COVID 19 - My Journey

 
     As I write this post, I am at day 10 of my 14 day quarantine.  The CDC now says a 10 day quarantine after the first symptoms is adequate, but I'm being a bit over cautious.  Every person whom I've spoken with is extremely interested in my symptoms, how I felt, and the unexpressed question...could I die?  As I spoke with many friends, family members, co-workers, and associates, I initially felt like a patient might feel with a terminal disease.  As soon as I assured them that I was indeed doing well, most wanted to understand how the symptoms developed and how I felt throughout.  I realized that they were wanting me to calm their fears in case they contracted the disease.
 
     I thought that for anyone interested I would go through how this disorder affected me and what symptoms were like and what I did to attempt to treat the disorder.
 
     I have been in a closed exam room with several hundred COVID 19 positive patients in my family medical practice.  We initially used full body covering suits, N95 masks, face shields, gloves and extreme cleaning protocols.  We continue most of these to this day.  We did drop the full body suits recently as we have become very good at avoiding direct contact while evaluating and testing patients.  I don't know where or who I contracted the virus from.  I don't know if it was from a patient, a co-worker ( though none of my co-workers has been ill in 9 months with this), or from a proximity issue as I went about my altered life movements.
 
     This is why I feel contact tracing is a fool's errand at this point in the disease spread.  Contact tracing is a valid and viable method at initiation of small localized outbreaks, but un-valuable when the mass population is under spread of a virus.  I suppose it gives officials some sense of purpose, in an otherwise futile situation.
 
     As I was driving home on a Friday evening, without warning I started to have a major coughing attack.  The cough was dry, I had no other symptoms and at first thought I must have gotten some mucous down the wrong neck pipe.  Within several hours I was a bit tired and feverish, but never ran a temperature over 100.5 degrees F.  Soon after my nose congested, my joints ached, and I developed a night sweat.  These symptoms persisted for 2 days.  I never had a headache which is common, and I never felt short of breath.  I did feel a full spot in the center of my chest that would clear with a deep cough.
 
     I would feel much better after a night's sleep and would wear down around 4:00 to 5:00 pm and would go back to bed by 8:00pm nightly for a few days.  I did not receive my official positive SARs CoV2 test result until day 6 of my illness.  This is typical as so many tests are being done that most labs are overwhelmed.  In the U.S. we are testing nearly 1 million tests per day.
 
     As most people do, I took Tylenol and some Ibuprofen for aches, discomfort, and fever.  I decided that I would take Hydroxychloroquine 200mg 2 times daily for 5 days and famotidine 20mg twice daily during the illness.  I decided that this course was safe and if it had any benefit, then I wanted it.  I had previously treated many patients with this regimen and none of them ended up in the hospital or with any severe complications. 
 
     We have no current treatment protocols for outpatient treatment of this viral disease and the use of the agents that I took have fallen under political rather than scientific debate.  I've used Hydroxychloroquine for rheumatic diseases for 38 years and have never seen any significant side effects.  I also have no major definitive proof that this protocol is effective.  In the face of doing nothing and because I am in the high risk age group for this disease, I elected to treat.
 
     I have always been and will always be of the opinion that the treatment of any disorder should be undertaken based on discussion between a patient and or patients family with their personal physician.  Scientific data is critically important and guidelines are needed, but they are only guidelines and the ultimate decision to treat is between the patient and Doctor. 
 
     After the second day of this illness, I felt stable and better.  From then until now, only the remnants of the infection linger.  A mild stuffy nose and an occasional dry cough.  It is possible that these symptoms could linger for several weeks due to the post infectious inflammation from the virus.  Follow up testing is not recommended as damaged remnants of viral RNA can exist in our nose, throat and lungs for up to 2 months.  We are not contagious at that point.
 
     The course I had with this COVID infection is much like the course of most of my patients.  I offered the same treatment to my patients and many accepted. Throughout this pandemic, I have not had a patient succumb to this illness.  I have had a few in the hospital, and even some in the ICU.  To date, my patients have weathered the illness.  
 
     I have written about my experience not to belittle this potentially deadly disorder, but to share my experience in hopes that it might allay some fears that we have all had.  I am a strong believer in masks, distancing, and handwashing.  I believe we must care for ourselves and by doing so care for others.  I hope that each of you can avoid this virus and that soon a vaccine will be available to render it harmless to the population.
 
     As for the vaccine,  I recommend taking it.  We are very good at making vaccines and no short cuts have been taken.  I have reviewed phase II and III data at present and believe that if enough of the world's population will take it we can stop the Coronavirus Pandemic.  This pandemic will end and we will become better because we triumphed over it.

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