Dr. Adadevoh at this time was in a pensive mood. Patrick Sawyer was now a suspected case of Ebola, perhaps the first in the country. He was quarantined, and strict barrier nursing was applied with all the precautionary measures we could muster. Dr. Adadevoh went online, downloaded information on Ebola and printed copies which were distributed to the nurses, doctors and ward maids.
Blood and urine samples were sent to LUTH that morning. Protective gear, gloves, shoe covers and facemasks were provided for the staff. A wooden barricade was placed at the entrance of the door to keep visitors and unauthorized personnel away from the patient.
Despite the medications prescribed earlier, the vomiting and diarrhea persisted. The fever escalated from 38c to 40c.
On the morning of Wednesday 23rd July, the tests carried out in LUTH showed a signal for Ebola. Samples were then sent to Dakar, Senegal for a confirmatory test. Dr. Adadevoh went for several meetings with the Lagos State Ministry of Health. Thereafter, officials from Lagos State came to inspect the hospital and the protective measures we had put in place.
The following day, Thursday 24th July, I was again on call. At about 10.00pm Mr. Sawyer requested to see me. I went into the newly created dressing room, donned my protective gear and went in to see him. He had not been cooperating with the nurses and had refused any additional treatment. He sounded confused and said he received a call from Liberia asking for a detailed medical report to be sent to them. He also said he had to travel back to Liberia on a 5.00am flight the following morning and that he didn’t want to miss his flight.
I told him that I would inform Dr. Adadevoh. As I was leaving the room, I met Dr. Adadevoh dressed in her protective gear along with a nurse and another doctor. They went into his room to have a discussion with him and as I heard later to reset his I.V. line which he had deliberately removed after my visit to his room.
At 6:30am, Friday 25th July, I got a call from the nurse that Patrick Sawyer was completely unresponsive. Again I put on the protective gear and headed to his room. I found him slumped in the bathroom. I examined him and observed that there was no respiratory movement. I felt for his pulse; it was absent. We had lost him. It was I who certified Patrick Sawyer dead. I informed Dr. Adadevoh immediately and she instructed that no one was to be allowed to go into his room for any reason at all. Later that day, officials from W.H.O came and took his body away. The test in Dakar later came out positive for Zaire strain of the Ebola virus. We now had the first official case of Ebola virus disease in Nigeria.
It was a sobering day. We all began to go over all that happened in the last few days, wondering just how much physical contact we had individually made with Patrick Sawyer. Every patient on admission was discharged that day and decontamination began in the hospital. We were now managing a crisis situation. The next day, Saturday 26th July, all staff of First Consultants attended a meeting with Prof. Nasidi of the National Centre for Disease Control, Prof Omilabu of LUTH Virology Reference Lab, and some officials of W.H.O. They congratulated us on the actions we had taken and enlightened us further about the Ebola Virus Disease. They said we were going to be grouped into high risk and low risk categories based on our individual level of exposure to Patrick Sawyer, the “index” case. Each person would receive a temperature chart and a thermometer to record temperatures in the morning and night for the next 21 days. We were all officially under surveillance. We were asked to report to them at the first sign of a fever for further blood tests to be done. We were reassured that we would all be given adequate care. The anxiety in the air was palpable.
The frenetic pace of life in Lagos, coupled with the demanding nature of my job as a doctor, means that I occasionally need a change of environment. As such, one week before Patrick Sawyer died, I had gone to my parents’ home for a retreat. I was still staying with them when I received my temperature chart and thermometer on Tuesday 29th of July. I could not contain my anxiety. People were talking Ebola everywhere – on television, online, everywhere. I soon started experiencing joint and muscle aches and a sore throat, which I quickly attributed to stress and anxiety. I decided to take malaria tablets. I also started taking antibiotics for the sore throat. The first couple of temperature readings were normal. Every day I would attempt to recall the period Patrick Sawyer was on admission – just how much direct and indirect contact did I have with him? I reassured myself that my contact with him was quite minimal. I completed the anti-malarials but the aches and pains persisted. I had loss of appetite and felt very tired.
On Friday 1st of August, my temperature read a high 38.7c. As I type this, I recall the anxiety I felt that morning. I could not believe what I saw on the thermometer. I ran to my mother’s room and told her. I did not go to work that day. I cautiously started using a separate set of utensils and cups from the ones my family members were using.
On Saturday 2nd of August, the fever worsened. It was now at 39c and would not be reduced by taking paracetamol. This was now my second day of fever. I couldn’t eat. The sore throat was getting worse. That was when I called the helpline and an ambulance was sent with W.H.O doctors who came and took a sample of my blood. Later that day, I started stooling and vomiting. I stayed away from my family. I started washing my plates and spoons myself. My parents meanwhile, were convinced that I could not have Ebola.
The following day, Sunday 3rd of August, I got a call from one of the doctors who came to take my sample the day before. He told me that the sample which they had taken was not confirmatory, and that they needed another sample. He did not sound very coherent and I became worried. They came with the ambulance that afternoon and told me that I had to go with them to Yaba. I was confused. Couldn’t the second sample be taken in the ambulance like the previous one? He said a better-qualified person at the Yaba centre would take the sample. I asked if they would bring me back. He said “yes.” Even with the symptoms I did not believe I had Ebola. After all, my contact with Sawyer was minimal. I only touched his I.V. fluid bag just that once without gloves. The only time I actually touched him was when I checked his pulse and confirmed him dead, and I wore double gloves and felt adequately protected.
I told my parents I had to go with the officials to Yaba and that I would be back that evening. I wore a white top and a pair of jeans, and I put my iPad and phones in my bag.
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