On a gorgeous day in early March, I set out on my usual morning commute to clinic. The recent rain had turned the mountains green, there was some fresh snow atop Mount Baldy in the usually dry Inland Empire of Southern California, and the Lakers had just beaten their rival Clippers the preceding weekend. As I drove in to work, I was listening to coverage of the story I had been following for the past few months on PRI’s The World regarding the novel coronavirus in Wuhan, China. By this point, it was a nightmare scenario: families were stuck in a perpetual lockdown for weeks, tourists were trapped on cruise ships with no way out, and the virus had already killed thousands. I knew the facts and appreciated the gravity of the situation, but that issue was an ocean way. It wasn’t our problem, right?
Life comes at you fast. Like most of us, little did I realize how much our lives would change in a few short days. The headlines moved at lightspeed, covering the virus that began in a Chinese province and overwhelmed the infrastructure of the developed world. However, as a second-year pediatrics resident, I continued to work. I kept seeing my slated schedule of well-child and various acute visits while spending a larger portion of each visit educating parents on the threat of the novel coronavirus based on the limited information we had. While the atmosphere was already tense, the situation escalated on March 19 when our governor Gavin Newsom issued statewide shelter-at-home orders. I drove home that day with a growing level of anxiety about what the future held, but also an unusual amount of fatigue. I decided to take a nap in preparation for a long night ahead, but after two hours, my head felt as though it weighed a ton. Diffuse myalgias made it difficult for me to stand up. I called in sick that night, and as California’s shelter-at-home drill began, so did mine.
I routinely take care of sick children with viral infections, so I told myself I just got another bug from one of them: a routine occurrence in the life of a parent or pediatrician. This would probably get better on its own. However, amidst the concerns of a growing pandemic, I was advised to see my primary care provider to be cautious. Office visits were limited at the Loma Linda family medicine clinic, but I was able to get a video visit that morning. Given my symptoms and our clinical algorithm, I was tested for COVID-19. I stayed in isolation, fatigued, and barely eating over the next two days. Around midnight on March 20, I received a call from the lab stating that I had tested positive.
The next few days were a whirlwind of phone calls from concerned family and friends as I was the first person that they knew diagnosed with COVID-19. I was also one of the first in San Bernardino County to have tested positive for the virus. In unison, they all asked: Have you had a fever? Have you had any shortness of breath? Where do you think you got the virus? Thankfully I had neither symptom, but I also had no idea where I had got the virus from. I myself was confident I would recover from the virus, but I wanted to perform the appropriate contact tracing. A sense of panic initially gripped me as I thought about who I might have infected. I reached out to everyone I could and hoped that no one else would have been infected because of me. On March 23, my fiancée, who lives apart from me working as a surgery resident in Los Angeles, developed symptoms and also tested positive along with a few other residents I had come in contact with.
Over the coming weeks, my screen time increased to over 9 hours a day as I FaceTimed with my friends, family, and fiancée in isolation. Technology was a lifeline at a time when I felt more isolated than I had ever been before. My fiancée and I actually had the opportunity to spend more time together than we had in months through our shared quarantine routine. We both recovered day by day, and gradually, we were able to smell and taste our food. Thankfully, we never developed the dreaded respiratory failure. Once I started feeling better, I started fielding patient calls and messages from home, which allowed me to feel helpful amidst the Netflix binges and novels I was devouring. After two weeks, I received the call from San Bernardino public health, clearing me from isolation. Mentally and physically, I felt ready to go back to work.
With everyone around me urging me to stay positive, I took that advice quite literally. I have tested positive for the virus ten times in a span of six weeks, even after public health clearance. I require two consecutive negative nasal swab tests 24 hours apart before I am cleared to return to work. After testing positive, when is one cleared to go back to work? Policies vary widely among institutions, and nobody has a clear answer on whether prolonged positive cases are actually infectious. My colleagues and mentors are all rooting for me to come back to work as soon as I can, but no one can be sure when it will be safe for me to return. I am now hearing of others who are prolonged positives as more information is compiled worldwide, but it is still a limited number of cases estimated to be 1 to 2 percent infected those with novel coronavirus. As testing becomes widespread, there will likely be many more in the population who will face the new challenge of knowing when they will actually be cleared to return to work as we re-open the economy.
Rohith Mohan is a pediatric resident.
Image credit: Shutterstock.com
