I Am Baja’s First Covid-19 Case…or Am I?
Special to JenniferMargulis.net
I live and work in Baja California Sur in northwest Mexico. As of this writing, March 17, 2020, there have been no “confirmed” cases of Covid-19 in our region. But I believe I am Baja’s first CoVid-19 case, even though it’s unconfirmed.
Let me tell you why.
No, I’m not a hypochondriac. I’m not attention-seeking. I’m not looking for an angle. I am an environmental scientist. But I’m also on Day 12 of a brutal illness. Feeling as sick as I do right now, I’m learning more than I ever thought I would about how the world treats, reacts, and cares for victims of CoVid-19.
Tourists arrive in Baja daily. A week ago, I began to wonder how we continue to remain virus-free.
Then my own illness became my teacher.
Just a Cold
I had a cold. But not just any cold. This one was a MoFo, especially the cough.
I had a dry hacking cough that squeezed my lungs and made my eyes water. It gripped my whole body. My stomach clenched so tightly when I coughed that all too often the coughing would make me pee.
No, that’s not normal for me. I’ve barely turned 50 and I’m in good health. I surf. I hike. I’m not incontinent. I don’t usually pee myself.
On Day 3 of the cold, I woke up with aching bones that made me think I might have dengue fever. Except dengue doesn’t make you cough. So by Day 4, I really started wondering if the illness I had wasn’t just a common cold.
For three days I tried to rest while keeping up on work. I ate lots of fruits and vegetables, upped my vitamin C intake, drank bone broth and kombucha. I took probiotics and pushed the liquids, liquids, liquids (which, as you can imagine, did little to help the urination situation.)
I hadn’t made the connection even a little in my mind yet with the news happening in other parts of the world about the spread of coronavirus.
As I said, Baja’s first case of Covid-19 in Mexico wasn’t a thought that crossed my mind. I texted my friend who lives in Italy to check in on him, not even thinking about myself. It was Day 1 for him. Not of a cold, but a historic, nationwide lockdown.
Italy was long, long gone past its first Covid-19 case.
“I’m fighting a nasty virus over here,” I texted. “Never felt such pain in my body as yesterday morning.”
“Uh… personally, I’d get a test,” my friend texted back.
And then it opened up in my mind.
“Hmmm… been wondering…”
Soon he sent me a link to basic information about the novel coronavirus. We struggled to find reliable information. As a scientist by training, I wanted to separate fact from fiction.
After some thought, I texted my doctor. He told me there weren’t any tests available in Baja California Sur and there were no cases reported in the state. He texted I should STOP panicking.
I think he thought he was being funny.
I told him I wasn’t worried, which I wasn’t.
I hate to admit it, but I felt reassured. Doctors know what they’re talking about. Right?
I’d been sick for five days but I went back to work
My doc told me to stop panicking. I had a cold or a flu. I needed to go to work. I took some real estate clients on a tour for a couple of hours.
My job brings me into contact with a lot of travelers. I was cautious, just like I am every time I have to be in public when sick. I avoided touching anyone. I brought tissues to cover my mouth and water to stem any coughing fits. I let others open doors and avoided touching surfaces.
But my clients traveled in my car from house to house. At one point, I had to retreat to a bathroom to quell a coughing fit and pee.
That night when I lay down I noticed an unusual sensation in my chest.
The lower part of my lungs felt leaden and there was a sensation in them like I was holding my breath, even though I wasn’t. My mind flashed to my father, who died of pulmonary fibrosis.
I suddenly understood how he must have felt in the middle stages of his illness. I’d watched him cough until his eyes watered, doubled over, sucking in air between coughs.
For the first time since I’d become ill, I started feeling fearful, realizing that I must have something worse than the common cold.
That night, the coughing wracked my body. I was coughing so hard I thought I would throw up. I remembered I had two valium a friend had given me (“just in case”).
Being unfamiliar with the drug, I took a quarter tablet. It did the trick. With the help of the valium, I managed to fall and stay asleep.
Instead of getting better, I got worse from the first Covid-19
The next day I knew something else had me in its grips no matter what the doc had told me. I thought I was getting better the previous day but I was worse. Much worse.
(As the New York Times has reported, this is what happened to a young woman who was a medical professional and was among the first Covid-19 deaths in China.)
I texted my boss to say I wouldn’t be able to attend our morning sales meeting. I called into a smaller meeting later that morning. The sound of my own voice caught me off guard. It had changed from the previous day’s Lauren Bacall sexy huskiness to a baritone.
“Dawn?! Is that you?!” the sales director asked.
Then I got my research instinct to fire up. It wasn’t easy. It’s hard to think clearly when you’re sick. But I needed reliable information.
I checked the CDC website. It mentioned dry cough, fever, and fatigue.
I checked the National Institute of Health website. Same list of symptoms.
Guilt swept me up about my time out in the world the day before.
I needed the damn test even if it meant I would be Baja’s first coronavirus case.
I found the “official” phone numbers for Baja’s public health team. Should I call? I didn’t want to overreact. It was almost eight o’clock at night. I doubted anyone would answer.
“Buenas noches, Secretaria de Salud, Dr. Flores a sus ordenes.”
I filled the doctor who answered in on what I had been experiencing and mentioned my doctor had told me there were no tests available.
“Well, there are tests, but they are held by the Secretary of Health in La Paz and there are criteria that must be followed before we can administer one. Have you traveled out of the country recently, or have you been in contact with someone who has a confirmed case of the virus?”
He interrupted me before I could complete my answer.
“Then what makes you think you have the disease when there are no confirmed cases in the state?”
“Please understand, I’m not panicking. I’m a scientist. I have a master’s degree in biology. I understand how disease transmission works, but I have all the most common symptoms and I work at two hotels full of tourists.”
The doctor dismissed my concerns. “Look, it’s much more likely that you have the flu. You should stay home. Avoid other people because unless you’ve been in contact with someone with a confirmed case of the disease I can’t do anything for you.”
I’d let myself get bullied out of doing what was right once already. I tried again, this time more forcefully.
“If this is the flu, it is unlike any I’ve ever had. Don’t you think it’s irresponsible not to determine whether I have the disease? At some point, someone is going to have to be tested or the disease will spread undetected. Don’t we owe it to people to figure out as early as possible if it’s here so people can start taking more precautions?”
“I’m sorry, but we must follow the protocol for using the tests.”
I thanked him for his time and hung up dismayed.
I reached out to the doctor I’d spoken to on Day 4 and told him about the strict criteria the authorities were using to determine who should get tested.
“Yes,” he texted back, “that is correct. Obviously you don’t have CV19.”
“Why do you say that?”
“Because you haven’t been in contact with anyone who’s positive based on a lab result. Go to the hospital to get checked out and so they can explain it to you.”
“I understand the concept,” I replied, “but it’s wrong to say it’s impossible. A person with the virus can be asymptomatic.”
“Go to the hospital and get the tests then. I can’t send you to have a test because I don’t have any control over the management of the tests. I’m very sorry. Perhaps you should consult with a lung specialist?”
He sent me the contact information for Dr. Bernabe, a pulmonary specialist I’d seen in January when my long-absent asthma reemerged.
I chastised myself. Why didn’t I think of him? As a pulmonary specialist who already knew my history, he might be more open to my concerns.
It was 8:30 p.m. I texted rather than call him with my symptoms and situation. To my surprise, he called me immediately.
“I agree with you completely. You need to be tested. I’d like you to come to my consulting room tomorrow morning so I can examine you and do the necessary tests.”
Day 7 of being sick, finally being tested for Baja’s first covid-19 case
I went to the clinic in the morning. As a nurse took my vitals I was hyper-aware of her bare hands and unmasked face. My heart rate was higher than normal, but still within normal limits. Everything else was normal. As I waited for the doctor in the hallway outside his office, one of the receptionists appeared and, arm outstretched, handed me a surgical mask.
“Put this on,” she said tersely.
Dr. Bernabe looks like a real-life Doogie Houser. He’s professional and confident without the arrogance of so many doctors.
He pulled a mask out of the drawer in his desk and put it on, quickly reviewed my vitals on a small piece of paper the nurse had handed him and listened to my lungs with his stethoscope. He returned to his seat on the opposite side of his desk and pulled out his prescription pad and began writing.
“You don’t have pneumonia. That’s good,” he said and started prescribing me things to help. He cautioned me about the risk of secondary bacterial infection. Then he looked up from writing the prescription and put his pen down.
“As you already know, there are protocols established by the Secretary of Health we must follow in order to test anyone for the coronavirus. I think I have a solution to this problem. I’m going to test you for influenza. If the test comes back negative, I think I can convince the authorities that we should test you for the coronavirus.”
I needed to be tested by the process of elimination. Smart guy, I thought and relaxed a little more. A technician gave me the test and the doc told me to get the meds and go home. The results would arrive by email sent to both of us.
A little over an hour later the email arrived.
I texted Dr. Bernabe.
“The test is negative. I know there’s a possibility it’s a false negative. When do I come in for the Covid-19 test?”
An hour later I still hadn’t heard from him. I didn’t want to be impatient, but he’d said it would take three hours to get the results and it was now afternoon. I sent him another text.
He responded a few minutes later, “I’ll confirm with you in one moment.”
An hour and 20 minutes later, I still hadn’t heard back from Dr. Bernabe. I imagined that he and everyone else involved wanted to get this thing done and wondered what the hold up was. Maybe they had to put measures into place to prevent transmission of the virus to staff and other patients. If this was the first suspected case they’d had in Los Cabos, they might be in panic-mode. Maybe they were debating where they should do the test. I nudged him with another text.
“Hola Doctor, any news?”
“They’re going to let me know.”
“Could you clarify, please? Are you waiting for the test to arrive?”
“Not exactly, I’m dealing with operational questions from the Secretary. Their epidemiological protocol.”
My head began to throb. I needed a nap, but there was work I needed to attend to and friends kept texting me, wanting to know if I’d had the test yet. At four o’clock, I received a phone call I thought was Dr. Bernabe’s number.
“Doctor Bernabe?” I answered.
“No, this is Doctora Smith, epidemiologist, Secretary of Health.”
“Oh…” I wondered if this was a step forward or back.
“I have some questions I need to ask you as part of the epidemiological protocol we must follow before the Secretary can allow you to be tested.”
My heart sank. I knew those questions would include, “Have you traveled recently or been in close contact with a person who has a confirmed case of Covid-19?”
She went down a long list of questions, asking me about every organ in my body.
I stopped her so we could cut to the chase.
“The only health conditions I have are asthma and hypothyroidism.”
She asked me the two sticking-point questions and I explained, again, how I was in regular contact with tourists from the U.S., Canada, and other countries.
She finished our conversation with this: “Can you please tell me who you’ve had contact within the last two weeks? Anyone you’ve been within two meters of. I need their name, age, address, phone number, and email address please.”
“Shouldn’t we find out if I have the disease before we go to all this trouble compiling lists? Aren’t you doing this backward?”
“This is part of the protocol to determine if we can give you the test. There are criteria you have to meet in order to receive the test. This is the protocol established by the Centers for Disease Control.”
“Look, I’ve been in contact with a lot of people. This is going to be a long list! Do we have to do this over…”
She interrupted me, “Please send me a list by email. I will text you my email address.”
I hung up. I really needed that nap. I blasted off a list of six people I’d had the closest contact with.
I got a text from my friend Jane less than five minutes later.
“Your epidemiologist just called me to ask how I’m doing. I told him I was fine.” A toothy grinning emoji completed the text.
I pictured my clients freaking out when they got a call from an epidemiologist asking them if they were feeling ill. I texted them immediately to let them know what was up. They took it in good stride.
And then I waited.
No such thing as free with first covid-19
Toward the end of an exhausting day, Dr. Bernabe texted.
“Well, the Secretary of Health says you do not meet the criteria following the rules established by the CDC,” he wrote.
He followed this with a text all in English that was apparently an official boilerplate response, which came back to the fact I had no known contact with someone with the disease. It turns out to be Baja’s first coronavirus case, you actually have to be second or 90th or whatever.
There can be no first.
He apologized and told me I could have a blood test and send it to Guadalajara. The results would come back in five to seven days and the cost was 9000 pesos (about $450 USD).
“Crazy, I know,” he texted.
I explained that was almost my entire rent for a month and the delay meant the results would be virtually meaningless. Furthermore, if I had to quarantine myself, I needed to explain to the executives at my brokerage why I couldn’t work my shifts. He apologized again and said he understood that I just wanted a clear answer so I could warn people I’d been in contact with, without sounding like an alarmist.
“So what do I do?” I asked.
“The worst part of the illness is over. You still need to self-quarantine for at least five more days.”
He signed off, “Feel better.”
Day 12 and feeling like I’m going to be okay
I’ve been sick for twelve days. I’m taking the antiviral medication and cough suppressant the doctor prescribed. I’m improving. I sit at my desk in a house on the shores of the Sea of Cortez, an hour from the city, a world away from bureaucratic insanity. In the Mexican state of Baja California Sur we still don’t have a single confirmed first case of Covid-19. And it’s pretty clear why.
To date, only nine Covid-19 tests have been given in BCS. We have just over 1,000 hospital beds in our entire state, 125 of which can be converted to inversion beds for patients with serious respiratory illness, and 119 ventilators, according to El Sudcaliforniano.
If you don’t ask the right questions you can’t get meaningful answers. Since public health officials insist on employing criteria that negate repeated contact with tourists as a significant risk factor to test for Covid-19, we have no idea who, if anyone, has the virus down here.
Did I have the first covid-19 case in Baja California Sur? It looks like we’ll never know.