Mark (pseudonym), a fourth-year medical student from Mxxxxx Uxxxxxxxxx, expressed annoyance at his 5th visit to a COVID testing site since he commenced his paediatric rotation at Mxxxxx Cxxxxxxx Hxxxxxxx 7 weeks ago. “That is more than the number of OCEs I have managed to get done!” he complained to a friend.
When he had his first COVID test 6 weeks ago, he was filled with trepidation – Does the test hurt? Could I really have COVID? Did I wear my N95 mask properly? Did I perform hand hygiene 99 times instead of 100 times on Wednesday? Does the test hurt?
However, upon questioning today, Mark no longer had any fears. In fact, he did not even smile at the person doing his COVID swab and hoarsely answered all her questions before she could ask them. “Not your first time?” the nurse asked, with a broad grin.
Mark did not have the energy to answer, simply blowing his nose in a tissue as she prepared the swab. Mark had noticed that his respiratory symptoms were always preceded by the same event – namely, being coughed or sneezed on by a “cute” and “adorable” child who also happened to begin a monstrous, high-pitched wailing noise when any attempt to examine was made. From behind his N95 mask, Mark had watched, with a degree of wonder mixed with disgust, the cloud of particles that aerosolised from the child’s gaping mouth. “Trillions,” he estimated, generously.
As Mark drove home, he noticed that the upper part of his nose was unusually tender. “The swab must have been pushed too far this time,” he grumbled. As some clear fluid ran down his nose, his mind temporarily entertained a discomfiting thought – “perhaps it is a cerebrospinal leak?” He made a mental note to look out for headache and neck stiffness.
However, there was another issue worrying Mark – why exactly had he been getting sick so easily? He monitored himself closely – no polydipsia, no polyuria, no loss of weight (in fact, the opposite), no loss of appetite, no bruising, no petechiae, no splenomegaly, no unhealthy meals (usually). He checked his box of antihistamines and satisfied himself that it contained no corticosteroids or immunomodulators. After his URTI resolved, he discussed this with a fellow medical student, who suggested that perhaps he was stressed. “Maybe you have worked on too many matrix conditions?” he suggested helpfully. “But I haven’t started on the matrix yet!”
After this conversation, Mark returned to paediatric ED, where he was greeted by the charming sight of a little boy vomiting copiously into a bag. Mark felt he wouldn’t be surprised if he had these symptoms in a few days’ time. “Hopefully, it’s not norovirus…” He then groaned when he remembered that GI upset was also considered a symptom of COVID-19.
He mentally prepared himself for his impending 6th COVID swab.