By Avesh Ramnarain
CAPE TOWN - Many people I've spoken to don't know of anyone who's lost a loved one to Covid-19. Unfortunately, the younger generations overlook the fact that they could spread this virus to someone elderly like my dad who was at the wrong place at the wrong time.
I'm sharing this experience to create awareness on the seriousness of this virus and that it's our oldest and wisest members of family who pass away from Covid-19.
We lost our Dad on 13 May 2020, a day before my moms birthday.
During what Durban called a “level 4 lockdown” my dad went out to buy veggies at a supermarket that was shut down the very next day due to a staff member later testing positive for Covid-19.
It felt like the festive season - everyone was scurrying around and buying groceries. Malls were crowded, roads and highways were congested like any normal day. It was strange in comparison to what I've experienced where I live in Gauteng.
My dad had retired earlier this year at 61 years of age with no known medical issues besides being slightly overweight. He was always equipped with all the personal protective equipment (PPE) that was needed: 3 ply masks, fabric masks, gel sanitisers and disinfectant sprays.
Two days before he was admitted into hospital, he had been diagnosed with diabetes due to being a overweight. Soon after he was admitted the doctors confirmed that he had tested positive for Covid-19.
I phoned him the next day, he mentioned that he was feeling much better and that he couldn't wait to come home and relax. Never did I think that was to be the last verbal conversation I was going to have with my father.
In the space of around 6 hours his health deteriorated when the virus set into his lungs. Talking to a nephrologist, or kidney specialist, the next morning I was told my dad's lung capacity dropped to 88%. The doctors immediately sedated him and put him on a ventilator.
I was in Johannesburg and all of this was happening in Durban during a lockdown where inter-provincial travel was not allowed unless a permit was granted by the police. All we could do at that moment was cry, question why this was happening and start to wonder how my dad contracted the virus if he was so careful and went out with all the necessary PPE.
The next daunting step was to get everyone in our Durban household tested, which included my brother, his wife and my dad’s girlfriend. Fortunately, with the assistance of our family doctor we were able to get forms so they could get tested via a Lancet Lab Drive Through. We received the first set of results the next day and heard that my dad’s girlfriend had tested positive, while my brother and sister-in-law tested negative.
My Dad was known to be a fighter – physically and mentally we knew he had a strong chance of coming out of this recovered from Covid-19. We all started looking for miracle cases online where patients came off a ventilator and recovered from the virus.
My dad lasted 13 days on a ventilator under an induced coma where his vitals remained stable but critical on most days.
Days 1 to 6:
My dad had been on the ventilator with 100% oxygen. His white blood cell count were low at the beginning which is what the virus does initially so he was given steroids to assist with him together with immune boosters, anti-virals, vitamin C, morphine and antibiotics. Around Day 5 he made progress where the ventilator was reduced to 90% oxygen. By day 6 his vitals dropped where the ventilator was put back to 100%.
Day 7 to Day 11
Days 7 to 10 Dad was weaned off the ventilator back to 90% oxygen with his saturation levels ranging from 92% to 97% showing stable but small progression. We realised that this was a marathon he has to run as opposed to a 100m sprint so progression was going to take time but he remained stable during these 3 days. During this time, we were advised that my Dad had no bacterial infection, his infection markers were normal, all his organs were fine, vitals were stable.
On day 9 I received a call from the pulmonologist who advised that there was a drug we could try that became available again. Actemra also known as Tocilizumab: a drug used for rheumatoid arthritis. Already doing research on this drug I noted that an inconclusive trial was done on 21 patients with Covid-19 in China. There was some hope but I noticed that the drug was administered as a combo with the use of Remdesivir – an antiviral drug. Unfortunately, I was told that Remdesivir was unavailable.
On Sunday 10 May my dad was administered the Actemra/ Tocilizumab via dosage according to weight per mg dosage. It sounded like the doctors and medical teams were getting my Dad ready to come off the ventilator and go onto a non-invasive form of oxygen.
I got a call from the ICU Specialist for the first time saying that they had to move the ventilator back to 100% oxygenation & my Dad’s saturation levels had dropped to 90%.
Day 13 – The day my Dad passed away
On calling the hospital in the morning and chatting to the nurse I was told that my Dad’s vitals remained the same at 100% ventilation with 90% saturation. By midday I received the second call from the ICU specialist where he asked if there was any family in Durban to come and visit my Dad as they don’t think he’s going to make the day.
I called my brother immediately and he rushed to the high care ward at the hospital. He couldn’t recognise my Dad and said all that he could see was a sort of resemblance of him with the ventilator inflating his lungs causing the hospital blankets to move up and down.
15 minutes later I got a call from a nurse saying that my Dad passed away at 14:05. My dad went into cardiac arrest - his body wasn't getting enough oxygen. The heart increases blood pressure in an attempt to receive more oxygen until it eventually fails.
Obviously being given this news you’re instantly overcome with emotion. Fond memories of your loved one flashed back. Then the telephone calls start to come in from family and friends paying their respects and you’re left with hardly any time to deal with these emotions. Being the elder sibling, I had to go into organisation mode trying to make calls and start with funeral arrangements.
It was then disclosed to us that due to my dad passing away from Covid-19 his body was not allowed into a mortuary. This meant that a same day cremation had to be done with no family being able to attend.
I then called the hospital in a panic state trying to get letters in order for me to get a permit to travel to KZN in time for my dad’s cremation. All the doctors were conveniently unavailable to take my call or assist with providing me a letter to get a permit. An admin person within the hospital then assisted with sending me an admission form for my dad with hand written details stating that he passed away.
The SAPS in the area I live, turned me away twice when I got there to attain a permit to travel. There was a lack of empathy towards my situation. At the first police station, I was told that I needed a death certificate in order get a permit to travel. At the second station I was told the commander in charge was not available to assist me so I need to come back tomorrow.
What does non-admission to a mortuary actually mean?
We weren't allowed to wash or bath my dad or put on his suit and jewellery. We weren’t allowed to say goodbye or have some sort of closure that he passed away, family members were not allowed at the cremation and as a Hindu, the last rites could not be done at the time of cremation either.
I received sufficient documentation from the hospital literally five minutes before my dad’s cremation could begin. There were no flights during Level 4 so I couldn’t make it in time even if I drove from Gauteng.
My brother & his wife were allowed at the cremation venue. They allowed me to watch my dad’s cremation via videocall. The cremation ceremony lasted 10 minutes where the priest did what he could in the short space of time thereafter two men in hazmat suits put my dad’s sealed coffin into the furnace for cremation.
After spending some two hours at the third police station I finally received my permit in order to travel to KZN to be with my brother who had to face everything head on by himself.
I hope my sharing of this experience will urge people to take Covid-19 seriously.
Please take care of your families especially your elders.
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