Lessons from the quarantine

The writer heads the Sustainable Development Policy Institute.

I was down with Covid-19 and in isolation for the whole month of June. That does not turn me into a Covid-19 expert – just as a diabetic person does not become an expert of diabetes. But having survived this disease, I believe I can make certain observations and suggestions that might help other patients.

First thing first, the symptoms of Covid-19 can be different in different people. According to the United States Centers for Disease Control and Prevention (CDC), fever or chills, sore throat, cough, congestion or runny nose, shortness of breath or difficulty in breathing, fatigue, muscular or body aches, headache, sudden loss of taste or smell, nausea or vomiting and diarrhea are so far the known symptoms of the disease.

I had a sore throat followed by a mild fever. Initially, I opted for self-medication, taking antipyretic, anti-allergy and an antibiotic for four days before a physician friend asked me to get my complete blood profile test done. That test rules out – or confirms – bacterial infections. My test result came out normal; I was not infected by a bacteria, so the next step was a Covid-19 PCR test. On the fifth day after the onset of the above-mentioned symptoms that test revealed that I was positive for Covid-19.

The second most important thing to do is to avoid being a spreader of the virus. To alert all those who might have interacted with me in the 10-12 days before I tested positive, I posted on my social media accounts very clearly that I had been infected by the virus. I also isolated myself as soon as the symptoms first showed (without waiting for the test results) which saved my family and friends from getting infected from me. And even though none of my immediate family members showed any symptom, all of them quarantined themselves for the next two weeks.

I will, therefore, suggest that anyone showing any of the Covid-19 symptoms should immediately go into isolation. If precautionary isolation is logistically not possible, then wearing a mask even indoors and keeping a physical distance from other family members will help contain the infection.

Then comes the treatment, which varies with the symptoms and their severity. In the beginning, I had recurring fever and a dry cough. I was regularly monitoring my blood oxygen saturation level and temperature. My physician gave me antipyretic, anti-allergy and antibiotic medicines that I used until the fever and dry cough ended. I also took non-steroid pain killers to get relief from muscular and body aches; and a blood thinner to avoid formation of blood clots, as Covid-19 tends to increase blood coagulation. On top of it all, regular steam inhalation with table salt and baking soda was quite helpful for soothing nasal congestion.

The medicine was supplemented by immunity boosting minerals (especially zinc), vitamins (A, B & C), fruit (especially mango and apricot) and chicken soup. I also took a lot of ginger and honey tea but completely avoided Senna Maki tea. Senna is a laxative that can cause severe dehydration and added fatigue so it should be avoided by Covid-19 patients. As I would stay indoors all the time, I also took vitamin D capsules to compensate for the lack of exposure to the sun.

The fourth factor is your psychological strength. Isolation for 25 days, even in my own study, made me admire the strong nerves of those who face solitary confinement and house arrests. It is certainly not an easy task. To avoid an emotional breakdown, I kept myself busy reading, watching PTV’s old comedy shows and listening to my favorite music on YouTube. On top of it all, talking to old friends on the phone helped me stay positive and emotionally healthy.

All that psychological and emotional support may still leave a Covid-19 patient bereft of energy to do anything. For instance, I felt extremely tired – to the extent that my back and shoulders ached for two days – after I wrote an opinion piece during isolation. The last week of the disease was also quite discomforting. I had no fever or cough but my body experienced weird sensations. I had severe chills running down my spine but at the same time my feet would be burning and my calves would be aching.

Lastly, Covid-19 patients in Pakistan must remain extremely wary of any public health sector facilities being offered to them as well as the medical advice they get.

When I found out that I was Covid-19 positive, I was expecting a text message or a call from the district health authorities so that they could ensure that I was in isolation and was not spreading the disease around. My expectation was based on the fact that the private laboratory where my test was conducted had taken a picture of my CNIC and noted down my phone number.

I did receive an automated message for self quarantine – but a good ten days after my test result. If it takes that long for the administration in the federal capital to collect information from private laboratories and contact Covid-19 patients, one may imagine the level of coordination in peripheral and remote districts.

Until I tested positive, I used to think our health authorities were not doing enough screening and testing. After my personal experience, I realised that they are also not doing enough to ensure that patients do not become spreaders of the virus. They are similarly making no effort to inform patients about the criteria for discontinuing their isolation.

This has only resulted in confusion. While some patients discontinue their isolation as soon as their symptoms disappear, others keep on paying hefty test charges at private laboratories until their test results show that they have been rid of the virus.

My own experience has been no different. On the 17th day of my isolation, I turned asymptomatic (experiencing no fever and cough even while taking no medicine). I availed the home sample collection service of a private laboratory for a test and found myself virus positive yet again. After another week (the 24th day of my isolation), I started enquiring about the protocols to discontinue my isolation.

The majority of the physicians in my contact list who were dealing with Covid patients in private hospitals advised me that I should first test negative for the virus before discontinuing my isolation. On the contrary, those dealing with Covid-19 patients in public-sector hospitals, were of the opinion that no test was required, in my case, for the discontinuation of isolation after turning asymptomatic.

In a state of confusion, I started browsing the internet and found out that as per CDC USA, WHO, NIH Islamabad, and government of Sindh guidelines, “isolation can be discontinued in asymptomatic patients after 10 days from the Covid-19 positive test result. Whereas patients with symptoms, in order to discontinue isolation, must wait for another three days after the resolution of symptoms, provided a minimum 10 days have passed between resolution of symptoms and the time when symptoms first appeared”.

The exception to this rule are healthcare workers, immunocompromised patients and people living in congregations. They require two consecutive negative tests 24 hours apart to discontinue their isolation. According to these guidelines, I was good to discontinue my isolation. However, for my own satisfaction I did get my COVID antibodies test done before discontinuation of isolation and now with sufficient levels of antibodies I can be a plasma donor if it can save someone’s life.

At the end, I hope that my suggestions are taken just as what they are: suggestions. Anyone showing any remote symptoms of the disease must seek competent medical advice and follow that completely.

Twitter: @abidsuleri