COVID and Vaccination: A Physician’s experience

I am Dr S P Mathew, practising as a Consultant Physician in General Medicine in Mumbai, India since the past 25 years.

There has been a huge increase in the number of cases of Corona once again at the time of writing this.

India’s daily tally of new infections of Covid-19 stopped just short of the 200,000 mark on Wednesday 14th April 2021

Since March 2021, I am seeing quite a few people who get RT PCR/Rapid antigen-positive symptomatic Corona after taking one or even two doses of the IM Vaccination against Corona.

Even more troubling for me is the many cases I am seeing who get breathlessness, fever, and decreasing Oxygen saturation a few days after taking the first or even second dose of the intra musclular COVID vaccine being administered currently.

Their RT PCR test is not done yet or the report is awaited. There is a huge Diagnostic Capacity over load for the RT PCR test, once you book it often takes 3 to 5 days to have someone come over to take the swab. So, many people are unable to test, and hence definitely there is under reporting of actual number of active cases. The HRCT Chest done for these patients shows featured typical of COVID. The patients have to then hunt for a bed in a COVID facility, even though they are not officially positive.

14th April 2021

A few of the vaccinated ones, especially Healthcare workers, who were among the first to get vaccinated in early 2021, developed Corona symptoms with RT PCR and Rapid Antigen positive. They have got good levels of S1/S2 antibodies in their blood when tested. And yet they became ill.

Here is an example of a Doctor, who took the Covishield vaccine as follows:
1st dose 20th Jan 2021
2nd dose 11th March 2021.

Rapid Antigen positive on 2nd April 2021. He had fever with minimal weakness. All routine fever workup tests were negative. We tested him for protective S1/S2 antibodies.

Twice vaccinated and then COVID positive Health care worker

As you can see, even after taking two vaccines and having good antibody levels, he became symptomatically ill and had to be quarantined for 14 days.

The good thing is that he had a mild illness and could be managed at home with basic medications. Ofcourse he could not go to work, and a Radiologist is also a daily wage earner like millions of others.

We repeated his antibody levels after eight days of natural infection.

As you can see the natural Corona infection that he got pushed up his antibody levels to more than 400.

Surprisingly, I have yet to see a single patient who got Corona naturally in the past. and then gets symptomatic and RT PCR positive Corona again.

This led me to ask a few basic questions: There are literally millions who have already got Corona in the last one year in India itself. Why are no cases of confirmed reinfection reported yet in those who caught Corona naturally? Why have I not seen a single case so far here in Mumbai?

Is it because natural Corona infection somehow confers better protection than the vaccine? Does the natural Corona infection give you better local upper respiratory tract humoral immunity? 

I am definitely not advocating that you should preferably get Corona naturally. An infection with the Corona virus can be fatal especially in the high risk populations.

How then do we develop immunity against Corona in the best way possible?

I feel that a nasal vaccine that mimics the natural Corona infection may give you better local and systemic immunity than the present intra muscular vaccine.

Much research is on going on this very important next advance in COVID vaccines., which you can find out by clicking here to open a new tab

As of now, it could be selection bias that as a Doctor I am seeing so many cases who are presenting after taking the im vaccine.

My recommendation is to consult a specialist before going for the vaccine to make sure that you are safe from the potential side effects, especially if you belong to the high risk groups that have been shown to have a higher potential for side effects.

You can click here to open a new page that will explain more about the latest regarding COVID vaccines, from the WHO.

Another important precaution to take if you are going to get vaccinated is to avoid crowded centres, ensure physical distancing and hand hygeine very strictly.

Also please remember that our bodies and immune systems are designed to work best when the mind and spirit are at peace, the Shalom concept that is vital to good health.

So my plea to you is that you would also set aside time daily to connect with your Creator who has designed you in a most wonderful way, and rest in that relationship of love, acceptance and joy. Shalom!

What does Christ mean on Christmas?

I am writing this on Christmas Day 2020. What an year it has been so far. So many firsts.

This was the first time in my life that I witnessed, and became a part of a global pandemic.

This was the first time in recent history that the entire world literally went into a state of lockdown. No one was allowed to leave home, unless they were essential service personnel.

We soon realised what and who were truly essential.

Apart from the essential physical bare necessities like air, water, food, nothing else really mattered. I realised that so many industries and sectors were not really essential at all!

The essential spiritual and mental needs of people remain, for which God has had a plan all along, in the person of Jesus Christ.

He is called the sinless substitutionary sacrifice, who defeated sin and death by undergoing the ultimate punishment for sin, death.

And because He was sinless, death could not hold him. The tomb where He was buried stands empty, in sharp contrast to the tombs of every other religion or idea.

This just shows that Jesus Christ was not just an idea, or the founder of another religion.

He came to restore humans to a relaitonship of Shalom to their maker, the triune God consisting of God the Father, Jesus Christ the son who took on human form, and the Holy Spirit.

And that is why we realised this:

Man tries to be good and holy but fails. Only God can transform us.

Jesus Christ, theamazing hyperdimensional being who transcends time and space and will come again in the future to rule the earth, as revealed in the prophetic book of Revelation.

I wish you all joy, peace, shalom and hope, as I have trusted, in the one who holds the future, Jesus Christ the King.

Wishing you a blessed Christmas

I have a fever: Is it Corona? A Doctor’s personal experience

What happens when Doctors get fever? Are all fevers Corona, especially as at the time of writing this we in the throes of a pandemic caused by SARS-COV 2 also known as COVID-19 or the Corona virus, affecting the entire world since over 7 months?

Background

I am Dr Mathew S P, 50, a MD Physician in private practice since 1996. I have my OPD and rounds at Ashok One Hospital in North Mumbai, India. As it is a Multi-Specialty non-COVID Hospital, we treat all medical, surgical, and orthopedic cases and of various other specialties. Since March 2020, at times we have had to admit a few suspected cases [in isolation units] who were critical, stabilize them and refer them, after confirming their diagnosis, to COVID care centers designated by the Municipal authorities, as these centers do not admit cases without a confirmed diagnosis. As I had been working nonstop at the front lines, I often wished that I would get a break, and rightly so I did get a break, in a most unexpected [to others] way!

Onset and progress:

On Wednesday the 2nd of September 2020 I noticed head heaviness and a flu like feeling, took a Paracetamol. On the 3rd as I was returning home from work in the evening, I was feeling sick. By 10 PM I had high fever, body pain and was feeling terrible.

I isolated myself in my bedroom, drank plenty of fluids, and kept a chart of my temperature, pulse and spo2 levels. My fever started rising as you can see in the fever chart below. I was watching my body closely for any other signs but apart from muscle cramps when I tried to bend, there were none.

Fearful thoughts

I could identify with the thoughts that go on in the mind of patients. The C word comes to mind immediately whenever anyone has fever. C for Corona!

As I often counsel my patients, your mind is like your house. There is a door to the house that is closed. Unless you permit, no one can enter your house physically. You have the power to choose, to decide whom to allow inside. It is exactly the same with your mind. What thoughts do you allow inside? I will give you a tip at the end that has really helped me.

I chose to think of C for Christ instead. The only one who defeated sin and death by his substitutionary sacrifice on the cross for my sins, and then coming back to life, because He was sinless. Death had no power over Him. I have known Jesus Christ in a real way in my heart since many years, and it was only by leaning on Christ that I was able to survive these difficult days, I must confess. If not, my mind would have been flooded with thoughts like “What if this is Corona? I will develop all sorts of complications! I may end up on a ventilator, etc etc”

Charting of vital parameters

As a medical professional I am used to recording vital parameters of the human body and I continued to do so for myself.

I recorded my fever diligently.

My heart rate was also tracked by the Fitbit Versa 2 which I wear 24X7

Heart rate on Day 1 of fever
Chart

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Chart

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Heart rate on day 2 of fever

As you can see my heart rate also remained high for almost 48 hours, the entire time I had fever. Of course, my smart watch is not so smart, it thought I was doing fat burn or cardio all the time!

Investigations and Treatment

I rested and thanked God that He has designed my immune system in such a way that it knows the best way to handle this infection, which I was not able to diagnose. I made sure that I was well hydrated. I took a vitamin supplement and had a predominantly liquid and soft diet. My wife took good care of me I must say!

My role was and is always to have a heart that is filled with faith [in the living God who has created me and in whom I could fully trust to do what was needed] and gratitude for the amazing gift of life that He has given me.

I rested in this and knew that whatever happens, I am in the best hands.

As a medical Doctor I knew the protocols for managing fever and hence did the required blood tests on the first day itself from Jariwala Labs who came for a home visit. The reports were all within normal limits. So, I did not take any other medication, except Paracetamol thrice, whenever my fever went above 102 and I was having body aches.

Recovery

After 48 hours, on Sunday the 6th of September 2020 I woke up afebrile! The fever was gone, and I was feeling fresh and had a good appetite. Since then I have not had any fever at all.

I am grateful to all my friends at the Church that I am a part of for praying for me and I believe that faith is vital for the process of healing. However, I did not know what the diagnosis was. I thought it could have been a flu.

Diagnosis:

On Monday the 7th of September I was active and went for some personal work. Then I got to know that my neighbors have already been diagnosed to be positive for COVID-19. I learnt later that 6 people in the apartment next-door were positive.

I was planning to resume work on Tuesday the 8th of September, as I felt that I had taken more than enough of leave! Since the blood tests did not reveal the diagnosis, the BMC Doctor recommended that I get my COVID Rapid Antigen testing done, which came positive.

Quarantine and progress:

COVID positive. Many thoughts went through my mind. I home quarantined for a period of two weeks, I continued to take rest and cut down on my work, doing limited video consultations.  

My activities are always tracked and here is the graph of the same.

COMPLETE ACTIVITY TRACKING WITH FITBIT

I was feeling a bit fatigued. I lost 50% of my smell sensation around the 10th of September, and it returned gradually over a week. I continued with a Vitamin supplement which caused a great deal of hunger! I found that I gained two kilos by the end of my quarantine!

I repeated my blood tests from Clinilabs after a week and they were all normal, including the markers for COVID activity like CRP etc.

Follow up:

I also did the Rapid Antigen test again on the 21st of September 2020 at a camp organised by the BMC at our Hospital, thanks to Dr Madhavi from R North ward, and that was negative also. All my staff also tested themselves and were negative.

I must commend the Municipal Corporation of Mumbai for the efforts they are taking despite limited manpower to screen people for the virus.

After my RAT [Rapid Antigen test] came negative, I also did my HRCT Chest at Vcare which was also normal. I am incredibly grateful to God for this.

After 4 weeks were completed, I did my COVID Antibody IgG test which showed that I have good levels of IgG antibodies. So, my immune system has successfully overcome the attack by the Corona virus on my body.

I also tested antibody levels of patients who had Corona in May 2020 and was happy to note that their antibody levels remain high even 5 months later.

Lessons learnt:

Our bodies are wonderfully designed to protect us from all pathogens.

I thank my Creator for the amazing ways in which He designs our immune systems, just raising the temperature to destroy pathogens. And the various other defense mechanisms that work without us knowing.

That is why I did not try to bring down the fever. It remained above 101 F for almost 48 hours [even after taking Paracetamol which I took three times in 2 days only because I was having body pain] and then started dropping.

Our immune systems are amazingly complex and medical science still does not fully understand how it works. So please, be positive. Rest, and just allow your body to do its work.

BE POSITIVE IN YOUR SPIRIT

I have written earlier on what we do know about the immune system.

I have also seen patients who fear and tremble at the word Corona. Let me reassure you here that the Corona Virus is harmless to THE MAJORITY of healthy individuals.

There is something much more dangerous than the Corona virus. It is called Fear!

Fear can paralyse your immune systems, or make them react in very abnormal ways.

As I have noticed repeatedly in my experience as a clinician over the decades, fear attacks all parts of the human body. In the cardiovascular system it increases the likelihood of heart attacks and hypertension. In the nervous system, it can lead to an increased risk for strokes, anxiety, and depression. It also increases the levels of adrenaline and cortisol in the body, leading to decreased immunity and insulin resistance, which is a predisposing factor in Diabetes.

The cytokine or bradykinin storm that is released in some cases of Corona are all the result of the immune system malfunctioning.

 

What can you do?

I believe in the simple fact that God made me, and that He has designed me wonderfully. If you choose to believe in this fact, your heart will be filled with faith, and love. There will be no room for fear.

Know the facts about the virus, but do not over do it. Half knowledge is deadly.

There is no need to take any unnecessary medications unless recommended by a qualified Medical Doctor.

Follow your healthcare Practioners advice. I was in touch with our team of Internal Medicine and Chest Medicine specialists, Dr Neelesh Kamath and Dr Parthiv Shah and kept updating them about my vitals and investigations. Please avoid alternative therapies, most of them are unproven and cause undesirable side effects.

I want to leave you with this encouragement and exhortation:

‘Finally, dear, whatever is true, whatever is honorable and worthy of respect, whatever is right and confirmed by God’s word, whatever is pure and wholesome, whatever is lovely and brings peace, whatever is admirable and of good repute; if there is any excellence, if there is anything worthy of praise, think continually on these things [center your mind on them, and implant them in your heart]. ‘ Philippians 4:8

https://my.bible.com/bible/1588/PHP.4.8

And do you know what will happen then?

‘Do not be anxious or worried about anything, but in everything [every circumstance and situation] by prayer and petition with thanksgiving, continue to make your [specific] requests known to God.

And the peace of God [that peace which reassures the heart, that peace] which transcends all understanding, [that peace which] stands guard over your hearts and your minds in Christ Jesus [is yours]. ‘

Philippians 4:6-7

I have experienced this peace in a way I cannot fully explain. It is real and has enabled me to overcome Corona.

God bless!

Not all sunsets are spectacular

People can easily get the impression that others have impressive lives. Especially when they see the impressive pictures that others post. I have been guilty of posting impressive pictures of sunsets actually seen from my home.

Here are a few of them.

An actual sunset in north Mumbai

While sunsets do remind me of the magnificence of our creator, they can also provide an opportunity to show off.

July sunset scene in Mumbai

While there have been many magical moments, no doubt, I would like to say that most of the days are, well, not so spectacular.

Yellow and grey shades

In fact, most of the days the sky can be just plain and grey too.

Grey and dark clouds hover

At other times, the heavy brooding clouds can just descend in a heavy downpour within minutes.

I guess that I am trying to say here is that you need not envy anybody just because they can see some good sunsets.

God has made each one of us unique, just as no two sunsets will be alike. And the sunsets fade into night in a few hours. Let us live and love well in the brief time we have on earth. God bless

Why Corona affected Mumbai: bitter truths

This will take real guts: Corona cases increasing in India, and especially Mumbai.

Maharashtra, the state where Mumbai is the capital, has more cases than China now!

The state of Maharashtra has more cases than China as of 8th June 2020 HT Mumbai headlines

Look at the Containment Zones list. The majority are fromover crowded residential areas with common toilets like slums.

COVID-19 not 'exploded' in India but risk remains: WHO expert ...


Why is no one talking about the most obvious cause of the problem here?
Instead of just clamping a lockdown, why not use this as the best opportunity to get these slums and chawls transformed.

As it is, many of the residents staying in such areas have fled to their villages.
The Government needs to immediately put in action a plan to relocate these high risk people. Then they need demolish all these unsanitary dwellings. Provide prefabricated rapidly scalable multi-storeyed modular homes with toilet facilities for these residents. This way the area will become habitable and open up green spaces too.

Modular Construction - Everything You Need To Know
https://www.cnstrctr.com/blog/modular-construction/

Don’t the slum dwellers [those legally eligible, of course] have a right to live with dignity and basic health safety? ! Mumbai is the Commercial capital of India for Gods sake!
If there is a will there is a way!
Does anybody have the guts to do this?
Why should the Healthcare system alone handle the mess created by poor infrastructure and corrupt networks which have caused such overcrowded slums to exist? The answer is not just to increase funding for Healthcare, but to provide basic amenities to the poor and marginalised.

At a fraction of the cost of expensive Hospitals, one can provice sanitary living conditions that will not only help for preventing Corona but a host of other diseases liek TB, Dengue, Malaria, Dysentry etc.

And if you say you do not want to give these people free houses, fine. Would you rather see your tax money being spent on costly treatments, Hospitals, and sops for the economically affected industries?
The BMC, MMRDA, Local politicians, and people must join hands and work towards this solution or any other way to ensure a dignified living for the marginalised. I believe they are precious people in God’s eyes and have been serving the city since ages.

Pin van architect op http://challengearchitecturestudio.com/ (met ...


Everything else we do to tackle this Corona crisis, and many other communicable diseases, is only like treating a leaking tap by mopping the floor!

I am writing this as a Physician working in a Hospital in North Mumbai. Our team of frontline COVID-19 warriors face this reality daily. Increasing number of cases are coming from areas around, largely from chawls and slums. I really hope people staying in such conditions have a real chance to live in homes with self contained basic toilet facilities in 2020!

Benefits of the Lockdown: Corona Effect

Pictures speak an universal language.

A total lockdown has been in effect in India since the 22nd of March 2020. This was declared to help contain the spread of the novel Corona virus. The cyclone Nisarga hit the west coast of the state of Maharashtra yesterday [3rd June 2020] evening. Thank God, the cyclone did not cause any damage in the city of Mumbai.

This picture was taken yesterday, the 3rd of June 2020 from my window in North Mumbai.

Sun set during the Lock down and Nisarga Cyclone

There are some very important things that I would like you to notice here.

Never before in Mumbai has the horizon been so transparent and pure. The setting sun is seen so clearly. It is so bright and the air is transparent, as it ought to be.

Before the lockdown, Mumbai, as with many other large urban cities, had a brown haze which extended up for thousands of feet from the ground. Aviation experts were well aware of this phenomenon. This is called the Asian brown cloud.

Sunset before the lockdown showing the brownish haze in the lower part

The Asian brown cloud is created by a range of airborne particles and pollutants from combustion (e.g., woodfires, cars, and factories), biomass burning[5] and industrial processes with incomplete burning.[6] The cloud is associated with the winter monsoon (November/December to April) during which there is no rain to wash pollutants from the air.[7]

One major impact is on health. A 2002 study indicated nearly two million people die each year, in Asia alone, from conditions related to the brown cloud.[12]

The effect of the lock down has been dramatic in reducing this pollutuon. The health benefits of this will be seen for years in the future.

Data from the pollution control board documents this huge reduction in atmospheric pollution across Maharashtra.

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This certainly shows that the lock down has helped to improve the air and help the earth to recover from the effects of man made pollution. One needs to question why we need to pollute the earth in our frenzied desire to grab more and more unwanted junk into our lives.

Sunsets of exceptional beauty are possible when we stop pollutiing the earth to feed mindless consumerism.

I hope we will learn to live by respecting nature in the future. The lessons learnt during the lockdown and the Corona pandemic should always be remembered. Let our needs be simple and few. Let us treasure people and use things, instead of the other way around as it was before the lockdown, I pray.

We are called to be good stewards ot this planet. God has kept us as tenants on this earth. Let us align our lives to His to enjoy life in all its abundance.

The root of the Corona Problem

I am sharing something very urgent and hope this will spur the administration to take action that is essential and yet difficult: Our Hospital is seeing many cases of Corona [COVID-19] as we are located close to several hotspots in Dahisar East in North Mumbai.

The majority of these cases are from chawls and slums where there are common toilet facilities. People are leaving these hotspots en masse as of today.

slums mumbai

My suggestion [echoed by many field workers on the ground] is to make use of this time to convert all those residential areas having common toilets [mainly slums and chawls] into housing units with attached toilet facilities in a legally demarcated land use as per the Development Plan.

Don’t these people deserve a life of dignity and clean, healthy living conditions? And considering the changed socio-economic scenario post-COVID-19, I feel hygiene and safety will remain our top priority. Mumbai is the commercial capital of Mumbai. Our residents surely deserve this!

How can this be done practically, you may well ask. Modular units can be built and shipped. Some friends suggested that we use Cargo Containers. Homes with toilet and water facilities can be built in a few days or weeks.

Container homes

Beautiful houses can be constructed, complete with attached toilets. Not just two or three floors high!

CLOSE-UP_PERSPECTIVE
Ganti + Associates Design’s proposal for a shipping container skyscraper in Mumbai. Image Courtesy of GA Design

I am sure innovative civil engineers and entrepreneurs will chip in and suggest even better alternatives than these.

It will take coordination from the local leaders, politicians, police, army, and civil engineering teams. It will be costly and disruptive.

Tackling the root of the problem takes courage. But we have to make use of this opportunity if we wish to really recover from this Corona Pandemic and prevent even more catastrophic pandemics in the future.

Praying that God would give us wisdom and courage to do what is required, in a time like this. Jai Hind.