In the ‘Covidomania’ atmosphere that has been prevailing for over four months, anything from a headache, singular sneeze or cough reflex is construed as a Covidrelated symptom. Apart from me, three other members of my family are doctors. My first daughter is an infectious disease specialist and a frontline Covid warrior. My second daughter is a microbiologist and my son-in-law is a radiologist.
I had a travel history — two international trips to Australia and Indonesia between 15 February and 2 March 2020. I took eight international flights and transited four times through Singapore. Thankfully, my next trip which was scheduled between 7-14 March was abandoned because the Conference on Retrovirus and International Infectious (CROI) in Boston got cancelled on the eve of its starting. That was a saving grace as Boston was on Covid-19 potboiler.
Naturally, I always preferred to self-diagnose and self-medicate when I didn’t feel well. Last month, during one night, I got a fever with shaking chills. Having noticed mosquitoes and a possible bite, I suspected malaria and started popping-up anti-malaria pills. Last year I had suffered from chikungunya and overcame its debilitating consequences with great determination, physiotherapy and family support and also by popping-up lots of homeopathy pellets. These pellets were suggested and shipped by my friend Dr S.N. Mothi’s homeopath father from Mysore, as well as by my family friend Puja Ambwani. I also added HCQ (hydroxychloroquine) to that for a considerably long period. Considering myself immune to coronavirus was natural in the wide-ranging discussion on HCQ’s effects on Covid-19 prevention and its inclusion in the ICMR guidelines.
Next day, I self-tested for malaria, dengue and chikungunya with complete blood count. All came negative. With some acquaintance, with lab reports and patients during her counselling and supervisory stint at the clinic, my wife added ESR to the testing profile. We were astonished when the ESR was 120/hour (normal range is <15 for adult male). My lowgrade fever continued, but it was in the evening when my headache started with some night sweats. Mild dry cough got added to the list. Now I diagnosed myself with another condition — tropical eosinophilia — and started diethylcarbamazine, a drug to cure it after taking my younger daughter into confidence but also requested her not to tell the elder one.
Another round of blood work-up followed along with a sample for IgE to look for any allergy. By then, the cat was out of the bag, and under pressure from my caring-turned-scaring family, we ran lots of tests to throw light on Covid-19 diagnosis along with a thyroid test. Nothing came conclusive, but the thyroid test reports were awaited.
Loss of 4 kg weight, pain in neck, loss of appetite and continued fever led us to suspect tuberculosis. Radiology and blood tests followed. In the back of mind also came the consideration of malignancy with my age being over 62. By now, all three doctors were fully involved and started discussing in their respective specialty circles. Ace radiologist Dr Bhavin Jankharia suggested full-body PET/CT scan with radio-uptake study for thyroid. Next morning’s appointment was fixed, which was to be followed by a swab test for Covid-19. A new development happened when I noticed some painful swelling in the lower end of my neck in the region of the thyroid. The TSH came very low. That was a saving grace for me, as it was suggestive of acute inflammatory or infectious thyroiditis. Endocrinologists were consulted and we postponed the PET/ CT. All along, I was reluctant to do the swab test and kept postponing it, owing to its associated stigma. But I did do my Covid rapid antibody test when my blood was drawn; which was negative for both IgM and IgG antibodies suggesting neither current nor past infection with Covid-19. A steroid course was started to treat thyroiditis. That gave me some relief as the fever started subsiding. Experience suggested all these can also happen in Covid-19 and that’s pretty common.
But the debate on the possibility of Covid-19 never stopped. Both scenarios were discussed. If I turned positive, then all of us had been exposed, presumed positive and remained asymptomatic, so infection had come and gone in everyone. This was considered the most ideal scenario as the other seven would have escaped, considering the long duration of my symptoms. If negative, that’s also fine, but the sword of Damocles was always on us with the possibility of Covid-19 in the future, especially with the escalating Covid-19 cases in Mumbai and my clinic and residence both being in the red-zones and my continuous medical practice with standard precautions.
I was left with no option but to succumb to the pressure and submit myself for the swab test. Home visit was preferred. Discussions continued on what to do if the test came positive. The technician who came to take swab had used handgloves, mask, disposable paper apron (costing Rs 20), that she removed from her backpack — supposedly reused several times since morning and head-shield in hand. This was all that in the name of PPE kit for which labs charged Rs 600 extra. The swab was put in my nose and I felt a terrible pain which I do not remember in recent times. Physical pain settled and psychological pain started. I was wondering, “What if the results come positive?”
Though I have no co-morbidity, my age is considered high-risk. Whereas the children started discussing which hospital to prefer, which physician to consult, ambulance, oxygen support, ICU, ventilator and all the possibilities. That waiting night was terrible. My wife started listing assets and liabilities, credit card numbers, passwords, PIN and told me to show everything to children all in run-up to the winding-up mechanisms as if I won’t return alive from the hospital. In the back of my mind, I was assured of a decent cremation with my wife and children in attendance, unlike what we had been seeing, though not expecting my other family and friends.
Next morning, my wife drove me to the clinic. I don’t drive and she has been driving me up and down for four months. Driver being from the containment zone was given off. Every hour discussion was on whether the report has come, but it kept postponing. While returning from the clinic, we stopped by a cake shop and purchased a cake for celebration. Awaiting the report, the table was laid, cake decoration was done with confused faces around.
Report finally came — it was negative! It was a cause for celebration. Negative report was more solace for me as I had already lived and died. In my dream I had already got an array of medicines following different protocols — Ivermectin, Azithromycin and Favipiravir tablets, Remdesivir injections included, reached the so-called cytokine storm and got Tocilizumab shot, both were made available to me despite scarcity. I was just short of writing my own obituary. I am now much better on steroids with final diagnosis acute painful thyroiditis and doing my bit to better the course of the Covid-19 pandemic and for prevention of stigma and discrimination.
The author is the president at AIDS Society of India and governing council member of International AIDS Society.
