Covid-19 test
Four days after Beacon reporter Dana Kampa called the government hotline to report that she was experiencing symptoms consistent with Covid-19, two doctors arrived to administer a nasal swab test. Six days later, government announced that a batch of 17 tests, which apparently included hers, had all come back negative. (Photo: DANA KAMPA)

Government officials announced the first two confirmed cases of Covid-19 in the Virgin Islands on Wednesday, March 25, just as Beacon journalists were completing our final edits for that week’s print edition.

The next day, I felt exhausted, but that was nothing new coming after deadline on a busy workweek. I had covered a coronavirus-related press conference, interviewed business owners, and walked around Road Town taking photos, all while practising social distancing to the best of my ability.

On the morning of Friday, March 27, I woke with a sore throat, which I already knew to be one of the early signs of Covid-19.

Throughout that day, I developed other symptoms associated with the virus. I started feeling feverish and tired. Knowing that a distinctive side effect is losing a sense of smell, I picked up a lavender-scented deodorant stick that is normally almost offensively floral: I could hardly smell it, and by the end of the day my sense of smell was virtually gone.

I joked with my family that I was perhaps experiencing a placebo effect from reading and reporting extensively on the pandemic. But as I started experiencing more of the symptoms, I feared that wasn’t the case.

Dana Kampa shares a list of symptoms with her family via WhatsApp on March 27. (Photo: PROVIDED)

“I’m starting to feel a lot worse,” I wrote to a friend on WhatsApp that Friday afternoon. “I’ve been halfway [between] sleep and awake all afternoon. I felt short of breath just from walking between the kitchen and my room and then briefly talking with my roommate through the door.”

 

At the urging of friends and family members, I called the government’s coronavirus hotline at around 3 p.m. that Friday. After giving a list of symptoms to a nurse, I was given the number for an emergency line in case my symptoms worsened. The nurse also told me to isolate myself as much as possible.

This was easier said than done. I currently live with four other people, and I feared spreading my illness to my roommates, one of whom has underlying health issues that could make her especially vulnerable to the highly contagious virus. Luckily, I already had been practising social distancing even at home, staying six feet apart from my roommates.

Isolation

Once I began experiencing typical Covid-19 symptoms, we took the illness more seriously. I shut myself in my room — which wasn’t much of a challenge considering that I felt too sick to leave my bed anyway by the end of the day on Friday.

I received a follow-up call from national epidemiologist Dr. Harmony Brewley-Massiah at about 6 p.m. that day, and I provided an exhaustive list of all the places I’d visited and people I’d met over the previous 12 days.

They included my roommates, co-workers, interviewees, grocery store employees, attendees at a friend’s dinner, and even the premier, other government ministers and journalists who attended recent press conferences.

Based on my symptoms, the epidemiologist planned to send a team the following day to do a swab test. Other than that, she said there wasn’t much that could be done unless my symptoms worsened enough to require hospitalisation.

So, like everyone else in the territory, I prepared to go into lockdown.

Dana Kampa self-isolated in her room (show above last week, after her recovery) until she was released from quarantine after testing negative for Covid-19. (Photo: PROVIDED)

“I’m pretty sure I’m going to be in quarantine for the next 14 days,” I wrote to my family on WhatsApp that Friday evening. “I’ve been getting sicker and sicker all day. My roommates said they’re well stocked, so I’m just going to focus on sleeping and hydrating as much as I can. … I’m exhausted right now, but I’ll try to call later. Love you all.”

Symptoms worsen

Early on, I didn’t anticipate any serious complications even if I did have Covid-19. Although information about the virus was evolving day by day, experts around the world reported that the elderly and people with underlying health conditions were most at risk.

I am 25 years old and otherwise healthy. I don’t smoke or have asthma. I believed that my illness would be similar to a bad case of the flu.

Nevertheless, my roommates and I took every precaution, and did what we could to prepare for what might come.

From the start, my roommates left water, meals, tea and medicine outside my bedroom door. We repeatedly wiped down every door handle, light switch and counter. I often heard the jostle of the doorknob as someone used a disinfectant-soaked sponge to wipe it down. I took similar steps until the skin on my fingertips started to peel from the constant use of bleach-based cleaners.

We also set up a group chat of roommates and co-workers to communicate about what was needed.

To the hospital?

As my symptoms quickly worsened throughout that first Friday, I read up on Covid-19. Social media offered some guidance on what to expect, though the effects can vary widely person to person.

I bookmarked threads on Twitter of people sharing their experiences. Their sentiments resonated with my own:

“For two days I sat in the dark, extremely weak and tired, waiting for it to pass.”

“Every day there was something new developing and it was hard to keep up.”

“The dry cough didn’t show up until yesterday. Got bad last night. And now it’s mostly gone.”

“Slight exertions will exhaust you.”

“This virus is absolutely brutal. ‘Mild’ is not mild by any definition.”

I also found useful information about what painkillers to take, how people eased their breathing, and indicators for when to seek medical intervention.

On the World Health Organisation website, I read that there is no vaccine or cure for Covid-19.

“However, those affected should receive care to relieve symptoms,” the website stated. “People with serious illness should be hospitalised.”

The United States Centers for Disease Control and Prevention, I read, recommends seeking medical attention right away for a list of emergency warning signs: trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips or face.

“How much trouble breathing is too much trouble?” I wondered. “How do I know when to go the hospital?”

I was already asking myself these questions by Friday evening, when my temperature seemed to spike in waves and I felt too tired to lift my head or take a sip of water.

“It was hard falling asleep because it felt like I had a giant rubber band around my ribcage,” I wrote to my friends.

Saturday, March 28

On Saturday, the fever worsened and I added muscle soreness and occasional chills to the list of symptoms. When I woke from a mid-afternoon nap, I cried as the wave of pain and heat returned.

Nevertheless, I fell into a routine of mustering enough energy to sit up and eat meals. Otherwise, I lay in bed with my eyes closed, not fully asleep but too exhausted to move. With nothing else to occupy my time, I worried endlessly about my friends getting sick.

I don’t know exactly how high the fever reached because I had no thermometer, but I believe I started hallucinating that afternoon. All the pain temporarily melted away, and I felt like I was floating. The day passed as a blur of exhaustion, sweat and discomfort.

One friend took to checking in throughout the day, and I’m grateful he did. I didn’t want to eat or drink because the effort completely drained my energy, and my appetite was absent anyway. Without taste, food held no comfort. Still, I knew the situation would only get worse if I didn’t take care of myself.

No medical team came to do a swab test that day as planned, and no one called to give me an update. As a reminder, I emailed more specific directions to my apartment to the epidemiologist with whom I’d spoken the previous day.

Sunday, March 29

In response to my roommates’ Sunday morning check-in, I wrote to them via WhatsApp, “I woke up around 4:30 panting and coughing and sweating, but it eventually passed. … I definitely want to try the hotline again.”

My roommates called the hotline on my behalf to ask when a medical team might come, because I was too fatigued to hold up the phone and easily got out of breath from short conversations. When a doctor returned the call, I was informed that the testing team didn’t work on Sundays, but I had clearance to go to the emergency room if my symptoms got much worse. The doctor recommended paracetamol and a cold shower to bring my temperature down.

I dreaded the thought of going to the hospital for several reasons. I didn’t want to risk infecting anyone there. And given that I didn’t feel well enough to drive myself, I also didn’t want to endanger my friends by confining them to a car with me and potentially a notoriously contagious virus.

Around this time, a roommate whose mother is a doctor recommended checking my breathing rate periodically. I don’t have any medical experience, but from watching the clock I learned it was just under 20 breaths per minute at resting (whereas normal rates are 10-15), and slightly over 20 with mild activity. We agreed that if it hit 25, we would consider taking action.

The “rubber band” feeling returned that evening, but not as severely.

The Centers for Disease Control and Prevention offers the following recommendations for when to seek medical help for a suspected Covid-19 case. (Photo: PROVIDED)

On Monday, I again spent most of the day in bed, waiting for the symptoms to pass. Thankfully, the fever temporarily abated, though I felt dizzy and my breathing was shallow and quick.

We again called the hotline, and I was told the team was gearing up and would be there later that day. However, they didn’t come, and I was later told that other people took priority given my young age and lack of other health conditions.

Meanwhile, my condition worsened significantly.

“This afternoon has been pretty rough,” I wrote at 2:30 p.m. “I get out of breath every time I talk. I’m starting to get a headache. I think the fever is back and I just generally feel wiped out.”

By this time, I was frightened. I’d seen photos of patients on ventilators, and I didn’t want to confront the reality that I might need one if things took a turn for the worse.

Given my difficulty concentrating, I struggled to research the virus further, but I did read about a study indicating that the fifth day of Covid-19 symptoms often marks a turning point: Severe cases tend to see their symptoms worsen around this time — and require hospitalisation a day or two later.

I also found several personal stories on social media posted by patients who started to feel better after this point. For me, day five was looming, and I didn’t know which way the scales would tip.

Meanwhile, I was unable to find enough information to understand when breathing difficulties require hospitalisation. Were my own struggles to catch a breath simply anxiety inducing and uncomfortable, or did they constitute a medical emergency?

The epidemiologist called after 5 p.m. to check whether the testing team had come. They hadn’t. She said they would arrive first thing in the morning.

Tuesday, March 31

I felt slightly better on Tuesday after sleeping through the night. I was still dizzy upon standing, but not while I was resting. I developed a dry cough, but it wasn’t as bad as other symptoms.

Around 1:30 p.m., two doctors dressed head-to-toe in protective gear walked through my bedroom door.

A doctor displays the Covid-19 nasal test kit before administering it. (Photo: DANA KAMPA)

They administered a nasal test for Covid-19, which involves inserting a long swab in one nostril until it reaches the back of the throat. The preservative-coated swab then should pick up evidence of the virus. The same thing is then repeated on the other side.

I was warned the sensation could be distressing, and indeed it felt like the tool was just about scraping my brain. I went into a coughing fit after it was over that didn’t abate until after the doctors left.

While the process was tear-inducing and uncomfortable, it was necessary. I believed it was not only important to know if I had the virus to guide further treatment, but also to know if it was transmitting within the territory. I hadn’t travelled outside the VI since I moved here in December. Since all three of the confirmed cases here were imported, I could be the first locally transmitted case in the territory if my results returned positive.

I was told that the hospital would call me with the results when they came in, but I wasn’t given an estimate of how long that would take.

Later in the day, I felt too hot and too cold at the same time, but I was mostly simply fatigued from getting tested.

Shortly after the test, we learned that our entire household had been officially placed under quarantine for 14 days beginning from my first day of symptoms. Three of my co-workers were also placed under quarantine the following day because of previous contact with me.

Recuperation

For the next six days, my symptoms persisted. My breathing was so shallow that I counted my breaths several times a day to see if I exceeded 25 per minute. I never did, but I came close, and I wondered often if I should go to the hospital given that I had passed day five and my symptoms did not seem to be improving.

Day seven — Thursday, April 2 — was among the worst of the entire ordeal. Even while lying completely still, I felt as though I had just run a marathon and couldn’t catch my breath no matter how deeply I inhaled. I was afraid.

Asked how I was feeling in a WhatsApp group, I succinctly wrote, “Pretty bad. Just trying to focus on breathing normally.”

I also consulted a doctor though WhatsApp, asking if there were any severe symptoms I should watch for as a sign to consider going to the hospital.

“It is concerning that you are having worsening of symptoms,” the doctor replied. “Severe symptoms would include severe shortness of breath. But it sounds like you are progressing. … I would advise we keep a close eye on it.”

Beyond drinking warm tea and taking deep breaths, all I could do was wait. Taking care of my basic needs remained difficult in the following week, and it took more willpower than I knew I possessed not to give up.

On the evening of April 4, I nearly passed out while brushing my teeth. My ears were ringing, my vision went dark on the edges, and I lost strength in my extremities.

When a nurse from the hotline called that day, she said the experience likely resulted from dehydration. I redoubled my efforts to drink often, and I continued to rest.

The efforts must have paid off, because from that day forward I slowly began to recover.

Result confusion

By Monday, April 6, six days had passed since my test and 10 had passed since my symptoms set in. I was feeling much better, but I still hadn’t received my test results. That day, government went live with an announcement on Facebook. As Deputy Premier Carvin Malone began reading off statistics, my heart started pounding. He celebrated the fact that 17 test results recently sent to the Caribbean Public Health Agency in Trinidad for confirmation came back negative.

Presumably, this batch included my results, but I was surprised: No one had told me anything yet. Could I assume I was in the clear and had just experienced a particularly vicious form of the flu?

Later that afternoon, I received a call from the BVI Health Services Authority to check in on my symptoms, as representatives had been doing daily. When I asked about my results, I was told that the initial results were in, but I needed to wait for confirmation from CARPHA. As of press time Wednesday afternoon, I still hadn’t received information about my individual results despite attempts to contact the Ministry of Health and Social Development.

However, last Thursday, April 9, I received a digital certificate dated April 6 from the Ministry of Health and Social Development officially releasing me from quarantine. My roommates and co-workers who had been quarantined also received similar certificates around the same time.

False negatives

I wish I could say I felt relieved to hear the news. But even though I was feeling better, I still had concerns. A recent study suggests that false negatives happen in about a third of nasal tests, and medical professionals have shared similar concerns from their experience.

Dr. Alain Chaoui, head of Congenial Healthcare in Massachusetts, told The Boston Globe, “A lot of my patients who have symptoms, who I clinically think have COVID-19, are testing negative.”

Mr. Malone announced last week that of 64 samples that CARPHA tested, 61 returned negative.

I want to believe that my test came back negative and that it was accurate. But I can’t ignore the fact that I experienced almost all the possible symptoms.

Just to be on the safe side, I resolved to remain isolated until the full 14 days passed.

Out of isolation

The occasional dry cough persisted until early this week, and I would get short of breath if I stood for too long. I still get tired more easily than normal.

I also realised that I had rapidly lost a somewhat alarming amount of weight. I don’t know the exact amount, but I realised I could feel newly defined floating ribs. My sense of smell and taste returned, but my appetite did not.

But on Friday I enjoyed stepping out onto our apartment’s balcony, catching up with my roommates and feeling the sun on my face. Though I couldn’t leave the apartment because of the curfew, I was out of isolation, and none of my roommates had caught whatever I had.

It’s tempting to throw caution to the wind after hearing the news that the recent results came back negative and no transmission has been confirmed in the territory. But Covid-19 has a long incubation period. It’s easy for someone to walk around and spread the virus before they even feel sick.

The coming weeks will be especially important in stopping coronavirus here in the VI, and it’s up to everyone to make a real difference.

The border closure and curfew has hit our household hard both financially and emotionally, as it has for many in the territory. But we’re doing what we can to protect one another. If the past three weeks have taught me anything, it’s that nothing is more important than the people we love.

I would like to offer a quick thank you to the essential workers who helped ensure my roommates and I were taken care of while in quarantine, including the doctors, nurses, case workers, security officers and volunteers who delivered groceries and water.

For their safety and everyone’s, stay vigilant.


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