Surviving Covid-19 Part 2

A Filipino doctor in Texas and a Filipina nurse in the UK reveal their survival stories from the frontlines of the global fight against the new coronavirus. 

Yes I was scared,” said Dr. Emanuel Mantilla, a neurologist/neuro-oncologist based in Fort Worth/Dallas, Texas in the USA. “I was scared for my family, my kids are young, and my wife. If I succumb to this disease then who will take care of them?

“You know, I’m a physician, I took the Hippocratic Oath to save people’s lives, it’s unfortunate that I got something that could potentially prevent me from going home to my family because of work. To be honest, every day that I go to work, I’m torn between fulfilling my commitment and responsibility as a physician and potentially letting my family down. It’s something that I struggle with, because every day that you do your patients’ rounds, every day that you treat your patients in clinic, there’s this potential that you will get the disease and won’t be able to go home to your family.”

“It was my faith in God that kept me strong because I know on our sickbed He will sustain us. And the prayers of the people we love helped us to win the battle,” explained April Mendoza Ilejay-Gadayan, Intensive Care/Recovery Nurse based in Birmingham, England.

“I know that God is in control of everything,” declared Mantilla, “but I also know that God puts people in the right place to help our current situation. I know that there’s a pandemic going on, and I know that God is not asleep through this. God puts scientists in place and helps to develop the vaccine, then God places doctors and nurses to take care of the sick. My background is science and I know that God put us here to help stop this pandemic.”

For both Gadayan and Mantilla, their personal and professional lives clashed the moment they were diagnosed with COVID-19, testing their knowledge, skills and courage.

“Now I had got to the point where it was real, I had the disease,” said Mantilla, who has two sons, 8 and 2. “I met the criteria for treatment based on the inflammatory markers on my blood count, x-ray and also clinically because they had me do a walking test for about 5 minutes to monitor oxygen saturation. I started receiving antiviral medication. Also, there’s an experimental study of treatment with plasma from recovered COVID-19 patients, there hadn’t been a randomized controlled study yet. I decided it was reasonable for me to take it.

“I tried not to overdo it, I had some supplemental oxygen and basically I tried to be a good patient. After the 5th day my symptoms were stable. They were keeping an eye on my liver function which is a probable side effect of the medication, specifically remdesivir. It built up initially as expected, but then it stabilized and actually trended back down. The physicians let me go home because I was stable after five days of intravenous remdesovir and symptoms were not getting worse, I had no fever for 24 hours then I was clear to go. I was so happy to go home and to see my family again. The battle didn’t stop there though, a lot of the recovery process happened at home.”

In Birmingham, Gadayan’s knowledge was essential to her self-treatment. “I worked in intensive care so I knew that if ever I had shortness of breath to put myself into a prone position. I bought a pulse oximeter: if saturation reached 90 percent I would take it as a reminder to do deep breathing exercises, and even if I was really tired I would just encourage myself to sit upright. It’s like chest physiotherapy, it makes your lungs fully expand even at the lower part where the lungs tend to collapse.”

Both Mantilla in Texas and Gadayan in the British Midlands paid tribute to Filipino health care workers around the world. “A lot of my Filipino friends are in health care in one way or another, nurses, occupational therapists, physical therapists, you know?” said Mantilla. “Medical technologists, laboratory technicians, caregivers, doctors, a lot of Filipinos are at work in the hospital and that’s where the battle is. Every day they go to work, exposing themselves on a daily basis, they are making sacrifices so that patients who have COVID-19 can go home back to their family, and putting themselves at risk. Filipinos are the frontline of this battle against COVID.”

Nurses’ training standards and family values are a large part of what drives them to take these risks, according to Gadayan, and so is poverty in the Philippines. “We were brought up generally as a Filipino with a strong sense of responsibility, (on top of that) when we do nurses’ training we learn skills, knowledge and attitude to work. When we are told ‘Go there’ we will agree. It’s like nurses are ashamed to say no to our superior, you don’t want it to be said about you that you are trying to decline your job,” said Gadayan. “I think most probably for those who have just started work and migrated from the Philippines, of course they want the job, it is important to them. If you’re just new you have to show how you work, to prove something, at the same time you know that this life is better than it was in the Philippines. They don’t want to go back, they need this money, they need this job because of the poverty in the Philippines. We just adapt to the job, we have to do it even if we’re at the frontline and our lives are at risk.

“No virus can affect our sense of responsibility to our family in terms of poverty. So people will continue to try to get out from the Philippines to work abroad – parang risk-taker tayo. Mamatay ka sa hirap o mamatay ka sa virus? Marami’t marami pa rin ang mag pa-produce ng mga Filipino nurses going abroad.”

Mantilla has confidence in the development of vaccines to protect everyone.

“I think the worry and the fear comes from the expedited process of having the vaccine approved. But the process of making the vaccine, of getting the protein out of the virus and working in the lab to make a vaccine out of it is still the same process as all the other vaccines of other diseases. The government just cut out the red tape to make the process quicker. This still (went through) randomized controlled trials which for me, as a physician, is the standard of care for any medication or vaccine. For me this is legit evidence to base your medical practice on and because of that I trust science, I trust the process of having the vaccine developed just like any other vaccine that I have allowed to be inoculated in my body.”

It will take months, if not years, for most people to be vaccinated. In the meantime Gadayan advises everyone to act as if everyone else has the virus, wear a mask, wash your hands and sanitize surfaces. Mantilla agreed caution is still needed: “As a physician I took the oath to save people, but during a pandemic everybody has the opportunity to save someone’s life, and ending this pandemic.”