Covid-19 has shattered the world like broken glass. It has brought about the consequences the modern world would not have imagined. The global trend, however, is that people are more focused on the curative side of any disease rather than its prevention. Covid-19 pandemic is no exception. Simple public health measures were ignored resulting in severe losses in terms of economy, direct and indirect costs, as well as the physical and psychological trauma from unwillingly being boxed into the hospital routine.
I witnessed a similar incident when I visited my parents’ house in Kathmandu a few days back. Prior to Covid-19, I used to travel to the capital once every two months from my working place in BP Koirala Institute of Health Sciences, Dharan so that I could see my parents. This time, however, it was more than six months since I had visited them last. The Covid cases were rapidly on the rise, and Dharan Municipality decided to impose a lockdown. Although we were supposed to organize a training program in our department, I felt that the lockdown in effect would prevent people from coming to the training program, and thus it would be postponed. I called my Head of Department and he granted me permission to leave my working station. Thus, I and my wife decided to go to Kathmandu. The day we left for the capital, the local municipality reconsidered its lockdown decision. I would miss the training program that I so dearly wanted to be a part of.
The same day I arrived at my home via a domestic flight from Biratnagar and started spending my time with my relatives—parents, brothers, nephews, nieces, and in-laws. The week-long visit was sound and fulfilling until my three years old niece caught the fever. Her mother had already been diagnosed with Covid-19 and was living in isolation in the same house (where I was staying). My mother and wife took care of my little niece. However, after just a couple of days, my mother started developing a mild fever and cough. Since she had already been tested positive, she refused to do a PCR test assuming that it was a common cold. However, when the symptoms persisted we forced her to undergo testing. She tested positive.
The next day, my wife developed a fever with a dry cough. She couldn’t sleep well the whole night, and we decided to go for a test. My wife tested positive too. While as a medical doctor and a public health professional, I can easily imagine the origin of the source and the transmissibility process, I am still not sure whether the transmission was the result of our flight travel (from Biratnagar to Kathmandu) or we caught it from my sister-in-law who was already in isolation in the same house.
A few days later, I myself had a mild fever and chills and a severe dry cough. Since I was exposed to my wife, I thought I caught the disease. But my test result came negative. My little niece tested positive.
In a short span of three days, three members of the same family tested positive and only one of them was a ‘Covid suspect’. My mother was admitted to a hospital for five days and she was administered Remdesivir. Similarly, my wife had to be taken to the hospital after she had two episodes of vomiting with severe weakness. We had a terrible time running blood tests, X-rays, and repeating PCR tests. The whole process was tiring and led to various forms of direct and indirect costs as well as physical and psychological trauma, which is not possible to describe in words. This period of hospitalization caused other family members to lose daily wages.
This terrifying experience made me realize the importance of public health measures for Covid-19 prevention—something that can help the public avoid the economic, physical, and psychological losses we faced as a family.
First, was it wise enough to travel in the midst of the Covid-19 pandemic? Our emotions pulled us to Kathmandu. We were dying to meet our parents and relatives. I realized, however, that during such situations one should control one’s movement and think of one’s health. Second, were safety protocols strictly followed in my parents’ house? Clearly, the answer is ‘NO’. Although we belonged to a family of health professionals, our public health measures for Covid-19 prevention were flawed. We had given in to complacency after receiving two doses of vaccines or we had reached the erroneous conclusion that Covid cases are falling.
That said, it is not always possible to take strict public health measures for Covid-19 prevention, particularly when there are young children and ailing elderly parents in the family. Someone has to take care of them and there is always a chance of virus transmission. The message is loud and clear though: Don’t be complacent until the pandemic ends. Until then, we need to strictly adhere to all the public health measures and try our best to keep the Covid-19 at bay.
Dr Prajjwal Pyakurel (MBBS, MD) is Assistant Professor at the School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan.