COVID in Delhi: ‘I was More Afraid of Suffocating Than of Dying’ Inside View 02/08/2021 • Jyoti Pande Lavakare Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) A health worker wearing personal protective equipment (PPE) carries a patient suffering from the coronavirus disease (COVID-19) outside the casualty ward at Guru Teg Bahadur hospital, in New Delhi, India. #COVIDReporting: For the past 18 months, Health Policy Watch reporters have covered the COVID-19 pandemic. But they have not been immune from its impacts on their personal lives as the virus has wreaked havoc with their lives. Over the next few weeks, we will bring you their stories. DELHI – Despite the utmost care, bordering on mild paranoia, COVID found me on 18 April 2021, like it did many in Delhi, during the peak of India’s second wave. I got my first jab of the indigenous Covaxin vaccine on 1 April, the very first day I became eligible, along with a friend (who had been even more careful over the past year) and her two staffers. Coincidentally, all of us came down with COVID within days of each other. Even before this strange and ruthless virus breached my defences, I’d been watching in silent horror as the numbers of COVID-afflicted in several Indian states, including Delhi, rose sharply during India’s election state election campaigns – in what was clearly the beginning of a second wave. I watched with helpless fury at the way every single political party held massive political rallies, entirely overlooking safety norms as they fought elections in three key states. None could beat the ferocious enthusiasm of Prime Minister Narendra Modi’s ruling Hindutva-nationalist Bharatiya Janata Party, whose single-minded determination to defeat its biggest rival in West Bengal, state Chief Minister Mamata Banerjee’s All India Trinamool Congress party, drove it to recklessly ignore all Covid safety protocols, even as cases began spiking dangerously. Religious and political mass gatherings paved the way for the virus Tens of millions gathered to celebrate the Kumbh Mela festival in India amid surging COVID-19 cases. What angered me further was the utter irresponsibility and impunity with which the BJP-ruled federal government allowed the kumbh mela – the largest religious gathering of pilgrims in the world, so large that it can be spotted from space – to carry on in early April as if there were no deadly pandemic sweeping the world. This was even worse than the chest-thumping victory bugle the Indian Prime Minister had blown internationally, barely a couple of months earlier signaling vanquishing of a virus which, it turned out, was just lying low to strike more venomously in a brutal second wave. With these super-spreader events in full swing, it would have been a miracle if India had not seen a second wave. It was mid-April when my first-floor neighbours in our two-family bungalow A Dutch-American couple with whom I shared a common driveway and entrance lobby, got it first, along with their staff from where perhaps it reached me via our staff. The fact that I had helped the families of all the staff on the premises access their first shot of the AstraZeneca Covishield three weeks ago didn’t seem to make a dent in preventing the spread of the infection. Or perhaps I was infected by the double-vaccinated physiotherapist I had taken a session for neck and back pain from. She contracted COVID around the same time. Wherever it came from, by the time I showed my first symptoms, Delhi was reeling under a medical crisis, an overwhelmed healthcare system – and a severe shortage of hospital beds, oxygen and lifesaving medicines. Just getting an RT-PCR test was proving challenging. Isolation, fever and lung damage I immediately isolated myself – my biggest concern was to keep the rest of my family safe. But as my fever rose to 104 degrees Fahrenheit and my oxygen-saturation levels fell from the safe norm of over 95 to under 92, occasionally touching 90, as paracetamol proved ineffective and Meftal (mefenamic acid), an anti-pyretic pain suppressant used widely in India, remained unavailable, as doctors remained elusive and news of friends and acquaintances struggling for breath, for hospital beds, for oxygen grew, so did my worry. Within two days of testing positive, (five days after my first fever) a high resolution lung CT scan showed an almost 50% lung damage from the virus – my score was 14/25, which the diagnostician had shaken his head, stepping back further as he told me I was on the border between moderate and severe COVID. ‘In some ways, I was more afraid of suffocating than of dying. What if I couldn’t breathe?’ I knew my lungs were already compromised from the polluted air I’d breathed for three decades. Recently, I had seen my non-smoker mother struggle with lung cancer, which her doctors said was triggered by the dirty air she had inhaled all her life, living as she did mostly in highly polluted north Indian cities and towns. Helplessly watching her die, gasping for breath in the terminal stages, had propelled me to write my grief memoir on the human cost of air pollution, “Breathing Here is Injurious to Your Health,” citing several scientific studie in an unusual intersection of two disparate genres. In some ways, I was more afraid of suffocating than of dying. What if I couldn’t breathe? An entire chapter in my book talked about the air pollution-COVID connection, citing research that proved that those living in high polluted areas were more likely to contract COVID and in fact, get a more severe form of COVID and included the now oft-quoted Harvard School of Public Health study that even measured increased mortality due to higher levels of pollution. A close friend, who is also a gynaecologist, ended up being my saviour. Anita had been checking on my saturation levels at regular intervals via text from the day I tested positive, ringing me every morning to find out how I was doing. One day, soon after my CT scan, I found an oxygen concentrator at my door. She had managed to retrieve her concentrator from a colleague at her practice for whom she had bought it in the first wave. Concerned at my unstable saturation levels, she sent it to me telling me not to hesitate to use it if my oxy-sat fell to 90. ‘Be prepared for anything’ My children, who had been scouring social media sites for oxygen cylinders and hospital beds, stopped panicking. Soon afterwards, I also managed to get a phone consultation with a pulmonologist known to me from my air pollution work who lost no time in prescribing favipiravir, (an antiviral) and steroids. At first, I was unable to source the medicines in local pharmacies. Too many sick people needed the same medicines, a common problem of scarcity in a country of over a billion people. Once again, a network of neighbours, friends and family came to my rescue as whatsapp groups buzzed with numbers of faraway pharmacies that had even one strip of Medrol® . I needed 20. This was not just my story. Even as the government failed its citizens, good Samaritans, communities of friends, relatives and families stood in lines for oxygen, medicines, beds – and in more unfortunate cases, cremations – sometimes forced to fight with each other over that last strip of remisdivir, or pouches of plasma. A friend who had rushed her COVID-positive father to the ICU in a nursing home in a small town in the neighboring state of Uttar Pradesh (because no beds were available in Delhi or its suburbs) told me how the doctors came around to tell her to “be prepared for anything” since they had only 2 hours of oxygen left. ‘One morning, when I looked into the bathroom mirror, a grey face looked back at me.’ Throughout my 21-day isolation period, I was in touch with my family only through phone calls or closed doors. A close band of Covid-positive friends and I kept in text- touch with each other, all of us checking in amongst us every day, worried if we didn’t hear back from each other. My pulmonologist prescribed diagnostic tests that were shockingly expensive, but in such high demand that labs quickly ran out of test reagents and other raw materials. I was also monitoring my Covid-positive housekeeper, who sounded breathless every time I spoke to her on the phone. My anxiety for her was tinged with worry at the test expenses I knew she could ill-afford and I would have to help her with, when the time came. With no one able to cook, my family ordered-in most meals, but despite the heavy, oily outside food – and zero exercise – I lost 6kgs in 10 days, nearly 8% of my body weight. I also lost my sense of smell and taste. Jyoti Pande Lavakare One morning, when I looked into the bathroom mirror, a dull, grey face I could barely recognise looked back at me. I wish I’d taken a photograph. I’ve never seen that kind of metallic pallor on a human face in my entire life. Meanwhile, every day, news of the deaths of acquaintances, friends, even a first cousin who was younger than me, reached me via texts, until I became afraid to check my phone. Talking tired me. I tried to drown out the cruel pings of bad news with music, or a film, but discovered that I had lost the ability to concentrate. I had tried to continue tweeting for my clean air non-profit, Care for Air, but Twitter was full of desperate pleas for help, news of undercounting of deaths, pictures of bodies which were being abandoned on the banks of rivers in shallow, sandy graves because people didn’t have the resources to cremate them – information that made me so sad that Anita forbade me to follow the news. The isolation of those days – and more than the days, the empty nights, when the thump-thump of the concentrator was the only sound that cut through the stillness – will stay with me for as long as I live. ‘Feeling for my oxygen mask became my new normal. In fact, the concentrator and the oximeter became my closest friends.’ Sleep was elusive. That, the steroids ensured. Looking out into a vast, purple-polluted sky, barely a star visible, night after night, falling asleep in a prone position as dawn broke and waking up unrested, breathless just hours later, restlessly feeling for my oxygen mask became my new normal. In fact, the concentrator and the oximeter became my closest friends. So much so that even after my fever broke and my saturation levels stabilised, I couldn’t bear to send the concentrator back. Only the thought that someone may be needing it more urgently than I spurred me to finally return it to Anita, so that she could pass it onto some other desperate COVID patient, if required. The only great part of these days was that the steroids made my body feel like butter. Every ache and pain I had ever experienced, vanished. When I walked, I felt like I was floating, light and agile as a butterfly. Even after 21 days, I re-tested positive for COVID – and with no one fully-vaccinated at home, my anxious family only allowed me to step out of my room once a day, when I took short, floating walks in the small garden attached to our verandah, a venture that left me exhausted, but grateful. Often, I would lie on the grass, looking up at an endless sky, practising breathing deep, feeling small, insignificant – but alive. For me, it wasn’t those 21 days, but the following 80 days post-recovery, in which I felt the full effects of this strange, ugly disease. After I had tapered off the steroids, I felt like a ghostly version of myself. I had zero energy and would get tired just lying in bed. I tried to get back to reading and writing but just couldn’t concentrate. Almost constant brain fog made me start feeling that I wasn’t even truly alive. For someone with no serious co-morbidities, I was surprised to find my blood pressure fluctuating wildly. One day, I would see a sudden fall in my systolic blood pressure, followed by high diastolic blood pressure, another day, the exact reverse. The second month, it was tachychardia, followed by bradychardia, my pulse leap-froggng between 70-110, even as my oxygen saturation levels remained stable. My cholesterol, triglycerides and sugar levels also shot up beyond normal ranges and I often felt a heavy feeling in the chest. And the absolute worst part was the return of every single pain I had ever had – and some joint pains that I had never felt before. As days bled into each other, and concerned friends advised me not to push myself to exercise, I started pranayamas, breath-work from my yoga days. I also turned to Ayurveda and homeopathy, all of which helped to different degrees. It is now more than three months from the day I first tested positive. I still have troubled sleep, get hot flashes every morning, feel breathless occasionally, have mysterious aches and pains and get fatigued more easily. I have lost a lot of my confidence and hesitate to commit to work deadlines. I’ve lost almost half my hair and my joint pains make me hobble along like an old woman, especially in the mornings. The only thing I have added is weight – those steroids have ensured that. But many other parameters – pulse, blood pressure included – are stable and I know I’m luckier than many truly long-haulers who are suffering so much more months after testing negative. I got my second shot of Covaxin last week, on 20 July. Fellow sufferers tell me some of my lingering symptoms should resolve after the second jab. I devoutly hope they do. COVID has been ruthless and relentless Recovering in Lodhi Gardens, Delhi But I know that no vaccine shot will resolve that unnamed, uncomfortable guilt that often creeps up on me as I drift into a determined sleep, nor the sudden feeling of panic when I see photos of crowds of unmasked people. I still can’t help thinking that it was our privilege that allowed my friends and me to protect our families. For those living in cramped quarters, it was well nigh impossible to truly isolate. I shy away from thinking about those who pleaded for hospitals and oxygen, trying not to wonder where they must be now. And I miss my friends, the ones I will never see again. For most people, COVID has been ruthless, relentless – sickening and killing loved ones, weakening not just our bodies but our souls as we grieve, endlessly grieve, for those who we took a little bit for granted because we thought we had time with them. For others, it has been an indirect cause for a different kind of suffering and frustration, as they lose livelihoods and slip back into a poverty they thought they had left behind. What is worse is that it still isn’t over, washing over us in waves, altering us forever, not just physically and mentally, but also socially, emotionally, psychologically and perhaps in other unkown ways that we still haven’t understood. As my father says, Covid is the perfect disease of Kalyuga. Jyoti Pande Lavakare pre-Covid Jyoti Pande Lavakare is a journalist, author and co-founder of the Indian clean air non-profit Care for Air. She has corresponded regularly for Health Policy Watch on air pollution, climate and health issues. Her memoir, Breathing Here is Injurious to Your Health, on the human cost of air pollution, was recently published by Hachette. Image Credits: Flickr – Trinity Care Foundation, Adnan Abidi/Flickr, Sky News. 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