“Jason, Jason, Are You Okay?” A Tale of March Illness

My last post prompted some back-channel questions about how I’m doing. Which is touching. So please permit a brief* follow-up post answering that question publicly.

* 1,600 words is “brief,” right?

A Wasted March

The first week in February, I thought I was coming down with a cold. However, by the time I took my buoyancy class on February 6, it cleared — and two days later, I jetted off for a week in sunny, spectacular Bonaire. And I didn’t feel at all sick on the island. However, one day on a dive, I think I might have given myself a mild over-expansion injury. I had a fast ascent (almost 60 feet in two minutes, which is the top end of the recommendation) while maintaining buoyancy solely through breathing and not by playing with my inflator or dumps. Later that evening, I experienced a bit of trouble breathing and some chest tightness, but by the next morning all was well. So I shrugged that experience off as a nod to the age-old diver warning to never hold your breath.

Our return trip routed through Miami International Airport on Saturday, February 15. At MIA, we packed cheek-by-jowl in a petri dish of humanity for two hours, in addition to back-to-back, full, three-hour flights in (alas) coach. 

About 10 days later, I got a cold, but it was an odd one. First, it was remarkably mild. And second, it stayed purely in the upper respiratory tract. No sore throat, no cough. That pattern was unusual; usually my colds always migrate to my lower respiratory tract with a sore throat and a cough. Instead, I just experienced two weeks of occasional sneezing and nose-blowing and mid-grade exhaustion. Not enough to be debilitating, but certainly enough to induce me to do just the minimum.

By the middle of the first week of March, the cold persisted, but the exhaustion got a bit worse. Again, not debilitating, but after I finished work, I was done for the day. No writing, just … existing, watching YouTube videos or staring blankly at my computer screen realizing I intended to write but couldn’t be bothered to move my fingers. And, oddly, I became significantly cold-sensitive. No fever, but just consistently chilled, which is odd because Michigan winter is my jam and my office this time of year typically clocks in somewhere between 52 and 56 degrees Fahrenheit. I actually turned up the furnace and kept a blanket on me and kept my feet on a hot pad.

Two weeks later, on March 18, things turned worse. For the next week, I alternated between feeling okay-ish and not. The pattern was consistent. Between 8p and 10p, a slight fever, somewhere between 99F and 99.6F oral (my baseline oral temp is around 97.5F) with intense chills set in. I’d go to bed and poor Murphy d’Cat couldn’t understand why I couldn’t stop shivering violently despite four blankets. But by morning, I’d be sweaty yet the fever broke. Until the evening. I yo-yo’d like this for roughly a week. I also developed a very slight cough, never productive.

One night — Friday the 20th — I woke up at 3a unable to breathe. Tight chest, labored breathing. I was thiiiiis close to thinking about going to the ER until I remembered I had a pulse-ox monitor. So I took a few measures, saw my sats were 96 or 97 or 98 percent, and figured I was talking myself into a worst-case diagnosis, so I went back to bed. Didn’t sleep much, granted, but I went back to bed nonetheless.

On the 23rd, I called the doctor’s office. Turns out, I needed a new doctor; mine doesn’t accept my new insurance, although the nurse triage line was kind enough to tell me that I should self-quarantine and there was no need or capacity for COVID-19 testing. Later that day, I found a new primary care doc, but because of the COVID crisis, I couldn’t be formally enrolled with a new-patient visit for 90 days. So, I’ve got an appointment … in mid-May.

By the 29th, the cold-like symptoms and the fevers mostly stopped, but it wasn’t until April 1 that I actually felt decent.  

Tips for Staying Virus-Free

My assumption through the long, tired slog through March was that I had the cold and then the flu. However, neither the cold not the flu behaved like normal — the obvious assumption is that I had COVID-19, but even then, my symptom progression didn’t really match a typical COVID-19 case: I never experienced significant shortness of breath, my fevers were mild (and, strictly speaking, didn’t seem to cross the 100.4F mark), and I didn’t develop a persistent cough.

I’m a fan of the Dark Horse Podcast, hosted by Bret Weinstein. He and his wife, Heather Heying, have been “sheltering in place” in Oregon so they’ve been live-streaming on YouTube twice each week. They’re both evolutionary biologists, famous for the kerfuffle a few years ago at Evergreen State College. They’ve shared some fascinating information about COVID-19, including Heather’s likely experience with it much earlier than the general pandemic in the United States. They offered some great information about the disease and its origins in their first and second livestreams. Their third livestream kept up the theme (it covered bats, bio-weapon theories and the social implications of the pandemic). I had asked them a question and, in the separate Q&A livestream they conducted, Bret actually answered my question about masks (by name!), which left me kind of geeked.

After reviewing some CDC materials and seeing how Weinstein and Heying addressed the subject, I think the odds are well above average that I acquired COVID-19 but my case was mild enough that I avoided hospitalization. It’s improbable, giving timing, that I was infected in Miami, but it’s also possible that a sequence of unfortunate events — potential lung over-expansion plus a mild cold — left me a bit more open to a lower respiratory infection than I might otherwise have been. However, without a test, this hypothesis cannot be verified. And in Michigan right now, there’s no capacity for screening for people who aren’t seriously ill.

One interesting educational tidbit that I learned from Weinstein and Heying relates to more advanced infection prevention. Everyone, of course, should follow basic guidelines for minimizing infection risk:

  • Wash your hands for at least 20 seconds with soap and water.
  • Do not touch your eyes, nose or mouth with un-washed hands.
  • For the coronavirus, wear an appropriate mask when you’re in a public space, and practice social distancing of at least 2 meters from everyone else at all times.

Weinstein recommended a few other precautions, to which I’ve added a few of my own:

  • If you don’t own a supply of N95 masks, make due with a doubled-up bandanna. Wear it over your nose and mouth in public, as if you were some sort of Antifa thug. A bandanna (or, as I’ve been wearing, a cotton shemagh) is likely highly effective, if not as good as an N95 mask, given the vector of coronavirus infection. Wash it daily. Clinical evidence from a 2010 study published in Applied Biosafety suggests bandannas are 11 percent effective at blocking 1 micron particles. The coronavirus is 100 to 120 microns and travels in droplets, suggesting that a well-fitted bandanna face covering could be something above 90 percent effective or better in blocking the virus. As they say — good enough for government work. (Weinstein recommends the bandanna in the absence of N95 masks, and my question to him in the livestream addressed this journal article.)
  • When you get home from a trip, strip and shower immediately and do not re-wear clothes. Virus particles could land, e.g., on your hair and then transfer to your pillow or to your eyes/nose/mouth through inadvertent touching. The SARS-CoV-2 virus is believed to live just a few hours on fabric, but that’s all it takes. If you decontaminate yourself after you get home, you substantially cut this risk.
  • Men with epic beards — yeah. You do know that they’re massive infection vectors in any case, right?
  • If you can sanitize your cart handles or basket handles at the store, do so. Sanitize them before you actually use them.
  • Decontaminate your hands with soap or alcohol sanitizer before you enter the store and before you get into your car. It’s not necessary to wear gloves in the store given that coronavirus doesn’t lead to COVID-19 through direct skin contact.
  • After you put your groceries away at home, wash your hands. The coronavirus can live up to a week on hard non-porous surfaces, so assume all the packaging of your groceries are contaminated. As such, wash your hands after touching all this stuff, especially before/during/after meal prep.
  • Safety glasses or sunglasses with side protection limit viral exposure to the eyes.

Lots of people have suffered from COVID-19, but emerging anecdotal evidence suggests it might have passed through parts of the country, especially California, earlier than people assume. Given that those early mild-to-moderate cases were likely misdiagnosed, odds are good that many more people have contracted the virus and either proved asymptomatic or experienced non-acute symptoms that have kept them out of the denominator of public-health stats. Until serology tests hit the market, however, we have no way of knowing who might have encountered the virus but avoided COVID-19 infection, or who encountered it and experienced mild symptoms.

Did I have COVID-19? Hell if I know, but it’s more likely than not. Some of my symptoms are consistent, some aren’t. Then again, my “cold” and “flu” weren’t typical, either. All I know for sure is that I basically lost the entire month of March to a mild, yet real, malaise — one that didn’t break until April 1.

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