
I have not been this sick since I as a child had the potentially deadly diseases measles, mumps and whooping cough. Being home 1-2 weeks extra from school was a matter of course.
Convalescence meant rest and nutritious food. Today, careful rehabilitation is being added. Successfully increasing physical activity, from walking in the apartment to walking in the garden. Return to regular sleeping and meal times.
From freedom of fever, I expect at least two weeks for recovery. This means a total disease period of at least one month. It is too early to say if I am getting any residual symptoms.
Getting corona at 70+ does not mean a few days of fever and then return to healthy as usual. Even if you do not become seriously ill, the illness will take a heavy toll on your body. We have weakened immune systems compared to younger people – we cannot count on a mild illness.
Even you who believe that you are so old that it does not matter if you die you have to think carefully. You must make it clear to relatives and healthcare that you do not want to receive anything but home care – that you refrain from intensive care that allows you to survive for yet some time.
Ingrid Eckerman, 78, MD, retired General Practitioneer in Stockholm, Sweden.
Comments from Ingrid regarding the piece:
1. No, I was never tested. As I didn’t get any breathing difficulties while lying down at rest, I was recommended by the ambulance staff to stay at home. Only those who have to stay in hospitals are tested in Sweden, as the capacity isn’t high enough to test the population as a whole. But I find it hard to imagine any more likely diagnoses.
2. I know nothing about whether I get immunity. Normally, there is flu and cold viruses around us in society, and we get a boost to our resistance every now and then. It helps us to maintain immunity. But this is a new virus that my body does not recognize at all. Maybe I need to get infected several times before I have a lasting immunity.
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Thanks for this and best wishes for a speedy and complete recovery to your mother, Hampus.
That’s an excellent piece, and I hope it has some effect. Best wishes to you, your mom, and all your family, Hampus.
That’s a beautifully written piece, Hampus. Thank you for making sure it’s seen outside of Sweden.
Impressive piece. Best wishes to you and your mother.
Thank you for sharing this! I sent it to my siblings and my mom (who is 77 and had been pretty casual about the whole thing til my brother and his wife finally got down to Florida to sit on her). She said it was “sobering” so I hope it made an impression. I sent the link to my wife and a friend who also have parents who have been stubborn about staying home as much as they should.
Thank your mom for me, she is doing a service well beyond the circulation of that newspaper!
Hampus, Best wishes to you and your Mother!
Glad to read that she is getting over here infection & it is quite sobering to read about the lingering after-effects.
I am fascinated that this even had to be said; what I’ve seen in the US is that the old are being sensible but some of the young are being stupid (by report, and direct observation: I walk around the neighborhood to keep a bit fit with the gym closed, and saw parties on both Friday and Saturday.) Here’s hoping others will heed her experience.
Chip Hitchcock: I am fascinated that this even had to be said; what I’ve seen in the US is that the old are being sensible but some of the young are being stupid
A significant number of older people have been listening to Trump and FOX News claiming for weeks that the coronavirus is just a liberal hoax, and I suspect that many of those are not yet taking it seriously.
Please thank your mother from me Hampus for that essay. I’m going to share it with a friend in his 80s who is not being as cooperative with the medical advice as he should be!
Dear folks,
It’s possible to be paying too much attention to the “elderly” when it comes to covid-19 mortality. Mortality vs. age curves are all over the place (we are still getting very incomplete data) but — very roughly — Hampus’ mother was at 3-4 times the risk of someone in the 40-to-60-year-old range. Someone who’s only in what is now medically considered to be late middle-aged like me (70), only twice the risk.
That’s not the kind of jump many folks imagine. Sure, it’s a lot worse playing Russian with three (or two) bullets in the chambers instead of one… but playing with one bullet is still pretty damned risky.
Worse, we don’t know how many chambers there are in the gun! That’s why I talked about relative risk. The great majority of covid-19 cases are either asymptomatic or the symptoms are so minor that the person doesn’t even realize what they’ve got. Those cases, though, are infectious. (To what degree compared to the symptomatic? We don’t know yet — we just know they are.)
Consequently, we know that cases are being undercounted, which would make the absolute mortality risks lower than what is being reported. BUT… deaths due to covid-19 are also being underreported, because in the absence of a confirming test they are often listed as flu or pneumonia. Correcting for that would make the mortality risks higher than what is being reported.
Put all of that together and you can understand why the range of predictions is so large. Equally (and entirely) competent researchers have to make their best guesses on all these uncertainties to plug into their models and consequently the models have outcomes that range over more than a factor of ten. We live in uncertain times.
Do not be cavalier about this just because you’re younger!
pax \ Ctein
[ Please excuse any word-salad. Dragon Dictate in training! ]
As one who has been sick in corona for just a few days less than my mother, I’d agree with Ctein that it isn’t necessarily a play in the park for us younger people either.
My brother has just barely recovered , more than a month after first getting sick. Myself, I had to sit down to rest for 20 minutes after a walk of just 100 meters to throw away the garbage. I start coughing and lose my voice after talking for just 10 minutes on the phone. Not being deadly doesn’t mean it won’t take a toll on your body. I’m looking forward to at least one more week where I have to be careful. Maybe two.
But more or less all epidemics show higher mortality at the start where the sick have been tested more often than those who didn’t notice anything. And we don’t even know anything about natural immunity yet. But regardless, healthcare isn’t prepared now for what it has to handle. Even if you believe in lower mortality risk, now is not the time to test it when healthcare workers are walking on their knees and lack of safety equipment exists.
My mother was one inch from being sent to hospital, taking up yet another hospital bed. A significant number of younger people will too. The healthcare system needs time to adapt, expend and get serious protection.
Dear Hampus,
Oh my god, I am so sorry to hear that. (And very happy to hear you all came out the other side.)
Here in the San Francisco Bay Area, where we are in our third week of shelter-in-place and will be continuing such for almost five more, they are hoping to push the peak of the curve out to mid-May.
I have a partner in Minnesota who’s managing a proposal for a new mass testing protocol (so I’m constantly hearing up-to-the-minute epidemiology) and she says that with the new s-i-p in place in Minnesota, they’re hoping to push the peak out until mid August. That seems very ambitious, but great news if they can pull it off.
Me, personally, I’m probably in fine shape. My best guess is there’s a 50% chance I will get covid-19 before this burns out, but an 80% chance I will be asymptomatic or minimal (based on my personal medical history). Which means, most likely scenario, I will be a potential carrier who will never know it! That’s disturbing.
I’m also partnered with an 83-year-old transwoman and, man, you want to talk about uncertain times! We broke protocol and I visited her about a week after s-i-p went into effect, because we ran the numbers and concluded that the risk factor to her was down in the 1:10,000-5,000 range. Which is considerably less than her normal risk of dropping dead over any particular weekend. So, okay.
But now the risk factor computes 100-fold higher, and that’s just not acceptable. Especially with our heightened level of uncertainty because — transwoman! She’s not working with an OEM body and trans-geriatric medical data is essentially nonexistent (one of the downsides of being at the front of the pack).
So, we stay apart.
Sheltering in place is proving to be an unexpectedly difficult adaptation, seeing as I work for myself from home and don’t go out at all most days. Except — now that I am required to stay at home I feel a lot like a cat faced with a closed door. “Well, no, I didn’t want to be on the other side of that door… until you closed it!”
pax \ Ctein
[ Please excuse any word-salad. Dragon Dictate in training! ]
Ctein:
Please, do not think that. Because that is what my mother thought, what we talked about just one week before she got sick, and the description above is what happened in reality.
And yes, two weeks locked inside my home and I’m crawling on the walls. I did not expect it to be so hard beforehand.
Dear Hampus,
I greatly appreciate your concern, but please do not fret over me too much. I do think that, but that doesn’t mean I believe it, put any faith in it. It’s merely what the statistics tell me. Trust me, I ain’t counting on that. We’re prepared, here, for the worst.
I don’t tell my friends and sweeties, “Oh, no cause to worry about me; I’ll be fine.” They are right to worry. I just want them to keep it in perspective.
pax / currently-contingently-non-covid-19 Ctein
@JJ: I’d like to think the young are less likely to buy into the Cheetoh’s lies, but I’m not sure how true that is — the old were not rioting at Charlottesville, for instance. (I suppose what matters is that there are some old fools who might attend to this article.) And I was wondering more particularly about Sweden, which from this side of the pond looks liberal enough that they should be immune to his nonsense — but I suppose that’s a limited view. I also have a limited view here, since I’m in Boston and have only been as far out as 128 once in the last ~month; I don’t know firsthand how the people who preferred Brown to Warren — let alone the 30% of this state that voted for Trump — are behaving.
@Ctein: you’re hardly alone in that feeling; the local paper ran a story on that line last weekend. It’s probably paywalled, so here’s the opening:
(Interesting — the double-asterisk-to-bold that was discovered here a few weeks ago doesn’t work inside a blockquote.)
I’m far enough out that going for a walk is still possible (and desirable — I need the exercise), since I can step off the curb if necessary to keep 6′ from someone coming the other way. But I’ve seen photos of how crowded the parks closer to downtown were last weekend, and am wondering how people living in those areas will get along over the next several weeks.
Clip Hitchcock:
People in Sweden are certainly not immune to the nonsense from Trump, I guess some 5-10% eat it up with a spoon and others have opinions that mirrors his, but as we have a centrist government in Sweden that is taking a very moderate approach, our rightwingers tend to be up in arms about the dangers of the virus.
The problem here is more of human nature, people not wanting to believe in their own mortality. Many who get angry at being called old when they feel so healthy. As if it was a personal attack and not a biological fact about changes in the immune system. Didn’t help that Sweden doesn’t impose a lockdown, curfews or close any stores.
But I think the last recommendations will get more people to understand. Yep, we don’t impose laws or forced restrictions. Our government recommends things. And if you don’t do what is recommended, then you prove that you don’t have folkvett (i.e common sense as applied to what everyone knows) which is a grave insult.
@Chip —
I am SOOOOOOO glad that I get to walk around on my own six acres of property. LOL!
@Hamus:
Even English, notorious for … borrowing … from other languages, is short of vocabulary to show aging as a sloping spectrum rather than a series of absolute steps; the U.S. may or may not be worse about this because of making so much fuss about milestones on the way up (e.g. legal ages for driving (16 or 18) and drinking (21)). I suspect the mostly-artificial division into age brackets (boomers, Gen X, …) doesn’t help.
Parts of the U.S. are very good at applying group ethos enforced by social sanctions — but ISTM it’s always on a tribal or religious-subgroup basis; the idea that the government could possibly have a common-sense idea is anathema to a large part of the population, which part has a large overlap with the part that’s most ardent about do-what-the-neighbors-do — and in this case the uncompliance has been aggravated by more-local governments insisting they know better than either the national government or the pointy-headed intuhlleckshuls. (Florida just put up a stay-in-place order yesterday; Texas still hasn’t, the last I heard.)
The BBC has written recently about Sweden, suggesting that Swedes may feel less worried because they lead the world in the fraction of population that lives alone (IIRC, just over 50%) — but I don’t recall whether the writer was close enough to have a plausible view.
Yes, I read the BBC article and I think it was a very good summary. But I think a lot of our trust lies in politicians taking the back seat. They are appearing on TV to talk about economics and how to handle the well-fare, unemployment and so on. All talk about how to handle the epidemic are done by scientists and experts from the department of public health. Having them patiently explain risks, what we can expect, how we can help, answer questions, makes everything much calmer.
@Hampus: The percentages Ctein gave don’t strike me as working out to low risk. 50% chance of infection, times 20% chance of seriousness if the person gets infected, means a 10% chance of being seriously ill.
Even “there’s a two percent chance that you will become seriously ill in the next few months, and there may not be enough doctors or hospital space to take care of you” is scary. (I am not sure of my actual risk; at this point nobody is.) But the other thing is that it’s additive: The more people you know, the more likely it is that at least one person you know will have a serious case of COVID-19.
Dear Vicki,
You’re reading way too much into what I wrote, giving it far more weight than you should and far more specificity. I was talking about the kind of numbers I use for my own personal decision-making.
Nobody knows with any degree of certainty what the ultimate penetration will be. It could be as low as 10% or as high as 95%, at the unlikely extremes. 50% seems like a plausible number to me, trying to err on the side of conservatism.
Similarly, asymptomatic-to-so-mild-you-don’t-realize-you-have-it cases could be as few as 50% or as high as 90% of them. I’m using 80% which is at the high end of the most probable range, because I’m thinking conservatively about the health of my sweeties.
You may mean something different by “seriously ill” than I would. But to my thinking, there’s a big gap between “so-mild-etc.” and “seriously ill.” The overwhelming majority of cases where people know they are sick impact them about as severely as a mild-to-serious cold or a normal case of the flu does. Yes, you know you’re sick and you’re definitely not happy. That’s way below the “need to be hospitalized” level.
Please do not try to extrapolate from numbers I’m casually tossing out. You will get wrong answers, badly wrong answers, in both the optimistic and pessimistic directions. I’m not providing complete epidemiological data and even if I were, it would be obsolete in a day or two.
pax / Ctein
[ Please excuse any word-salad. Dragon Dictate in training! ]
Excellent if very sad essay (get well, Ingrid).
Speaking as one with more than a passing familiarity with the literature on the subject (and a background in biochemistry and microbiology)… the symptoms she describes indicate catastrophic thyroid shutdown. This is not unknown secondary to other infections, but it is consistent for serious COVID-19 — I’ve seen the same telltale symptom set over and over with these firsthand descriptions, and with doctors’ descriptions. The question is … when we can’t get MDs to look at low thyroid as a root cause for other disorders**, how do we get them to consider it as a particular issue with coronavirus?
** probably half of all chronic health issues, and most of the “symptoms of aging” are [per a broad swath of the literature] in fact due to low thyroid, which can cause everything from tooth decay to cancer (yes, really). Look up “300 symptoms”, a non-exhaustive list. And 80% of people over age 50 have some degree of hypothyroidism (usually due to declining conversion of T4 to T3, which the TSH test will not catch. Test FreeT3 instead.) That alone may explain why this disease clobbers the aged so badly.
@Ctein: I’m not making plans based on your numbers, so no worries there.
My point was just that while someone else was interpreting your numbers as reassuring, the same numbers read to me as yes, this is serious.
The question being, what percentage chance counts as high? That’s partly individual psychology, and partly what those numbers are relative to. It’s also partly how the numbers are presented: “don’t panic, your risk is less than one percent” and “we estimate that this will happen to 30,000 people in Massachusetts” could describe the same situation. [These are numbers pulled out of the air, please don’t use them to predict anything. Like Ctein’s disclaimer above, but moreso.]
Dear everyone, I just want to tell you all that I have close to recovered by now. At least when it comes to intellectual work. I still loose my breath when I try to walk fast.
Concerning the hypothesis on hypothyrodism: I have never heard of “acute thyroid shut down” in combination with an acute infection disease. The later are very common, in all ages, in all parts of the world, in all societies. This shut down should be followed by an acute starting up again? Does not seem plausible.
During different periods, in different parts of the world, various explanations have been put forward as the causes of diffuse combinations of diffuse symptoms. In Sweden during the laste decades, the causes has been amalgam in the teeth and radiation from mobile phones and mobile masts. The hypothyroid theory is not so strong. There is no scientifical evidence for any of these causes.
I’m MD, specialized in family medicine (5 years), Master of public health. I have been the president of the Swedish Doctors for the Environment.
Hi Ingrid,
Glad to read that you are recovering well.
(Here in New Zealand we are still in lockdown but the daily new cases are reducing & we might be in a position to eradicate COVID19 from our country if we keep going this way.)
Soon Lee: If you want to have a country without corona, you have to isolate the whole country from the rest of the world. No travelling to New Zealand – you will have to continue isolating yourself for ever. Everyone who wants to enter NZ must stay in quarantaine for at least 2 weeks. Noone in NZ will be immune, so travels abroad is not recommended.
No, we have to accept that the corona virus will spread all over the world. It is a question about how fast it spreads, and how the health care systems can cope with it. In some years, we will have a “herd immunity” that slow downs the spreading, like with any other influenza. Plus probably vaccine.
In Denmark, the politicians decided to close the borders and the school. Now they are afraid that the virus is spreading too slowly, so there might be a serious second wave after summer. It’s a delicate balance …
@Ingrid,
Yes I agree that we will be living with COVID19 for some time to come. New Zealand (being an island nation) has the advantage of being able to close its borders and keep people (and COVID19) out. The current plan is to eradicate COVID19 from New Zealand. And have a 14-day quarantine for anyone coming into the country.
It will effectively kill our tourism industry. Life will be different under those conditions. The number of new cases reported in the last five days are 89, 67, 54, 50 and 29 which tells us that the current lockdown is working.
I think another reason for wanting to keep New Zealand isolated is that we (in the Southern Hemisphere) are now heading into our winter, so want to avoid an outbreak of COIVD19 and/or influenza.
Well, probably not forever — only until the development and mass production of a safe and effective vaccine. I’d say likely 2-3 years at most.
There are huge efforts currently underway to develop a COVID19 vaccine but it will take time. Currently there is no vaccine for any of the known coronaviruses, so if/when we get one for COVID19, it will be the first.
(And because nobody has made an effective coronavirus vaccine before, it’s hard to predict how long it would take. I am not holding my breath for a quick fix.)
Today New Zealand’s second COVID19-related death was announced and 44 new cases. The number of new cases is flattening out, but we’re not out of the woods yet. FYI New Zealand has a population of ~5 million.