Questions from a Mild Covid-19 Case

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The nonstop flow of info about COVID19 often doesn’t answer questions to help me stay healthy, not dead. Listen for the questions of this person with mild coronavirus.

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Credits

Music by permission from Joey van Leeuwen, Boston Drummer, Composer, Arranger

Sponsored by Abridge

Thanks to these fine people who inspired me for this episode: Laura Marcial, Sharon Hibay, Ellen Schultz, Cynthia LaRouge, June Levy, Natalka Slabyj, Sameenuddin Syed, CJ Sandy, Judy Thomas, Freddie White-Johnson

Links

CDC:Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020

Johns Hopkins coronavirus Mapping

Related podcasts and blogs

Share the Stories. Help the Helpers.

Dementia, Covid-19, Oh My

Kind Re-Equilibration in the Age of Coronavirus

About the Show

Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once. We will listen and learn about what it takes to adjust to life’s realities in the awesome circus of healthcare. Let’s make some sense of all this.

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Creative Commons Licensing

The material found on this website created by me is Open Source and licensed under Creative Commons Attribution. Anyone may use the material (written, audio, or video) freely at no charge. Please cite the source as: ‘From Danny van Leeuwen, Health Hats. (including the link to my website). I welcome edits and improvements. Please let me know. danny@health-hats.com. The material on this site created by others is theirs and use follows their guidelines.

The Show

Proem

The coronavirus affects everyone. Most of us know someone who has it, had it, died of it. If not directly, then no more than a couple of degrees of separation.  The popular media saturates us with reports on those hospitalized and those dying. Yet, some say that 80% of people with coronavirus infection have mild or no symptoms. I can’t figure out how they come up with that figure. Testing a random sample of people (what random sample?) and extrapolate to the whole population? Is that a US national figure, China, New York State, or NYC, people of color?  I’m having trouble pinpointing where these numbers come from besides Wuhan, China. What does that say about US testing and US data? It seems essential information to me. As I look at the nonstop flow of information and stories about coronavirus, I’m impressed with how little it informs me, helps me make decisions about staying healthy, not dead in Covid19 world. I find the clinical research hard to understand and apply to me. What about applied to not me? I’ve been working with a group of people listening to questions people ask about the Coronavirus and figure out where they listen. Then how good is that information? Can we trust it? How do we know?  Anyway, my nephew, Michael Boland, was one of that 80% I mentioned earlier who had mild symptoms of coronavirus. Let’s meet Michael, 42, married to CJ, with a six-year-old daughter, Carolyn, living in Brooklyn, NY. As I look at the nonstop flow of information and stories about coronavirus, I’m impressed with how little it informs me, helps me make decisions about staying healthy, not dead in Covid19 world. A cold, the flu, Covid19?

Introducing Michael Boland’s Covid19

Health Hats: Michael, thanks for joining me today. I appreciate it.

Michael Boland: My pleasure.

Health Hats: Please tell me about your escapades with Covid19 since you were one of the lucky early ones.

Michael Boland: To be fair, I was early in the United States. Our friends in the Asia Pacific, Europe, and Northern Africa saw it a few months before we did. In the United States, I contracted the virus about a week into our shelter in place in New York State. My employer asked us to start staying home on March 16th. A week later, I started not feeling well. I thought I had a cold with mild flu-like symptoms, body aches, fatigue, but uncommon for me was running a high fever of 101 to 102 degrees when I wasn’t taking a fever reducer. If I did take a fever reducer, I’d come down to somewhere around 99.5 -100 degrees for a couple of hours and then shoot right back up. I still had energy. I wasn’t completely wiped out. I managed to continue to work from home and handle some fatherly duties. This went on for a few days. After not feeling well for about five or six days, I decided to get checked out, have a doctor take a look under the hood, kick the tires. Usually, I would have continued to take cold medicine and go about my business. I went to the doctor. They took my vital signs, listened to my chest, looked in my throat, ears, eyes, so on, so forth. He said, ‘I think you’ve just got a chest cold. Go ahead and head home. If you’re not feeling well, come back.’ I went home and said to my wife, CJ, ‘Hey, guess what? It’s just a chest cold.’  We celebrated, happy with relief. But things started to take a different turn the following day. I began to experience other symptoms. The fever became a little bit more intense, I experienced very sharp chest pain, specifically when I would inhale deeply. I don’t know, Danny, if you’ve ever had bronchitis, but it was similar to that, with the tightness and the discomfort. But unusual and somewhat frightening was the pain. Thankfully, that’s as bad as it ever got. I went back to the doctor the next day. They took a chest Xray. The chest Xray came back with no fluid in my lungs. No real damage to the bronchioles. But given the symptoms, fever, they suspected Covid19 and did a test. Thankfully, I plateaued at chest pain and discomfort with a high temperature. Per the recommendation of the doctor, I took that following Monday off from work, just stayed in bed and rested, drank lots of fluids, watched a lot of streaming online. I quarantined myself from my family.

Quarantine

Health Hats: How big is your place? I’ve never been to your place.

Michael Boland: We live in an 850 square foot, single floor apartment in Brooklyn. It’s a C-shaped floor plan. We walk into the living space, which includes a kitchen. Then there is a small hallway that juts north from that space with the main bathroom right off the hall from that. Then at the end of the hall is our bedroom on suite. We have two bathrooms. Our bedroom is basically separate and farthest away from the living space. I stayed in the bedroom. I didn’t come out.

Health Hats: How did you interact with CJ and Carolyn?

Michael Boland: She would come in and bring food, take away dishes from the door. Our bedroom is deep. If I was on the bed and she was at the door, we’re about 12 feet away from each other. The weather was reasonably nice during this time, not particularly cold, so I could keep the window cracked a bit. We would send text messages back and forth. The quarantine only lasted about six, seven days. On the day they tested me, the doctor recommended treating the symptoms, not the diagnosis. ‘If you’re telling us this is the worst you’ve felt since what we suspect is you contracting the virus, we’re hopeful that with some rest, you’ll recover naturally. Keep taking fever reducers, stay comfortable, drink lots of fluids, eat healthy foods, broths, things of that nature to stay hydrated.’ I was sure that I’d make a natural recovery. How would I know when and if I’ve recovered? Is there a duration? They said, ‘honestly, at this point we still don’t know a hundred percent but per the CDC, if you stop experiencing symptoms and you can remain fever free for 72 hours without having to take a fever reducer, from the second you hit that 72 hours, that’s when you’ve recovered and you can leave your quarantine and you won’t be contagious or spread it to anybody else. If we look at the timeline, from my first onset of symptoms, it was basically 14 days later that I recovered.

Health Hats: So other than fever reducers, you didn’t need oxygen?

Michael Boland: I’m not gonna lie, I can’t speak for other people that have contracted it and recovered, but a big portion of it for me was the anxiety that came along with it.  The world that we are existing in is one where you have to purposefully avoid hearing about the deaths and the sickness and the scenes from the hospitals. So, married with a young daughter and things are going well with my job, I’m not ready to punch my ticket by any stretch of the imagination. I started to get scared when I experienced the chest discomfort, because one of my phobias is suffocation, drowning. I’ve always inherently been scared of those realities.

Health Hats: Seems like life to be scared.

Michael Boland: I’ve never been great with tight spaces. I was experiencing this chest discomfort. I wouldn’t say that it was hard to breathe by any stretch. I was breathing normally. It was painful when I would take a deep breath, but I never felt like my breathing was shortening at all.

Health Hats: Sounds like you went to the doctor twice. Did you have further interactions with doctors? How did you manage your medical support?

Testing, telehealth, childcare

Michael Boland: The in-person appointments were fine. I don’t want to say that I’m disappointed because I think the first doctor that checked me out did a thorough job. I was under the impression that I wasn’t experiencing the telltale symptoms that would have necessitated a test at that point in time. I think, in retrospect, that doctor would probably have administered the test the first day. March 20th was different than it is today.

Health Hats: And the availability of testing is different as well.

Michael Boland: That’s a good point. At the second appointment, they did a thorough job. They were extremely communicative, very upfront, informative in terms of how I should navigate going forward. They kept reiterating that if I was experiencing any type of shortness of breath or worsening shortness of breath that I should go to the emergency room right away.

Health Hats: Did you use telehealth?

Michael Boland: I had a couple of follow-up calls to discuss the test results.

Health Hats: That took a while you were telling me, right?

Michael Boland: It did.  I got my test results back about 10 to 12 days after I got tested. At that point, it was kind of thanks for nothing.

Health Hats: A little anticlimactic.

Michael Boland: I was confident that I had been recovered and was no longer in quarantine.  I know my body well enough to know that if the medical professionals were telling me that symptom-free without a fever for this period means you’re recovered, I knew I was recovered. I will say this much: It was a relief to know the diagnosis, to see the test results, to know that I did have it. That has helped shape the decisions that my family is making ever since. As we’re getting towards the summer and school is not going to be in session anymore, and there’s not going to be any summer camp. We are trying to make informed, responsible decisions about childcare over the summer, knowing that I had it and recovered from it. We can only assume that CJ and Carolyn, my wife and daughter, were exposed to it.  If we trust science, everything is telling us that we’re pretty safe people to be around right now.

Health Hats: How did CJ take this, other than doing her usual taking good care of you? That must’ve been freaky.

Michael Boland: She played it pretty cool, and to be honest, we haven’t gotten too in-depth about it. I think she’s relieved that it was a relatively short-lived thing for me. She’s been extremely encouraging of my blood and plasma donation.  She’s been supportive even though it often means me having to drive to Staten Island and missing a huge chunk of the day when she is home trying to work, be a teacher, and a mom. There was a palpable difference in the way she was reacting and the way she was carrying herself from when we all thought it just a cold. When I came home from that second doctor’s appointment and said, ‘you can’t come near me. I’m going into the bedroom. They did a test. They think I have it,’ you could tell that the anxiety meter went up a few notches quickly. But she was fairly stoic through it. I could hear her and Carolyn through the door.  There was a lot of laughing and playing and stuff going on.  She did a great job of not allowing for anxiety that she might be having or that I might be having permeate through to our six-year-old daughter.

Health Hats: I’m of the outlook that kids know what’s going on. That can vary. So how do you think Carolyn integrated it?

Michael Boland: At first, she was confused. She was about to turn seven. I’ve been reflecting these past couple of months because I’m trying to empathize. I’m trying to remember when I was her age. You know, I’m no spring chicken. I’m about to turn 42. So that was 35 years ago. I don’t remember much from being six years old. That has been a bit of a relief.

Health Hats: You were a real cutie.

Michael Boland: Oh, thanks. What happened? That gave me some relief because I think if things get back to normal in six months or so, I think her memory of all of this is to be limited. She sees it through a different set of eyes than you or I or older kids or adults. Leading up to the shelter in place, the closing of the school one day I was at school, I had a weekend. I usually go back to school on Monday, and now I’m home. I can’t see my friends.  Mom and dad are making me do work. Every once in a while, my schoolteacher jumps on a Zoom call and reads a story. That may have created a level of anxiety that she’s still dealing with. When I was sick, and it went from daddy’s gonna lie down, he does not feel that great to you can’t come near Dad. You can’t come into the room. You can stand in the doorway with Mom and talk to me from there. I think that freaked her out pretty good.

Health Hats: Yeah.

Michael Boland: CJ was fantastic with her the whole time.  It was a nice release for CJ to have that distraction. Also beneficial for Carolyn to have her spirits kept high throughout it because it could have been a situation where everybody was freaking out.

Health Hats: Now you’re a month and a half, two months out. What’s different about either your health or your outlook having experienced this moderate Covid illness?

Michael Boland: That’s a great question, Danny. There are some days where I’ll take a deep breath and feel a little short of breath.  We live in a third-floor walkup, so some days I’m coming back with the groceries, and I feel a little short of breath. I take a second and pause and take a couple of deeper breaths and check the baseline as it were. And then I conclude that I’m 42 years old and haven’t exercised in two and a half months and walked up three flights of stairs with 50 pounds worth of groceries. I think it’s a lot more mental than physical, to be completely honest with you. I’m not advocating this for anybody by any stretch of the imagination, but I did lose 15 pounds while I was sick.  I have noticed a somewhat more suppressed appetite than I had prior.

Health Hats: Did you lose your sense of taste and smell?

Michael Boland: I think I did. That often happens to me when I experienced normal my winter cold symptoms. I didn’t pay much attention to it.

Now a word about our sponsor, ABRIDGE.

Use Abridge to record your doctor visit. Push the big pink button and record the conversation. Read the transcript or listen to clips when you get home. Check out the app at abridge.com or download it on the Apple App Store or Google Play Store. Record your health care conversations. Let me know how it went!” 

Unpause, roll the dice, mindfulness

Health Hats: How are you thinking about the un-pause, the coming out of it? Do you feel like I got to get out of this place versus my goodness, I don’t want this again, and I don’t want CJ or Carolyn to get it? Maybe I’ll be a little more cautious. How do you think about that stuff?

Michael Boland: I consider myself a pragmatic person. I’m like 98%, 99% agnostic, as well. I tend to look at nature and science as my all-powerful. We’re just leaves on a tree and we’re either gonna keep growing and be okay or something’s going to come along and get rid of us.  The human body naturally creates systems to fight against something, once you’ve been exposed. I do have the antibodies now. Will these carry me through for six months? Will these carry me through for a year. We don’t know. I happen to think that as a society, as essentially animals that need socializing, that needs to be part of the community. It’s ingrained into our DNA. We need to have releases that allow us to thrive and be healthy. I worry that being overly cautious and keeping people home so to a point where it just goes on and on and on and on for months and months. I think that’s going to have more negative health effects on human beings than actually starting to lift the regulations a little and allowing people to go out into the world. This might sound cold, and some people might not agree with me, but if you’re a relatively healthy person, if you don’t have a preexisting condition, you should roll the dice, go out there. If you get it, chances are you’re probably gonna recover from it. Unfortunately, in that scenario, there are going to be people who are relatively healthy that pass away. It’s just how it is until there is a proven vaccine. We have to start thinking about getting those people who are recovered and have antibodies out into society again. Then it should be a personal decision by someone over the age of 18 that could make their own decisions if they want to go back into society. I think there are things that we can do Danny, to be mindful of each other and to make this thing work. People will probably get sick. I live in New York City, and this is something that we’ve never had to think about in my lifetime. Nobody likes being squished into a subway train, but I think nowadays, people are going to let that subway train go by and they’ll wait for the next one.

Health Hats: What do you wish you or CJ knew, before this all started for you?

Michael Boland: I would have taken it a bit more seriously, Danny, to be completely honest with you.

Health Hats: Meaning your early symptoms?

Michael Boland: Meaning the way I was carrying myself out among the world the first couple of weeks as people were starting to get sick in this area. We weren’t sheltered in place yet. I did the math to trace back my symptoms. I’m confident that I contracted it while we were sheltered in place and not when I was commuting to the office the week before. You’ve known my family longer than I’ve known my family. We are sometimes a little too stubborn for our own good. I was of the mindset that it was a bad cold and would go away.  That first week when I contracted it, I could have got it someplace in the neighborhood. I was walking around without a mask, without gloves. I was in and out of the pharmacy a couple of times, the grocery store. I was in close contact with people I knew and saw them on the street. Thankfully, nobody I know personally contracted it, so I know that I didn’t submit it to them.

Health Hats: That was going to be one of my questions, so that’s good.

Michael Boland: But I’m hopeful that I was not the catalyst for somebody’s terrible illness or unfortunate demise. I remember some elderly people in the pharmacy, who also weren’t wearing masks. From what I understand, it’s transmitted via droplets, but I think there are enough droplets in an exhale of breath, and that’s why this thing is spreading. You think droplets, that means somebody has to sneeze on me or spit on me or lick their hand and touch my face. Now, if you take a deep breath in, you’re within a couple of feet to somebody you’ve got enough to get somebody sick. So, I wish that I had just been a little bit more mindful. Not because I got it. To be honest with you, I’m pleased that I got it and recovered from it because I think it’s good to have. People that we know and love that have gotten it can save to their friends and family some anguish. This is as bad as it got for me. I’m ready to get back to work. I’m ready to start doing things we need to do to get our kids back into school. These are the conversations that we need now. I do feel a bit irresponsible for not being more aware of the severity of the situation that we were in early on. I hope that I was not somebody that spread it to people who unfortunately were not able to fight it off the way I did.

Health Hats: Thank you. I appreciate you taking the time. I love that I see you. Give my love to CJ, and I hope we can meet in person before too long.

Michael Boland: Thank you. We’re good. We’ll have to get to Katz’s Deli early this time because I don’t think the tables are going to be that close together anymore.

Health Hats: Right. There’s going to be a ripple effect of this. We have no idea the ripple this is going to have on our lives and our kids’ lives. Alright, man. Take care of yourself. I love you.

Reflection

A day in the life. A month in the life. A story of fear, relief, annoyance, recovery. What questions do I hear in Michael’s story? How do I know I have Covid? When should I get a test to see if I have it? What should I do when I have symptoms and no test results? What percent of people get Covid infection without symptoms, with mild symptoms?  Are those numbers for people like me? How long should I quarantine? What’s the risk to my family? I’m scared.  How do I manage my fear and anxiety? How do we talk about this with our kids? When will telehealth work, and when should I see a doctor in person?  Can my kid go to summer camp this year? How do we find safe daycare? Does exposure mean I have some resistance to future exposure? How long does it take to recover?  What does recovery look like? How do we balance managing the virus and getting on with life? Where can I get tested, give blood, give plasma? Why isn’t it closer to home? I’m afraid I’ve given it to someone else I don’t know. How do I deal with the guilt I feel? How does Covid spread anyway? What will going to Katz’ Diner look like when they open?

What questions do you have? Ask in the comment section or email me at mailto:DannyHealthHats@gmail.com