Editor’s Note: Emmanuel “Manny” Asika spent 10 days at the Isolation Centre in the Infectious Diseases Hospital (IDH) in Yaba, Lagos. An IT professional who took precautions early to protect himself and his family against the novel coronavirus, he was shocked to learn that he had tested positive for COVID-19, when his ‘malaria symptoms’ persisted after treatment. In this exclusive piece for Nigeria Health Watch, Manny shares his journey from becoming a COVID-19 patient at IDH to becoming a COVID-19 survivor and advocate.

I remember waking up early on the 28th of February 2020 to the news that Nigeria had recorded its first case of COVID-19. My first instinct was to restrict movement in and out of my house immediately until we ascertained the details of the index case. We quickly implemented all the safety protocols: no one could enter my house without washing their hands and using hand sanitizers. We even restricted visiting and having visitors around my aged father as we considered him to be high risk. By the second week of March, as the number of COVID-19 cases continued to rise, my organisation decided to close our physical offices and start our Work from Home (WFH) policy. Within my limited sphere of influence, I was literally at the forefront of communicating and educating people about sticking to the required COVID-19 protocols. I had calculated the odds and I was thinking “We are over 200 million people in Nigeria. What are the odds that little me would contract the disease?” I thought I was taking the necessary precautions so I didn’t think that I would get it, not for a second. It was quite ironic, then, when I was told that I had tested positive for the virus.

I thought it was malaria, but the fever persisted
On the morning of Tuesday, 17th March 2020, a day after I started working from home, I noticed that I had classic malaria symptoms: a fever and body aches, so I went to a hospital in Victoria Island, Lagos, and got tested. It never occured to me that it could be COVID-19. My last trip outside the country was over a month before and I had shown no symptoms upon my return. The test results showed I had a bit of malaria, and we treated the malaria for two days. I finished the drugs, but the fever persisted. I got admitted, primarily because I was dehydrated, and I wasn’t eating well at this point. They did all the tests; the stool tests, the blood tests, everything. The doctors were very transparent and said to me, “Your tests are fine, but we don’t know why you still have a temperature and diarrhea.” They said they would do a second level stool culture test to ensure they were not missing anything.

How did we go from Malaria to COVID-19?
A day later, on March 18, 2020, one of the physicians came to me and told me he read the new World Health Organisation (WHO) guideline for COVID-19 and diarrhea had been added as one of the symptoms. He advised that we consider a COVID-19 test. Of course, I rebuffed this at first. How does one go from malaria to COVID-19 in an instant? I wanted to wait a bit longer. Eventually the fever persisted, and we had to do the test. We got in touch with the Nigeria Centre for Disease Control (NCDC) and, a few days later, on March 23, 2020, the test came out. It was positive.

Personally, I didn’t expect it, so I was shocked. I moved from shock, denial, anxiety, questioning and eventually acceptance. I kept the information very close to just my nuclear family, not because I was afraid of stigma but because I knew people who would panic. For the few people I had spoken to already, I could hear the fear in their voices even though they tried to encourage me. They were very worried and rightfully so. With the pictures and images we see from Europe and America, it’s almost like it’s a death sentence. Contact tracing was done, everyone in the hospital, my office, my house and everyone who came in contact with me also went through the process. Those who were exhibiting symptoms were tested. I had a very low transmission rate and I suppose this was because I went to the hospital early.

All roads lead to IDH Yaba
As soon as I tested positive, I was moved straight from the hospital to the Infectious Diseases Hospital (IDH) in Yaba, Lagos. I came in from a very decent hospital and I was concerned. I wasn’t sure what to expect, and I was bracing myself for the worst. But I was pleasantly surprised. We started out in a tent, where we had 24-hour electricity, air conditioners, fans, cleaners who cleaned three times in a day, running water, and very good food. Eventually we were moved to Ward B, a brick and mortar ward.

In the morning, the cleaners woke us up as they attended to their morning duties. The nurses would come in right after with our drugs, labeled with our names. They would also test our temperature and blood pressure. We would afterwards have breakfast. Some of us who were up to it tried to keep fit during the period. We would walk round the large tent in the mornings. This routine was repeated in the afternoons and evenings. In between, we had vibrant conversations on politics, economics, and religion, to name a few topics. There were a range of emotions at the centre; anxiety, solidarity, optimism. There was also a lot of spirituality — we had people who functioned as resident imams and pastors. There was also frustration — at some point we shared talking points and feedback from our experiences, which I think eventually got to the Commissioner for Health and the Governor. We got frustrated with the delay in communication of test results. This I believe has significantly improved today.

We bonded as a group and still have a group chat that is active today. I am glad to say that all 16 of us are now fully recovered. Our group had entrepreneurs, students, politicians, and professionals, and the diverse demographic made for very dynamic and unforgettable conversations. I believe our camaraderie was key to our collective recovery.

Frontline health workers; true warriors, true heroes
It was from some of those productive conversations that we developed the idea to shed some light on what was going on in the isolation centre. We wanted people to know that testing positive for COVID-19 wasn’t a death sentence. We were having something close to a normal life in the isolation centre. We were not all on ventilators or drips. We also wanted to appreciate the health workers. We were so impressed that we created the video appreciating the doctors, nurses, cleaners and all the support staff. It went viral. Despite the far from perfect conditions they never had sour dispositions, they were very friendly, supportive and professional. I would rate them 9.5 out of 10. We had their numbers on speed dial and they were available 24/7 to respond to us. Treatment was personalised, so it was not one-size-fits-all. For instance, people who had underlying conditions had a separate treatment regime. When I was nauseous and was constantly vomiting, I was placed on a special diet plan that included oats and custard. When I was recovering, I asked for noodles (Indomie) and they were quick to prepare it even as I dictated how I wanted it cooked. They went out of their way to make us comfortable. It was amazing.

I will always look for every opportunity to say this; the health workers are a blessing to Lagos State and indeed Nigeria; they are the true warriors, the true heroes. They are putting their health on the line for us every day, sacrificing as well. Because when they are at risk, their families are at risk. Most of the health workers in Yaba are staying in nearby accommodations so that they don’t have to go home. Despite the challenges in their compensation structure, they remained very friendly, going beyond their call of duty to help. I know the government is working to address this.

Every two days or so, I had a call from a Lagos State doctor who was a psychologist. He would call to check my mental welfare, and I know it happened to others as well. I didn’t have any mental challenges, but the fact that they would call to check on us was a pleasant surprise. After I left IDH, I also had people who were following up to ask if I was integrating well, about my wellbeing, and if I was facing any stigma.

Of course, there are expectedly, negatives. In terms of administration, the way information on results was communicated from the lab to the case managers, there were small gaps, though I know these are being addressed. Overall it was a good experience.

Rough patches on the road to recovery
I was at the IDH in Yaba for about 10 days. My lowest point was not being able to eat for days. I lost a great deal of weight. I knew that I was getting dehydrated and I couldn’t replace or replenish the fluids I was losing. I was throwing up everything I was eating. As the food was coming in, it was going out. At some point, I was throwing up bile. This was definitely a big cause of anxiety for me. I was a constant name with the doctors because I was always conferring with them. We talked about having a dietician at some point to see what fluids I could take and eventually how we could stop the nausea.

Sometimes we minimise the seriousness of what people with COVID-19 face. Some people in the room had upper respiratory problems, some people were almost going into depression. People were fighting very crazy fevers, others had uncontrolled diarrhea. There were very bad days and there were good days. This is definitely not a normal flu. This is something serious. We all know that it is life threatening. You know that if it goes ‘south’, it quickly becomes a life or death scenario. Every single day you wake up, you are hoping that your condition does not deteriorate. This played silently in everyone’s subconscious.

Sound the alarm: Nigeria “sitting on a keg of gunpowder”
The only way to stop and contain the spread of this disease is social distancing, or in our case, the temporary lockdown. But, the government must find ways to assist people to feed. Developed countries are struggling to contain this pandemic. We do not have the infrastructure to take care of an outbreak in Nigeria, and people need to understand this. We are sitting on a keg of gunpowder and one of the problems that we face is that people do not take this virus seriously. People still think it’s a scam, and I’m not talking about illiterate people, but educated professionals.

I am alarmed because people don’t seem to understand the gravity of what we are facing. People do not realize how easily it is spread. Saliva sometimes can travel unnoticed. You see people exercising in groups, you see people walking in groups. This is one of the reasons our group decided it was important to go public, to share with people that this can potentially destroy the very fabric of our society, and the only tool we have is preventative measures. Today community transmission is 50–60 percent. It means that people are actively passing the disease across. We need to halt this.

Grateful to be home: “I don’t expect any stigma”
I tested negative to COVID-19 for the second time on Wednesday, April 1, 2020. I did another test on the 2nd of April 2020 and got a third negative result, so I was discharged to go home that day. So far it has been mostly congratulatory messages from family and friends. At a recent meeting in the estate where I live, to discuss security amidst the currently escalating violence in the state, I mentioned openly that I just recovered from COVID-19 and encouraged everyone to take the disease seriously, to understand that transmission is very easy and to follow safety protocols. I didn’t notice any stigmatisation. Rather people came together, wanted to know what I went through, and how I overcame COVID-19. A lot of people were just happy for me. I do not know if they would let me into their houses though!

I don’t take for granted the fact that I have to be careful, and I isolate myself as much as I can and limit human interactions. Most of my family members were tested thanks to NCDC, and they were negative. I’m strict about safety procedures: wash your hands well, don’t go anywhere that you don’t have to go to, maintain social distancing. I still try to maintain a 10 feet distance from people. I do my best to avoid compromising situations, and I am doing that as well for my family.

I tell people that I have tested negative thrice, if anything I should be the one scared of people who do not know their status. I should be the one stigmatising people and not the other way around. I am someone who doesn’t look forward to being re-infected, but I don’t expect any stigma.

The images and videos in this piece have been edited and published with permission. Manny’s interview was transcribed and edited by Atinuke Akande and Ada Nkem Ezeokoli.