Life as one of ‘the vulnerable’
New Zealand’s Covid-19 restrictions continue to ease as case numbers dwindle. However, a life of anxiety and constant vigilance continues for the immune-compromised.
Dallas Cherrington has been fighting off infections all his life. He has cystic fibrosis, a lung and pancreatic disease.
It’s a life-threatening illness, says his mum, Sheridan Waitai. His condition puts him in the vulnerable group outlined by the Ministry of Health as being at risk of severe illness from Covid19.
Although the last community transmission case was recorded in early April, the virus is still likely to be present in New Zealand.
‘‘It’s definitely playing on my mind a bit. The thought that it’s out there somewhere,’’ says Cherrington.
This week, Prime Minister Jacinda Ardern announced a phased de-escalation of alert level 2, opening up more parts of the economy and possibly increasing the size of gatherings every two weeks. Cherrington is in no rush to get to level 1, or for the borders to reopen.
For the 21-year old, the scariest thing about level 2 is the number of people in public. It’s made him more cautious about leaving home.
‘‘It’s definitely a big concern going out into public, even just to the gas station,’’ he says. ‘‘I wear my mask everywhere and have heaps of hand sanitiser in my truck.
‘‘It’s kind of scary. It can spread easily because everybody is active again.’’
Cystic fibrosis is a lifethreatening genetic disorder. Normally, mucus lubricates the insides of a body and helps protect from infections. But cystic fibrosis thickens the mucus and makes it sticky, trapping bugs. The condition can affect all the organs, but mainly the lungs and digestive system.
‘‘It blocks the tiny fibroids of the lungs, that’s why you’ve got to do lots of physio to break it up,’’ says Waitai. ‘‘When they get blocked, it’s susceptible to growing infection, bad bugs.
‘‘They scar the lungs. You can never heal.
‘‘If you’re lucky you might get the gift of lungs. If you survive that, you might get a few more years.’’
Although medical advancement is continually improving the lives of people with the chronic illness, Cherrington knows the disease has shortened his life expectancy.
He tries not to dwell on it, and his wha¯ nau and friends help keep him positive. He keeps busy and has started making hunting videos with his cousins. Counselling has also helped him.
‘‘We had a bit of a scare last year. I was growing a bug that could have been fatal,’’ says Cherrington. ‘‘It does get me down every now and then, especially over this last year or two.
‘‘I just try to look at the positives. I live a fortunate life. I may as well live it and be happy with what I’ve got.’’
His life expectancy isn’t something they’ve talked about too much as a wha¯ nau, says Waitai.
‘‘Every day for us is a blessing, every moment. I worry about him daily. If I was to think about it too much I’d probably lie down and not want to get back up.
‘‘Some days I wonder how the f... do I stand up.’’
The wha¯ nau is from Te Paki in the Far North. But Cherrington lives with his grandparents in O¯ ta¯ huhu, south Auckland, so he can access Auckland City Hospital and study for his accounting degree.
He’s still considering whether he will return to classes at Massey University in Albany or continue to work remotely for the rest of the year. He’s selective about whom he meets up with.
‘‘I’ve been able to visit a few of my friends who have been properly isolating. Any that I know that didn’t isolate properly I’m like: ‘Mmm nope, don’t come around here.’
‘‘I don’t want to get myself sick and I live with my grandparents, so it’s putting them at risk as well.’’
About 550 people in New Zealand have cystic fibrosis.
There have been a few reported cases of coronavirus infection and recovery among cystic fibrosis patients overseas. However, the Lancet reported in April that there is no room for complacency. The directive for social shielding of the patient and family members remains clear and important.
Public health expert and epidemiologist Professor Michael Baker says complacency is also the enemy when trying to eliminate the virus.
‘‘The threat of Covid-19 has been consistently underestimated across the globe, with tragic consequences. Outbreaks are possible at any time and can develop rapidly before they are detected, taking many weeks to contain.’’
He says New Zealand needs to consider additional measures that could safeguard everyone.
‘‘These measures include the introduction and high uptake of a contact-tracing app or card, ‘mass-masking’ in enclosed public places, and a strong emphasis on measures to protect vulnerable populations in hospitals and rest homes.’’
Waitai says their family has never been complacent about her son’s care.
‘‘It’s part of our life. We’ve always let wha¯ nau know when
Dallas is unwell they’re not to come around. If someone is already vulnerable you shouldn’t visit their house.
‘‘When Dallas is at the marae, I sometimes say don’t shake his hand, he’ll greet you with his eyes. It breaks our heart because that’s not our tikanga, but that’s my son’s life.’’
Cherrington doesn’t want to stay isolated and he doesn’t think others at risk need to remain at home, because they will feel excluded. Mother and son would prefer the public to take more care of their own actions to protect vulnerable people.
Ardern says rapid contacttracing, social distancing, staying at home if even slightly sick, washing hands and tight border restrictions are our new normal. That new normal is what the family has been living for the past 21 years.
‘‘Don’t just be rolling up to your grandparents’ house to say hello after you’ve been hanging out with who knows. It puts them at risk,’’ says Cherrington.
‘‘People just don’t get the consequences. You could get your grandparents sick and literally kill them. It’s not really a good idea, eh.’’
Public health specialist Dr Rhys Jones doesn’t want to see those at risk disadvantaged, but
says they do need to be protected. ‘‘If they’re prevented from going back to work because they’re at high risk of Covid-19 then we need to be doing something to provide financial support during that time.
‘‘Employers need to think carefully about how they could accommodate people who are at high risk of Covid-19 coming back to work. But to do that where they are safe and physically distanced and taking all the precautions, so they’re not exposed to the coronavirus.’’
He says going back to work can have really positive health benefits, not just financially.
‘‘Sometimes employees just need to be innovative about how people are brought back into work. They may need to work differently to be able to protect themselves but can still contribute and be part of the workforce.’’
Cherrington was meant to go into hospital a week before lockdown for his regular three-monthly mucus cleanout. But his wha¯ nau told him to stay away from the hospital and get out of Auckland because of the coronavirus risk. He drove to Te Paki to be safe with his family in a three-house bubble.
Waitai says the decision was a difficult one, because missing a three-monthly cleanout basically takes time off his life.
Despite the risk to his health, the wha¯ nau helped set up a
Covid-19 response hub for their iwi, Nga¯ ti Kuri, and the neighbouring tribe, Te Aupo¯ uri.
Cherrington was able to work even though he stayed at home. He logged all the comings and goings of the response so the two iwi and Te Pu¯ ni Ko¯ kiri, the Ma¯ ori Development Ministry, could track all the data and identify where the need was.
The response included an 0800 helpline, water deliveries before lockdown, hundreds of food and care packages and road checkpoints. Each parcel had the
0800 number stapled to it with an orange ribbon. It was tied to the RD box to let others know people were self-isolating.
The borders were closed before level 4 in four geographical bubbles, from Te Rerenga Wairua/Cape Reinga to Te
Ha¯ pua, Te Kao and Te Ngataki.
Demographically, it’s one of the most deprived areas in the country, says Waitai. It has a high Ma¯ ori population, predominantly elders and children. The community has been hit by other epidemics in the past. They felt vulnerable to coronavirus.
Waitai is a trustee for the Nga¯ ti Kuri Trust Board and was asked to mobilise the community. She says her first response was: ‘‘Why me? I’ve got more to lose. I’ve got Dallas.’’
The iwi knew she would make sure everyone was trained because she understands the risk and wouldn’t let anything happen to her son.
‘‘For the first two weeks, every time someone left the bubble to get supplies or food I felt sick,’’ says Waitai. ‘‘I felt like I was sending them out on enemy lines.
‘‘I was like what if it’s one of us that brings it in? Because the one who’s going to die will be my son.’’
Cherrington will be admitted to Auckland City Hospital on Monday for a cleanout that could take days, maybe weeks, or even months if a bug has grown.
Jones says that, as the health system ramps up again, priority will be given to the people with the highest risk. Particular focus should go on some of our most atrisk populations, such as Ma¯ ori and Pacific people.
Covid-19 is likely to go on for a long time.
‘‘So we need to look for ways for people to get out and about in ways that are safe and don’t expose them to undue risks.
‘‘If people follow the guidelines really strictly, then it will help reduce the transmission.’’
He says there isn’t one rule for everyone who is at risk from coronavirus. To some extent, it will rely on them and their wha¯ nau to make common sense decisions.
For social gatherings such as tangihanga, he suggests participation is judged on a caseby-case basis.
‘‘You may be able to have tangihanga again, but make sure some of our kauma¯ tua and highrisk people are kept out of the main part of the hui where there are going to be crowds of people.’’
He says it will be critical to know where the virus is, and he is backing strong contact-tracing measures for all communities.
‘‘There needs to be a longterm focus on coronavirus.
‘‘We need to be very vigilant. We always need to be on the alert for it reappearing in our communities.’’