Pakistan can get the dangerous Indian Covid situation, warns Indian doctor

‘A very important public service message started circulating in WhatsApp groups in Pakistan and India. It highlights that new Indian COVID variant can be as disastrous for Pakistan as it has been for India. It is written by Dr Pradeep Senha from Sassoon General Hospital Maharashtra. He says “COVID19 new mutation is giving false negatives in nasal swaps.”...

‘He writes, “The virus is now hitting straight into the lungs. It is carrying no symptoms like fever or cough. Just body ache, weakness, loss of appetite. Patients go from mild condition to extreme life and death situation within 8 to 10 hours.”

‘Dr Senha reports an alarming situation in India, he writes, “Our colleagues in small towns across India especially North Eastern regions are saying it is a battle we have already lost. It is now damage control and save as many lives as possible. We have seen 400 plus children just in our district die within 10 to 12 hours. Initial period they showed no symptoms and within hours their oxygen levels dropped and deceased.”

‘He says “We have also attended to several patients who traveled into Mumbai from overseas and had received their jabs and ended up contracting the Indian COVID and 17 out of 28 have died. Health services both in public and private hospitals have collapsed. Rich, middle class and poor all are affected and it is spreading fast, very fast. Any further mutation or variants will potentially be a doomsday scenario.”

Read here (Global Village Space, Apr 24, 2021)

India’s health system has collapsed

‘As human tragedy unfolds, there is a shortage of everything — oxygen, drugs, beds, vaccines, even cremation space...

“We have collapsed, Maharashtra is sinking and other states will follow.” The starkness of these words from Dr Jalil Parkar, a top pulmonologist in Mumbai’s Lilavati Hospital, silenced me in a way that little has through 2020 and 2021, when most of my journalistic energy has been spent on reporting the Covid crisis on the ground. “This is worse than World War Two,” Parkar said, lashing out in rage and hurt at how doctors and health workers are still targeted by angry and distraught families as well as armchair commentators “who sit behind their laptops and in their ivory towers”.

Read here (Hindustan Times, Apr 17, 2021)

How Covid can change your personality

‘I don’t know about you, but I’ve found the latest stage of the pandemic hard in its own distinct way. The cumulative effect of a year of repetition, isolation and stress has induced a lassitude — a settling into the familiar, with feelings of vulnerability. The shock of a year ago has been replaced by a sluggish just-getting-to-the-end.

‘I’ve got the same scattered memory issues many others in this Groundhog Day life describe: walking into a room and wondering why I went there; spending impressive amounts of time looking for my earbuds; forgetting the names of people and places outside my Covid bubble.

‘My extroversion muscles have atrophied while my introversion muscles are bulging. If you tracked me on a personality chart, I suppose “liveliness” would be down and “reserved” would be up; “carefree” down and “anxious” up.’

Read here (New York Times, Apr 1, 2021) 

How Covid can change your personality

‘I’m trying to describe a year in which we’ve all been physically hunkered down but socially and morally less connected. This has induced, at least in me, a greater fragility but also a great sense of flexibility, and a greater potential for change.

‘I’ve found I’ve burned out on my screens, burned out about the politicization of everything, and have rediscovered my love for the New York Mets. People who have endured an era of vulnerability emerge with great strength. I’m also convinced that the second half of this year is going to be more fantastic than we can imagine right now. We are going to become hyper-appreciators, savoring every small pleasure, living in a thousand delicious moments, getting together with friends and strangers and seeing them with the joy of new and grateful eyes.’

Read here (New York Times, Apr 1, 2021)

There is no one pandemic anniversary

‘Disaster anniversaries are powerful in part because they’re communal. The bomb went off in an instant. The tornado tore through town in an afternoon. The earthquake rocked the whole region at once. The pandemic, though, did not come to everyone on the same day, or even in the same month, and nor will its anniversary. In this way, as in so many others, this is not an ordinary disaster.

‘For each of the country’s more than 526,000 dead, nine people grieve. Hundreds of thousands have spent time in the ICU, an experience that can bring its own unique trauma. And then there are the smaller losses, the ones that did not threaten lives but still changed them. Today is the day I missed my mother’s funeral. The day I would have gone to prom. Met my grandson. Gotten married.’

Read here (The Atlantic, Mar 12, 2021)

Sg Buloh Hospital: Lessons from frontline of country's main Covid-19 centre

‘Sungai Buloh Hospital (HSB) had been at the forefront of the fight against the Covid-19 pandemic since the day the virus was detected on our shores. Serving as the main dedicated Covid-19 centre, it has treated nearly 50,000 positive patients to date.

‘While the hospital had been successful in helping the country battle the outbreak, little is known about what has been happening behind the scenes, especially the struggles faced by frontliners who had dedicated their lives for the sake of their patients.

‘Malaysiakini spoke to HSB director Dr Kuldip Kaur (above) in an exclusive interview recently, during which she revealed some of the biggest challenges they faced.’

Read here (Malaysiakini, Mar 9, 2021)

I’m alive today because of our healthcare frontliners! — Joseph Ong See Sung

‘While at the hospital, I also made many friends among the patients. I was touched by what I saw. Everyone in the ward was helping one another. There was no racial barrier. Everyone took turns to look out for one another. I told myself — this should be the Malaysia that we should have, not one that’s divisive and ruined by people with selfish interests! 

‘I saw one very filial son who was with his father. Both had Covid-19. But this young man, despite being down with the virus, made all efforts to care for his father, who even suffered a stroke there! 

‘Every minute of my waking hour there, I saw people putting aside their personal and ethnic differences to help anyone within their sight! It warmed my heart and spurred me to get better so that I can tell the outside world that people were so caring at the hospitals. Both frontliners and patients! Why can’t more people be like that?’

Read here (Malay Mail, Mar 5, 2021)

Covid year: Topsy-turvy and gains

‘What should spring up eternally is compassion, tolerance, humility and other qualities that would unite us in this beloved land no matter what our ethnic or religious affiliations...

‘Any change in societal or personal lives is influenced by gender, social class, race, culture, age and other variables. I can only speak as a 73-year-old woman, former academic, Christian and Malaysian-Chinese, and post-polio person. Each facet of our multi-layered identity will be affected in different degrees by this season of Covid-19.’

Read here (Aliran, Mar 4, 2021)

I was the Australian doctor on the WHO’s Covid-19 mission to China. Here’s what we found about the origins of the coronavirus

‘As part of the mission, we met the man who, on December 8, 2019, was the first confirmed COVID-19 case; he’s since recovered. We met the husband of a doctor who died of COVID-19 and left behind a young child. We met the doctors who worked in the Wuhan hospitals treating those early COVID-19 cases, and learned what happened to them and their colleagues. We witnessed the impact of COVID-19 on many individuals and communities, affected so early in the pandemic, when we didn’t know much about the virus, how it spreads, how to treat COVID-19, or its impacts.

‘We talked to our Chinese counterparts — scientists, epidemiologists, doctors — over the four weeks the WHO mission was in China. We were in meetings with them for up to 15 hours a day, so we became colleagues, even friends. This allowed us to build respect and trust in a way you couldn’t necessarily do via Zoom or email.

‘This is what we learned about the origins of SARS-CoV-2:

• Animal origins, but not necessarily at the Wuhan markets
• Frozen or refrigerated food not ruled out in the spread
• Extremely unlikely the virus escaped from a lab

Read here (The Conversation, Feb 22, 2021)

‘Pure, liquid hope’: What the vaccine means to me as a GP

‘Clinicians everywhere are all nervous about what will happen if that loosening of restrictions occurs too quickly. Though death from Covid among the under-50s is relatively rare, it can still be a terrible, terrifying disease, capable of rendering its victims breathless and exhausted for weeks (and in some cases, months) after its fevers have run their course. One of my own patients, a nurse in his 20s, used to run 10km three or four times a week. The staff vaccination programme was too late for him: he caught Covid on the wards just before Christmas. Though he’s now back at work, he still hasn’t recovered sufficiently to be able to get back to running.

‘For the next six months, all my colleagues and I will be vaccinating as needed, as many hours as we’re able to. This week I’ve been gladly trudging the streets in the snow, vaccinating our housebound patients, and there aren’t too many still to go. In Scotland, the programme is anticipated to go on at least until 31 July, and the hope is that everyone over 50 will have had a first dose by May.

‘The numbers are daunting, but there’s a spirit of anticipation and celebration in the air. Many are starting to dare to plan for a world post-Covid, and I’m tempted to share that optimism. Opening my first box of vials, I thought of a friend in Orkney, a GP who’d already vaccinated all the over-80s of his practice, and who’d begun to call in the over-70s. We met briefly in Kirkwall, outdoors, on my journey from Orkney back to Edinburgh. “How did it feel to get started?” I asked him.

“I almost wept as I opened that box of vials,” he said, smiling at the memory. “Each one was hope – pure, liquid hope.”

Read here (The Guardian, Feb 11, 2021)

Pregnant during pandemic: The bump that no one saw

‘Sometimes I’m grateful for the isolation. I got to endure nausea in private, be exhausted in private and work from my couch on the days when it felt too hard to stand. Luckily for me, I had a job that allowed me to work from home. Luckily for me, I had a job at all. And as others also reported in a 2020 survey of 70 pregnant women in Ireland, taking a break from life’s fast pace while I grew another life did, at times, bring me peace.

‘My challenge instead has been letting go of the picture I had in my head of what pregnancy was “supposed” to look like. Gone is the fantasy of the Good Samaritan on the crowded bus giving up his seat for me or of colleagues in the hall asking how I’m doing. Also gone are the strangers trying to touch my belly or giving me unsolicited advice. Sometimes, without that constant feedback, I forget I’m pregnant. At other times, the aches and pains I feel in isolation seem stronger than they would be if someone was around to provide distraction.’

Read here (Scientific American, Feb 4, 2021)

The second Covid-19 shot is a rude reawakening for immune cells

‘Side effects are just a sign that protection is kicking in as it should...

‘At about 2 a.m. on Thursday morning, I woke to find my husband shivering beside me. For hours, he had been tossing in bed, exhausted but unable to sleep, nursing chills, a fever, and an agonizingly sore left arm. His teeth chattered. His forehead was freckled with sweat. And as I lay next to him, cinching blanket after blanket around his arms, I felt an immense sense of relief. All this misery was a sign that the immune cells in his body had been riled up by the second shot of a COVID-19 vaccine, and were well on their way to guarding him from future disease.

‘Side effects are a natural part of the vaccination process, as my colleague Sarah Zhang has written. Not everyone will experience them. But the two COVID-19 vaccines cleared for emergency use in the United States, made by Pfizer/BioNTech and Moderna, already have reputations for raising the hackles of the immune system: In both companies’ clinical trials, at least a third of the volunteers ended up with symptoms such as headaches and fatigue; fevers like my husband’s were less common.

‘Dose No. 2 is more likely to pack a punch—in large part because the effects of the second shot build iteratively on the first. My husband, who’s a neurologist at Yale New Haven Hospital, is one of many who had a worse experience with his second shot than his first.’

Read here (The Atlantic, Feb 2, 2021)

A doctor's fight for survival in ICU

‘On Dec 27, 2020, after 23 days in the hospital, I was finally allowed to return home. I was told that my blood parameters and X-ray would only return to normal after many months. All this would not have been possible if not for the prayers and love of my wife, family, friends and God. I was grateful for a strong social support group...

‘It's been a month since I was discharged from the hospital, but my joints still hurt, I suffer from fatigue and shortness of breath when walking far or fast. There is also social stigma as many people won't come near me because I'm a former Covid-19 patient. A friend even declined my small change claiming that the virus would be on it.’

Read here (Malaysiakini, Feb 1, 2021)

NST editor under quarantine at MAEPS 2.0 shares 'humbling' experience

‘The ambience was quite festive with laughter and banter, not solemn, quiet and sedated as I had expected it to be. The residents — not patients — as I prefer to be called since I didn't feel any pain or discomfort, were either talking to each other at their beds or walking but not aimlessly. There were none within my sight seen lying on the bed covered by the thick white hospital blankets. But these were not the usual hospital beds, they were portable and foldable camp beds made of aluminium frames and canvas covers...

‘As I completed my first 24 hours at PKRC MAEPS 2.0, I had to admit that it was not too bad at all. The facilities were good — clean toilets/showers, two surau even though the spaces were quite small and food which was quite tasty though I wished for a bigger portion of vegetables. Truly, it was a most humbling experience. But my utmost appreciation went to the staff, everyone from the medical personnel to service staff and Rela personnel.’

Read here (News Straits Times, Jan 20, 2021)

Daisy Chain: Can a Cornish town adapt to survive another lockdown?

‘When the remote town of St Just, Cornwall, was locked down in March, the small community worried that its economy wouldn't survive. But one town councillor, Daisy Gibbs, rallied an army of volunteers to form 'the Daisy chain', an informal support network to ensure every household in the district had support. Inspired by her imagination and resilience, filmmaker Sky Neal followed the Daisy Chain for seven months, as local businesses adapted and the community pulled together to realise a more sustainable future. However, as a second wave of restrictions threatens, the town has to dig deep to find the resilience they need to ensure their future. Can they re-invent their local economy to survive and thrive beyond Covid?’

View here (The Guardian, Nov 2, 2020)

Being a coronavirus tester has been a life-changing experience

‘Back in the first week, the manual sample handling process allowed us to process several hundred samples. With more volunteers coming in, this increased to several thousand, and when we roped in robots to help, it quickly reached tens of thousands of processed tests per day. Just like the spread of the virus we were competing against, our capacity was growing exponentially. What would normally have taken months or years to establish, now took days or weeks.’

Read here (Channel News Asia, August 22, 2020)

The new stability

‘I look for hope and find none, but I am not allowed to admit to total free fall. “Stronger together” say the screen savers on every screen in the hospital, the banners on the sides of the shuttle bus. What I’ll see in the coming weeks is just how much this isn’t true, how so many of our sickest patients are Black or Brown like you, “essential” and yet unprotected. I will see a 46-year-old Black man, infected with SARS-CoV-2, die instead from having a police officer kneel on his neck. I will see those who protest police brutality, though masked and mostly peaceful, tear-gassed and shot with rubber bullets. I will see unregulated corporate bailouts, record unemployment, record housing insecurity. I will see political polarization recast common-sense public health policy as liberal propaganda. I will see your death multiplied by 10,000, by 100,000, all those bodies, mothers and fathers, daughters and sons. I wish I could tell you how sorry I am, for my fear, for our nation, for what happens next.’

Read here (New England Journal of Medicine, July 17, 2020)

The pandemic broke end-of-life care

‘The first day the palliative-care doctors walked into the ICUs, Thomas [Jane deLima Thomas, the director of palliative care at Brigham and Women’s Hospital and Dana-Farber Cancer Institute] says, “we felt like tourists.” They were dressed in business casual, while their ICU colleagues raced around in scrubs and masks. But the palliative-care team—which includes physicians, nurses, chaplains, and social workers—found ways to integrate themselves. In the early days of the pandemic, when protective gear was scarce, no visitors were allowed. Palliative caregivers, along with ICU nurses, held iPads cocooned in plastic bags so families could say goodbye on Zoom. They were sometimes the only one in the room when a patient died, otherwise alone. I interviewed several members of the Boston-based palliative-care team, and their stories, which have been condensed and edited for clarity, are below...’

Read here (The Atlantic, June 16, 2020)

I'm an ICU doctor treating coronavirus patients. But somehow I'm not angry

‘Sometimes I wonder if my lack of anger means I don’t care enough; if I’ve been worn down by ventilators being turned off, patients dying, families asking for a final call. Perhaps emotions overwhelm and suffocate each other in such a situation, leaving no air for something as indulgent as anger. Perhaps my anger couldn’t compete with the humility of knowing that until early March, I and every doctor I knew had predicted that this virus posed little threat beyond a bad seasonal flu. Like my better judgment, perhaps my anger had lost.’

Read here (The Guardian, June 11, 2020)

A pulmonary physician on what it's like to treat Covid-19 patients

‘I did not think much about my risk. Doctors are always at some risk of contracting a disease. However, that changed when I was exposed to a COVID-19-positive patient without my personal protective equipment for a considerable period of time and in close proximity. I questioned my "recklessness" in examining the patient (who did not exhibit any COVID-19 symptoms) and my ability to infect my family and other patients. I felt guilty and foolish for putting myself and my family in such a position. It was not a good day. One of my colleagues had even written a living will, just in case.’ 

Read here (Asia Society, June 3, 2020)