By Apoorv Kumar Chaudhary
[This write up is being written to share my personal experiences with Covid-19 in a small town in Uttar Pradesh, in the hope that it might be useful for people. It is not intended to be medical advice.]
It was in January 2020 that I came to know across a mysterious virus affecting hundreds of people in China. At that point, I thought it to be similar to the SARS epidemic of 2002, which mainly affected parts of East Asia for a few months. However, this virus was different and soon, it spread across most parts of the world, leading to lockdowns in many countries. In June 2020, when the national lockdown was partially lifted and trains started running, I made a journey from a city in Bihar to a small town in Uttar Pradesh. Surprisingly, in spite of a lack of sanitization and utter lack of cleanliness on the train, I did not catch Covid-19. However, it was in August 2020 that I possibly came in contact with a Covid-19 positive patient and got Covid-19. This is an account of the virus, the procedures adopted for treatment and things you ought to do when you possibly have Covid-19.
In the first week of August, I came into contact with a patient diagnosed with Covid-19 who was in home isolation. I started feeling certain symptoms like mild fever, mild body aches, dry cough and sore throat. I suspected that I had the virus and discussed it with my father, who advised against being tested. On the next day, he got more severe symptoms like fever and body pain. Still, he was of the opinion that it was possibly malaria and did not want to get tested. However, ultimately, we decided to get tested together and went to the Community Health Centre, Najibabad (Uttar Pradesh) to get tested. We underwent Rapid Antibody test and I tested positive whereas my father tested negative. However, on the doctor’s recommendation, my mother and father had to get tested and were diagnosed with Covid-19, even after my father had tested negative the previous day. They were shifted to the Quarantine centre on the day their results came positive. On the next day, I was also shifted to Tirthankar Mahavir University, Moradabad.
The timeline of events may be summarized as under:
- 8th August, 2020: I got diagnosed with Covid-19 and was put in home isolation for 17 days.
- 9th August, 2020: My parents got tested for Covid-19. They underwent RT-PCR test where results would come only after 2 days.
- 11th August, 2020: My parents tested positive and were shifted to the Quarantine Center in Suvaheri, Bijnor.
- 12th August, 2020: I was shifted to Tirthankar Mahavir University, Moradabad
- 16th August, 2020: I was discharged from TMU, Moradabad and reached home, being advised one week of self quarantine.
- 18th August, 2020: My parents were discharged from quarantine center and reached home.
As the timeline has been discussed now, I would now discuss my experiences in dealing with Covid-19.
To test or to wait
When it comes to Covid-19, the usual wisdom says that the earlier it is detected, the better it is. However, I have often seen that people are hesitant to undergo testing. My father’s approach towards testing was not unique, it was in fact influenced by some of his colleagues who were also hesitant to undergo tests. This approach stems from a strong fear of hospitals and moreover, a fear of being hospitalized. The stigma has increased because of the way Covid-19 invokes the picture of overburdened hospitals with little facilities. It is also a testimony of the mistrust that people have accumulated about the doctors and the healthcare systems of the country.
There are two reasons why it is beneficial to have an early testing. Firstly, the earlier Covid-19 is diagnosed, the better the chances of survival in serious cases. The medicines and supplements can boost the immunity help the body cope up with the effects of Covid-19. Secondly, the earlier it is diagnosed, the earlier the quarantine and/or home isolation ends. It is because the hospitals, particularly government hospitals do not test whether the patient is actually recovered from Covid-19, but it is assumed that the Covid has ended after passage of a particular period of time. The policy reasons of such assumption are not very clear, but the assumption continues. Thus, the earlier you get tested, the better it is.
Home isolation or Hospital Quarantine
When I was diagnosed with Covid-19, a few of my well-wishers were aghast that why I was in home isolation and not admitted to a hospital. This was also exacerbated by the death of one of the most prominent Indian poets, Mr. Rahat Indori, who died on the day he was diagnosed and admitted to hospital. However, there are distinct advantages that home isolation has over hospital quarantine, particularly for patients with mild symptoms. Firstly, in home isolation, you have to purchase certain instruments like Oximeter, Blood pressure monitor and thermometer on the recommendation of the government doctors. Thus, you would be able to monitor your health at a regular interval, which happens only once a day in the hospital. On any deterioration which you may detect on these instruments, we can call the doctors who would be able to take appropriate steps. Secondly, as Covid-19 has no cure, herbal and Ayurvedic remedies play a good role in soothing the lungs. Inhaling steam 2-3 times a day, having milk with turmeric, having herbal teas and syrups- these do not cure Covid-19 but help a lot with the symptoms associated with it. These, unfortunately, are not possible to do in a hospital unless you take your own kettle, milk and other medicinal stuff along with you to the hospital which is quite difficult, if not impossible. Thirdly, the patients in a government hospital are provided with a bed in the general ward. Thus, the lavatory and bathroom facilities are certainly better in the home as compared to a hospital. It is for these reasons that home isolation has been advised for mild symptomatic and asymptomatic patients by the Government of Uttar Pradesh.
The stay at Hospital
The medical college I was shifted is situated about 120 km from my house. It took me about 3 hours to reach there in an ambulance. However, as I reached there, I had to wait about three and a half hours in the waiting area for formalities to be finished before being admitted. If the first impression is the last impression, this impression was certainly poor because not only were 20 patients, some with symptoms like breathlessness, waiting for about three and a half hours but also because there were at least five or six patients who were admitted in a critical condition in an emergency. However, once we were admitted, it was smooth sailing. The stay at the hospital was comfortable for the most part, except for waking up at night when the hospital staff shouted names of people for blood sample, urine sample and X-ray. The ward was cleaned up twice a day, bed sheets were changed every day and the food was delivered thrice a day at a prompt time. The quality of the food was good and the quantity was so much that a lot of food was wasted by people admitted. The doctors visited once a day but nurses were available all around, in case they were needed for emergencies. The overall atmosphere at the hospital was more or less cheerful because of people over there and it did not seem that COVID was such a big deal for most people. In fact, most of the people admitted there would have fared very well in home isolation but were admitted due to reasons like age or home isolation is not possible at their homes. Nevertheless, the stay at the hospital can be termed as satisfactory.
On a side note, my parents’ stay at the quarantine centre had one thing to be desired-cleanliness. The halls were not cleaned properly and the toilets were mostly dirty. Moreover, there was no water for two days due to a problem with the motor. Apart from cleanliness, the other things were up to the mark.
What to do if you suspect/test positive for COVID-19?
This question is relatively common but surprisingly, I had to search a lot to get proper answers. In fact, most articles on the internet were either fear-mongering ones or did not advise on a clear cut course of action, which prompted me to write this article. There are certain things you can do if you suspect or test positive for Covid-19:
- Be positive, not callous: It is important to maintain a positive attitude towards the disease. However, one must not be callous as it is likely that we can spread this virus to others. A delay in diagnosis of the virus does not benefit anyone and only has a negative affect. A positive attitude also affects how early you are going to be healed, from what I observed in the hospital.
- How long do symptoms last?: When I searched on the internet, most of the articles, even from reputed sources, were doomsday articles. For instance, ‘some people may never recover their sense of taste or smell’, ‘people’s lungs may never recover’ and articles similar to these. In most of the cases, such symptoms last for a few days after the time period of the virus has ended. Some issues like tastelessness, in normal circumstances, would not last for more than a week. I would recommend this article as it covers the journey of a COVID-19 patient quite well.
- Internet and fear-mongering: It is important to note that the media often creates unintentional fear by pointing out the most severe or exceptional cases of Covid-19. Also, much of the studies done about the impact of Covid-19 have been limited to Wuhan and China, and the impact has been different in India when we compare it to Europe or China. Thus, not every study or every report about the effects of Covid-19 present a gospel truth. It is important to rely only on reputed sources and if possible, look for at least the abstract of the report cited by the article on the Internet.
- Listen to your doctors: This seems like obvious advice, but a lot of people don’t do it. If you feel like having symptoms, maintain distancing even from your family members. Download the apps you have been asked to download and maintain proper records on the app.
- Herbal/Ayurvedic remedies and Covid-19: Covid-19 does not have a cure as of now. But the symptoms of COVID-19 can be controlled. Ayurvedic remedies can play a crucial role in controlling symptoms of Covid-19. However, it is important to rely only on trustworthy sources of such remedies. The first source of the same would be the instructions by the state government, which advises taking steam, herbal tea and turmeric milk. Additional remedies are also available at the website of Ministry of Aayush and the app Aayush Kavach, specifically for Uttar Pradesh. Moreover, breathing exercises like Pranayama would help with increasing the capacity of lungs and release of mucus from lungs.
- Special message to well-wishers: It is good to know that well-wishers care about you in testing times of Covid-19. However, it is important not to show concern through the phone call. The body and lungs feel exhausted due to Covid-19 and the person is often, not in a position to talk for more than 2 minutes without straining the lungs. Fortunately, in my case, this wish was well respected by the well-wishers.
A review of Government action in my case
I express my sincere gratitude to the Government of Uttar Pradesh for their actions regarding my Covid-19. However, nothing is above criticism and I have certain suggestions for the government.
Firstly, the action in all the cases was prompt in nature. As soon as I diagnosed positive, I was informed by the government and isolated by evening. My parents also were shifted to the quarantine centre the day they received their results.
Secondly, the treatment, except home isolation, was completely free, even though the medical college I was shifted to was a private medical college. This is one of the best part of the response by the government. The medicines, food and other amenities are taken care of quite well by the government.
One of the major minus points of the government approach is the policy on return of patients from the hospital. Once we are discharged from the hospital or quarantine centers, we are expected to reach home by our own convenience, but are advised 7 days of strict home quarantine. 7 days of strict home quarantine would mean that we are not completely OK to mingle with people. But finding our convenience home would also entail interacting with people, and taking public transport as vehicles without a valid pass are not allowed on the days of lockdown, i.e.: weekends in Uttar Pradesh. Thus, it would be better if the patients are provided convenience to their houses from hospital.
Second negative I can point out is about the policy of home isolation. Under home isolation, patient is expected to buy his own instruments and medicines, which cost about 4000 Rupees. These instruments play a crucial role to self analyse the condition and detect any deterioration before it is too late. If the government can spend thousands of Rupees on stay at hospitals and quarantine centers, the government has the capacity to provide two essential instruments- Blood Pressure monitor and oximeter. Government can also acquire these from people recovered from Covid-19, which will save the money of the patient as well as the government.
The last negative I have to point out is about certain problems already pointed out earlier with regard to hospitals and quarantine centers. The process of entry at the hospitals could be resolved easily by devoting one or two more doctors for initial check-ups. The cleanliness at quarantine center can be easily resolved by having more cleaning staff and sudden inspections to ensure the cleanliness of quarantine centers.
Overall. I am grateful that only had relatively mild version of Covid-19 and my parents were mostly asymptomatic. I express my heartfelt gratitude to all the medical and non medical staff because of whom, I was able to successfully recover. Covid-19, isolation and stay at hospital has been an experience worth remembering throughout my life.
I did not really wish to add this, but with the approach the governments and the oppositions are taking, I am forced to include this. When I was discharged from the hospital, it was based on Uttar Pradesh Government guidelines that a person would be kept in hospital 10 days from being tested. It could not be conclusively said that I was negative and thus, the prescription from the hospital read “strict 7 days home quarantine”, which is the policy of Uttar Pradesh Government. Neither the hospital nor the Government provided any convenience to go home. Consequently, I was forced to rely on public transport, wherein the other people using it were university students who had exams. I had no symptoms at the time so I really hope and pray that no one has got the virus because of that journey. If the Government and the UGC are adamant on conducting exams, the least they could do is to create a bio-safe bubble for students. Students travelling on public transport are bound to come in contact with someone recently discharged or someone who is diagnosed COVID positive. The opposition could also ask the Government to provide for Biosecure bubbles for students and state governments where the opposition is in power could try providing such measures, but everyone is busy in scoring political points.
Apoorv Kumar Chaudhury is a Research Fellow at Centre for Innovation, Intellectual Property and Competition Law, NLU Delhi. He is an alumnus of National University of Advanced Legal Studies, Kochi and CUSAT. He is also the recipient of the very prestigious Junior Research Fellowship. He is also a prodigious reader of an eclectic collection of books and an animal lover.