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?
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.
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
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.
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.
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.
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.
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.
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.
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.
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
‘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]. ‘
I have experienced this peace in a way I cannot fully explain. It is real and has enabled me to overcome Corona.
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.
While sunsets do remind me of the magnificence of our creator, they can also provide an opportunity to show off.
While there have been many magical moments, no doubt, I would like to say that most of the days are, well, not so spectacular.
In fact, most of the days the sky can be just plain and grey too.
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
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!
Look at the Containment Zones list. The majority are fromover crowded residential areas with common toilets like slums.
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.
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.
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!
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.
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.
The Asian brown cloud is created by a range of airborne particles and pollutants from combustion (e.g., woodfires, cars, and factories), biomass burning and industrial processes with incomplete burning. The cloud is associated with the winter monsoon (November/December to April) during which there is no rain to wash pollutants from the air.
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.
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.
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.
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.
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.
Beautiful houses can be constructed, complete with attached toilets. Not just two or three floors high!
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.
The Corona pandemic has brought about a global lock down never seen in recent times. Those who are unaware of how fearfully and wonderfully their bodies are made are now full of fear. Many try out any remedy to improve their immunity and somehow protect themselves from this Corona virus.
As a Medical Doctor, I felt it is important to address this issue with facts, that can avoid you inadvertently causing more harm than good. Your body is complex and superbly designed. There are many defense mechanisms constantly at work in your body to protect you from viruses. Medical and Biological sciences are discovering newer ones even as this is being written.
I will give a short summary of the wonderful way in which our defense mechanisms have been designed. Designs always point out to a designer, whom I have had the privilege of knowing personally. I hope that you will understand the love that the Lord God your Designer and Creator has for you. I also hope that none of you would ever think that such sophisticated defense mechanisms just came about by mindless,random accidents of the so-called evolution process, as many would love to believe.
I hope this awareness of the facts will also reduce your fear and anxiety against the Corona virus. This virus does not have eyes, wings, hands, or feet. It is just a piece of RNA code encoded by a fatty membrane. I sincerely hope that your fear will be replaced by faith, trust, and hope.
This does not mean the virus is harmless, and you should not have a false sense of confidence in your own ability to withstand this virus. What I mean by is faith, trust and hope in the God who made you, which I hope will develop or increase as you read this.
I have taken the scientific material mainly from the latest edition of Harrisons Principles of Internal Medicine, known globally as the Bible of Internal Medicine. which every student of modern medicine will know.
The way in which God has designed our bodies, our immune systems, are to be seen to be believed. The details mentioned below are technical, but I am sure you will learn to trust in God and cultivate a heart of gratitude to our Lord, which will make your immune systems in turn work optimally. Science has confirmed that fear and anxiety damage the potential of your immune system to work to its full capability 1, and I believe that peace, love, and forgiveness are keys to healing.
Here are some of the amazing ways known so far to Science of how our defense mechanisms help us to fight viral infections.
HUMAN BODY’S RESISTANCE TO VIRAL INFECTIONS
Physical defense mechanisms: Resistance to viral infections is initially provided by physical factors that are not virus specific. Physical protection is afforded by the many layers of the skin and by mucous secretions that continuously sweep over mucosal surfaces. So, it is important to maintain the integrity of these surfaces by drinking enough water.
Blood borne defenses: Blood actively maintains life by providing a vital function for all cells, tissues, and organs, and thus the life of the whole body 2. So says Leviticus 17:11. Science is discovering the astonishing variety of defense and offense mechanisms present in our blood. Our Immune systems are indeed very cleverly designed.
Here are the main ones.
Cytokines: As soon as the first cell is infected, cytokines are induced. These are substances, such as interferon IFN, interleukin, and growth factors, which are secreted by certain cells of the immune system and confer resistance to RNA virus replication.
Viral infection may also trigger the release of other cytokines from infected cells. These cytokines attract inflammatory and immune cells.
The cellular army: Viral protein epitopes seen on the human cell surface stimulate the expansion of Killer T lymphocyte populations with receptors that can recognize these virus-encoded peptides presented on the cell surface by MHC class I proteins. These Killer T cells are among an elite warrior group roaming in your body.
A cytotoxic T cell (also known as TC, cytotoxic T lymphocyte, CTL, T-killer cell, cytolytic T cell, CD8+ T-cell or killer T cell) is a T lymphocyte (a type of white blood cell) that kills cancer cells, cells that are infected (particularly with viruses), or cells that are damaged in other ways. Cytokines and antigens released by virus-induced cell death further attract inflammatory cells, dendritic cells, granulocytes, natural killer (NK) cells, and B lymphocytes to sites of infection and to draining lymph nodes. IFNs and NK cells are particularly important in containing viral infection for the first several days. Special White blood cells called Granulocytes and macrophages are also important in the phagocytosis [eating up] and degradation of viruses, especially after an initial antibody response.
By 7–10 days after infection, virus-specific antibody responses, virus-specific human leukocyte antigen (HLA) class II–restricted CD4+ helper T lymphocyte responses, and virus-specific HLA class I–restricted CD8+ cytotoxic T lymphocyte responses develop. These responses, whose magnitude typically increases over the second and third weeks of infection, are important for rapid recovery.
Antibodies and Complement: In the initial days, a powerful Immunoglobulin M IgM antibody is secreted glandular-associated B cells. The process is almost magical. Following viral antigen stimulation, IgM-producing plasma cells migrate from the lymph node to bone marrow, where they become long-lived plasma cells. A 5- to 10-day lag time occurs before IgM antibodies appear in blood, and peak IgM levels occur at 21 days. Between the second and third weeks after the first infection other even more powerful IgG or IgA antibodies can then be detected at infected mucosal surfaces. Antibody may directly neutralize virus by binding to its surface and preventing cell attachment or penetration. Complement can significantly enhance antibody-mediated virus neutralization.
Antibody and complement can also dissolve virus-infected cells that display viral membrane proteins on the cell surface.
Cells infected with a replicating enveloped virus usually show the virus-envelope glycoproteins on the cell plasma membrane. Specific antibodies can bind to the glycoproteins, fix complement, and lyse the infected cell.
Surveillance to prevent recurrence: Once our Immune system is activated, it never forgets! Antibody and CD4+/CD8+ T lymphocyte [white blood cells] responses to viral infection can remain at high levels for several months after primary infection but usually wane over time.
Low-level persistence of antibody-producing B lymphocytes and CD4+ or CD8+ T lymphocyte responses as memory cells can provide a rapid response to a second infection or an early barrier to reinfection with the same virus.
God has given you an entire army with diverse defense and offense mechanisms that protect you.. You can choose to fear a virus, or you can choose to trust God.
It is your choice always, for God has also given you free will. By faith we understand that the universe has been created by a word from God so that the visible came into existence from the invisible.
Gratitude to God is an attitude that can also work wonders for your immune system. Peace and joy and other such emotions are the result of knowing this truth, which sets us all free.
Make sure that you follow the guidelines issued by the local health authorities. I wish that you and your family stay safe, healthy, and happy.