Chronic Rants

For weeks, whenever someone asked me when I would be eligible for the Covid-19 vaccine, I told them I would be eligible at the start of Phase 2. They nodded. It made sense. It made sense to me, too. After all, I have a bunch of risk factors. Phase 1 was for medical personnel, and Phase 2 would be for folks with risk factors due to age and/or health conditions, as well as essential workers who weren’t covered in Phase 1 (grocery store worker, utility workers, delivery workers, etc.). Phase 3 was for everyone else. The first part of Phase 2 was for folks who were 65+ or had 2 or more co-morbidities, which I knew I had. But somehow, oddly, I was wrong.

I started to suspect something when I saw the list of conditions that Massachusetts was counting as co-morbidities. At the time, the state’s website simply offered a link to the CDC’s website. The CDC (the Centers for Disease Control and Prevention) offered two lists. The first list was for more serious conditions. I didn’t have anything on that list. The second list was where I fell. I have 5 different conditions/medications that fit into that list. But for some reason, Massachusetts wasn’t using the second list, only the first one.

Then Massachusetts did something mysterious: they added smoking and obesity to the list of eligible conditions. So now people I knew were qualifying because they smoked and were obese but were otherwise totally health. Meanwhile, I wasn’t eligible yet despite having multiple autoimmune conditions and taking an immunosuppressant medication, in addition to other things that were also suspected to be co-morbidities, like central complex sleep apnea. In fact, I wasn’t going to be eligible early at all. Nope, I was getting lumped in with the general population in Phase 3. WTF???

Over and over friends would ask, when are you eligible? Over and over I responded, “I’m not eligible until the general population.” I lost track of the number of times someone said, “I can’t believe I’m eligible before you!” or asked “Why the hell aren’t you eligible before me?” (Spoiler alert: the answer is ableism.) I watched friends with similar health conditions getting vaccinated in other states. I watched friends get vaccinated because they were technically eligible, even though it wasn’t intended for them. For example, one was eligible because she works for a hospital, even though she works in administration, having no contact with patients, and has been working at home all year.

Meanwhile, at my last medical appointment my doctor said, “You need to get the vaccine as soon as possible.” That was immediately followed with, “You aren’t eligible until Phase 3.” I tried to convince myself that waiting wouldn’t matter. After all, I’m staying at home, right? But what happens when I can’t stay home? What really changed my mind was the breast cancer scare I had several weeks ago. I absolutely had to be seen in person. What happens the next time I have to see a doctor in person? Because sooner or later, it will happen again. The vaccine won’t protect me 100%, but it’s a good start.

And to me, that’s the point. Yes, everyone wants the vaccine. But while some folks want to get it so they can eat at a restaurant or hang out with friends (both very important, and I’m definitely not negating the importance of either one), those are optional. There are ways to see people outdoors and at a distance with masks on. Meanwhile, some folks must get medical care, in person, up close, and indoors. Yes, medical offices take precautions. Still, these are not optional visits, and we should be as protected as possible.

Are there folks who need a lot more medical care than me? Yes. Are there folks who are at much higher risk of Covid complications? You bet. I’m not suggesting that people like me should have been first in line. Not for a second. I am saying unequivocally, without the slightest hesitation, that we should not be last in line. It is inexcusable.

This is nothing short of ableism. I have had many doctors tell me that I am at higher risk. My rheumatologist keeps reminding me to stay isolated. I have been following the science. I see folks who have higher risk factors than me who are likewise not eligible until the general population. And yet, Massachusetts did not take us into account. Who determined the order of the vaccine eligibility? Were there doctors and scientists involved? How on Earth did this happen? Why allow folks on that first CDC list but not the second? Why allow people who are obese and have type 2 diabetes to get vaccinated at the start of Phase 2 but not allow someone with type 1 diabetes and severe asthma until the end of Phase 2, and not allow someone who is 54 years old with type 1 diabetes and liver disease until the general population? This makes no sense.

This reminds me of one year ago, in the spring of 2020, when we were first learning about the risk factors of having severe complications from this horrible virus. Over and over people said that most folks shouldn’t worry too much because it mostly just effected the sick and elderly. They were saying, “I’m not worried because I’ll probably be fine, it’ll just kill others.” They were saying that they didn’t care about our lives. That our lives didn’t matter as much. That our lives had less value. Well, fuck that. Our lives have plenty of value and suggesting that it’s okay for those who are sick and/or elderly to become incredibly ill and possibly die is horrifying and inexcusable.

And now, one year later, so many who are sick and older are told to wait because their/our co-morbidities don’t count. What bullshit!

This week, Massachusetts announced that in one month everyone will be eligible for the vaccine. So many disabled people, already at a disadvantage because of difficulty accessing the system, will be forced to compete with healthy, less-at-risk folks for those coveted timeslots. If the past is any indication of the future, a lot of disabled folks will end up at the end of the line, behind healthy folks. This is not ok.

There is nothing I can do about this. I called the governor’s office and reached out on social media. I have spoken up about it in the few ways that I could. I know that this post won’t change anything. But hey, this site is called Chronic Rants, after all, so I am ranting. I am ranting because once again, the government is being ableist and getting away with it and it makes me want to scream.

Maybe we shouldn’t be first, but we absolutely should not be last.

With hospitals becoming overwhelmed with COVID-19 patients, choices have to be made. Who will be treated first? If there aren’t enough ventilators for everyone, which patients will get one, and which won’t? This is a difficult conversation to have. Unfortunately, many places are putting policies in place which devalue the lives of people with chronic illnesses.

Part of the rationale is that people with certain medical conditions will take more care than people who are otherwise healthy. I understand that spending 10x more hours on 1 patient means that others will receive less care. Another part of the rationale is that the focus should people in the patients with the greatest potential health outcomes. If the choice is between saving the life of someone who is 70 or saving the life of someone who is 30, this reasoning says the 30-year-old should be saved because they are likely to live longer than the 70-year-old would, even if both recover fully. And if two 30-year-olds need treatment, one with a chronic illness and one without, the guidelines say to treat the one without chronic illness first. In fact, a ventilator may be taken away from the chronically ill patient and given to the otherwise healthy patient!

This is where these conversations often quickly devolve into which lives are most “worth” saving, both amongst policy makers and amongst everyone else. I have a lot of issues with this. Yes, I have chronic illnesses. Yes, my care could be more complicated than the care for someone who has no chronic illnesses. But does that make my life less worth saving? Does that make me a less valuable person?

In the chronic illness world, we say that our productivity does not determine our worth. That is so true. I’m biased, of course, but I think my life has a lot of value. I have not had a full time job in more than 8 years but, contrary to what many believe, that does not mean that I haven’t contributed to society in that time.

On a smaller scale, I am a good friend and daughter. I provide advice, let loved ones cry on my shoulder, celebrate good times, and more. I also do volunteer work in formal settings and provide help to many people in informal ways. (So many friends and friends of friends have sought my advice on how to approach doctors, how to research health problems, or even how to fix a computer problem. Earlier this month I even helped a couple of friends do their taxes.) I have written a book about chronic illnesses, I stop to hold open the door for strangers (pre-pandemic, that is), and I do random acts of kindness (like when a kid at the convenience store could afford the food he’d picked up, so I paid the balance – again, pre-pandemic.) I write this blog, which I believe helps people. Does it change the world? No. Does it change some tiny part of it? I hope so.

Why is all of this considered to be worth nothing simply because I don’t have a job? Infuriatingly, people are arguing that’s the case.

And what if you can’t do any of the above? Your life still has value, and you deserve to be treated as such. These are just examples from my own life. I’m sure you can offer your own examples, past, present, or aspiring to in the future.

What’s more, why should someone be treated as “better” because they are “healthy” and work full time regardless of other factors? Is a CEO who earns millions while harming others somehow superior? What about people who are racist or homophobic but work full time? What about people who steal or assault others? What about those who are just plain mean? Why is working at a job so often a litmus test, while these other factors are completely ignored.

To be clear, I am not suggesting that patients must pass tests to prove they are “good” people before receiving treatment. I am simply pointing out that there are many factors that *could* be used when the conversation turns to who is most “worth” saving, yet so often people talk about folks who receive government benefits and who do not work at jobs as having less perceived value. This hurts. They are saying that I have less value. They are saying that people I care about have less value. They are saying that we should be allowed to die so that someone else might be saved, and that this choice is being made solely due to our having chronic illnesses.

That is why I am standing up today to say that I have value. And so do you.