The pandemic is coming to a close, but the scars remain

The last three years were the longest and scariest of our lives

As the World Health Organization (WHO) meets anew to determine whether the pandemic is no longer an international emergency, many of us who were caught in the middle of the storm still struggle to come to terms with the events of the last three years. This time of year, many healthcare workers remember the pitched battles we fought against a deadly and insidious virus that had the potential to kill millions of Filipinos. In the midst of caring for and helping our patients, we ourselves were not immune to getting sick, and many of our colleagues paid the ultimate price.

Three years ago, I had the scare of my life when I felt a tickle in my throat on March 14, 2020 after previously attending to two patients who died and subsequently tested positive for Covid-19. These were among the first deaths of the pandemic and they had been referred to me in my capacity as an infectious diseases physician. Since they did not have a history of travel to China, these patients were initially not placed in isolation. They were subsequently identified as having exposure to known Covid-19 cases in the community, but not before those of us involved in their care had been exposed without proper PPE.

I also realized in horror that if I tested positive, I had exposed the President, the Vice President, the cabinet, and the entire Philippine General Hospital (PGH) leadership since I personally met them in the preceding days as part of my advisory duties. I immediately put myself in isolation in the hospital and I advised the health department of my situation. I also did this to protect my family, especially since we live with my elderly in-laws. There were no vaccines and no known effective treatments at that time, and so staying at home was not an option.

Upon admission to the hospital, I got a chest x-ray and basic laboratories. Thankfully these were normal. My medical school classmate Albert (a pulmonologist) and Eva, my former IDS fellow and now co-faculty at PGH, took care of me.

Those were the longest seven days of my life. I told the nurses to just leave the BP apparatus in the room so I could do my own vitals to save on PPE. I would wake up crying in the morning thinking today was the day I might die, even as I did my duties in advising the government and fielding innumerable calls from patients and colleagues who needed advice.

As I waited for the results of my swab, I continued working online even as I feared for my life and the lives of my family and friends that I might have inadvertently exposed. In those days, the capacity of the Research Institute for Tropical Medicine (RITM) to do Covid-19 PCRs was only a few hundred tests a day. Our own laboratory at the University of the Philippines-National Institutes of Health (UP-NIH) was still in the process of being accredited. Recovering confirmed Covid-19 patients still needed two negative repeat RT-PCRs prior to being discharged from isolation and this really clogged up the testing pipeline. Amid reports of VIPs and politicians jumping the testing line, healthcare workers like myself who had real exposure had to wait longer for our tests to come back. I was already in direct contact with the head of the testing laboratory at the RITM, and yet he could not assure me of when my test would be back. There is a special place in hell for people who jumped the line for RT-PCR tests just because they could strong-arm the DOH, and these delayed essential tests for healthcare workers and patients. Some of these instances are well-documented and should not be forgotten.

I got a call from Dr. Raul Jara who was one of my cardiology professors in medical school and he asked me what to do as they were wheeling him to the ICU because he was short of breath. With tears in my eyes, I told him to be strong and that I myself was in isolation waiting for my test result. That was the last time I talked to him. I found out a few days later that he had died.
I have never prayed harder for myself and for other people than during those early days of the pandemic. I have never been so scared for myself and others than at that time. As reports of colleagues dying trickled in, each death was like a knife stab straight into my heart. I learned that Dr. Sally Gatchalian, a pediatric infectious diseases specialist on the frontlines and a close friend and mentor, was fighting for her life. She later succumbed to severe Covid-19. There was no time to grieve since I needed to do my part in fighting the spread of the virus. My expertise was badly needed and everyone was asking me what to do. I have no idea how I made it out alive but the test finally came back negative and I got to go home. I remained in isolation for another seven days since I knew that false positives did occur. It is still hard to talk about those days, but every year the memories flood back and I am grateful and relieved for having survived.

Even as people remove their masks and think the pandemic is over, the scars remain for those of us who were at ground zero and had to put our lives on the line every single day. It did not help that there were those who were spreading fake news, who pushed dubious remedies, and those who politicized the response and accused us of not telling the truth. History has proven us right, and I can only hope that as part of the healing process we can forgive these people who kicked us when we were down, even as we scrambled against all odds to save as many lives as we could. I am grateful for the opportunity to have served my country, but it was not an easy path to take.

I hope that those of us who survived continue to remember with gratitude the immense sacrifices that were made to win this war.