January 1 2020
After all the well wishes and reflections with family and friends upon the arrival of a new year full of hope, a Leap Year at that, I plant my pepper seeds, determined to get a headstart in my garden this year and settle in for travel planning. I’m off from work for the holiday and I’m travelling with my mother and sister to Thailand and Cambodia at the end of the month. As the trip planner, I have an itinerary to finalise. When I get back to work in a couple of days, I will be working non-stop until our departure.
But as with every other task, I must first procrastinate. On my Twitter feed, I read about an undiagnosed pneumonia in China from the ProMED-mail account. The organisation is an excellent source for staying abreast of emerging infections and I have followed them in one way or another since discovering old stacks of Emerging Infectious Disease journals in college.
PRO/AH/EDR> Undiagnosed pneunonia – China (HU), RFI https://t.co/Wxf88uixae
— ProMED-mail (@ProMED_mail) December 31, 2019
I admit I don’t think much of it. When I bought our flight tickets back in November we had made it a point not to transit through China nor Hong Kong because of the unrest and had chosen a more expensive transit stop in Qatar (the Middle East, fingers crossed). Still, this is a reminder to check the travel insurance that comes with the credit card. I end up buying a supplemental travel insurance policy to cover medical and repatriation just in case, mostly because of my mother. I also decide to forgo group tours and to hire private drivers, a decision made easier because it’s more economical.
January 2 2020
I’m still enjoying my quiet time at home. News outlets are talking about this “mystery pneumonia” and followers of ProMED-mail are evoking SARS. Ugh! I hope not. I go to Target to buy a few travel-size hand sanitisers and bleach wipes in addition to getting my travel prep shopping done and seeing what leftover Christmas decorations I can get on sale. Can never be too careful. I see pictures of the Wuhan “seafood market” on TV which also sells butchered meats and live wildlife believed to be the source of the “mystery pneumonia”. I cringe because I enjoy going to open-air markets and have several in mind for our trip.
January 8 2020
I’m back to work and it’s very busy. Influenza activity is high. I learn from news media online that dozens in China now have this “mystery pneumonia” and that Chinese scientists think it’s a new coronavirus. Many common colds are coronaviruses so hopefully nothing to worry about. But then again the deadly SARS of 2003 (774 deaths out of 8098 cases) and MERS of 2012 (851 deaths out of 2468 cases) were coronaviruses. Not good. The world is now watching this “Wuhan pneumonia” with interest and I am too! I ask my mother and sister to get their influenza vaccines if they haven’t already.
January 13 2020
Oh no! There are news reports of the novel coronavirus in a person in Thailand, a traveller from Wuhan, China. I hope my mother hasn’t heard about it because I am not cancelling this trip. I entertain the thought of getting fashionable fabric face masks from Amazon. I can’t decide between an all-black one or one with a pretty print. In the end, I procure a handful of regular surgical masks and a lot more travel-sized hand sanitisers, antimicrobial hand wipes, and on-the-go bleach wipes.
January 14 2020
Ugh! Now there is a report of a cluster of 2019 novel coronavirus (2019-nCoV) in a family in China suggesting that person-to-person spread is possible. Not confirmed but still, what a crappy time to plan a holiday to Asia. Fingers crossed this is not true.
January 21 2020
Ugh to the umpteenth power! The World Health Organization is calling an emergency meeting on 2019 novel coronavirus. Health care workers in China have been infected by their patients. All doubt of the capability of this virus to spread person-to-person is gone. This gives me great pause. We are to leave for Thailand in five days. There’s been another case in Thailand, another traveller from China.
What do I do? Do I cancel the trip? I’m nervous. Chinese New Year coincides with our air travel to Thailand. It’s as if we are flying right into a flame. I find it eerie that neither of my parents has raised concern. They are such extra cautious people. I know that if they did raise a concern I would insist on travelling with or without my mother. My sisters who are not travelling with us warn us not to bring the virus home. I scoff. “It will be here before we get back, so don’t you worry about us”, is my reply. But it’s already here. I tell myself to keep things in perspective. It’s a respiratory illness. It can’t be worse than influenza!
One of us tends to get a cold with changes in temperature and another has a wicked cough that acts up on a monthly cycle. I’m not so nervous about catching the novel coronavirus in Thailand, I think we can be careful enough since it’s still quite new and not widespread. But I’m worried that with our sniffles and our cough we will attract attention to ourselves for extra screening and nasty looks from others.
When I go to the convenience store to pick up my “in case of travellers diarrhoea prep” (azithromycin prescription, bismuth subsalicylate, probiotics), I find myself picking up zinc lozenges, vitamin C, cough drops, decongestants, antihistamines, and a thermometer. I would have picked up elderberry too were it not for my dislike of berry flavours! I even hovered over the oscillococcinum, familiar from my childhood. At home, I thinly slice fresh ginger to dehydrate for the trip. Yes, I realise I’m an infectious disease physician.
January 24 2020
Deaths are increasing in China. Wuhan is on lockdown. Should we be worried about the new Wuhan coronavirus? I’m worried. When colleagues find out I’m travelling in the next couple of days to Thailand they urge me to cancel. Too late! Another colleague tells me to watch Pandemic on Netflix not knowing I’m about to travel to Asia. I’m most certainly not going to do that. I bookmark a new up-to-the-minute coronavirus tracker from Johns Hopkins. It’s both fascinating and alarming. I ask a couple of unit nurses for N-95 masks in my last-ditch effort to be ready for what lies ahead!
January 26 2020
We say our prayers and head for JFK airport. All is well. Our flight isn’t full. On arrival to Qatar, we have to go through screening again to catch our connecting flights. There are people wearing facial masks. It feels like a different world. We put on our surgical masks as well. We play musical chairs often in the few hours that we have to wait for our next flight because whenever someone comes to sit near us and coughs we move. The struggle is real.
Our connecting flight to Thailand is essentially empty. We have whole rows to ourselves. Still, I exercise my full Naomi Campbell (skip to minute 2:35) and wipe down my seat area. I instruct my mother and sister to do the same. China may or may not be able to contain the 2019 novel coronavirus but one thing is for sure. We are not going to be sick on this holiday!
January 29 2020
Wearing masks all day long is not easy. At airports, we are asked to remove them for facial recognition when our documents are being checked. Then we remove them to snack, eat, or drink. We handle them just because they need adjustment. We handle them because others can’t hear our muffled words. We handle them for a breather! We are re-using our masks day after day since we don’t have that many. I’m fully aware that our “security blanket” i.e. mask is serving as a fomite but at least it helps with the smog and dust when sitting in traffic on the roads. Plus, it’s easy to wear them out and about because many other people are doing so as well, especially the locals.
Washing hands, using sanitiser, avoiding coughing people it must be. We skip Chinatown in Bangkok, but we have been going to other street markets in Bangkok, Siem Reap, and Chiang Mai. I am thankful that we have private drivers for many of our tours. It gives us an opportunity to breathe freely in our own company especially since all the drivers are wearing masks. We are even offered complimentary masks in addition to the complimentary water and refreshment wipes.
Everywhere we go people are cognizant of the new illness. There are billboards telling people how to stay safe from the novel coronavirus. We learn that China is the number one source of tourists for Thailand and the tourism industry is suffering already because of the bans enacted on travel in China. Phuket is particularly hard hit. Still, the people of Thailand are upset that their government has not banned travel from China.
We are enjoying ourselves in Thailand and Cambodia. But 2019 novel coronavirus hangs over us like the sword of Damascus. Many of our photographs have us smiling with our masks underneath our chin or dangling off one ear. I know! Useless. When we have access to WiFi one of the first things we do is to check the news for the count in China and to see where else in the world it has gone. Then we sanitise our hands some more.
The epidemiologists on Twitter are raising concern that there is a much larger underlying epidemic not accounted for. But the US seems to have things under control and the numbers in Thailand aren’t too bad. We just need to survive this holiday, make it back to the US healthy, and we will be fine. I’m optimistic.
February 5 2020
I’m worried about African countries. China is a major investor in so many of our countries. I’m worried about our capacity to detect cases of 2019 novel coronavirus, let alone handle sick people with it. The good news is that Africa CDC is reporting ramping up rapid detection and testing for the virus in 15 African countries. In addition, the Bill & Melinda Gates foundation committed “$10 million in emergency funds and corresponding technical support to help frontline responders in China and Africa accelerate their efforts to contain the global spread of 2019-nCoV.”
The bad news is that the conspiracy theory loving side of Twitter tells me that in October 2019 the Gates Foundation had a pandemic simulation exercise based on a new fictional coronavirus. I don’t like conspiracy theories but the results of this simulation is clear. We are woefully unprepared for a pandemic.
February 8 2020
We are in Phuket, Thailand now. The last phase of our holidays. After temple-hopping extensively in the past several days, it’s time for total relaxation. Loads more European tourists here. Thailand’s health minister is in the local news for having an outburst. He’s upset that European tourists aren’t wearing facemasks as often as they should. It’s true. They are not.
The Reporter’s Notebook: Life and death in a Wuhan coronavirus ICU is not exactly beach-reading material but here we are. I’m enjoying a surreal panoramic sunset at a rooftop bar in Cape Panwa while reading this horror story.
I often cried because so many patients could not be admitted to the hospital. They wailed in front of the hospital. Some patients even knelt down to beg me to accept him into the hospital. But there was nothing I could do since all beds were occupied. I shed tears while I turned them down. I ran out of tears now. I have no other thoughts but to try my best to save more lives.
Dr Peng Zhiyong, director of acute medicine at the Wuhan University South Central Hospital
February 11 2020
By now the 2019 novel coronavirus has a new name – SARS-CoV-2 and the “mystery pneumonia” is now known as COVID-19. Our holidays are over and we have made it without any onset of respiratory symptoms. Still, I check our temperatures before we leave for the airport. We wouldn’t want any nasty surprises there. We are all afebrile! Fantastic.
Sure enough, we are screened for fever at the airport in Phuket. All travellers. After check-in and before security. It doesn’t worry me because I know we are afebrile. We breeze through security. This is one of the rare times I’m excited to reach the end of a vacation. We just need to make it to the boarding area in Qatar for our flight back to JFK airport and we will be golden!
I couldn’t be more wrong. We had not encountered a larger crowd of sniffling and coughing people on our entire trip than this boarding gate for the JFK flight. I have a window seat. I’m lucky to have no one next to me. But why does my aisle seat neighbour have the most horrendous cough and congestion of everyone on this plane?! Luckily he is wearing an N-95 looking contraption. But still, it means my mask will need to stay on as well for the entire 14-hour flight.
I’m so relieved when we touch down in New York City. I pull the mask off and dispose of it in the first rubbish bin I can find after exiting the plane. I breathe deeply and freely. We have made it back alive. We have made it back healthy.
At Immigration & Customs, the officers are not wearing masks. Yep, we have definitely left Asia. We are asked if we travelled to China. We have not and so we are through and we are home.
February 15 2020
I’ve spent the past few days trying to get my body clock back in sync with the Eastern Time Zone. It has not worked. I am so tired in the late afternoon. But I am not achy, febrile, or coughing. I want to go to the gym but I’m not motivated enough. That’s nothing new though. Yet I tell myself, you shouldn’t be in crowds anyway.
It’s my first day back to work. Weekend call but I’m in luck because the census is low. But why, oh why is every hospitalist sniffling and coughing as they approach me to ask a question?! Argh! I feel like I just spent the past two-plus weeks avoiding coughing and sniffling people and now here I am trapped with them at work.
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