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Covid-19: Up close and personal

10 March 2021 Dr Julian Fuller

ASMS Vice President Dr Julian Fuller left New Zealand late last year to visit his dying brother in South Africa and contracted Covid-19. He returned to New Zealand last month and used some of his time in managed isolation to write about his experience.

I am an anaesthetist at North Shore Hospital, and undertook a compassionate trip to Durban in December, to visit my 63-year-old younger brother, who was dying from amyloidosis of the heart and kidneys.

When I booked my flight in early November, Covid-19 in South Africa was relatively stable. There were roughly 1,500 new cases a day, with 55 deaths. 4,800 cases were in hospital, with 500 in ICU and 250 being ventilated.

Five weeks later when I touched down in Durban on December 19th, it was a different story. Daily cases had risen to 8,500, with 8,500 in hospital, 1,100 in ICU, and 430 on ventilators.

By the time I myself developed symptoms on January 6th, the numbers were even grimmer, and when I finally managed to fly out on January 21st, daily cases were peaking at 20,000, 17,000 people with Covid were in hospital, 2,500 in ICU and 1,400 being ventilated.

Looking back it was almost inevitable that I would get Covid, despite taking all the usual precautions, including masking up, hand sanitising, and social distancing. I rarely “went out” apart from visiting my sick brother at his home every day.

I am pleased to say that before I got sick, I did have ten wonderful, quality days with my brother, before he passed away on December 29th.

It was the undertakers who described Durban to me as being like a “war zone” with so many dead. The mortuaries were all full, as were the morgues, hospitals, undertakers, and crematoria.

A former anaesthetist colleague told me there were no hospital beds left in the city. Private hospitals had stopped elective work and were treating Covid patients in the wards and in ICUs. Patients were being ventilated with makeshift ventilators.

Durban was now so full of Covid, that if you suffered a heart attack or some other medical emergency, you were on your own.

I also heard story after story of fit and well young people succumbing to Covid, including physiotherapists, doctors, and nurses – just anyone.

How did I know I had Covid?

To begin with I developed fevers and rigors which lasted two to three days, and then the worst myalgia I have ever had – muscle aches and pains all over my back and shoulders, along with chronic persistent headaches. Add to that extreme lethargy, loss of appetite, and an upset stomach. It was remarkably debilitating. Five of our bubble all had similar symptoms and tested positive. None of us had marked respiratory symptoms, just a mild productive cough. These chronic symptoms lasted around 10-12 days.

With my symptoms starting on January 6th, I self-isolated in my hotel room.  My PCR swab test came back positive on the 13th.

South Africa’s President had announced strict lockdown conditions with immediate effect, on December 28th. I lived in trepidation that he could also close the borders again.

I had flown to South Africa with Singapore Airlines, arriving in Johannesburg only to find they had cancelled my return flight! I then re-booked with Emirates, but they went on to cancel all flights out of South Africa, six days before I was due to fly out. The last major airline flying out of the country going east, was Qatar Airways.

After catching Covid, I’d had to delay my return in order that I could have a full 14 days of self-isolation in Durban before flying.

I then had to make an application for an “Emergency Allocation” of an MIQ slot back in New Zealand, but even with the support of my DHB, this was turned down.

I applied again, with further support from my DHB, just two days before my intended departure. You cannot imagine my relief when at around 6:30am, after being up all-night checking, emailing, phoning and worrying, I saw an emailed MIQ voucher arrive. It came just three hours before I was due at Durban Airport.

The last couple of weeks in Durban, I had only survived by being an eternal optimist, always positive, but also always a realist. I’d had so many ups and downs – emotionally with my brother, contracting Covid, cancelled flights, and chasing MIQ vouchers – I knew I could only relax once I was actually on board the plane home.

By this time, I was also quite an expert in all the rules for PCR Covid testing, such as who required it, which airlines, and the average course of Covid infection.

Wisely I’d decided to to obtain a medical certificate from the hotel doctor in Durban, simply stating that I had tested positive on the 13th, been symptomatic since the 6th, and was now asymptomatic and not contagious. Most information at this stage suggested a person was infectious for 10 days after symptoms began, but that the PCR test would remain positive for at least another two weeks.

You can imagine my utter frustration when I checked in at Durban Airport and was asked to provide a negative PCR test! Qatar Airways phoned New Zealand, but still insisted on a negative test, even though I’d informed airline staff that it was not a legal requirement. I then produced my medical certificate, which was sent to New Zealand. I was kept waiting 90 minutes, before eventually, a rather apologetic Qatar Airways staff member walked over and gave me my boarding pass!

I have never felt such relief or happiness as I did when we touched down in Auckland. I was then sent to the Jet Park Hotel to do my two weeks of quarantine.

Final thoughts

I don’t regret the time spent with my brother but if I knew what I know today, there is some doubt in my mind as to whether I would have made the trip.

When I got Covid, I lived day by day, hoping that it was just a “mild” version, but never quite knowing. My age was against me and it was like playing “Russian Roulette” because you really have no idea if you are going to draw the short straw. Managing my illness, coupled with the fluid lockdown levels, multiple cancelled flights, and the need to change MIQ dates, was incredibly difficult. If my MIQ voucher had not come through when it did, I would have been looking at a minimum of three to four months marooned in South Africa.

I cannot for the life of me see any reason to leave New Zealand at present, except on compassionate grounds, and even then, the decision needs to be taken seriously with “eyes wide open”.