Covid in my life - Nihal D Amarasekera

 Covid in my life by Dr Nihal D Amerasekera

 

Self portrait by ND

I retired after an active professional life in hospital medicine. Living in the shadow of a famous cricket ground in London I have watched the game in all its formats to satisfy a childhood passion. Not having the talent to play the game I did the next best thing and became a lifelong spectator.

SARS-CoV-2, the Covid-19 infection began in Wuhan, China in 2019. However, its true origin remains shrouded in mystery. It is the height of irony that the country where the infection began sells to the world the protective equipment, hand gels and masks to keep us all safe. The infection arrived on our shores and spread in waves in 2020.  With crafty mutations and a multitude of variants, the lurgy has remained with us in the UK ever since. The effective vaccinations and the new variants have made the infections less virulent but still very debilitating. Like for everyone all around world my life has been restrained and restricted by a virus invisible to the naked eye. Visits to the cinema and theatre became hazardous. There were no sports played. All foreign travel was on hold. There were successive lockdowns in early and then late 2020. Each lockdown incarcerated and confined us to home with the tragic loss of personal freedom. Life became boring, difficult and mentally challenging. Birthdays, Christmas and the New Year had lost its sparkle without the family.

As I stood by a  hairdressing salon which was shut for the lockdown, a passer-by quipped “It’s all going to get ugly very soon.” Even in the doom and gloom of the pandemic there was some dark humour to raise a smile. The lockdowns were soon followed by various forms of restrictions in 2021. For many older folk, like myself, time is of the essence. Time is an asset we don’t have much to spare. Taking 2 years away from us with restrictions was a tragedy.

In December 2020, UK administered the first COVID-19 vaccine in the world. The well planned and effective vaccination programme was tremendously successful. Following a decline in cases, all restrictions were lifted in March 2022. Now there is no compulsion to stay at home even if someone has tested positive. With it the hand washing, social distancing and mask wearing went out of the window.

I still was wary of the government advice and continued to wear masks in crowded place and public transport and washed hands regularly. To be fair the Health Service advised us to self-isolate for 5 days if we tested positive, to wear masks for our own protection and to wash hands.  They allowed us to use our judgment, and this was not compulsory. Some heeded the advice while others lived their lives as they pleased.

It was a Friday. Watching cricket has been one of my few pleasures in retirement and I’ve never missed a game. We were made to understand that in the open air, like in a stadium, with all that swirling wind the chance of spreading or catching Covid-19 infection was unlikely. I was watching a crucial T20 game. Being seated out in the open I did not wear a mask. It was a fun evening. The stadium was packed with people. Gallons of beer were consumed while I confined myself to a glass of Champagne.

When a team completes the 20 overs it is the ‘rush hour’ at the gents’ toilet. There was huge traffic into a confined place that was poorly ventilated. If anyone had the Covid-19 infection he would be oozing and issuing the virus from every orifice. The virus would swirl in that humidity to infect as many people as possible. Thinking of the cricket that was not going too well for my county, I walked into the gents’ toilet almost in a trance and forgot to wear my mask. I was overwhelmed by the humid atmosphere of the human breath and gasses. Within an instant I realised my folly. By then, perhaps, the damage has already been done.

All Covid restrictions were off. It is impossible to be certain when and where I was infected.  On the Saturday and for much of Sunday I felt fine. Very early on Monday morning I woke up with a high temperature. My mind seemed to be in a muddle. I was hallucinating and seeing the same dream, over and over again. I was sweaty and uncomfortable and slept poorly. Later that morning I developed a severe sore throat. My nose ran like a tap. The body ached as if I had been in the boxing ring with Mohammed Ali. As I got off the bed I felt like a Zombie and was rather unsteady on my feet. I tested positive for Covid-19 on a lateral flow test. Rather than lying down and looking at the ceiling I preferred to sit in the lounge and watch TV. My mind was not at all clear that day. From time to time I dozed off in the sofa. There were gastrointestinal symptoms too of nausea and diarrhoea. I had lost my appetite. Bouts of headache came and went all day long. My aches and pains were controlled well by Paracetamol taken 8 hourly. I was pleased to see the end of the 1^st day. My 2^nd day of Covid-19 was similar to the 1^st. Knowing what to expect and how to deal with it, I coped much better. On the 3^rd day I felt no change. Interestingly the infamous symptoms of the loss of smell and taste which were synonymous with the original infection were conspicuously absent.

I was eminently aware of the dangers of Covid at my age and began to worry. What was foremost on my mind then was the question “when do I call for an ambulance?”.  I had read that worsening of the symptoms, shortness of breath and a reduction in the blood oxygen saturation were the ominous signs. My symptoms and signs have been static. My breathing was normal. I had no proper pulse oximeter, but my Apple watch indicated my oxygen saturation was 97% which was in the normal range. I weathered the storm for yet another day.  It was not until the 4^th day that I felt marginally better. I was now on the mend.

 On the 5^th day I felt well enough to take a short walk. As I set off, I soon realised my muscles had lost some of its tone and power. Walking certainly needed greater effort than before. The tiredness that has built up during the height of the infection tends to linger on. I still needed some paracetamol for body aches and for the occasional headaches.

 Covid-19 has the propensity to affect every organ in the body. Pneumonia, acute respiratory distress syndrome (ARDS), multi-organ failure and septic shock, are the common causes of death. One in five Covid-19 patients get mental health problems. I experienced an inability to concentrate at the height of the infection, but this soon disappeared as the infection cleared. The potential serious consequence of the illness is a source of stress and anxiety to many.

 Most Covid-19 sufferers get better in 10 – 14 days. Those who are fully vaccinated have an easier ride. The headaches, cough and muscle pain can linger on for several weeks before clearing. For a minority of Covid-19 sufferers symptoms can persist for several weeks or months when it is called Covid-19 syndrome or long Covid. Many antiviral treatments have emerged which are said to shorten the period of infection and infectivity. They also seem to have the ability to prevent hospital admissions.

This narrative is intentionally not meant to be a treatise on Covid-19. It is merely a patient’s story, a description of my symptoms, its rapid progression and a synopsis of my suffering. The media depiction of the current variants of Omicron BA.4 and BA.5 as mild and like a simple cold is far too flippant and fanciful. Nothing could be further from the truth. Even for those whose infection lasts just 5 days, those days are long, could be disastrously debilitating and utterly exhausting. Although fewer patients need hospital admission, people should be under no illusion of the unpleasant nature of the challenges it will pose.

Do all you can to avoid getting the infection in the first place. Vaccinations, mask wearing, hand-washing and social distancing still remain as the backbone of personal protection against Covid-19.

 The pandemic has changed life for us all. It has brought widespread changes to the way we live, work, play, and stay healthy. For some the drudgery of the daily commute has stopped. Zooms have replaced formal meetings. Online shopping and home deliveries are now well established. Telehealth and telemedicine is now the way healthcare is delivered for the many. Covid has overwhelmed our lives and monopolised the media since it made its debut in 2019. When it all seems never ending, I seek the wisdom of the Persian poet, Rumi “This too shall pass”. Let those prophetic words bring us joy.

We have not experienced a pandemic for a hundred years. Initially no one knew how to deal with it. I am personally immensely grateful to the government that got to grips with the situation swiftly and to those in healthcare for developing a vaccine so quickly. I extend a generous thank you to those dealing with the enormous task of mass vaccination. Hospitals were overwhelmed and bore the brunt of the burden. The doctors and the staff saved so many lives by their expertise and dedication. My heartfelt thank you to everyone who has helped in this most difficult of situations. I simply wish the WHO played a more dominant role and was far more proactive as an organisation in the battle against this pandemic for the greater benefit of the developing world.