C. NICOLE SWINER, MD | CONDITIONS | DECEMBER 28, 2020
On Friday evenings, my family usually listens to my husband DJ music in the basement, streaming online on Twitch, and dancing along. During one of these nights, I went upstairs to check on my two girls and remembered to check online for my routine COVID-19 screen results that I’d done the day before.
Since the beginning of the pandemic and when our clinic received COVID PCR swab tests, I’d been doing them every few weeks routinely. As a family doctor, I’ve seen patients still every day of the week, either in person or virtually, and I’ve treated multiple COVID-19+ patients in the last 7 months. To protect me, my family, and my community, I decided to do testing and do it often, sometimes alternating with testing my antibodies in my bloodstream to know ahead of time, before becoming symptomatic, if I had been infected or not. My family was doing our best to be as preventive as possible by obsessively following the 3 Ws: waiting (being patient in line six feet away from people and socially distancing), washing our hands feverishly and wearing our masks, even when with our dedicated, committed pandemic pod (lovingly called Blexcellence). I was stripping down at the door when coming home from work and running up to the shower before touching anyone or anything. I was wearing appropriate PPE and N95 masks with every patient I encountered and when walking or meeting with staff members. We were sanitizing and wiping down all packages or groceries that entered our home. And, on this Friday night, I tested positive the first time in seven months.ADVERTISEMENT
Imagine my panic.
My husband is Black and a diabetic (two major risk factors), and I have 7 and 9-year-old girls at home. What if I’d gotten them sick? My panic set in. I immediately grabbed and put on my N95 mask I have at home and ran upstairs, leaving my children downstairs without saying a word, to begin my self-isolation in my bedroom. I texted my husband to come upstairs with his mask to come and talk to me about something important. As I waited, I took slow deep breaths to slow down my now racing heart rate. As he approached the door, on his way in, I held up my hand to stop him at the doorway and blurted out, “I’m positive.” His face immediately changed, and I could see the anxiety in his eyes. His worst fear was now here … for his frontline wife to catch COVID. He brought a chair to the doorway, and we took deep breaths together to make a plan for our quarantine and my isolation for the next couple of weeks.
OK, now with my scientist hat on, I thought … what happened? What does this mean? Where did I contract it? Who do I tell first? I had been careful and diligent. My husband and I decided to tell our pandemic pod first since they were our closest possible contacts, and I had seen them 5 days before my test. All of us were masked, and most of them had recently tested negative shortly before or after Thanksgiving. We had a zoom call with them to talk through scenarios, and I finally cried for a little bit after having to say it out loud to someone else outside of my family that I “had COVID.” The pod began thinking of when each member would get tested.
But, did I, in fact, “have COVID”? I thankfully had zero symptoms. I didn’t have fever, cough, fatigue, headache, shortness of breath, loss of smell or taste, diarrhea, or any of the textbook symptoms. This would remain to be true throughout my quarantine. Thank God. However, I was afraid that the other shoe would drop every day, that I would become ill, and my husband would have to call 911 to take me to the hospital, and that no visitors would be allowed. I took my temperature twice a day, and my family and I stopped taking elderberry (there is thought that taking it during infection can worsen symptoms) and began to take increased amounts of vitamin D, vitamin C, zinc, and I added aspirin to prevent heart and blood clot issues. I drank orange juice and had chicken noodle soup daily (shout out to my neighbor for dropping some homemade soup off).
My family went the next morning to have drive-up PCR swab tests, and I decided to do it, too, since it was available. Ultimately, everyone’s tests, thankfully, returned negative, including mine. This caused even more confusion. Did this mean my test was a false positive (the literature says the rate is extremely low for the PCR tests)? Had I caught myself at the end of my infection from days or weeks prior on Thursday and cleared the virus by Saturday? Was my PCR sample spun down for too long, and it resulted in a positive test? I still don’t know. I’m going to wait on my antibody levels to help tell the rest of the story. However, that still may not answer all of the questions. We decided to do the most responsible thing and pretend it was positive, that I had the infection and began my quarantine from the world and isolation from my family for at least 10 days. I set up a work area to do virtual patient visits, and my family left food and other items at the door.
It was depressing mostly, with moments of quiet relaxation. I stared out the open windows a lot or watched senseless TV, mixed with COVID updates and social media. It definitely took mental toughness to remain uplifted and faithful while alone for the most of the day and sleeping alone at night. I had some tears while remaining connected with Ric and the girls via Google Hangouts and video chatting while they were in virtual school and working remotely. I thrive off of physical touch and affection.
My staff, family, co-workers, and pod members all tested negative. The last known patient of mine that had tested positive was seen three weeks before that. I still don’t know where I contracted the infection, but I thank God that my family and I have remained well. Since all tested negative twice more now, I have rejoined my family in our home. I’ve decided not to go out in public or return to work until after day #14, just to be safe.
While all of this was happening, the first Pfizer COVID-19 vaccine was administered.
But, before I get to my feelings about that, let me say this about how people react when a patient tells them they have tested positive for COVID-19: They don’t know what to say. Once my patients began to figure out that I was on quarantine, they were both scared for me and scared for themselves if they’d been seen within the prior two weeks. Reactions were either hot or cold and rarely lukewarm. The patient feels like a leper often. Either loved ones flipped all the way out in fear and became afraid that death was upon me (like my 9 year old tearfully did) or that I was going to be fine and it wasn’t a big deal because I was asymptomatic. When I tested negative two days after testing positive, I had to redirect friends who thought I should stop being dramatic and return to “normal life” because obviously, the original test was incorrect. The truth is, we don’t know. There have been many horror stories when patients thought they were fine and didn’t have symptoms and ended up hospitalized, intubated, or worse in a matter of days. I was hurt and offended by those who didn’t seem to realize the emotional burden that my family and I was going through, not knowing what was happening and not seeing or touching each other as we normally would. However, we did have faith in God and had prayer warriors everywhere, putting in a good word for us with the man above. My wonderful pastor sent me a healing scripture to repeat daily and meditate upon to build up my faith muscles and remain positive (in thinking).
So, now on to my thoughts on the arrival of the new vaccine. I was excited and cautiously optimistic about watching the first nurse, a Black essential worker in New York, receive the first shot here in the U.S. I reflected on how many people have been lost, infected, and affected by this horrible pandemic this year. I remembered the fear we all had as doctors and providers in clinics as we knew the obligation we had to serve and protect our patients, all the while risking our own health and families’ health in serving them. I pondered how many people are still not following the 3 Ws or think that this virus is fake, as I remember the many virtual funerals my family members and friends have had to attend from those lost. I cheered on my colleagues that shared pictures and videos of them receiving the vaccine. I was on TV on the news twice last week and on the radio once after announcing on social media that I tested positive to share my experience. And, when I was asked the inevitable question, “Doc, are you going to take the vaccine?” my answer was “Yes, eventually.”
Apparently, one of the news stations I appeared on received backlash for my interview because it appeared that I was discouraging the Black community from getting the vaccine. I understand how that could have been perceived. I also understand that this comes with the territory of being a voice in media. There will be nay-sayers, and there will be negative feedback. But this perception could not be farther from the truth. I am a Black female physician, and with being all of these, including a wife and a mother, comes great responsibility. I speak to my patients the same way I speak on media: honestly and with transparency. And the truth is, I have questions about the vaccines. The good news is, with more and more of my colleagues receiving the first dose and having positive experiences and Dr. Fauci being able to speak more openly about the pandemic (he was muted a lot by the current administration when he should have been leading these efforts) and the vaccines, I am becoming more comfortable. I will always be a patient educator and advocate, allowing people to make their own educated decisions for themselves and their families for their own health. My job is not, nor has it ever been, to convince or force patients to do what I want them to do. I give the information or the avenues to get more information and encourage all to make their own informed decision. This is especially important for the BIPOC (Black, indigenous, people of color) community, which has largely been disenfranchised, disadvantaged, and marginalized by the medical community and in politics, so this is how I operate. This is what I owe them. If that is perceived as being discouraging, those individuals are largely misguided.
I will get the vaccine, eventually. I likely will not have access to the vaccine until early spring 2021 because I am an outpatient physician and not one in the hospital or a nursing home facility. That means I’ll have time to watch and wait and see which version and manufacturer of the vaccine has been helping the most, which one we’ll get in our clinic and how the BIPOC community responds medically to it, and which ones cause the least amount of side effects. But, let’s be clear, we’ll all need to get a vaccine, along with its booster shot (depending on the manufacturer), to all move on from this global pandemic. It won’t go away unless we all do our part to increase herd immunity, and part of that includes getting this vaccine. Period.
C. Nicole Swiner is a family physician and can be reached at #docswiner.
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