By Delaney Kenyon | Image by Patil Khakhamian
Amidst the pandemic and recent discussions of vaccination and related anti-vaxxers, people have suddenly become aware of a population of people that have always been here — immunocompromised people.
Immunocompromised people are generally considered a subset of the differently-abled community. It is highly diverse, including some people undergoing temporary treatments that lower their immune system’s ability to function fully, such as undergoing chemotherapy or radiation, others undergoing steroid treatments, recent surgery patients, and more. Others in the community have long term, chronic health conditions that constantly affect their immune system — people with blood disorders, organ transplants, or lymphatic issues.
I fall into the last category. I was born with a permanent malformation of my lymphatic system, which basically means I get bad bacterial infections very easily and quickly. For example, a simple cut with staph in it would get trapped in my malformed system and reproduce quickly, leading to fever, swelling, tenderness, redness, itching, and pain. Sometimes I have to be hospitalized with IV antibiotics and sometimes I can get away with just oral antibiotics. Over the countless infections I’ve had in my life, I’ve become good at identifying the severity and speed at which an infection could take hold and determining what I need to do. I’ve gotten good at learning how to adjust, as has every other immunocompromised person.
Growing up, my parents always had the mentality of “do everything you want to, but always be prepared for the worst.” My dad, an avid outdoorsman, always strived to get me involved outside. With a strong preventative safety mindset, we would set off into the wilderness with emergency antibiotics bouncing in the brain of my backpack.
Being immunocompromised in the outdoors has always been a subconscious thing for me. I try to wash off or towel off regularly. I bring hand sanitizer and wash my hands before and after meals. I bring more bras and shirts than I need so I can change out regularly (part of my malformation includes making sure my left arm and chest is as clean as possible). I avoid getting too dirty. I monitor myself for symptoms daily. I always bring an emergency course of antibiotics.
Before COVID-19, immunocompromised people were already battling a pandemic. Antibiotic-resistant bacteria threaten the life, health, safety, and sanity of every immunocompromised person I’ve ever met, but it’s not talked about, researched, or explained because it’s not economically profitable for pharmaceutical companies to invest in use-for-two-weeks-and-then-you’re-done things. It’s much better for said companies if they work on developing lifetime drugs that people must then continually rely on, such as pills for high cholesterol and high blood pressure.
While being immunocompromised in the outdoors may not have been a conscious thought in the past, being immunocompromised in the middle of a pandemic surely is. Every single thought and decision is peppered with “Can I avoid this?” “Can I do this differently?” “How can I avoid contact as much as possible?”
Now that thinking has been applied to my time outdoors, and I have noticed that more and more people who normally wouldn’t have gone outside are getting outside. Which is great! … and bad all at the same time. I’ve seen more litter and more detritus on the trail than ever before, and more confused, lost hikers who need help orienting a map. I see more out of shape, huffing and puffing people without a mask (don’t get me wrong, I’m out of shape, too — it’s the not wearing a mask part that’s bad) that more experienced hikers who have a long-standing relationship with the outdoors must deal with.
Being immunocompromised just further adds to moral dilemmas in the outdoors for me. Previously, if I saw trash, I would pick it up and continue on. Now, I weigh the risks of my personal harm should I contract COVID-19 from that surface with the wide-scale ecological disaster that littering is causing. I have had to figure out how to orient hikers from afar when previously I could help them from up close, and I’ve had to learn how to assess how lost they truly are.
Do I have a moral duty to put myself at risk to prevent someone from getting lost, potentially injuring themselves, and/or dying? Should I just stay home even though the outdoors needs environmental stewards now more than ever? And even though getting outside is pivotal for my mental and physical health? Should I visit less-trafficked trails to avoid people, even though I could be harming the environment there? Should I be avoiding inexperienced hikers? If I do, will the trails and spaces I love be destroyed in my absence?
None of these are yes or no questions; none even have answers. I think about all of them now. I’ve never had to consciously think about my immunocompromised relationship with the outdoors before, and now I don’t think I’ll ever have that luxury again.
So, to the people who have the privilege of not being immunocompromised: be responsible on our trails. Treat them nicely. Always pack out your trash. Stay on the trail. Never carve things into trees. Wear your mask. Because if you don’t, we, your immunocompromised peers, may never be able to engage with the outdoors in the same way again.