Karen Taylor, who has been accepted to Clinica Ruiz, wants a medical exemption when she comes home. Photo / George Novak
A Tauranga woman unable to walk and with a compromised immune system fears the country's managed isolation facilities won't be able to care for her when she returns from weeks of extensive chemotherapy.
Karen Taylor's application to self-isolate at home when she returns from extensive medical treatment in Mexico to slow the progress of her multiple sclerosis (MS) has been declined.
It's despite another Tauranga woman having her exemption granted when she came back from the same treatment late last year. That woman said going into a hotel room with a compromised immune system was "out of the question".
But the ministry in charge of isolation facilities says Taylor's needs can be met in an isolation facility and applications are assessed on a case-by-case basis.
Multiple sclerosis is an autoimmune disorder in which the immune system eats away at the protective covering of nerves. It affects movement, sensation and body functions and there is no cure.
Taylor was diagnosed with the disorder in 1996 but it has only progressed recently.
Sitting down, the real estate agent looks like anyone else.
It's when she stands up to walk, using the wall as her aid you realise just how much she has lost.
"I can just feel my legs, it's like a dead leg ... and it is getting worse. [In December] I picked up a coffee and I couldn't even lift it so I had to use my left hand.
"I wasn't walking very well and Paul [Taylor's husband] and my son said 'you are going to have to resign, you can't sell a house when you can't walk'."
Now Taylor is readying herself for a treatment to help slow the progress of the disease.
"I just hate feeling like this but the main thing is I need to move forward and now I have no job I just want to try my hardest to get some help.
"I never thought I would ask but I think I need a crutch to walk with because my balance is completely shot."
Taylor will be arriving in Mexico on May 2 to receive an autologous hematopoietic stem cell transplant - a treatment for autoimmune diseases to slow or stop the disease progression.
Put simply, the treatment removes auto-toxic immune cells from the body. Then the patient is exposed to high-dose chemotherapy to combat the disease. Finally, the cells are replaced with stem cells that no longer attack the body.
The new stem cells migrate to the bone marrow and over time rebuild the immune system.
After treatment, Taylor is due to return to New Zealand on June 1 and applied for a medical exemption to isolate at home rather than in a MIQ facility.
Her neurologist, Dr Andrew Chancellor, believed recovering from treatment at home would be best for her due to her low immunity, so they applied for a medical exemption.
In a supporting letter to the Ministry of Business, Innovation and Employment, which runs MIQ, Chancellor wrote, "her risks for acquiring Covid in New Zealand are less if she isolates at home in Tauranga, rather than in a government-directed facility where there may be pre-symptomatic individuals".
But on February 12 the ministry declined the application.
A letter outlining the decision read: "Advice from medical experts at our managed isolation and quarantine team confirm that all of your particular needs can be safely met within a managed isolation facility.
"Having considered your circumstances and all of the information available, and balanced these against the rise to public health, I have determined, that unfortunately, your application must be declined."
Taylor cannot understand how she would be safer in a facility where she might not be able to walk to her own bathroom compared to at home where her husband could ensure she was okay.
"I wanted to come home and have it here, I have upstairs with a bedroom, bathroom and a deck. If I am not feeling 100 per cent they will have to help me shower, I could feel faint - but what I will have to do is ring when I shower so someone is in the room.
"I know some people are coming home because they are dying, which is very sad, but I am trying to get better so I can live."
People can apply for exemptions on specific grounds but the threshold is extremely high and very few exemptions are granted, a MIQ spokesman said when asked about Taylor's situation.
Decisions on exemptions from managed isolation were made with the health and safety of the New Zealand public at the forefront, he said.
"All medical isolation exemption applications are carefully assessed by an independent and external health adviser, to determine whether the medical needs of the applicant can be supported within a managed isolation facility.
"The final decision ultimately rests with the appropriate delegated authority in MIQ."
People can apply for a medical exemption to isolate at home if their medical needs cannot be met in the managed isolation setting.
"In this case, the application was declined because the applicant's needs can be met within a managed isolation facility, and didn't need hospital-level care.
"A comprehensive plan will be developed to support them in their room and meet their dietary requirements."
Managed isolation facilities were equipped to handle most medical needs unless hospital admission was needed, the spokesman said.
On-site medical staff could support a range of care requirements, including phone or in-person consultations with a general practitioner and assistance with any prescribed medications.
Tauranga's Lee Merritt returned from the same treatment in Mexico in October last year.
She applied for an exemption three weeks before leaving for her month-long treatment and it was granted seven hours before she left Mexico.
Merritt told the Bay of Plenty Times staying in a managed isolation facility was not a possibility health-wise.
"It was so important for me to get home and recover in my own home. Your immune system is severely compromised, going into a hotel room that was not going to be sanitised daily was out of the question."
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Daily sheet changes and sanitising the room to avoid infection, plus the appropriate food to supplement her recovery, were all things Merritt did not believe the Government facility could provide.
"If there was any food poisoning it would have caused sepsis which is deadly, I was not prepared to take this risk.
"At the time I needed to avoid people, colds, flu, and Covid, I did not feel being in a hotel room was the best possible situation with no fresh air, and most importantly to keep my body moving - my goodness I could go on and on."
Merritt believed the application process would be straightforward but as the treatment made her ill, her caregiver took over the application process - which included late nights answering emails and sourcing medical letters from the clinic stating why Merritt should be at home.
When questioned why the two women in the same situation were given a different treatment, the ministry reissued its first statement.
"In [Taylor's] case, the application was declined because the applicant's needs can be met within a managed isolation facility, and didn't need hospital-level care.
"All medical isolation exemption applications are assessed on a case by case basis."
A disregard for authority could be why those attending court are thumbing their noses.