A Lone Exit

Anisa is back home after a 14-day quarantine and waits for a call from the hospital about her husband Arif’s condition. Arif’s younger brother Irfan knows that she will never get such a call. The last time he talked to Arif was on March 29th. A few hours later, his brother was dead. “I spoke to him just five minutes before he was shifted to a government hospital. He told me he was feeling much better than before and that the hospital staff at CHL took good care of him. His voice was a bit low because of his sore throat,” says Irfan. That was at 9 PM. The next morning, he got a call saying Arif, 41, had passed away at 3 AM. Irfan is in the dark about what went wrong in those few hours. He does not know who was by him or if he said anything. He is still puzzled. The only words ringing in his mind are of his brother saying he is feeling better.

On a mid-March afternoon, Arif had returned home from his tailoring shop in Indore with fever. His blood test showed he had malaria. But, with no sign of improvement after treatment, he visited another hospital. The medication still did not help him. On March 22nd, the day of the Janata Curfew announced by Prime Minister Narendra Modi, his condition worsened. The following day, a doctor advised him to take a test for coronavirus. As his condition kept deteriorating, the family took him to at least five hospitals. “Nobody was ready to take him in. The situation was bad,” says Irfan.

On March 24th, a day before the countrywide lockdown started, Arif was tested for coronavirus. He was immediately isolated from the rest of the family. On March 27th, the result showed he had tested positive for SARS-CoV-2, the virus causing Covid-19. Immediately, 11 members of his family were quarantined. All of them underwent tests and five of his relatives tested positive. Arif had no history of travel or contact with anyone who had travelled abroad. His family was shocked. There was fear, uncertainty and anguish. “We have no idea how he contracted the virus. It could be from a customer at his tailoring shop,” says his brother. Arif, who stitched suits for men, used to earlier shuttle between Indore and Betma village, 20 kms away. But eight years ago, he had moved to Indore where he ran the shop in partnership. Irfan describes him as a simple man who would leave home for work at 9 AM and return at 10 pm. Outside Indore, the only place he visited was Dahod in Gujarat, where his in-laws lived. Overnight, life changed for the entire family. Anisa has not seen her husband since March 24th.

Dr Suraj Verma, chest specialist at CHL under whom Arif was hospitalised, recalls that he often asked about his relatives. Though he was yet to be tested for coronavirus, the hospital had started treating him for Covid-19, and he was isolated the day he was admitted. As per protocol, no relative or friend was allowed in to see him. Only the doctor on duty and hospital staff had access to the ward. “Like most patients, he wanted to see someone from his family, his wife, children, brother, etcetera. He would say, ‘show them to me just once from outside.’ But there’s enough awareness about the disease and when we tell these patients about the risks involved, they understand,” says Dr Verma.

Arif would watch television, which is provided by the hospital in isolation wards, and speak to the nurses and other staff while having his meals. That was when his biPAP (Bilevel Positive Airway Pressure) machine was removed so he could eat. He was allowed to speak to his relatives twice a day—once in the morning and once in the evening, on the hospital line. He would talk to his brother occasionally. Being on ventilator, Arif was not allowed to keep his mobile phone with him. Usually in such conditions, all they want is for someone from the family to be near, says Verma.

As someone who has attended to Covid-19 patients, he admits that in isolation the patients undergo depression. “We try to motivate them. We keep telling them about improvements in their reports and parameters. We make them talk to their relatives. There is panic even among asymptomatic persons and so it’s understandable how much more worried symptomatic patients would be,” he says.

Arif had been running fever for seven-eight days before he was admitted at CHL hospital, diagnosed with malaria. “When he was admitted, he was breathless and his saturation level without oxygen was 87-88 per cent. With oxygen, it rose to 94 per cent,” says Dr Verma. A chest x-ray was conducted, and he was detected to have bilateral pneumonia. He had high-grade fever. The next day the oxygen requirement had increased. The doctors started treating him with anti-malarial hydrochloroquine, azithromycin and antibiotics. As his oxygen requirement went up, he was given ventilatory support. After 48 hours of admission, his condition had started improving. By the fourth day, his oxygen requirement had reduced. The x-ray showed improvement. Arif’s initial fears gave way to hope. On the fifth day, the government machinery took charge. He was to be shifted to a government hospital.

The toll, updated each day, may just be a number for the rest of us, but for each family of the deceased, it’s a saga of pain. For relatives and friends, scattered in isolation wards or quarantined somewhere, at times cut off from the
last rites, the reality takes time to sink in

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“I was not on duty when he was shifted. He asked why he was being shifted and requested to be allowed to remain at CHL,” says Dr Verma. Since CHL was not a Covid-19 dedicated hospital, he had to be moved out. The doctor spoke to his relatives and told them he was stable. Arif told his brother he was feeling better and asked about his family.

But the next morning Irfan got a call from the government hospital to say Arif had died. They told him the body was being prepared as per protocol for the last rites. Arif’s entire family was in quarantine. None of them could go to the cemetery. Some neighbours went. As per local guidelines, not more than 10 persons can attend the funeral, and they too have to maintain social distancing. “In many cases, the family is unable to go. It is sad, but one has to take care of the rest and save them, which is the reason these guidelines have been stipulated,” says Verma.

Irfan hid his tears from the rest of the family. He kept the information about his brother’s death from Anisa. She asks him every day about him. He tells her Covid-19 patients are kept in isolation and that the doctors have asked them not to disturb him. “My sister-in-law is a heart patient. She is very sad. I am scared to tell her,” says Irfan. He is waiting for the rest of the family—the five who tested positive—to return home. He will then break the news to her and return to his village.

The toll, updated each day, may just be a number for the rest of us, but for each family of the deceased, it’s a saga of pain. For relatives and friends, scattered in isolation wards or quarantined somewhere, at times cut off from the last rites, the reality takes time to sink in. They may always wonder what remained unsaid in the isolation ward, with only strangers around their near and dear ones. And, there is more torment— the stigma, even in death.

“The stigma attached to coronavirus is horrifying,” says 40-year-old Peter, a businessman from Shillong, whose uncle was the first person in Meghalaya to become a fatality of the virus. Dr John Sailo, 69, founder of Bethany Hospital, died on April 14th. Denied a burial near his home in Nongpoh, as well as a cremation in Shillong—protesting locals were worried the virus could still infect them—he was finally laid to rest on April 16th at the Riatsamthiah Presbyterian Church cemetery after the government reached out to churches. “Tributes are flowing in now about how he was a gentle and compassionate soul, one of the finest doctors in Meghalaya, and his immense contribution to our society. But all that came after the nightmare his family had to deal with—the hatred, contempt and spite that went viral almost immediately on social media, all while accepting the fact that they could not say a last goodbye to their much-loved and much-respected husband, father, grandfather.”

Nobody from the family could attend Sailo’s last rites. It’s the same story, cutting across class, creed, caste or region, for victims of Covid-19. On April 15th, Sailo’s son-in-law, a pilot who has tested negative twice, put out a statement in which he wrote that it might be pertinent to consider that one of the patients that Dr Sailo treated in the line of duty may be responsible for the transmission. “The search and isolation of this person is where the state’s energy and resources should be directed at.” Seven of his wife’s family had turned positive.

For Sailo’s family, the wounds from the stigma and pain may take a long time to heal. One day, Anisa will be told that her husband is no more. One wonders what would be the first thought that comes to her mind then.

(The names of Anisa and her family have been changed)

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Amita Shah