Ten days of terror
Covid gets personal
Twelve days in ICU, further treatment in a renal ward and approximately three months of home-care recuperation. If you survive a severe case of Covid-19, this is a description of its cycle. My mother was one of those statistics, a 67-year-old with no co-morbidities. Thankfully, she is finally out of the woods.
I have written this as a reminder to myself not to become complacent about this devastating Covid-19 virus, to describe to those who are unaware of the cruel and lonely suffering that severely ill patients endure, to remind people of the extremely demanding mental and physical struggles our frontline healthcare workers undergo every day to protect us, and to appeal to my friends to stave off our Covid fatigue and continue to practise responsible habits so that we may safeguard each other.
Before this personal Covid-19 trauma, I thought I behaved cautiously and rationally. We masked and gloved, followed stricter hygiene rules, and social distanced to a degree. But I lacked what a doctor described as the “moral knowledge” of this pandemic. Sadly, it took this horrible experience to wake me up.
When my mother first developed Covid symptoms at the beginning of December, it did not seem possible. My parents had been so careful the entire year, leading a secluded, insular life. And then out of nowhere, disaster hit.
For those who are unsure of the malignant nature of Covid, let me explain how it nearly destroyed my mother. We learnt to measure the daily development of Covid from the onset of symptoms. For extremely ill patients there are critical days when they must be hospitalised to have a chance to survive, approximately days 7-10. Here is my mother’s story.
Day 1: Monday December 7: My mother experienced a cough, lower back pain from a kidney infection and gastro symptoms.
Day 2: A morning fever, body aches and continued cough persuaded her to have a Covid test. She then isolated in her bedroom, and the rest of our family masked and kept our distance in our holiday home.
Day 3: High fever, colossal cough, sore throat, body aches, exhaustion and nausea. At the beginning of our first wave in March, I had arranged an oxygenator and oximeter for home use in preparation for such an event. I remember some people calling me paranoid. Today the entire country faces oxygen shortages. My mum was set up on the oxygenator.
Day 4: Symptoms worse, exhausted and confused. We were lucky to find a nursing service and a lovely care worker, Nomalinga Blom, who, protected by hazmat suiting, nursed my mother for a further four days. As two GPs, Dr Peta Lynn Jearey and Dr Pete Berning, telephonically cared for her, our family agonised over what to do, all the time waiting to see if any of us were Covid-positive. My father, a 74-yearold diabetic, was also a concern.
Hospitals cannot offer a bed until the patient is very ill, so we waited and watched from afar, feeling helpless, as my mum’s oxygen levels dropped, 94, 93, 92 … The initial danger of this virus lies in the fact that it slowly starves the body of oxygen. The patient does not immediately start to gasp for air but rather undergoes a silent hypoxia, which is why so many do not initially notice its seriousness.
While my mother continued to deteriorate, she suffered alone. We could not sit by her side and hold her hand, wipe her brow, help her drink fluids, comfort her. After a week of torment with no respite, her mental strength too had waned. We felt she was slowly giving up.
Day 7: Extremely ill, physically and mentally exhausted, my mum was taken for chest X-rays and bloods and the doctor discovered she had developed Covid-19 pneumonia. Her immune system was unable to beat back the virus and it travelled down her windpipe to attack her lungs. And the tired physician still sent her home! A quarter of her lungs were covered with “Covid glass”. I had no idea what that meant, nor terms like cytokine storm, D-dimer and CRP markers. We were soon to learn. After a hysterical phone call, a bed at Morningside Clinic was booked. Then came the effort to move her back to
Johannesburg. With the life-saving help of Hatzolah, a Jewish nonprofit organisation offering emergency medical services, and our medical aid provider Discovery Health, we secured an emergency aircraft to deliver her to the hospital.
Day 8: My mother was airlifted from Plett to Morningside ICU. By the time she entered hospital, she was in critical condition. A day later, the hospital was full.
My mother was placed on high-flow nasal oxygen and a cocktail of Covid-19 treatments. Since there is no single cure to treat Covid-19 once a patient has contracted it, several supportive treatments are offered. Patients with severe Covid-19 can develop significant inflammatory responses. To mitigate these harmful effects, the corticosteroid dexamethasone was administered. Several non-targeted antivirals were also used. Severe Covid-19 displays evidence of vascular dysfunction, so it was important to manage this with anticoagulants. After the virus had assaulted her lungs, my mother developed liver inflammation or hepatitis as a consequence of the virus. Her kidneys were also at risk. The virus was systematically attacking her organs. On top of this, her soaring anxiety levels raised her blood pressure to unsafe levels. Within 10 days, the virus had ravaged my mother’s body.
We were told by friends who had similar experiences that we should prepare ourselves for little communication from the doctors and no access to the hospital. We were lucky enough to receive a once-aday phone call from my mum’s Covid cardiologist, Dr Farai Dube, a truly wonderful man who will remain a hero in our hearts forever. Luckily, once my mother began responding to the medication, she was able to call us most days. We measured her recovery by the sound of her voice. One day it was strong, the next weak and shaky. The doctors explained that recovery would not be a linear process. We learnt to measure our expectations, not becoming too excited when she sounded better and trying to remain calm when we heard it was a bad day. The volatility of this virus is excruciating. Too afraid to hope too much, we anxiously awaited each day for more news.
We began witnessing marginal improvements after a week in ICU and then, though some days were still unstable, a general upward trend. Once my mother was no longer critical she was moved to a renal ward. In the last few days in hospital, her progress was markedly rapid and finally, on day 21, she was discharged.
Back home, still weak, exhausted and fully dependent on supplementary oxygen, my mum described the things she saw and heard in ICU. One day, as my mother began her chest physiotherapy, she witnessed, through the glass wall that separated them, a nurse covering an old man’s body with a white sheet . “Turn away,” the physio gently said. My mother told us how a woman was called into the Covid ICU, in full hazmat suiting, to say goodbye to her 32-year-old son. My mother cried silently as she listened to the woman’s pleas, begging the doctor to ventilate her son to keep him alive. In and out of bouts of sleep, she heard the accounts of depleted nurses and their lonely 5am travels to the hospital, returning home late at night, risking their lives and their families’ lives by possibly bringing back Covid to their homes.
Covid-19 is a physically painful, mentally taxing, lonely disease. Families are not allowed to comfort their loved ones as they lie in hospital. Patients are often left to pass away on their own. Even the burials are less natural, with limited numbers of people allowed to pay their respects. Our doctor said: “It is one of the cruellest illnesses I have come across.”
I have restrained myself from lashing out at those who have not practised mask wearing and social distancing. It would be self-righteous of me to preach as I, too, am guilty of not maintaining safe standards all the time. And perhaps, had I not been through this experience, I would not be as vigilant as I am today.
It is a sad day when our government must enforce, by law, the mandatory use of masks. To those who do not abide by these safety standards, I ask, have we become so indifferent to those we must protect?
Please tell me we have not lost all our humanity, that even when our resolve begins to diminish, we will safeguard the weak, and surely our parents and grandparents, the very people who protected us when we grew up. This is our duty.
More than 35,000 South Africans have lost their lives to Covid, leaving a lot more than 35,000 families in mourning. Worldwide, nearly 2-million people have died. This statistic may only be a droplet in the ocean of our world population, but I pray that none of you ever endure my mother’s suffering or, much worse, the untimely death of a loved one.
I empathise with everyone’s “Covid fatigue”. I understand the frustrations at the government’s unpreparedness and often senseless decision-making. We are embittered by the economic destruction and extreme poverty that pervades our country. We are right to be angry, but I still have faith in our capacity to make it through another challenging year.
After a difficult 2020, we are worn out and weary. We yearn to interact and socialise freely, to reunite with our families, to hug a friend when we greet each other, to travel, to walk along our soul-enriching beaches. There’s a massive temptation to just rip off that mask and “breathe” away the dictatorial, controlling National Coronavirus Command Council levels 5,4,3,2,1. But as we enter our second and much stronger wave, we cannot give in to this fatigue. And we certainly cannot afford another economic lockdown. The responsibility to curb the spread of this virus lies with us as individuals and communities, to protect each other and to shield the elderly and the vulnerable.
I am profoundly saddened for those who have lost loved ones, angry at those small-minded enough to mock the severity of this virus, desperate for the frontline care workers and doctors who place their lives at risk every day to help save us, and terrified that I could still pass this virus on to my father if I am not careful.
My mother was lucky. We caught this virus in time, with only a few weeks in hospital, and she was one of the privileged few to receive excellent medical care. The majority, unfortunately, do not have these advantages. Please do not let fatigue or apathy wear you down. Please do not think it cannot happen to you. Covid-19 does not discriminate. Let us all help to protect each other. Wear a mask, wash your hands, social distance.
While my mother continued to deteriorate, she suffered alone. We could not sit by her side
A woman was called into the ICU, in full hazmat suiting, to say goodbye to her 32-year-old son