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Thursday, July 09, 2020

May 19-June 7, Delhi: A Covid diary

As the Centre and Supreme Court raise alarm over the Capital, where numbers are surging and hospital facilities falling short, Shalini Langer on her family’s story — from a testing centre to an ICU, sanitisation to house inspection, officials to RWA, and infection to recovery.

Written by Shalini Langer | New Delhi | Updated: June 14, 2020 7:41:48 am
May 19-June 7, Delhi: A Covid diary MCD officials sanitising the rooms with hypochlorite solution as home isolation begins. (Express Photo by Shalini Langer)

Day 1

After two days of fever, husband is getting tested for the novel coronavirus. At the private hospital, there is heat, anxiety and chaos — across both sides of a glass partition, between the doctor writing the prescription and patients shouting aloud their symptoms, Aadhaar number, address, cellphone details. When the doctor hands us the prescription, charging Rs 600 above the Rs 4,500 standard fees, it lists symptoms we never mentioned — he must write these, he says, as otherwise, the Indian Council of Medical Research (ICMR) will ask them why the test.

Minutes stretch into hours, exasperation slides into some mirth. A young woman on the bench to the left, a smiling cancer patient with red lipstick who needs a Covid-free tag for her next chemotherapy session; another one on the right, her feet on the bench, her chunky, intricate anklets clinking, laughing because she doesn’t know the name of the hospital she is at… provide perspective.

Husband lightens up, talks about the “spacesuit-clad man” who will touch down to collect samples. Finally, it is two swabs lasting seconds.

The next day, a sobering minute. Of the 40-odd samples taken on May 19 at the hospital, only husband is Covid-19 positive.

Day 3

It’s the turn of my son, who had fever the day before, and me to get tested. I am holding on to scepticism that has carried me through two months of a dizzyingly shrinking world. Driving down, we see a queue of migrant labourers at a school for scanning, their rucksacks standing in for their spots in the sun. The wait at the hospital is as long as it was on Day 1. Six policemen have lined up to get an all-clear to travel home on leave. While we wait, a hospital staffer throws up. It’s most likely the heat; we move away.

Day 4

Husband’s fever is climbing. Now we are official statistics, names on the government’s coronavirus list, and our designated District Surveill-ance Officer (DSO) thinks my husband’s high temperature combined with his blood pressure issues warrant a hospital admission.

May 19-June 7, Delhi: A Covid diary A poster comes up outside certifying the house’s Covid-positive status (Express Photo by Shalini Langer)

The DSO insists on an “ambulance” to take him to a “government hospital”. Our neighbourhood hasn’t had a single case so far, can we avoid the attention? So we try another route. Unable to get through to any of the private Covid hospitals’ helpline numbers, husband and I, and our driver, go down to the nearest one.

I enter through doors that swish open, the hospital’s corridors stretching empty — something out of a dystopian fiction, with the world struck silent. A woman, in PPE, rushes over, her horror showing through the mask and her glasses. The hospital has no beds, she says, “how did you make it this far?” We are back on the road, we call everyone we know, who know others, to finally find a ‘Covid care facility’.

It’s a hospital functioning out of a residential area, with a talkative lone guard warring bravely against mosquitoes, a sleepy receptionist, a too-friendly executive and a disinterested doctor — a facility seemingly going about its new job with as much reluctance as its neighbourhood. For, all around are Residents’ Welfare Association posters that this hospital should be shut down. Husband is admitted, and I am told to leave.

Day 5

Word has got round and my WhatsApp groups are buzzing, as much due to the fear of coronavirus as fear for us. A notice comes up outside our door confirming our house’s positive status. The arrival of an ANM (Auxiliary Nurse Midwife) with a police officer has been noted by all. But the offers of support outnumber the gentle, prodding questions on how we got infected. The comfort of neighbours is a relief.

By afternoon, my son and I are positive too, kicking off yet another chain of informing our DSO, listing both our contacts and calls from concerned friends and family.

Husband is not having an easy time either.

Explained

Delhi failing test

One of the five most affected states, Delhi is struggling to meet its coronavirus surge. Central government projections show it may have run out of ICU beds and ventilators already, and would not have any isolation beds with oxygen left by June 25. This, even as the AAP government locks horns with the Centre over charges that it failed to increase capacity sufficiently.

Day 6

There’s been an episode in the early hours and husband is now on oxygen support. The doctor assures me it is “just dehydration” and “a drop in blood pressure”. Mid-morning, at home, we get the second official visit, this time by MCD personnel in PPE gear to “sanitise” the house with hypochlorite solution. Images of migrants being hosed down flood me, but we are spared, though not our things, including beds.

The children are told to “stand clear” and take “good photos” of the exercise, to share with the officials.

By evening, the unravelling. There’s a fire in the hospital where my husband is. A short-circuit in the OT, we are told.

News feeds start filling up with images of charred rooms; I am even forwarded a video by a friend of the hospital’s Covid patients sitting by the roadside, husband included, sharing an oxygen cylinder with a heart patient.

The hospital has to shut and patients moved. But, where? The hunt starts again, till the hospital convinces another to take its patients in. They require special Covid ambulances, and are to be taken one by one. It’s nearly five hours later by the time husband finally manages to get a bed, and even later when a meal is fought for and served.

Day 7

My son and I testing positive means our house is upgraded to red-poster status, for 17 days of isolation from the day of the test results. A new set of officials arrives to put up this notification.

As I approach them from behind the house’s screen door, a woman official almost shouts at me to stay back. The other official, in PPE, makes a hasty round of the house to check out the facilities, especially separate toilets for the patients. Official requirement also is for patients in home isolation to have a “caregiver”, and my 15-year-old daughter signs an undertaking as one.

Strict orders are given to my son and me to not venture out of our rooms, sending daughter into panic. But even as they hand over some bleach and HCQ tablets, shooting instructions at her on their use — which mostly blow over her in her nervous state — her first task is to escort the two past the dog on the stairs.

Eventually, both bleach and HCQ remain unused, with the promised “clearer instructions” never coming.

Meanwhile, there has been no contact with the husband, with word finally arriving late evening that he has had difficulties breathing and so has been shifted to the ICU and put on an “NIV (non-invasive ventilator)”.

The doctor is very efficient, but she also tells it like it is. His chest X-ray is not looking good, she says, and I need to give my approval in case he needs a ventilator. It’s a difficult decision, made harder by the fact that I can’t meet him.

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Coronavirus India LIVE Updates: Cases cross 3 lakh mark, PM Modi holds review meeting to assess Covid-19 situation At a Delhi hospital (Express photo/Prem Nath Pandey)

Day 8

Having barely slept, I am relieved to know husband has not needed a ventilator and may not need one now. So, after days, I decide to check my Twitter feed. The first thing that pops up is a New York Times front page with names of 1,000 Covid casualties. I tell my editors and my newsroom groups that I am exiting — for a while.

The calls from neighbours have been mounting — from those gently enquiring about our living arrangements to others asking about husband, to one delightfully angry neighbour who wants my help to file a PIL against the coronavirus “hoax”. Her outrage is comforting.

As is the ease by which a system falls into place, from the RWA to the guards, to drop the things we need (groceries, medicines, Amazon orders, chocolates from a friend of son’s) outside our door. In-laws take care of one meal for the day, a neighbour offers to take over the same.

I juggle calls, between parents wondering whether they should get tested too, and how that can be arranged, to the DSO seeking a daily report, to instructions to update the Aarogya Setu app, to an RWA fearful of its exit-lockdown strategy falling flat, to twice-a-day calls from “Chief Minister Arvind Kejriwal’s office monitoring his home isolation programme”.

There are also calls to be made to the hospital, to chase X-rays, bills, insurance, and goods lost in the fire. And in the background, the ominous beeps of the ICU as I call up husband.

Day 9

The first good news. My son’s contacts and my parents test negative. Could we be turning a corner? I tell husband this, then am unsure if it was a good idea. The hospital progress continues to be slow, and the first images of husband from the ICU, with an oxygen mask covering most of his face, are not encouraging.

Home isolation also comes with its price: a constant battle to keep the house and daughter clean of any virus, and myself clear of symptoms. What is safe, what not? What is clean, what not? How to clean and how much? Ration the masks, but how? Clean the masks, but how? Work out our spaces, daughter’s spaces, including chairs and eating area.

Organise separate utensils, clothes washing cycles. Ensure healthy eating, “build immunity” with everything from vitamin tablets to home concoctions, and then convince the children it is good for them. Then, sanitise, sanitise, sanitise.

In between, keep monitoring our temperatures and SPO2 (oxygen saturation in blood). There is just a 2% gap in SPO2 between healthy people and those requiring hospitalisation.

Day 10

We are settling into a routine, of cleaning, cooking, watching something together, and working out deliveries. After 48 hours in the ICU, husband has now moved into “stable” zone. By now, the word of our status has reached our domestic help in a nearby settlement. She wants a test; the DSO says she can’t just demand one as they have their own criteria (yes, revised several times). Finally, testing is fixed for the next day, both for my help and daughter. They are required to reach a government dispensary. Now, there is another hitch; the RWA won’t let the daughter out of a house under home isolation. Words are exchanged, with officials saying we should ask our RWA to pay for a private test then. The battle is unsurprisingly won by the RWA; and after a day-long wait, a private lab technician in PPE arrives to take the sample.

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Delhi covid-19 news, covid news Delhi, Delhi coronavrius, Coronavirus in Delhi, Delhi coronavirus testing, Delhi coronavirus news update, coronavirus test Delhi, Delhi coronavirus test Medics take samples of suspected COVID-19 patients for a lab test at a government hospital in New Delhi (Express Photo/ Amit Mehra)

Day 11

We are now used to our “untouchable” status, and so is our garbage. I have four overflowing bins, and am told to inform my DSO, RWA and an MCD helpline. Sometimes, the system works to impress, and after a few calls, two men decked in PPEs arrive to collect the waste. Their nervousness is telling, particularly the sharp instruction to put everything in bags, which they hold pinched by the ends. As I run around figuring out whether I have collected all, they assure me they will come “every day” — and they do.

The rest of the day passes more smoothly. First my daughter and then my help test negative. This means there need be no change in daughter’s “caregiver status”, and we can stay in home isolation.

From the hospital, the doctor calls to say she is trying out a new medicine that has given excellent results against coronavirus, Tocilizumab. She also wants me to try arranging for Remdesivir, a drug not available in India. Just names in stories I have edited, the drugs now roll easily off my tongue as I place calls to enquire.

Day 12

We are approaching the 14-day landmark for son and me. As husband makes his excruciating recovery, with Tocilizumab helping and Remdesivir finally not needed, the calls have moved on to figuring out how we got the virus.

We took the needed precautions, stocked up on sanitisers, washed hands regularly, maintained social distancing. Yes, we laughed at the cleaning regimens friends had drawn up, as “panic”… so were we wrong, and they right? What more could we have done?

That night, there is another scare. My father, who recently had a heart procedure, and who has been “exposed” to us, has chest pain. His coronavirus report had been negative, but at this point, that means nothing as we try and remember what we know about the virus, the 5-14 day dynamic, the early-vs-late test debate, the chest pain as a symptom, and the possibilities of acquiring the virus in a hospital where he is headed in an ambulance. And, should he be positive, would the hospital turn him out, even at night?

My sister, who lives in the US, is struggling with rising panic — a factor as much of old uncertainty about “Indian systems”, and new ones born of President Trump vs the virus.

Eventually, it turns out to be a false alarm.

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Day 13

The countdown has begun for husband’s return, and so I have the grace not to comment when the District Magistrate’s office decides to call all these days later, offering services of volunteers should we need anything.

Plus, the weather has taken a turn for the better, and this evening there is blinding sunlight and a rainbow after a dash of rain. As I sit in the balcony, vehicles rush past, I see people out walking, fetching essentials, or returning from work. Two children out on the road wait to be splashed by cars speeding through the rainwater. Nearing 10 pm, a woman walks past in a rush, swathed in red, returning minutes later down the stretch — an unusual sight for a lonely road in Delhi. Her calm intent, in the diffused yellow of the streetlight, reminds me of the other woman in the hospital, on Day 1, in red lipstick.

A medical staff member helps a patient outside the emergency ward at Sant Parmanand Hospital in New Delhi (Express photo/Praveen Khanna)

Day 16

We first got word a day earlier, by a hospital employee chasing payment, that husband is likely to be released today.

But we are waiting for the doctor to confirm. She has been a pillar of strength (including negotiating the Delhi-Faridabad coronavirus tussle at the border daily), and as she doesn’t mince words, we will take her word if she says he is fit to go.

The nod comes at 1 pm. Husband doesn’t want anyone from the family to venture out and says he will handle discharge himself, particularly as he can come home only in an ambulance. He expects to be back by 6 pm.

The preparations begin at home, including sanitisation of the room and toilet to be kept exclusively for him for 10 days, as per the doctor’s instructions. While the excitement and relief build up, the wait drags, first inexplicably, then incredulously.

After payment of more than Rs 5 lakh has been resolved by insurance and a friend rushing over, the discharge gets stuck on less than Rs 1,500. Amidst the back and forth, the hospital slips into “shift change”, from morning to night. It takes about 45 minutes for the next shift to get into their PPEs, which means more delay. Night shift also means there is not enough ambulance staff to help husband, either into the vehicle or up three flights of stairs at home. Eventually, he is forced to almost crawl as a PPE-clad staffer gingerly urges him on. At 10.30 pm on June 3, he collapses exhausted into our dining chair — the whole house in tears.

Day 20

The debilitating pain in husband’s feet has developed now into Covid toes. He is also struggling with weakness.

However, the day we have been waiting for is here. At around 10.30 am, two police officers arrive to tell us our home isolation is over. My son and I sign statements certifying that, and the officers make us hold these up for a photo. I am worried about being photographed for official posterity in sweaty shorts and T-shirt, having just finished cleaning.

Will they tear the notification outside our door please, I ask. Sure, one of them shrugs, and rips it off. There, it lies, crunched into a ball on the house floor.

Is that it?

Delhi covid news, Kejriwal Covid test Delhi has over 32,000 cases (Express photo/Tashi Tobgyal)

POST-SCRIPT:

Or, is it? We have memories of an ICU where one is an outcast, with disposable cutlery, watery food, no spoons, overworked staff, the indignity of calling out for help, and daily images of death. We have fought the loneliness of facing one’s worst medical crisis without any loved one nearby. My children have seen their father in tears, struggling up the stairs, like a child.

In the 24 days between when husband got tested and when I write this (June 11), Delhi numbers are up from 10,554 to 32,810. We were the first cases in our colony, now there are a couple more. Both testing and hospitalisation seem a steeper climb, as the system strains and stretches, like we had been warned.

People assure us that chances are we now have “immunity”. The jury is out on that — we shall wait for a while before we take ours.

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