Day 1

Tuesday 3rd – What’s just happened? We have to be Self-Isolated!

Got home from work…went to the gym as I was in the rare position of finishing work at 1600hrs….very unusual I know….Even managed to get in a walk with Ann (my wife). Liverpool were playing Chelsea in the 5th round of the FA cup so wanted to be back for then with dinner ready and in the lounge!! Things were not going well in the Liverpool game…we were 2-0 down…it was now 2130hrs….Whilst drowning my sorrows with Roobos tea…school night…I steer clear from alcohol especially as I have to be up at 5 in the morning to go to work….My phone rings…”No Caller ID”….now when this happens this is usually a bad sign…I guessed it might be work….I went to the quiet of the kitchen and sure enough it was a Consultant from the ICU at work…..what’s going through my mind?…well it is either, “Noamaan have you….or Why haven’t you?”…..or “Noamaan, x has rung in sick tonight, can you please do the night shift?”…..But no…to my horror, it was…after the usual polite formalities “Noamaan you have been identified as looking after patient y last weekend. They have now been found to be COVID19 positive. As per the advice by Public Health England, you are not to come into work for 14 days”. He also said that I “should follow the guidance as prescribed by public health which means I cannot leave the house”. Now with all the media hype that had been going on etc, various thoughts went through my mind…like “what does this all mean for me?” …”Err…what is the incubation period for this….and what are the symptoms exactly apart from the chest related issues”. Anyhow what was the Public Health guidance he was talking about? As far as I am concerned it was all about PPE (Personal Protection Equipment) and washing my hands every time I touched a patient…oh and the usual infection control policy at work…but does this mean I have to do the same at home? I do not have aprons and gloves. I felt well in myself. The Consultant was very supportive and told me that there would not be any issue with regards to my training and as things are changing so rapidly, the guidance might change. I felt reassured that the ICU team were looking after me. However, my wife who was listening to the conversation came into the kitchen and asked me if I asked about partners, especially if they work in the NHS…”Can they go to work?”…To be honest I never even thought about that…I was still taken aback by the news of what I heard. I have to be off work for 14 days!!! What the hell?? I felt deflated at the thought of not going to work…I will let the team down, I really enjoy what I do, I am an academic trainee in anaesthesia and not dual training in ICM….and now two weeks have been taken up because of self-isolation….and the worst part is I am not going to even leave the house!!!…..My wife on the other hand was, “why are you so disappointed?” you have two weeks off!! You are a workaholic! Most people would be glad to get two weeks off”…Obviously I did not see it this way.

Both Ann and I sit down looking through the internet to see if we can find the appropriate gov.uk websites on the subject….whilst I write an email to the ICU Consultant, copying in the educational supervisor and Teaching Program Director. I have a sense of guilt that I will not be in work, especially as I feel so well….Meanwhile Ann finds the website which confirms my thoughts https://www.gov.uk/government/publications/wuhan-novel-coronavirus-self-isolation-for-patients-undergoing-testing/advice-sheet-home-isolation The biggest thing for me here is that I have to stay at home for two weeks….Ann thinks I can go for a walk in the evenings wearing a disguise, considering also that there will not be many people around as well at that time of the evening. However, I think otherwise…Surely I have to stick to the gov.uk advice….I am an outdoors person, and now this…But what about family members, especially those who work in the NHS? Ann had a baby clinic the next day. I cannot believe the challenge we had to find any information on this…Our son Euan is a tennis player and is in London at the moment staying with his girlfriend. He was due to come home the next day. We both decide that, if it was ok with his girlfriend that he stays with her until later this week. Coronavirus has a 5-7 days incubation period and so I wanted to find out if I started having symptoms before someone else came into the house.

Eventually we find the following website pertaining to healthcare workers…it is now 2300hrs https://www.gov.uk/government/publications/novel-coronavirus-2019-ncov-guidance-for-healthcare-providers-with-staff-who-have-travelled-to-china/guidance-for-healthcare-providers-healthcare-workers-who-have-travelled-to-china It confirms that I have to be self-isolated for 14 days whilst Ann was pleased after reading section 5, “Household members of HCWs who are caring for patients with suspected or confirmed COVID-19 do not need to self-isolate and have no restrictions on any of their activities.”…meaning she could go to work. She decides to ring 111 the next morning to confirm and off she goes to bed as she has an early start. I mention that should I have symptoms she cannot go in and I will have to sleep in a separate room as I need to be greater than 2m away from her. This is really is going to be disruptive to family life….I guess just to be sure, I will stick to the guidance as if I have it, meaning I am going to have to be 2m away from Ann and anyone else. I will also have to keep my own cutlery, plates etc kept separate from Ann…We cannot do the usual kiss to say bye etc….

I am still on my laptop. The ICM consultant contacts a group of us on the ICU (via email) who were in work last weekend and Monday 2nd March, and tells us all to self-isolate. Those who were present on the 3rd March should be ok as the patient was intubated (March 2nd)…Basically, once intubated, the patient has a closed circuit, meaning the staff were not at risk…and as long as we are following infection control procedures we should be ok…Basically If you were in on 29th February to 2nd March, you have to self-isolate until further notice. He also sends a link with advice on how to self-isolate.

For my colleagues who received the news whilst in work for the late shift there were moments of disbelief. They waited as multiple meetings and conference calls involving the infectious diseases and microbiology teams, senior managers, executives, and Public Health England. From their perspective, there were numerous people to consider; the COVID-19 positive patient and their journey through the hospital, current patients, discharged patients and visitors, and the hospital staff. For those driving home late that night, it hadn’t sunk in yet that this would be the last drive for the next two weeks.

Now with all the media hype that had been going on recently, various thoughts went through my mind, like “what does this all mean for me?”, ”what is the incubation period”, “what are the symptoms exactly apart from the chest related issues”, and “what should I be doing?”. The Consultant was very supportive and, I felt reassured that the ICU team were looking after me.

About 5 minutes later the WhatsApp group for ICU started lighting up with multiple messages from colleagues trying to understand what has gone on and what we should do. Most people within the group said that they had no direct contact with the patient and so wondered why they had to self-isolate…additionally, how was this going to affect the rota and our training time?…

Will the rota be changed meaning our leave in the future will be cancelled…what about people who have holidays this weekend and next?? Will they have to be cancelled?….Will people get their money back?…so many questions??….I was supposed to be working as a pre-hospital doctor at a BMX event in Manchester this weekend…I have already cancelled this…this has a knock on effect to the pre-hospital provider as they now have to find someone with short notice.

We have many discussions on how we should self-monitor and how we should get shopping etc..that is the delivery driver should just drop the food etc on the front door….Soon afterwards the conversation turns to, “what are we going to do with all this time?”….Netflix or Amazon box sets?…Housework, learn a new language, a bit of gardening (that’s if we are allowed into the garden)….or maybe finish that article for submission, get up to date with Lifelong Learning and work-based assessments….what about revising for exams?? What a ticket!…two weeks to do that…that is if you have exams to do….I guess we were trying to be positive…especially as we all felt the same. I have decided that I will keep a twitter account of my self-isolation. If you are interested, my Twitter handle is @LeDyslexicMedic https://twitter.com/LeDyslexicMedic.
Most importantly we were concerned about the patient who tested positive. We hoped that they would be ok. They were transferred to another hospital with negative filter rooms.

Anyhow it’s late….I am now quite tired…lots of questions in my mind….I need to go to bed…I have become very self-conscious about any sneeze, cough or sniffle I have…which could all be coincidental but I just do not know…Can I go to my bed? Ann is there…or should I just sleep in another room….My rational mind kicks in and I go to bed as usual….thinking about my first day in isolation…..Oh by the way, Liverpool were knocked out of the FA Cup…that seemed an age ago….Good Night