Asthma and Coronavirus
Right about the time that the death toll peaked in China, I was calling my doctor. Symptoms? Persistent cough; some difficulty breathing; slight sore throat, and sputum in the lungs. I also experienced an overwhelming sense of fatigue when I sat down in front of my computer to try and do work in my online classroom.
Fortunately, I got an appointment with my pulmonologist right away, and was tested for coronaviruses; not the novel coronavirus; but for the genus of illnesses that bear the same name. My tests came back negative. I had a sinus infection; which, as I write this, has not gone away.
Why is this information so important? Because I am an adult asthmatic. The symptoms I described to my doctor have put me in the hospital before, and now, as I wondered what would happen to me this time, I felt just a bit more reassured that I could handle this medical issue the way I had many times before. Triggers like cigarette smoke, dust, and dog fur all seemed to make my symptoms feel like I had just sent a counterweight to strike the bell at the top of a carnival game.
For people who suffer from asthma, the idea of a virus that could collapse our already compromised lungs is truly frightening. We know we are not healthy, in the same way that someone who does not have a pre-existing condition is; but, we strive to establish that same sense of normalcy in our own lives not to feel separate, or sometimes different from people who do not have to wake up in the middle of the night coughing, or use a $300.00 steroid inhaler on a daily basis, to prevent a full and prolonged asthmatic attack.
I knew very little about asthma, until I contracted it at a somewhat late stage in life. And, perhaps like many others who suffer from the illness, I tried to ignore its symptoms, and maybe even deny that I had it on occasion as well. That was a mistake. I have lungs that function as well as they can, but will never be normal again. Walking in the cold night air can make my breathing labored, and stress can feel like I am breathing with a trashcan lid being forcefully pushed down on my chest. I also never know when the symptoms will hit, nor how long they will persist. I know not eating anything two hours before I go to bed decreases the chances that I will wake up laboring to breathe in the middle of the night, forced to watch reruns of ‘60s sitcoms, when all I really want is sleep.
So, when coverage of COVID-19 began to seep out, and then, became more voluminous in nature, I read every scrap I could about how susceptible I was to contracting this new disease. And, while my own symptoms moved from my throat to my nose, and into my lungs; I thought about how easily I could succumb to a virulent pandemic that affected the most vulnerable part of my body. It did not help that the swab used to take the test was longer than a chopstick, and made me feel like a novice sword swallower, while I watched the skinny tip being forced down my nostril.
It also didn’t help that since the novel virus is so new, the data on what causes the disease and who is most affected, is still inconclusive. And, the Asthma and Allergy Foundation of America reported that in a study of 140 COVID-19 cases, no data identified a link between the two kinds of diseases. That is the good news. Still with reports of the pandemic growing, it is unclear whether future studies will show that asthma symptoms will be exacerbated, following similar patterns they have displayed with other coronavirus strains.
Asthma and Coronavirus
Funny, it took a pandemic to make me come to grips with the concept that I am 61 years old, and getting older as well. Descriptions of vulnerable populations defined people in my age group as “elderly.” Never before had I thought of myself fitting into any such category, but labels are labels, and consequently, I accepted that I had another characteristic trait of those likely to become infected by the coronavirus. And so, even though I had not tested positive for the coronavirus, I started to slowly self-quarantine. For symptoms I have now, for symptoms I might acquire relatively easily in the near future, and even, perhaps, for symptoms that I could transmit to other people. And for the first time in my life, I also considered what it would be like to have my health completely compromised, to the point that it would be impossible for me to recover.
Partially in concession to my own desire to stay out of the statistical fray, I have even donned a mask, and stood in line to make sure my house is fully stocked with toilet paper and paper towels. And, until the “all’s clear” signal has been activated on a national scale, and our lives can try to return to some sense of normalcy, my hope is that, by sharing my story, I can offer an image of asthma that is not commonly portrayed.
We are not lepers, or outcasts; we are not necessarily overweight; nor predestined to get this illness. In my case, I was told by one or more doctors that the particulate matter in the air probably triggered my own illness. Moreover, the kind of asthma that I have is pretty much likely to last me a lifetime. And now, while we all wait anxiously to see if the coronavirus will be halted in this country in the near future; those of us with asthma have our own special set of worries about how vulnerable we are to resisting any impact of COVID 19.
Coronavirus and the Healthcare Provider
It was my turn to work the late shift on Friday afternoon at the medical practice. We often jokingly called it the graveyard shift, not really because it was always quiet, but because it was probably the worst possible time to be at work. End of the week, families spending time together at home, but you instead seeing patients until darkness fell outside, and creeping home to a house where little children are already in bed and there’s not time for much more than a shower and supper before falling into bed.
“But this is probably THE worst Friday evening in the history of the practice to be working,” I thought to myself as I rode to work with an eerie feeling of being very alone, and marveling at how true the term graveyard felt today. It was the first official day of lock-down in South Africa for the Covid-19 pandemic, and the usually busy streets of Johannesburg were empty, much too empty to feel normal. A lone straggler here and there, the suspicion of what the driver next to me is doing on the road, expecting to be stopped at any moment and questioned on why I’m not indoors. You feel like you’re in an apocalyptic movie, and that a fearful face will peak a look at you from the closest window any moment now, a face full of terror, rapidly pulling the curtain closed as they spy another human being.
I reach work and find only one other colleague present, busy watching the news and eager to leave me and be off home since it’s so quiet. For the last week my workplace has felt like a danger zone. This is now the place where I am being exposed to patient after patient who is potentially carrying the virus that can infect me (carrying an unborn baby), my fellow staff, and the other patients.
Attempting to successfully sift through the large groups of people with a sore throat or cough, wondering when I am going to miss that patient that really needed isolation, and then infected their families because I gave them false hope that they didn’t have the virus. Being stuck with so little information to really determine if someone is at risk, because we’re only allowed to test such a small group due to limited resources. Wondering which coughing patient’s droplets will penetrate my tired face mask that has been reused too many times, or when the droplets landing on my desk will gain access into my airways because I inadvertently touched my face. Or what day I will go home and transmit this virus to my husband and children, and see them fall ill due to my work in keeping others healthy.
Each day coming to work and hoping there will be a gown for me to use, a new mask that will still actually offer some protection, that we will get more testing reagent so we can test everyone who needs it. The load of responsibility has been lying heavily on us all to try to fulfill our role in containing this pandemic and keeping the society safe. I have been seeing the strain on the faces of the other doctors and staff, and feeling it in our tired bodies as we all complain of sleeping poorly. Overall, I feel like someone standing before a waiting storm that could hit any moment, but keeps on teasing me with a case here and a case there but promising worse things to come.
On this day, I see the nurse has been innovative and put an already-used gown in our sterilizer. It got stuck to the packaging and tears on opening, as it isn’t really meant for reuse. Thankfully the tears are at the bottom of the gown, and I can comfortably cover my clothes. Next a hair covering, face mask, and gloves. I clean my stethoscope and oxygen saturation monitor, and at last I am ready for my first patient. My screen for bookings is not very full, which is not surprising for today. Who wants to go out and breath the air of a room where hundreds of patients have been coughing and sneezing in? Well, doctors and nurses I guess. Yet not coming to work is no option either. This is what I have trained for, and here I will fulfill my duties diligently.
I note a message on my screen from a patient I had seen the previous week, requesting that I give him a call. He had been admitted for pneumonia, but they had not been willing to do a Corona test on him at that stage due to not fulfilling the criteria. There are however some patients waiting to be seen, and I only get a chance to phone him a while later. “I tested positive for the virus while in hospital”, he casually mentions. He doesn’t need to mention which virus.
It feels like someone drops a stone in my stomach. Guess what, we didn’t have protective gear last week…
Isn’t it amazing how someone can change your future in one sentence? Sometimes only for a while, but sometimes for the rest of your life. How true that words can be like that tiny rudder on a boat that changes the whole course of a big vessel from one direction to another. So here is one of those moments for me. I knew it was coming, had even been expecting it.
The nurse is very quick to inform our practice manager, and before I know it my appointment screen is being closed off before my eyes. Clearly they want me out of the practice, and ASAP. An extremely uncomfortable swab is done in my nostril, and I have a lot of new respect for any other person who has had to endure this amazingly comfortable procedure science has invented for us.
The manager tries to appear compassionate, but firmly advises that I leave. I put on a brave face as I slowly undress all my protective gear, washing my hands, and again washing, and washing, as I have been doing a thousand times this week. My hands have even taken on a new smell, one which I’m starting to despise.
“They’re kicking me out”, I jokingly tell the admin ladies at reception, but the only comment I get is concerned faces,faces filled with fear and anxiety for themselves, me, and the world we’re currently in. I’m reminded that I now represent something of the palpable fear that has been hanging in the air the past few weeks. The fear that we ourselves will become part of the statistics so carefully registered each day on the web.
As I walk outside the birds are singing as always, unaffected by human worry. I say a prayer before I phone my husband, who has been diligently reminding me and pleading with me for days on doing everything I can to not bring the virus home to our children. I needn’t have worried. As soon as I hear his voice emotion kicks in, and the only words I can get out before tears is that I have been sent home. Then he says just what I needed to hear. “Just come home, we’ll deal with it here. “ There is a numb feeling of unreality in me as I drive home. In a sense I am almost relieved that I may have the virus. With all the pent-up suspension, it will probably be better to just get it than wait and wait and wait, wondering whether it’s there at last. Wondering whether I’ll be the one that only gets a sniffle from it or end up in the mortuary.
The kids are in the backyard as I drive in, and I only greet my husband from afar before going into my prison. There I am to stay until being cleared of disease. Will it be hours? Days? Weeks?
Have you ever heard your child crying or even laughing, and not been allowed to touch them or comfort them? To wonder whether your very acts of love have been the passage for disease? Have you had the agony of only watching through a window as your children play, so close and yet a world apart, hiding behind the curtain that they don’t see you and cry to come to you but can’t? I wish it on no parent.
And so I washed my dishes and sterilized them that night, being careful to not finally touch anything they need to remove. I said good night to the family via a phone call. I hungered to be able to be with them and touch them, hungered like someone who hasn’t had food for days and feel the physical ache for what isn’t there.
So, we enter this new world. A world of an unseen enemy so small that eight of them can fit into the breadth of a human hair, yet powerful enough to claim my life. My story ends well for now. The test result came back negative the next afternoon, and I could leave my prison. At least for these few hours I can be sort-of sure that I don’t carry the virus. Tomorrow at work we start the fight again and, who knows? Maybe next week I’ll be back here…
