Pandemic Diary #2: Doctor, USA

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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

PANDEMIC DIARY #1

COVID-19: Through the eyes of an average Nigerian student.

‘’We don’t have any plans, no lecturers have reached out to us to tell us what to read, there is no online class. By the time we resume, Unilag will rush us.’’

This week, Pandemic Diary interviews a student of the University of Lagos. We get an insight into how the current pandemic has affected the average Nigerian student, the setbacks and possible silver lining.

Tell me how we got here.

I am a student at the University of Lagos.

The first we heard of COVID-19 was when it became a thing at Wuhan, China. We discussed it as students in my hostel but we never saw it as something that could hit home till we saw the news of how it was spreading around the world.

I remember, there was a day I saw on Twitter how rapid the spread was, and I prayed that Allah should just keep us safe. The next day, that’s when I heard that COVID-19 hit Nigeria *laughs*

That was when major paranoia started. People rushing hand sanitisers and face masks. I had a face mask but I didn’t have a bottle of hand sanitiser. It was on a Friday we got the news. On that very day, sanitisers were sold out at UNILAG, so I went to Yaba.

You went all the way to Yaba to buy hand sanitiser? 

Yeah, I bought hand sanitisers for my friends and me, the price was crazy but I just closed my eyes and I bought it. When I returned, I distributed it amongst my friends and I was paid back.

So, things were still cool, classes were going on fine. That was how Unilag announced that the upcoming convocation ceremony had been postponed.

Hmmm

The next Monday, we were on our way to class for a test when we got the news that the ASUU (Academic Staff Union of Universities) strike had begun. So for the first week of ASUU strike, COVID-19 was in Lagos but we didn’t see it as a serious thing. 

During the second week of the strike, DSA (Dean of Students Affairs) sent a message on Friday saying that all students should prepare to leave before 4 pm the next day.

The very next day?

Exactly. I already planned to leave that Friday because of the virus and of course, we weren’t going to have classes. All these happened between March 7th and March 20th. On March 20th, I was already home, today is March 31st, I have been home for 11 days. 

We don’t have any plans, no lecturers have reached out to us to tell us what to read, there is no online class. By the time we resume, Unilag will rush us.

I was going to ask that question. Looking backwards and then forward, how do you think this will affect your education?

Looking backwards, I was glad about the ASUU strike. But looking forward, this virus is going to make things difficult for students. We don’t even know when it will end, we don’t know what we will meet when we resume, we don’t know how the academic calendar will be affected. We haven’t heard anything from our lecturers, there is no communication whatsoever for online classes. 

You know how we have this document for GST (General Studies) that has everything you need for the exam? I was expecting some of our lecturers to do the same, compile their course-work and share on the group chat, it’s not rocket science.

I mean, we are not students anymore, we are just in-between life.

I understand that you are interested in current happenings, how do you think the government handled the situation?

Honestly, I am impressed with the government of Lagos state. It feels like SanwoOlu is making up for the Okada ban. The only mistake made was the late closure of the airports and the spread from one state to another. The federal government should have banned incoming flights and interstate transportation. Now it’s almost everywhere, not every state can handle it as Sanwo-Olu has done.

Tell me something interesting; your transition from home to school. 

Actually, before leaving school, I had written my strategies; my mental coping strategies. I called it home coping strategies, things that will keep me grounded when I get home.

To tell you the truth, that was not needed because we have help now that makes all the difference for all of us. The responsibilities at home are now divided. Although for an average student, I can tell you that it is not going to be easy. For example, my roommate is from a family of 5 and she is the one that is relied on for domestic tasks. She didn’t want to go home. She also had a rift with her mother before coming to school and her mum had not forgiven her, so she was looking for ways to avoid going home. Now she is home and she is surviving.

How did your typical Nigerian mum handle this pandemic?

My mum is handling it well. She doesn’t do all those ‘drink palm oil’. She is enlightened about the virus and keeps up with the news. She stocked up the house about three times for us.

How scared are you? How are you taking this?

I’ve had about three incidents when I thought I caught Covid19.

Gist me. 

I was on a bus, someone coughed in front of me, another coughed beside me. All through that day, I felt sick.

I thought – Yes, this is finally it. How am I going to break it to my family that I have the virus?

Is that you Rona?

*laughs* The other time, it was malaria I had to treat. The point is we see people recovering and people dying, it’s not a death sentence. It’s not something that should strike irrational fear.

The thing is you have to be aware that if you put yourself at risk, you don’t know the underlying factors present in you.

For example, I heard of a woman that was discharged and left the hospital with pneumonia and sepsis.

I’m very conscious of the fact that if I put myself at risk, I will be affecting other people. My brother is asthmatic and has a history of pneumonia so his lungs aren’t the best. My mom is a senior citizen and I wouldn’t want to experiment that with my mother. So, I am in-between knowing that it’s not a death sentence and being wary of catching it because it can’t be good for those around me.

I am taking the middle course, I am not so afraid, neither am I nonchalant about the situation.

You’re in your early 20s. How has this changed your perspective on life?

We are not unique.

Now I see, we are not unique in any way. We are like other generations, helpless. It makes me think of the deaths occurring in Italy and Spain. This life is fickle, honestly.

I used to think that because it’s 2020, the world has gotten to a level of advancement, in the sense that things like COVID-19 should be treated in one week; just find a cure, let’s move on with life.

Final word?

A lot of people feel that Covid19 has halted life. I just want you to know that it was bound to happen, and it happened now. There is nothing special about it happening in 2020.

There are a lot of people that are unsure of whether they will find something to eat tomorrow because of this pandemic, don’t just think of yourself, think of how unprivileged others are.

Also, this is the time for people to realise that capitalism isn’t it, we should add some socialism to it; look out for our neighbours.

Thank you for your time.

Thank you, bye-bye…. and wash your hands!

 Interview by Faridah Bakare