Pandemic Diary #2: Doctor, USA

Second entry in the series

Could you tell us how COVID19 started in America?

From the news, it started from the city of Wuhan in China and was reported back in December 2019. We did not get the information here in the United States until the end of February. Although our government knew about it, they did nothing. The first case in my hospital was discovered the first week of March; the patient I admitted from the emergency room.

How does it feel to face the risk attached to COVID19 every day?

The risk is there and it is very scary. Right from the moment I admitted the patient who had had symptoms for about ten days. He was a school teacher who taught in two schools. He had pains, difficulty breathing and dry cough. I admitted him the third day when his fever didn’t subside, one of my colleagues decided to test him for COVID19.  Thank God I had my mask and my gloves on when I saw him at the emergency room. 

It was very scary because this was the first patient at my hospital. Due to this, I was told to stay home. That day, everyone kept on calling, my children were frightened.  I eventually didn’t develop symptoms. Regardless, we still have to see the patients and protect ourselves. However, the background anxiety and the reality of the situation is there. 

How does this affect your mental health?

Right. The first week when we had a lot of cases in my hospital, it wasn’t easy. I’m in a group of physicians and we are about ten in my group. Everyone kind of broke down in tears. People were crying all around, the day I actually cried was the day I had about 11 patients. Having to constantly change, this and that, about ten times. My head was hurting, I came down to my office and broke down in tears. My colleagues were all there and at this point, we all agreed this had to stop. Unfortunately, it has not.

To help ourselves, one of my colleagues brought in a 10-minute meditation tool to relax. We all sat in the office, put the lights off and listened; we did that continuously for three days. At this point, we just joke about it in the office because we can’t avoid the situation. So, I honestly don’t think I am affected now. I have a lot of friends who I open up to and who pray for me. I release a lot of tension by talking to my friends. That kind of helps.

What’s the typical day like working with a COVID19 Patient?

Hmm. Firstly, we have designed a protocol at my hospital. Instead of going into the room with the patient, we use a telephone. I call their room, introduce myself and give them their results.  If positive, I ask about their current symptoms. If the patient has had any CT scan done, I explain what their oxygen levels are like. I then give them the opportunity to ask any questions on the forum. After, I inform the patient that I will be coming into their room to examine them and that I would not be asking any questions in the room, as it is highly infectious.  When I go into the room, I do all the necessary examinations and between a minute or two, I’m out. That’s for a typical patient.      

How has your personal life been affected?

Well as a physician, I’m passionate about the wellbeing of my patients. It is my priority most of the time. It really affects me when I see my patients not getting better and still having to transfer them to the ICU, especially the young ones. When I come home, I think about it and I follow them on the computer to see how they are doing. Like I said, because I have so many friends that are doctors, I kind of let out my anxiety through my medical school forum and I have a lot of friendsand relatives that keep on praying and calling me to make sure that I keep safe. At the same time, I pray for my patients, just to make sure that they are okay. So far, I have not had any deaths on my list.

Do you think America has done a good job so far?

The news that you guys see over there is the international news. Over here, we get first-hand information from other news channels asides CNN.  The President originally made it political rather than listen to the scientists. Due to this, it took the government a while to believe that this was real. Initially, the government promised that the number of cases will be very low, about 15 cases and after two weeks, it should go away. The President actually mocked the Governor of Washington state, which was where the first case was recorded. 

The Governor acted swiftly on the case, as a result, he was mocked by the President of America. The President said that he was trying to gain the attention of the media and referred to him as a snake. Due to these, the government was not prepared for the tsunami attack of the virus. When it started spreading to other states, nothing was done about it till about the middle of March or something. Many people had died at this point in New York. 

The government’s response caused the majority of the lives that were lost. The President didn’t call a national shutdown, but it was done state by state. Most of the republican states did not call for a lockdown, this was because they were following the President. News stations like Fox news are largely republican and the President and other republicans speak through Fox News. Hence, most of their listeners are old, Caucasian men who do not listen to any other news besides Fox News. The result of this was a large exposure because they initially assumed it was fake news.

Many were affected because they did not stay home. As we can see, they’re getting the aftereffect of not staying home. In the next two weeks, the President will most likely call off the lock-down. There are a lot of asymptomatic patients moving around who will be the next wave of people that will be seen in America if the lockdown is called off. 

Even though many people are dying, he’s still saying that it’s better for 240,000 people to die than 2 million. If any of them were to be affected, they would be given utmost care whereas the majority of people who are affected here are really the African Americans. Those who their socio-economic class is low. They live in poverty, are uneducated, obese and usually have diabetes, hypertension, cholesterol, heart problems, etc.  They really do not have the right kind of immunity. They are dying in thousands every day. The government has obviously not done a good job.

From another angle, the so-called African-Americans who are born here usually don’t have access to good health care due to educational status. Although the republican government has tried to remove so many subsidies away that makes life easier, they still largely depend on the government for assistance. This is one of the reasons it spreads fast among them. 

For example, an African American died of Corona so a funeral was organised in honour of the deceased. More than a quarter of the people that attended the funeral tested positive to COVID19. The funeral director and about four siblings of the deceased died.  I picked up one of the family members that attended this funeral and he informed me that he was still being tested.  By the time I arrived home that day, he had been moved into ICU.

Your advice to the common man 

We should listen to all the scientists talking on the radio and on the television. One, hand washing is very important. We must wash our hands for about 20 seconds, the back of the hands, in between the fingers and the nails should be caught short. This is not the time to have fake nails. Take out the fake nails and wash underneath the nails and all that. 

We should avoid putting our hands on our faces, mouth or the nose because that’s the source of the infection.  If you have to scratch your nose or eyes, you should find a cloth or tissue.

If you can wash your hands like hundred times a day, even if you had any contact with the virus, it would have been washed out. Also, if you have the virus or you develop symptoms like aches and pains, dry cough, runny nose, bad taste in the mouth that progresses to breathing difficulty, then it’s time to go to the health department in your local community. That’s not the time to go to your doctor’s office as this may lead to a wider spread of the virus. 

If tested positive, they can be isolated. However,  it’s going to be difficult for the Nigerian government to quarantine all patients in their homes. This is because people usually live in the face-me-I-face you apartments where there are a lot of people in a home. Hence, it’s better to go where the government is isolating the patients. 

What do you have to say concerning the use of various drugs to ‘cure’ Coronavirus? 

Yeah, these drugs are just being used as a clinical trial.

From the clinical trial being done with some medications, the analysis showed that nearly 14% of recipients were unable to complete the full 14-day experiment primarily due to adverse effects like anorexia, nausea, abdominal discomfort as well as diarrhoea. Some of these drugs have a lot of side effects. It can also prolong the QT level and if not monitored, the patient can develop cardiac arrest. In conclusion, the guideline I recommend is to use these only in the context of a clinical trial; additional clinical trials or prospective outcome registry are needed to conduct research.  There’s no guideline to practice for this new virus. We isolate them, tell them to hydrate themselves and manage their temperature. without giving out medication, the majority of patients will recover and go home. 

Wow. Thank you for your time and this information.

Thank you.

Interviewed by Faridah Bakare, 17th April 2020

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