What does the science suggest is a reasonable level of Covid shielding for PwME?

I'm wondering what the science about viral load thresholds, general epidemiology, etc. says at this stage about how PwME (or anybody) who needs to protect themselves from Covid should be shielding and what we can probably get away with.

For instance, is it safe to go into a shop for 10 minutes without a mask? If someone (unknowingly) has Covid, how long is it safe to be standing a normal distance from them indoors? Outdoors? What about if you're wearing an N95 mask? How useful is the two-metre rule? How likely is it that a random stranger you might talk to has asympomatic Covid?

Many thanks!

 

My understanding is that, if you're unmasked and you meet people indoors, it's mostly down to luck. There are too many variables you can't control to make it possible to manage (or even calculate) the odds.

Seeing people outdoors, and/or wearing a good mask, is different. It's not impossible to get infected, but at least you have the power to tip the odds in your favour.

Some people don't know they're infected when they pass it on others. They're not offered access to tests, it's no longer possible to differentiate Covid from other respiratory infections by the pattern of symptoms, and some never get any symptoms in the first place.

And then there are the people who do know they're infected, but have to go to work anyway. They can't afford to lose the income, or they've been told they risk losing their jobs if they take sick leave.

I think scientists only have a broad idea how prevalent it is at any one time, based on studies like the Office for National Statistics survey. This doesn't get much publicity, but it's still running—I've been on it since 2020.

 

I think if anyone proposes clear, definite numbers for risk/distance or risk/time in store, they don't really know anything about viral infections. There are way too many variables involved. There are some very broad guidelines, such as "wearing an N95 mask reduces your risk more than a cloth mask", or "risk does reduce with distance from the possible carrier", but I don't think you can put any hard numbers on risk. I think it comes down to using common sense. ... and not forgetting to take those common sense measures, such as remembering to check whether you have a mask with you when you go out. The few times I've remembered about masks it's usually when I'm partway through my shopping, and the mask might be at home or in my glove compartment.

 

I'm not sure there is any accurate answer to any of your queries.

I've had it 3 times now, with no serious long term effects. I actually managed to catch the very first version, during our first lock down. The only person I had met was my supermarket delivery driver, who with hindsight did look very ill, but was only on my doorstep for about a minute. Despite being quite ill, I didn't realise I had Covid for 10 days, until my GP told me that was what it was. Maybe my symptom pattern was a bit unusual, because I already had ME. Anyhow as I didn't realise I had Covid I didn't self isolate, and during those 10 days I shared a bed with my partner and hung out with my 84 year old dad, and neither of them caught it.

Since then I have had it again twice, and again didn't seem to infect anyone. On the other hand, that supermarket delivery driver may have infected half the town. I certainly know of somebody else in my town who has ME, who caught Covid from a supermarket delivery driver. Maybe it was the same driver?!

I guess the point I am trying to make, is that infectiousness seems to vary according to the individual. You can spend a minute with one person and catch it, and hours with another person and not catch it. Very strange. At this point, I think it's best just to not worry about it.

 

I have, including the first viral infection that gave me ME, and further infections have smacked me down further. I don't always come back up, even after many years. That's why I've been shielding thus far.

 

I hear you Sasha, i wish it were possible to know. For the first 2.5 yrs i shielded and was frankly obsessive, i wiped all my shopping, was really hyper vigilant. All my carers wore N95masks, as did i - they ate in their cars so they werent in my home without a mask.

And the risk is still the same, the most recent figures for ONS put the infection rate IIRC at roughly 1 in 50 people.

But since last yr i decided to assess based on risk/benefit. My fear is of becoming very severe and the thought is petrifying. However i take all sorts of other risks and dont think about them. Such as getting in a car - an RTA could leave me paralysed, seriously injured dead etc (although death would be a relief for me nothing to fear), bit i could be hospiitalised for a few days for some injury and end up ME getting more severe due to hospital environment.

And yet i think nothing of it.

So once i realised that covid was going to be round forever & that the measures i had then were unsustainable, i just now weigh each thing with how much benefit i will definitely get, against how likely (roughly) it is & mitigate wherever possible.

Eg my carers no longer wear masks but they must do covid tests before each visit. My carers were getting really fed up with the masks & it was affecting their ability to be in a good mood while with me. This affects me a lot so the benefit was higher than the risk. But i make sure the windows are on the latch to allow ventilation & i have monitored which way the air flows in my home (by getting someone to put something slightly smelling in one area to see how fast i smell it. (i have a nose like a bloodhound really really storng & sensitive sense of smell), so i open the window a little more in one side of room than the other so their breath it more likely to move away from me than towards.

That may not make sense but what i mean is i have thought about ventilation & air flow.

My cleaner who spends only 1 hour here still wears an N95 & so do i. - there is no benefit (to me!) of not doing.

I wear N95 in all public places indoors and crowded places outdoors, and i dont give a hoot about the looks or comments, - which to be fair i dont get many of - i am in wheelchair pushed by carer & due to sensory overload or crashing, i am often quite cognitively impaired, so most people think i am either super vulnerable, or intellectually impaired.

The only time i take it off indoors is when i am actually in consulting room with Drs - i have a 'somatoform disorder' dx on my notes as well as CFS, and the risk to my health of whatever dr i am with thinking i am hypochondriac & not taking whatever i seeing them for seriously, or of adding to the risk of sectioning or whatever - this is scarier to me than the slight risk i might get covid/flu etc. So i just have it on in corridors/witing room & then take is off in the consult room.

Isolation was making my mental health even worse which is a concrete harm that was actually happening - weighed against a potential harm that might happen...
In addition, the flu is just as likely to cause worsening & yet pre pandemic i went everywhere i needed to, unmasked, without thinking about it.

I want to avoid it as much as i can without making my quality of life permanently significantly worse against something that might never happen.

I also let delivery drivers bring shopping in now, but i wear a mask, & i open all doors & windows while they here & for a short while after they leave (depending on how windy it is lol if its windy the air exchanges faster - but then who knows what can blow in on the breeze?

It was really scary dropping all my shileding/hygiene measures, but luckily have been ok so far.

In the absence of science saying for definite any of these things, and most you can get for authorities/medics is either propaganda or ideology or just plain nonsense, i am just trying to do what is possible, what is sustainable. I have to take off my mask at the dentist. so i go as her first appointment of the day. This is possible and worth the gross inconvenience.

Its about what feels right to you. Its a terrible choice Sasha i feel for you i really do. Its just luck with minimal control, same as getting in a vehicle - the driver can drive well but you cant control for all the variables.

The lack of certainty is hideous.

ETA sorry @Sasha, that was an absurdly long ramble that didnt even asnwer you question - i got nothin on the science questions.

 

I haven't read anything about what science says about the specific risk to PwME. Maybe there isn't anything relating only to ME at all - ?

My last sudden deterioration happened a very long time ago after a very bad cold (could have been the flu I suppose) and my goal since covid is to avoid that happening again.

When I see most people not wearing masks, I assume every one of them is infected because knowing another sudden deterioration was my own fault would be more than I could bear. I'm prepared to live a different, more restricted life for the time being.

 

No worries, @JemPD, better out than in! Sorry you're also having such a struggle.

 

One of those dreaded "superspreaders"?

 

Viral emissions into the air and environment after SARS-CoV-2 human challenge: a phase 1, open label, first-in-human study (2023, The Lancet Microbe)

 

I wore a proper fitting quality N95 mask 2 1/2 weeks ago when I was out grocery shopping and caught a cold or possibly Covid. I developed a sore throat, coughing all night and mild muscle fatigue for one week. The maskless cashier was talking too much when I was only 3 ft away from her. My friend and I were the only ones wearing masks, my friend didn't get sick.

The medium size grocery store was only 1/4 full during that time.

I got my flu and updated Covid jabs a couple of months ago so that would have certainly helped lessen the symptoms but I don't know what virus I caught.