Ahead of the virus

Manish Tibrewal, one among Assam's first set of people to have contracted the COVID 19 infection talks about his journey with Fit Northeast that started with experiencing symptoms to plasma donation

One would expect a recovered COVID 19 patient to be a tad bitter and maybe grousing about the hospitalization and quarantine processes. Understandably so as the treatment and aftercare phase is strikingly different from other diseases. After all never did our human race anticipate that despite all the modern sophistications in medical science we shall be grappling with a virus as contagious as COVID 19 - a virus that has neither an established cure nor a proven method of arresting the spread.
Consequently, it is natural to surmise that most people who had contracted COVID 19 in the initial months after the pandemic had erupted were experiencing a plethora of fears and apprehensions in relation to the ailment, the treatment plan and also the government interventions.   
However, a detailed conversation with Manish Tibrewal, a resident of Guwahati's Spanish Garden lent me a completely different and refreshing perspective. He had a sense of composure and his balanced and logical insights kept me glued to all the minor details of his account. "On February 27 I had flown to Delhi for a two day work trip. This was a business conference at  Greater Noida," informed Manish. He added that he was experiencing a sore throat during this time that he was addressing with salt water gargles. "On Saturday morning which was the 29th of February I was left with some work that I wrapped up within an hour. I decided to utilize the rest of the day for a leisure trip to Agra and at 4.30 in the evening I was strolling in the expansive precincts of the Taj Mahal. I had traveled to Agra from Delhi via a cab and I must also tell you that during my visit the Taj was relatively deserted as the alarm bells of COVID had already started resonating in India," he recounted. Manish informed me that he flew back to Guwahati from Delhi via an evening flight on the 1st of March. "Enroute to Delhi from Agra I had stopped at Vrindavan for some homage and sightseeing," he elaborated.     
All was unfortunately not well after Manish reached Guwahati. "I am an asthma patient and started experiencing slight breathing issues. However, I attributed it to the seasonal change," he said, pleasantly adding, "By the way I generally experience these breathing issues every year around February and this year was an exception." The seasonal inhalers were not lending any relief and hence on the following Sunday, Manish visited a doctor for consultation. "I was put on nebulizers and infact nebulized in the hospital for three days," he shares. 
His respiratory issues were seesawing in the ensuing week. "Two routine blood investigations were also conducted, the outcomes of which were normal and did not raise any alarm. I consulted a pulmonologist around the 16th of March who changed my medicines and put me on oral steroids," Manish informed.
At this stage of narration I couldn't stop myself from asking, "You are so conscientious and careful about your health issues. Did you not contemplate on a COVID test at this stage? Moreover, the COVID scare was unleashing fast around that time." The answer was expected. "Well yes. I had confided in a friend of mine who is a practicing microbiologist in a reputed hospital in the city. She had said that a minuscule number of swab samples were being tested in GMCH at that time owing to the lack of testing paraphernalia and PPE kits. Moreover priority and attention was being given to people who were displaying symptoms of the virus after an international travel history or had any recent contact with people who were COVID positive."   
 "Also my apprehensions started fading as by around the 17th  or 18th  of March my breathing issues started resolving substantially. I would say I felt about 80% better. Holi celebrations had started around 11th March in my family and friend circle. I participated by maintaining physical distance. In a sense though I attended the social dos I would refrain from exchanging pleasantries through embraces and handshakes. I did not apply holi on anyone and would not allow anyone to sprinkle any colors on me," Manish recollected. "Infact during these days I was very cautious about using community infrastructure. For instance I would never get inside even slightly crowded lifts and would carry hand sanitizers. Infact I even started wearing face masks." As he stated this I understood why none of his social contacts had contracted the infection. I realized that socially conscious and educated people like Manish can go a long way in compounding the efforts of the health and government authorities in preventing the transmission of the disease. "Also days later when I was diagnosed to be COVID positive I immediately sent messages in the WhatsApp group of Spanish Gardens and to all family, friends and acquaintances about my condition and urged them to go for testing. Moreover I had updated my WhatsApp status too so that everyone could see that I was COVID positive," he remembers.         
Only symptomatic COVID patients can donate plasma for a maximum of four months after recovery as their plasma is fortified with virus antibodies
Manish is incidentally a businessman and well reckoned MEP consultant of the state. "When the COVID scare was gaining momentum in Guwahati around the third week of March I closed all my offices in advance as I preempted a lockdown. I also actively urged many trade bodies to close operations," he stated and added that by then he had embarked on stricter norms in terms of social distancing.  
Manish Tibrewal
Image: Manish Tibrewal
By the time the lockdown was announced in Guwahati, Manish started experiencing a slew of sharper symptoms. "On 24th night I had experienced a piercing headache which I casually attributed to my chronic acidity issues and tried to douse with a generous dose of my regular medicine. But the next day the headache persisted and I started feeling feverish and heavy. My wife recorded my temperature and found that it was 99. She immediately consulted a doctor friend who advised that the family members should quarantine. We implemented this advice very seriously," he narrated.    
In the following days, Manish had a full blown fever. At this stage he was referred to another pulmonologist by a friend who is an experienced orthopedic surgeon at GMCH. A new set of medicines were prescribed and he was put on a course of oral steroid for five days. "But my breathing deteriorated and on 2nd April I underwent another blood test, chest X-ray and CT scan at a private clinic at Dispur. The CT scan revealed pneumonia traces in my lungs and I was given pneumonia antibiotics and withdrawn from steroids. Simultaneously to rule out the worst, I finally underwent the COVID test," he revealed.
So did he expect the test to be positive? "I was prepared," says Manish adding "But my wife was not." The reports were delivered after a day's anxious wait. "On the night of 4th April I boarded the vehicle that was sent by the GMCH authorities with a bag of fresh synthetic clothes, my phone, charger and I had not knowing what lay ahead of me but nevertheless unfazed," he shared. "During that time the levels of uncertainty were much higher as not many patients had contracted the disease in India and very few had been discharged," he adds. "I was perceived almost like a ticking time bomb when I de-boarded the vehicle at GMCH. To ensure that I do not transmit the virus to anyone a clear set of instructions were etched in the building about the direction of my room," Manish stated pleasantly. "So were you disheartened with the sense of alienation around you?" I was curious. "Well on the contrary I must applaud the clarity and precision with which the state authorities and hospital staff had responded to this unprecedented medical emergency called COVID 19 even in the initial days. They selflessly rose to the occasion and collaborated with a thoroughly professional attitude. To cite an example of teamwork from the medical fraternity, the individual doctors who were treating me after my return from Delhi gave a comprehensive account of their line of treatment that was compiled as a detailed one page summary report and given to the COVID in charge at GMCH," he answers.
Manish Tibrewal has been hailed as one of the most cooperative COVID patients of the state. "I also realized that the frontline doctors and health workers who were interfacing with me at GMCH were not just risking their chances of contracting the virus but also in a great state of physical discomfort owing to the cumbersome PPE kits. These kits make their hands and fingers less nimble while inserting drips and injections that in turn translate to the patient's discomfort. But since I understood their situation I took all these things in my stride. Infact to ensure that they had minimal interface with me in the coming days I learnt how to monitor my pressure and the blood oximeter device," he shares. Talking about the administration he says that the systematic way in which they embarked on contact tracing and testing was commendable. "The nimbleness and efficiency with which the government has increased testing in geometrical rates and readied a colossal amount of PPE kits and equipment in such a short time deserves praise. Setting up so many COVID care and quarantine centers is also not less than a feat."           
For the initial eight days Manish was kept in the COVID ICU of GMCH after which he was shifted to the isolation ward for about eight days. "On reaching the isolation ward I was given my laptop to resume work," he shares. The mandatory three consecutive tests were conducted to declare him COVID negative. So did he return home on 19th April? "Unfortunately no," he says with a laugh and explained, "On 18th I was informed that I would be released the next day but suddenly everything changed within a few hours of my release. The containment period for Spanish Garden had been increased to 2nd May. It was heartbreaking but soon I reconciled to the situation by recollecting a quote, 'Hope but never expect. Look forward but never wait.' Now I was faced with two choices- spending the rest of the days quarantining in a hotel or the paid cabin of a private hospital. Going to my family home in Nagaon despite my father's insistence was not an option for me as I did not want my parents to contract the disease.  Finally I spent these days at a private room in an isolated section of GMCH. I had a television at my disposal and my I-pad. However, most of my time was spent on social media and introspecting about the COVID pandemic. I am convinced that the pandemic has subtly yet powerfully reiterated several truths about human existence and we all need to process these messages positively for a more compassionate and inclusive future. I can almost write a book on learnings around COVID."  
So was plasma donation a natural outcome of all his philosophical introspections? "Well I was just being human," replied Manish. "I feel fortunate that through plasma donation I have done my two bits in terms of helping save critical patients. Only symptomatic COVID patients can donate plasma for a maximum of four months after recovery as their plasma is fortified with virus antibodies. The plasma is actually a component of the blood and about two units can be donated every 15 days." So did you feel weak after donating plasma?  "No just that I was advised against any form of strenuous activity for a couple of days."
So what is his advice to people? "Nothing except that precaution saves while paranoia kills. While it is important to collaborate with the government and medical fraternity it is equally important to steer away from unnecessary and often misinformed speculations about the disease."



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