Corona Diaries - 22

I started these diaries back in April when I was admitted to the hospital with COVID19. So much has changed since then. I'm writing his post 7 months later and the world is still fighting corona. It's a tiny virus that has taken over the entire world. Europe is going into lockdown again. Entire families have suffered tremendous losses in lives. Our elderly population is decreasing everyday. We have more than 15 daily deaths due to either corona or complications of silly corona. In Kuwait, we don't have a second peak and the reason for that is we still haven't come down from our first peak. We're at a plateau of 500-800 daily cases and it seems as if we have things under control; when in reality that's not the case. Let me try to explain in a couple of points.

1. COVID19 cases are now considered negative 10 days after the original swab. Whereas before, a repeat swab had to be done at day 12 and you needed two negative swabs to be considered negative. That's why some people stayed in hospital or quarantine facilities for up to 40 days; due to a remnant positive virus. This means that we have less people admitted to hospital currently due to a shorter hospital stay, therefore less hospital bed occupancy in hospitals all over Kuwait.

2. We have gotten better at the management of cases in area hospitals as well as Jaber and Kuwait Field Hospital. Our dispatch system is working well. Cases are usually transferred to COVID hospitals as soon as the swab is positive as long as they're vitally stable. We are also transferring the sick ones to ICU as soon as they deteriorate and sometimes preemptively. We can somehow predict when cases will become sicker, although some cases still surprise us. Therefore, COVID positive cases are now mainly in Jaber and Kuwait Field Hospital apart from the few sick ones that are in ICUs in the area hospitals, which are too sick to be shifted.

3. Most positive cases are asymptomatic or have mild symptoms that do not require hospital admissions, and that has always been the case. However, back in March, April and part of May, all positive cases were admitted to hospitals or quarantine facilities. This means that hospitals are focused on dealing with the sick cases that require medical attention rather than wasting resources on the stable ones. This has freed up hospital beds for those that are actually in need. Overall, this means we have less admissions at any given time. Having said that, Jaber wards are still quite full as well as their six ICUs.

4. The treatment for COVID19 is mostly conservative and tailored to each symptom the patient develops. You manage complications and deal with them as they occur. Most cases do well. Nothing has really changed in the management over the past few months. We've stopped giving hydroxychloroquine due to lack of supportive evidence. We don't give IV fluids anymore unless there are signs of dehydration. We only treat with antibiotics if there's a superimposed bacterial infection. We give dexamethasone if symptoms have lasted more than 4 days and the patient is requiring supplemental oxygen or has a high D-dimer. The management is clear and has become routine.

5. Flu season has just started, so let's wait and see what will happen to the numbers in the next two weeks. I have yet to see a case that has both COVID and influenza at the same time.

Most doctors haven't taken leaves since February. The exhaustion and the burnout is real. Most of them have already had COVID19 themselves. I don't have an exact percentage but just thinking about my department, I would say around 40% have already been infected. Most of them had mild symptoms, although others have been admitted in hospital with complications. Some have also required to be on supplemental oxygen for a period at home before coming back to work.

We're all getting sick of corona. Doctors more so than others. Believe me. It's something that has taken over our lives for the past year nearly. It has changed everything we do. It has changed how we interact with our families and loved ones as well. I wonder when we'll go back to a mask-less existence. I wonder when a vaccine will appear that will put the COVID nightmare out of worlds forever.

On a lighter note, let me leave you with something beautiful. I have started reading non-medical and poetry books recently. I'm aiming to do an hour everyday and that has seriously given me peace. Reading takes you out of your world and puts you somewhere else temporarily and its beautiful. I recently got a book with the most famous love letters and reading them has transported me to the 17th century, when letters were the only way to communicate. Smart phones and text messages didn't exist, let alone Instagram, snapchat and video calls. Letters that describe years of unattainable love, months of torture and being torn away from one another. Read the following snippets and forget about corona for a few minutes.

Out of the depths of my happy heart wells a great tide of love and prayer for this priceless treasure that is confined to my life-long keeping.

You cannot see its intangible waves as they flow towards you, darling, but in these lines you will hear, as it were, the distant beating of the surf.

- Mark Twain to future wife Olivia Langdon

December 23, 1782

My Dearest Friend,

…should I draw you the picture of my heart it would be what I hope you would still love though it contained nothing new. The early possession you obtained there, and the absolute power you have obtained over it, leaves not the smallest space unoccupied.

I look back to the early days of our acquaintance and friendship as to the days of love and innocence, and, with an indescribable pleasure, I have seen near a score of years roll over our heads with an affection heightened and improved by time, nor have the dreary years of absence in the smallest degree effaced from my mind the image of the dear untitled man to whom I gave my heart.

- Abigail Adams to John Adams

I look down the tracks and see you coming—and out of every haze & mist your darling rumpled trousers are hurrying to me—Without you, dearest dearest I couldn't see or hear or feel or think—or live—I love you so and I'm never in all our lives going to let us be apart another night. It's like begging for mercy of a storm or killing Beauty or growing old, without you. I want to kiss you so—and in the back where your dear hair starts and your chest—I love you—and I can't tell you how much—To think that I'll die without your knowing—Goofo, you've got to try [to] feel how much I do—how inanimate I am when you're gone—I can't even hate these damnable people—Nobody's got a right to live but us—and they're dirtying up our world and I can't hate them because I want you so—Come Quick—Come Quick to me—Lover, Lover, Darling—Your Wife

- Zelda to Scott Fitzgerald

Dearest deeply loved Victoria, I need not tell you that since we left, all my thoughts have been with you at Windsor, and that your image fills my whole soul. Even in my dreams I never imagined that I should find so much love on earth. How that moment shines for me still when I was close to you, with your hand in mine. Those days flew by so quickly, but our separation will fly equally so. Ernest [my brother] wishes me to say a thousand nice things to you. With promises of unchanging love and devotion, Your ever true Albert

- King Albert to Queen Victoria

Even in bed my ideas yearn towards you, my Immortal Beloved, here and there joyfully, then again sadly, awaiting from Fate, whether it will listen to us. I can only live, either altogether with you or not at all. Yes, I have determined to wander about for so long far away, until I can fly into your arms and call myself quite at home with you, can send my soul enveloped by yours into the realm of spirits — yes, I regret, it must be. You will get over it all the more as you know my faithfulness to you; never another one can own my heart, never — never! O God, why must one go away from what one loves so, and yet my life in W. as it is now is a miserable life. Your love made me the happiest and unhappiest at the same time. At my actual age I should need some continuity, sameness of life — can that exist under our circumstances? Angel, I just hear that the post goes out every day — and must close therefore, so that you get the L. at once. Be calm — love me — today — yesterday.

What longing in tears for you — You — my Life — my All — farewell. Oh, go on loving me — never doubt the faithfullest heart Of your beloved

L

Ever thine. Ever mine. Ever ours.

- Ludwig Beethoven to unknown