#Kovid Recover Patient Re-Infected

[stephenremedios]

My experiments with Covid-19

Day 1 - 23rd September 2020:

Consistent with my morning routine, I returned from a game of tennis to discover that Dylan was feeling tired and fatigued after his morning soccer game with other kids in the community. He washed up and sat through his online classes. It was the third day of his first cumulative assessment. The boys had all begun their first term examination on Monday. It was a new experience for them, but they seemed to enjoy the new format much better! Aidan was of the view that the questions made him think more and write less. By lunch Dylan was spent. He went to sleep and woke up in time for dinner.

We all sleep in the same room, with Dylan at one corner and me on the other side. Aidan, Ethan and then Ray. I ended up giving his aching limbs a short massage as he struggled to go to sleep. He tossed and turned for a bit, but finally fatigue took over. Ray suggested I take his temperature. It was 98.1F

Day 2- 24th September 2020:

Dylan woke up feeling normal the next morning. We historically associate these bouts of fatigue and fever with a growth spurt. Dylan stood next to our Thomas height scale and I measured his height – he had grown 2 cm since the last time we had taken a reading, two months ago.

Known for being the paranoid person in the house, I insisted the boys take a break from soccer as a matter of abundant caution. I had a tennis date at 6:30 that I regretted – I was feeling fine, but I decided to play it safe. 

It was this same paranoia that had me list all the potential sources of infection when the pandemic first emerged. After looking at our lifestyle we decided to do away with a driver and a maid. We retained a gardener with the caveat that no one would work with him in the garden at the same time. We switched to shopping online to minimize exposure to many people in a mall or supermarket. 

These measures had been effective over the last six months so there was no reason to think we had contracted the dreaded Covid-19.

At about 6:00 in the evening I started to feel itchy at the back of my throat. I hadn’t had a cold or cough in over 7 months. Raynah suggested I do a Betadine gargle before I went to sleep that night, which I did. 

Day 3 - 25th September 2020:

I woke up with a high fever, intense body pain and a sense of having no energy whatsoever. It was a new feeling; unlike anything I had experienced before. It was like I had gone from a 100% to 5% in 24 hours. I woke up well past my usual wake time of 6:00 AM. The boys told me that their normal morning visit to Villa #10 to visit my mother and play with the kittens hadn’t fructified because she wasn’t answering the doorbell.

I proceeded to Villa #10 to see why she wasn’t answering the bell. Like the boys had reported, she wasn’t responding to the bell or to my calls to her window right below the garage. Spotty, the mother of the three kittens was pacing up and down the entrance of the house while the hungry kittens were scaling the curtains in desperation on the inside of the house. Clearly something was amiss. 

I used the duplicate key we have to the house to let myself in. Spot edged into the house before I could retrieve the key from the door. The kittens mobbed her desperate for their early morning feed. I made my way up to the bedroom.

Opening the door, I found my mother looking like she had been on an IV drip for the last week. She had a bad night too. We proceeded to exchange notes on our symptoms. We were both in awe of the speed of the onset and the extent of debilitation in such a short while. We agreed it was a bad flu.

We resolved that the best way to fight it would be to sleep as much as possible, to allow the body to recover from this nasty bug. Aidan meanwhile complained of a mild cough but didn’t have any fever or any other symptoms. Dylan rebounded like he always does and asked if he could go and hit against the wall in the tennis court for a while. He settled for a game of indoor squash with Ethan instead. I slept 13.4 hours of the 20 hours I spent in bed that day.

Day 4 - 26th September 2020:

A much better night after two torrid nights. I had begun a course of antibiotics the previous night and my cough was on the mend. I woke up feeling much better. The tennis gang was starting a little later today given the overnight rainfall had rendered the courts unplayable at our usual 6:30 AM start time. 

A notification on my phone asked “Are you good to play @8:00”. While I fancied a few sets of low intensity doubles I decided to play it safe again. The conversation ended with advice to do steam inhalation to overcome the cough. 

Raynah woke up later than usual, with a slight fever and body ache. She didn’t have a cough though. She pushed through the fatigue rustling up a special weekend meal. I could smell the aroma of the meal from the bedroom as she rustled it up in the kitchen. I reassured myself that it wasn’t Covid-19. After all I hadn’t lost my sense of smell.

The boys do athletics and fitness classes on the weekends. Raynah and I decided it made sense to keep them back from classes. We deliberated on whether to send Aidan and Ethan since only Dylan had been ill on Wednesday. We decided it wasn’t worth the taking the risk no matter how insignificant it seemed at the time.

Day 5 - 27th September 2020:

I had a restless night, struggling to find any periods of deep sleep. My body was still fighting the infection and I was convinced that this was a strain of flu that I hadn’t experienced before. Ray continued feeling a little unwell so I let her sleep an hour longer and fixed the boys cereal for breakfast.

Later in the day we all came together to record a short concert for my sister’s son, Neil in the US. We had forgotten to call on the 26th (his birthday). We usually all jump on a call and sing LIVE! This time we would have to settle for a recorded message.

All in all it was an eventless day and it seemed like everyone on was on the path to make a quick recovery from the flu. If Dylan had indeed been the one that brought it in, then surely we should make a speedy recovery just like he did. 

Day 6 - 28th September 2020:

With the antibiotic kicking in, my throat was on the mend. It felt like my energy levels were inching back up. The fever was on a downward trajectory. The worst was behind us. Raynah continued to have mild flu symptoms and my mother hadn’t shown any signs of a fever the previous night. She had recovered sufficiently to make food for the ‘patients in #145’ she joked. Her main movements over the next 48 hours would be to deliver food to us since both Ray and I continued to be under the weather. Ray began to experience breathlessness when she climbed the steps that evening. I was concerned but concluded it was probably just the fatigue of having cleaned the whole house that day. The larger picture suggested that we were all progressing in the right direction.

We would have gone to sleep that night without having considered for a moment that we might be Covid +ve. 

We are early sleepers. Lights go out by 9:00 and everyone is usually asleep by 9:30 after some bedtime banter. A little past 8:45 PM Ray read out an email from the Ozone Kovid Kare team – The live-in help at one of the houses of the boys who play soccer with Aidan and Dylan had tested +ve for Covid (It is a separate matter that he turned out to be a false positive when he was re-tested!). 

In that moment, the odds of us having contracted Covid increased from 0% to 1% in my mind. It was now possible that the boy got it from his house help, Dylan got it from the boy, that my mom and I got it from Dylan and then the rest of the family got it too! (It is a separate matter that Aidan, Dylan, Ethan and all the boys and their families tested negative and we still haven’t figured out where we picked the virus up from).

It was playing out like the closing sequence of the movie Contagion in my mind! Dylan picking up the virus as he rubbed his nose after touching the ball while playing soccer. My mom inhaling the virus as Dylan recited a poem later that evening while he was doing his studies with her. Ray interrupted my rampant imagination. “What should be do now?” she asked.

Given that there was now a 1% chance that we might have Covid, Ray and I decided that we should get tested. We were still sure that it was just a flu since the only person still feeling a little ill at that time was me. I’m intrinsically risk averse, and most of my reading suggested that people were dying when they were taken to hospitals too late in their fight with the virus. To save time it made sense to get tested along with the boy’s family.

After a few late-night calls and assistance from the very resourceful Ozone Kovid Kare Team we were all set to get tested the next day along with the family whose domestic help had tested positive.

Day 7 - 29th September 2020:

Our hall room has furniture on the sides with a wide-open space in the middle. The boys have spent hours during the lockdown hitting shuttles and table tennis balls against this wall. A broken light fitting that we decided not to replace after it was repeatedly broken by the boys tells the story of many hours of fierce combat with the wall. The wall also doubles up as a green screen for Aidan’s live streams and as a film screen when we run home movies.

When the lab technician arrived in full PPE to do the tests, our hall room looked more like a operation theatre than the usual improvised squash court it normally is. Today that expansive wall framed a single chair under the lights in the center of the room. We took turns to sit down on this chair while the technician first sent a swab up our nostrils and then down our throats. The technician did a thorough job, swabbing both nostrils till tears were streaming down my eyes. For the throat probe, he went deep enough to stimulate an involuntary cramp in my neck. If you experience discomfort during the swab collection, chances are that it is being done effectively. The technician told us that it takes 24-48 hours to get the results and that we should expect a call any time after 4:00 PM on the following day.

The boys meanwhile recorded the proceedings on their iPads with great excitement, unable to comprehend the gravity of the situation. They demanded to be tested as well fearing that they were missing out on this once-in-al-lifetime adventure.

My sister in Oregon, US had been anxious. Her husband was up late and received the pictures of the testing event. He assured her that all was well and that we would have the results the next day.

My mother and Ray looked to already be on a recovery path. The boys were fighting with us to allow then to resume their normal morning soccer routine. We asked that they be patient and hold on for one more day. The results would be here tomorrow, and they could return to their normal routine.

As we went to bed that night, I apologized to Ray for not having done anything for her birthday! I joked that a -ve Covid test certificate might be the most original, unique, quirky and memorable birthday present she would every receive.

Day 8 - 30th September 2020

I had an unusually high fever the previous night and felt lethargic and was exhausted when I woke up. Despite multiple doses of paracetamol my temperature had hovered between 102F & 103F without any signs of going down. My resting heart rate had also jumped from a normal 56 bpm to 69 bpm. My body was still fighting this virus. My mom walked over in the morning to deliver a cake for Ray and to drop a card in the mailbox. We were keen that that we cut it in the morning and start the day on a positive note. 

Ray received a call from the laboratory at about 11:00 AM. He was very apologetic as he informed her that all three of us had tested positive, while the entire family of person who had initially tested positive were all negative! 

It took about a minute for the information to sink in. 

We were all Covid +ve. 

My first reaction was to suggest that we all get tested again… this couldn’t possibly be true. After all, the house help had gone from being +ve to -ve in 24 hours. It might well be the same with us.

We hadn’t discussed the plan in the event of testing positive, so the first big decision was to figure out how to get my mom to our house given we now knew she was positive. Would we have to get an ambulance? 

In the hour after the call to confirm our infection a variety of worst-case scenarios flashed through my head. I am wired like that. My mother and wife would be taken in an ambulance to a woman specific Covid Care Center. The boys and I would be whisked off to a gent only center. Our phones would be taken away. 

Given the shortage of beds in general, how would they have 6 beds if all of us took ill? How was it all that four of us were symptomatic and I had moderate to severe symptoms when most people seem to have been asymptomatic? From all the metrics that I was tracking I knew there was something wreaking havoc on my vitals. Was I going to be admitted? Was I going to need oxygen? Was I going to end up on a ventilator? Was I going to die?

My mother meanwhile decided she wanted to quarantine by herself. She is an iron willed woman and I wasn’t in any shape to have a disagreement with her. It was particularly difficult for me to have her spend the next 14 days in isolation because she was at the receiving end of an acrimonious accusation relating to the cake she delivered for Ray’s birthday that morning. I absolved myself of the guilt I was experiencing at not being able to be there for my mom and got on with more pressing matters.

I reined my thoughts in and determined that this crisis called for some affirmative action. With tremendous help from my assistant Freeda, we were signed up for a home care Covid Care package within 4 hours of our positive result being known to us. At 5:30 that evening we received all our medication along with a digital thermometer and Oximeter neatly packed in a box.

The magnitude of the disease stuck me when I opened the box and saw the number of pills within it. I have never ingested so many pills in a single sitting ever. We all began our course of anti-viral medication that evening. I struggled to sleep that night. It was a combination of fear and a difficulty with my breathing that kept me awake and restless. I discovered the next morning that my fever had been well over 101F for most of the night.

Day 9 - 1st October 2020

While Ray and my mom seemed to be making good progress, my downward spiral continued. The chills had returned, and I spent most of the day covered from head to toe in bed. I had read that sleeping in the prone position helps the lungs in the fight and recovery, so I began to experiment with that. From time to time, the pulse Oximeter would show an initial reading of 93 and 94 before deep breathing would bring it to a more acceptable 95 or 96. I would feel breathless after climbing the dozen steps to get to our bedroom.

My temperature remained high through the day hovering between 103 F and 104 F. I decided it might be a good idea to speak with another doctor.

The first thing that the doctor did after a barrage of questions and giving me a patient hearing was to assure me that I was not going to die! He said that he had seen over 2000 cases in his ward, and that there was no need to be alarmed. It seemed like a silly thing, but the conviction in his voice when he said it made me hopeful and positive. 

The second thing he told me was that all the current medication I was taking was 'candy’, and that none of it had cleared clinical trials. The medication was essentially in his reckoning, a placebo. It wouldn’t do any harm. It wouldn’t help either. He told me to continue my course of anti-biotics and use paracetamol to manage the fever.

That conversation left me hopeful and distraught at the same time. How could I be taking so many pills when there was no evidence to conclusively say they worked? We resolved to continue our medication and see how our bodies responded. 

Antivirals are dosed in an interesting way as I discovered. The first two doses are monster doses (1800 mg) and then it drops to smaller doses (400 mg). It does not help that these tablets are manufactured in 200 mg shots. It is quite daunting when you have to put down 9 of them! By 10:00 PM that night I had 4000 mg of the anti-viral in me and I wasn’t feeling any better. I was starting to feel worse.

Earlier in the day, Shanthi, a doctor resident in our Community offered her research and findings as an alternate way to combat and inhibit the progress of the disease. She referenced the work of Dr. Paul Marik and suggested that we add a few common medications that had proven effective in helping fight the virus in some trials. She cautioned of course that these weren’t 100% proven but reduced the odds of fatalities.

From where I was both physically and psychologically, I would have taken any medication that reduced the odds of my death by as little as 1%. We went all in. I was now on three prescriptions desperately hoping that one would work and that I would start to get better.

Within minutes of us confirming that we would go with Dr. Shanti’s line of treatment, her husband Pravin dropped off all the medication for the three of us in neatly labelled Ziploc pouches. We promptly took our first doses before going to bed that night.

That night was the toughest night. My body wasn’t feeling good at all. I had now lost a sense of smell and taste completely. Repeated bouts of coughing incessantly made me feel like throwing up all the time. I had no appetite. I had lost 4 kgs in the week since I first felt an itch at the back of my throat. I struggled to sleep in a prone position since it isn’t how I normally sleep. I considered what I might pack if my Oxidation dropped and I needed to get admitted the next day. I had carried an Oximeter to bed that night. I wanted to stay on top of my oxidation levels should they drop suddenly. 

I had read enough about a condition that afflicts some Covid patients called ‘happy hypoxia’ and it had scared me sufficiently to make me even more paranoid. I took my Oxidation over a dozen times through the night. On a couple of occasions, it began at 93, but with deep breathing in a prone position rose to 97 within the minute. I didn’t sleep much that night.

Day 10 – 2nd October 2020

I woke up feeling fatigued. I hadn’t slept much; my fever had been high, and my cough continued. The cough was particularly severe when I woke up and I would have these bouts where I would cough incessantly for 2-3 minutes. It felt like there was a significant amount of phlegm at the bottom of my throat, but the cough was a dry one. I also began to notice that I would feel breathless when I spoke a couple of sentences at a time. Raynah and my mother had stopped logging a temperature and their oxidation levels had been healthy throughout. It was particularly frustrating that the virus had singled me out for this special treatment.

 I remember counting the pills I took that morning. I had 6 before breakfast and 12 after. I was throwing the proverbial kitchen sink at the problem. After downing all of them, I returned to the bed to try and sleep. I forgot to have my paracetamol that morning. The BBMP came to test the boys that morning.

I woke up at about 2:00 in the afternoon sweating profusely. My head was dripping with perspiration like it might after a lung busting rally on the tennis court on a summer morning. I hadn’t taken medication and my fever had broken. Surely that must be a good sign.

At 4:00 that evening I received a call from the hospital. I expected it was our usual doctor checking on my progress. It was a psychologist. I have never spoken to a psychologist in my life up to this point so I am not quite sure what to expect. From everything I have seen in the movies, I expect to do most of the talking.

Her first question explores my anxiety levels. I tell her that I am extremely anxious given that all six of us contracted the virus and I was the only one who got a knock out punch. 

Her next set of questions explore my history of stress and hypertension. I assure that I don’t have any such conditions despite a family history of these ailments.

She offers me medication to handle my nightly ruminations as an SOS if I am unable to sleep. I am also advised to wear a rubber band around my wrist which I am to pull and release every time I notice I’m having negative thoughts.

I slept for the rest of the day and my fever dropped from its previous highs. I had recovered enough by the evening to enjoy a cup of tomato soup without fearing that I would throw it up.

Day 11 & 12 – October 3rd and 4th

Two very similar days. It felt like things were in the balance and could go either way. 

The boys test results came in, and miraculously all three tested negative. A large number of people in the community including all our primary and secondary contacts tested negative as well. I didn’t know what to make of this. From everything that I had read, it was well past 10 days since the boys first got infected. Given they were asymptomatic with the exception of Dylan’s one day sickness they were probably virus free by the time we tested them. That’s the only plausible explanation for their negative tests.

None of us wake up hoping to spread a virus. 

As a family we heaved a collective sigh of relief that we hadn’t inadvertently infected anyone else in the community. Looking back we are glad that we erred on the side of caution.

My fever continued to hover between 100F & 101F. I was measuring my blood oxidation almost every hour to stay on top of any potential drop. I had begun to take melatonin but that wasn’t helping me sleep any better. My respiratory rate had been closer to 19 per minute, above my normal 17 per minute rate in the run up to the sickness.

The cough continued though I was now regaining my sense of small and taste. My appetite also began to return in a big way and I had a hearty meal after a long time. It wasn’t that the food wasn’t tasty over the previous week, I just couldn’t get myself to eat more than the bare minimum to be able to take all my medication.

Day 13 to 18 – October 5th to October 12th

What a tremendous relief it was to wake up without a fever finally. I concluded that the body had fought the virus successfully. That closed one potentially dangerous chapter and opened another equally threatening one – would a cytokine storm follow? An excessive immune response can also do damage to your body in several ways. While the cytokine storm begins in the lungs it can quickly spread to other parts of the body leading to a variety of complications.

This period was also filled with anxiety waiting to see if there was any googly along the recovery path. While the fever was gone, the residual dry cough was now being treated with a steroid. The doctor’s view was that the lungs would take between 3 to 6 months to repair the damage the virus had done. I would have to do an X Ray a month later to make sure that the repair was headed in the right direction.

As a matter of abundant precaution, I continue to track my blood oxidation every few hours. I know for certain that I’m no longer Covid +ve, but I’m not out of the woods yet. A statin and a blood thinner will hopefully cut the risk of a heart attack and a stroke (both run in the family!). A battery of other supplements like Zinc, Vitamin C & D etc. will reduce the internal inflammation and help the body recover faster. The path back from this disease is a slow one and I’m learning to be patient with myself. In a strange way, I am more aware of every breath that I take.

Day 19 - Today 13th October 2020

I still haven’t accepted that the risk level we signed up for resulted in the whole family getting infected. Worse still, the failure to identify the source and the limited immunity that you have even after contracting it means that we live in fear of the family getting it again. Looking back, I ask myself what I would have done differently!

1.     We should have gotten tested earlier: It helped that we quarantined as a family as soon as Dylan experienced tiredness for a day, but we all should have gotten tested earlier. The assumption that our limited contact with the external world made it impossible for us to contract Covid was a wrong one. If anyone in the family gets a fever or cough going forward, we will test at once.

2.     We should have prepared better from a knowledge perspective: Raynah did a great job preparing for Covid. We have had the sanitizers, household disinfectants, plastic gloves, disposable masks etc. for over 6 months before we got sick. We weren’t prepared however with the right knowledge. It is very disorienting to get different directions from well-intentioned doctors and choose a course of action when you can’t look after yourself! We were very fortunate to have Shanti share literally the latest research (published on the 28th of September!)  in the US with us. We will have a small Covid medication kit at home updated for the latest clinical trials going forward.

3. We should have had a plan in the event of testing positive: I was in denial even after the test results came in. I still spend a lot of my waking time retracing everyone’s movements in the run up to the first instance of fatigue in the family. Thinking through what you will do should you test positive is easier when you aren’t positive. We have a plan of action should anyone test positive again in the family.

We are grateful that we didn’t infect anyone, and that the limited set of people we had contact with all tested negative as part of the contact tracing protocol. Without knowing for sure who got infected first and where the infection came from, there is no way of knowing anything for certain.

Having been through this ordeal, what advice would I offer you? 

Take this virus very seriously. For many it might pass without them even realizing that had it. For a few however it can literally mean a life and death situation in a matter of a week if you ignore it. Take all the precautions you can. I saw this Swiss Cheese analogy on the internet from Dr. Ian M Mackay that made a lot of sense to me. We took all the precautions but the virus still reached our respiratory tract!

As I lay awake one night struggling to breathe, coming to terms with the new prone sleeping position I asked myself what kind of gambler I might be if I was gambling with my life.

If someone gave me the chance to roll a wheel with a 2% chance of dying, would I take it?

 The answer is a resounding ‘No’!

 If there’s one piece of advice that you take away from reading this piece let it be this – go to great lengths to protect yourself and your family from this virus. The only thing you have any control over is the risk level you expose yourself to. Once you contract the virus you are pretty much at the mercy of the virus and no one can predict what happens next. It is entirely a matter of chance!

It can pass without you even noticing you had it. Ask Aidan and Ethan. 

It can knock you out for a few hours. Ask Dylan. 

It can be no more severe than a common flu. Ask Ray and my mom. 

It can leave you breathless, with damaged lungs and a residual pneumonia. Ask me. 

It can kill you. Ask anyone who has lost a friend or loved one to the disease.

The science is still approximate with new cocktails and regimes of medication being added to clinical trials every day across the world. Do everything you can to minimize the odds of getting the virus, cut every possible surplus contact. Mask up and maintain physical distancing.

#covidquarantine #covid_19 #covid