My Mom - The Covid Warrior

 

It was 6am, June 18th 2021. How can I ever forget that faithful Friday morning, a day that would have changed our lives forever. Prior to the fajr athaan, I had a brief conversation with my brother who had informed me that mom's medical condition was relatively stable but there was no real improvement. We discussed oxygen saturation levels and oxygen flow rates and agreed to touch base later on in the day to keep each other informed about moms deteriorating health. I had just retired to bed after fajr prayers when the phone rang. It was sister Cleo on video calling. Naturally I was quite perturbed and answered the call in haste. Sister Cleo was quite anxious and in a state of panic as she took me through mom's vital stats. "Everything is dropping at a rapid rate. Her blood pressure is dropping and her oxygen saturation level is at 40. Please come to the hospital now. Your mom is extremely ill and is passing away." I froze and needed a few seconds to digest everything that she conveyed to me. After gathering myself together I jumped out of bed and quickly changed into a kaftan. Now came the difficult part. I needed to break the news to dad. I knocked on dad's room door. He was not yet asleep. He asked me if I called the hospital to enquire about mom. I hate being the bearer of bad news. I took a deep breath and finally let it all out in one go.

 " Papa, sister Cleo from the hospital called to say that mom is on her last. She is passing away. We need to hurry to the hospital immediately." Naturally dad too was in a state of shock. I guess he found it difficult to digest the news I shared with him. Together we informed my brother and his family. Our world had suddenly come to an end and we all realised that from that day onward our lives will never ever be the same again. 

 Naturally the trip to the hospital was indeed unforgettable. There was an atmosphere of sadness and melancholy in the car. As my brother read Quraan whilst driving dad and I to the hospital, my mind wandered far faraway. I had flashbacks of my childhood recalling the wonderful memories on Sitara avenue, mom driving us to school in her powder blue Peugeot 504, the incredible yearly overseas vacations, and of course all the amazing memories mom and I shared during my stay in Riyadh. As tears rolled down my cheeks, I was struggling to acknowledge and accept that the end was near, that I'd never ever see my mom again. I was hit with the realisation that I will never be able to hear my mom's laughter or eat moms signature dishes ever again. It felt as though my world was coming to an end. Dad was devastated but didn't show his true emotions. I guess he needed to be our emotional support and pillar of strength. As we neared the hospital he told my brother and I not to be sad. We should be happy that mom was passing away on a blessed day, al yowmul Jumu3a..He said that our lives will change. Life will never ever be the same again, but we can not question the will of Allah. Every soul will taste death indeed, yet no one is ready to leave the world. No one is ready to die. No one is ready to accept death. No one is ready to let go..

The drive to the hospital felt like an eternity. My mind was so faraway that I only realised we had arrived at our destination when the car came to an abrupt halt. Dad's late brothers' children arrived at the hospital as well. They had lost their dad a week earlier and so they were all going through their own emotional pain and trauma. My dad didn't really have the time to grieve or mourn for his elder brother as mom's medical prognosis was not good either. I can clearly remember the Tuesday afternoon when dad and I went to my uncle's home to greet him and see him off to the hospital. In many ways I think that he knew he was not going to return home. He kept on asking about mom. That was his biggest concern. 

 As we got off the car, we headed for the Covid ward where we were asked to suit up in PPE gear. The medical staff were waiting outside mom's room door. As we entered mom's room, she was totally oblivious of our unexpected visit. She had no idea that her vital stats were dropping. We were all reading for her at her bedside with tears flowing down our cheeks. Whilst the medical team were expecting mom to take her last breaths, God Almighty had other plans in store for mom. Quite miraculously, all the stats started going up slowly reaching relatively stable levels. From that point onwards, mom started making progress. It wasn't a lightning speed progress, but we were grateful and thankful that mom was still alive. As long as her heart was beating and she was breathing, there was always going to be a glimmer of hope.

Mom was rushed to hospital on Saturday, June 5th, 2021 around 6pm. I had just come out of the shower preparing for asr salaah when suddenly I heard mom screaming in pain. She was experiencing severe diarrhoea the day before. I then called my brother and we both agreed to rush mom to the hospital. 

Mom has always been a home executive par excellence. Allah has gifted her with green fingers thereby allowing her to design and create one of the most beautiful gardens in the neighbourhood. She has always taken an immense amount of pride and joy in her cooking and her culinary skills are definitely praiseworthy. She has always been immaculate when it came to setting a table especially when guests were invited. Arts and crafts, painting and needlework have always been hobbies that mom is passionate about. Every Friday mom use to cook for Mizaan's halaal takeaway located in Florida. Reading the social media comments about how tasty the food was ultimately motivated mom and gave her a sense of self worth. After all, her cooking was her joy and happiness. The Friday before moms admission to hospital, she got up as usual to steam the mutton biryani she had prepared the day before. She had become accustomed to her Friday routine. However when the pot was finally steamed to completion, mom was unable to lift the pot from the stove as she usually does. Her body was overtaken by weakness and that's when she realised that something was wrong. During the course of the day she had developed a cough with phlegm on her chest and asked me to bring medication for her from the pharmacy. 

During the course of the weekend mom just layed in bed. Despite taking antibiotics and various other medications to treat her symptoms there wasn't really a marked improvement in her health. Hence on Monday night our house doctor visited to assess moms ill health. He concluded that mom had bronchitis and added an additional antibiotic to the current treatment regimen she was already taking. He also wanted several blood tests to be done to rule out a few other medical conditions. As the days went by, despite mom taking all her medication as prescribed, there wasn't any significant improvement in moms health. The weakness became worse. Eventually the weakness was coupled with severe abdominal pain and diarrhoea leaving us with absolutely no choice apart from getting mom admitted to the nearest hospital. 

Upon arrival at the hospital, mom was rushed into casualty. My brother and I waited in the car as the medical personnel took various x rays of moms chest. They also conducted a number of blood tests. After a three hour wait we were finally called into casualty where we were told that mom had a severe bout of pneumonia and required intravenous antibiotic treatment. Subsequently mom was admitted and the doctor on duty said that he expected her to stay in hospital for no longer than a week. We were told that no visitors were allowed and that if we wanted to know about moms progress we should call the ward directly. We thereby exchanged contact numbers with the nursing staff assigned to mom and then left for home.

There was an absolute feeling of emptiness walking into the house without mom. Without a shadow of doubt it is a mother who turns a house into a home. Whenever I return home at night after work, I'd always find mom in the family room reclining on her specific chair or I'd find mom in the kitchen either baking fresh home made bread or croissants or cooking something special for us. Even before entering the house, an aroma of deliciousness always pervaded the air. Our family life has always been centered around the kitchen, a cosy space designated not only for cooking scrumptious meals but it is also an area in our home whereby good food is coupled with lots of fun, laughter and discussion collectively as a family.

Sunday is usually a day of leisure but in our home a Sunday is always associated with the gathering of family and friends and of course mom's signature rice dishes. Despite mom's absence at the lunch table, we tried extremely hard to retain a semblance of normalcy in our lives. 

Whilst having lunch, my brother received a call from the hospital informing us that mom tested positive for covid 19 as well and that she will be transferred to the specialised covid unit. We couldn't understand how did mom become covid positive as she remained in doors all the time. No one else at home had been ill despite the fact that we are in constant contact with patients all the time at the pharmacy. Sometimes we forget that sickness and health remains purely in the hands of the Almighty. All of us in life are going through different trials and tribulations. Indeed God Almighty tests us in different ways to assess our faith and belief in Him and of course to bring us closer to Him. 

With mom being in hospital it was only natural for everyone at home to be having sleepless nights and so on Monday morning at the crack of dawn I made my way to the hospital to seek permission from management to be able to visit mom and spend some time with her. The head nurse at the covid ward was an extremely kind middle-aged petite woman who understood my plight perfectly well. She gave me a set of protective gear and asked me to suit up before making my way to mom's room. During our brief encounter she mentioned to me  that a few years ago her daughter was in hospital in the ICU and she was prevented from visiting her. That entire experience was traumatic for her and so she vowed to God Almighty that she will never ever do the same to any of her patient's family members. Stepping into mom's room, the first thing I noticed was the high flow oxygen face mask that was placed firmly on mom's face giving her the image of someone out of space. Her face was swollen and mom looked visibly distraught. She was unable to speak to me but her hand gestures indicated that she was feeling extremely claustrophobic. At noon, the nursing sister assigned to mom passed by with mom's lunchtime meal. She asked me to feed mom and encourage her to be more accepting of the high flow oxygen mask. As we were chatting, my phone rang. It was the treating physician. 

 The gentleman on the other end of the receiver came across as a middle-aged man who was rude and abrupt. He lacked kindness, empathy and compassion. I was informed that mom was not doing well on the high flow oxygen mask and that there was no option left apart from intubating her and placing her on a ventilator. I then understood the seriousness of the situation and was also cognizant of the fact that a vast majority of patients who are placed on ventilators do not make it out of the hospital alive. The doctor wanted immediate consent from me with regards to two issues, namely intubating mom and secondly using high doses of ivermectin on her. Of course, I fully supported the utilisation of ivermectin on mom but I was unable to make an immediate decision to intubate mom without consulting with my dad and my brother first. As soon as I left the hospital, I drove straight to the pharmacy only to find dad extremely sad and distraught at moms illness. We were both two minded about placing mom on a ventilator. As we were discussing the pros and cons of the procedure, a family doctor called dad to enquire about mom. It was almost as though God Almighty was lending us His helping hand. Indeed, it turned out to be a divine guidance. Dr Bobat was following the progress of other covid patients in the area and he was also quite well informed with regards to numerous treatment regimens that were being applied by specialist doctors at various hospitals in Johannesburg. His input made our decision much easier and hence after much deliberation we took the decision as a family to have mom intubated and placed on a ventilator. 

 Initially mom was doing extremely well on the ventilator. She appeared to be much calmer and had lesser claustrophobic tendencies. Every day the medical personnel were weaning her off the ventilator which was a significant step in her recovery process. We were told that within a week or two she would be discharged. Every night my brother and I would take a drive to the hospital to visit mom from her room window. There were times when the nursing staff would yell at us for standing at the window and even though there was a curfew in place, it did not deter my brother and I from visiting our beloved Mom. We were determined to visit her and be with her throughout her ordeal. She needed our support and words of encouragement. 

Eight days after mom was intubated, I received a call from the head nurse of the covid ward. She asked me to pass by in the morning during her shift. She granted me permission to visit mom for 20 minutes but at the same time she wanted me to view mom's chest x rays.  Upon perusal I was in absolute shock and disbelief. I was unable to see the lungs at all on the x rays. All I could see was clouds of white. I knew the seriousness of the situation and a part of me felt as though this was the beginning of the end. I was also required to provide consent for dialysis as mom was going into renal failure as well due to her lungs being incapacitated. After spending time with mom,  I recall driving to the pharmacy with tears rolling down my cheeks. My dad called to enquire about mom and I burst out in tears explaining how bad the chest x rays were in just a matter of 2 days.  Mom's health was deteriorating and subsequently we were called in on that faithful Friday morning to bid her farewell, but God Almighty tested our faith and showed us all who is ultimately in control of life and death. 

My brother and I continued visiting mom at her room window. Then one day Allah placed mercy in the heart of the night time shift leader, the same gentleman who yelled at us a few times before for standing at the window. He befriended my brother and said that he could see how attached we were to mom. He could see the genuine concern we had for her and so he told us that whenever he is on duty he will allow us to suit up in PPE gear and spend time with mom in her room. We noticed that our physical presence had a huge positive impact on mom's mental state of mind which in turn had a positive impact on mom's overall health and well-being. Her oxygen saturation levels improved and with time they were able to wean mom completely off the ventilator 8 weeks after admission.  

During our midnight rendezvous at the hospital my brother and I witnessed a lot of disturbing incidents. Almost every night 2 undertaker vehicles were parked in front of the covid ward to collect the remains of those who succumbed to their illness. There is one incident that will remain etched in my mind forever. Whilst waiting to gain access to the ward, my brother and I met a gentleman who told us that he received a call from the ward asking him to come in immediately to meet his wife. She was a nurse in the covid ward and she contracted the virus becoming extremely ill. The caregiver became a patient herself intubated on a ventilator. The middle-aged man was so excited. Whilst chatting to him, a nurse interrupted our discussion and asked us to follow her. The gentleman remained outside. Upon reaching the ward, we learnt that the nurse had actually passed away and hence her husband was asked to come in immediately. I was gutted and heartbroken and even though the man was a complete stranger I could feel his pain. 

 Then there were incidents of gross negligence on the part of the nursing staff. I personally think that whether a patient is in a private hospital or a government hospital there is something seriously wrong with the quality of nurses employed at our hospitals. Many need to be commended for their kindness and compassion displayed towards their patients but the overall vast majority are just downright inhumane in the manner in which they treat their patients. We witnessed nursing staff sleeping on duty whilst they were assigned to critically ill patients who were all on ventilators. We witnessed the gross negligence ourselves when the nurse assigned to mom forgot to suction her tracheostomy tubing causing the accumulation of phlegm and thick mucous resulting in mom's medical condition deteriorating. She was almost at the end of the ventilator weaning process where her blood gas levels were improving but due to the negligence and don't care attitude of her caregiver, she was put back onto a 100 percent ventilator support. In other words, the weaning process had to be restarted all over again. We were told by the presiding physician that the doctors' hands were tied in these kinds of matters as the nursing staff are all outsourced from various agencies and are not on the hospital payroll. I came across nursing staff who were not even properly trained with regards to the way in which a ventilator functioned. I am pretty certain that many patients who were admitted to hospital died not because of ill health but rather due to gross negligence on the part of the medical personnel. The fact that family and friends were not allowed to visit made it much easier to hide medical malpractice. Mom lost a staggering 22kg of weight in hospital. From extra large clothing mom now fits into extra small making it impossible for me to steal her clothing occasionally. 

Mom was discharged on Eid ul adha. After a traumatising 8 weeks, it was undoubtedly a welcoming relief. Due to the fact that there were no beds available at the rehab centre, we had to make arrangements for a proper home health care facility that included the hiring of an oxygen concentrator, a full-time nurse as well as periodic sessions with the physiotherapist.

Mom required a full-time nurse to assist her with her daily activities. She was unable to walk or shower on her own. She was discharged from the hospital in an extremely bad state. Her clothes were soiled due to diarrhoea and she was unable to speak clearly due to the hole in her neck as a result of the tracheostomy. It was as though she was discharged from a psychiatric institute. The admission ward had windows but then a week after admission she was moved to a ward that had absolutely no windows. She was unable to decipher night from day and in the process mom lost complete track of time. Mom needed to be on 5L of oxygen continuously night and day. Her oxygen saturation levels had to be monitored extremely closely. It took almost 2 months for mom to be weaned off the oxygen completely. Mom's physiotherapy session's assisted her in regaining some of her strength back. A year has passed and mom is still facing a series of long covid symptoms such as extreme chronic fatigue, shortness of breath as well as nausea and excessive vomiting. These symptoms have sometimes warranted hospitalisation for a few days at a time.

 Mom's doctor's were quite baffled to discover that post covid mom is no longer hypertensive. They found it quite intriguing that joints and bones that were previously affected by rheumatoid arthritis were now disease free post covid. However, mom has now developed severe bone cavities in her right foot due to the excessively high doses of cortisone that was administered to her during her 2 month stay in hospital. Currently mom is experiencing severe pain on her right foot especially when she walks thereby impeding her recovery progress. She will most probably undergo surgery in the near future Inshallah to remove the diseased bone followed by the insertion of titanium plates to devise an anatomical foot structure that is as close as possible to mom's biological foot. To all the beautiful souls out there reading this article, do make a special dua for my mom. May Allah grant mom complete shifa e kaamila with aafiya. 

 It is indeed a miracle that mom is alive and yet on the other hand it is absolutely heart-breaking to see mom as a different person altogether. The bright and bubbly super active, super smart mom is no longer there. It depresses mom sometimes that she is no longer able to be that on-the-go woman she was. Mom has always been my best friend. We use to always visit the nursery together on a weekday or do the grocery shopping together followed by lunch. Mom's ordeal has undoubtedly been a traumatising experience for all of us. At the end of it all Allah never ever burdens us with more than we can handle. I am positive and certain that with time mom will gain weight and fully recover. There is always wisdom and goodness in everything that He has decreed for us. Covid 19 brought out the best and the worst in people. Parents didn't want to take care of their ill kids and vice versa. Family members ran away and refused to attend to the ill within their families. Funeral homes became homes of a leper where no one was willing to frequent that home out of fear of contracting the virus. Our masaajids and other places of worship were empty as per government decree whilst government officials squandered an excess of a billion rand in parties and entertainment as per official news reports. People had petty fights about masks, sanitisers and not being able to try on garments in a clothing store. The world became mad whilst the shayateen rejoiced and there was a complete ignorance and lack of knowledge that prevailed. I witnessed people walking around like zombies with strange get ups mimicking space suits. I was in stitches of laughter seeing a woman with a bucket like apparatus covering her face. For those with eyes who can see, this was a glimpse of qiyamah. Everyone was nafsi nafsi... worried about themselves only. Even the holiest of people forgot that it is Allah and only Allah who gives life and takes life. It is only through the command of Allah that we get ill. Even in illness there is blessings for you become closer to your Allah. Your prayers and remembrance in Allah increases. When a person is ill Allah cleanses them of sin. Allah accepts the duas and prayers of those who are ill and for those who passed away during the "pandemic", how fortunate they are to be given the glad tidings of being a martyr.  Mom mentioned to us that during her stay in hospital, Allah sent a farishta to protect her and look after her. Mom described him as a thin, tall dark-skinned gentleman with a huge smile on his face. He was stationed at moms' feet. It is pertinent to mention as well that there were nursing staff who were waiting for mom to pass on. They would pass remarks at mom such as ' Are you still here? Thought you'd be gone by the time I returned to my shift?" Through the fervent belief in Allah, miracles do happen and as a family we all witnessed this first hand through mom's miraculous recovery. Many a times people would ask how come your mom made it. The answer is simple, life and death are in His hands not ours. Allah still wanted to use mom as a part of His grand master plan. I also believe that duas, prayers and the person you are determines your destiny. Only after mom became ill, did I realise what a significant role she played within her community. During mom's stay in hospital, every day we received numerous calls from concerned individuals all enquiring about mom's health. Many recalled and reiterated with tears in their eyes the sincere acts of kindness that mom displayed towards them. Some remembered mom's hospitality whilst others remembered the delicious food, she sent for them when they were ill. Dad always tells mom that the easiest way to attain jannah is to feed people with an open heart. 

Mom's personality was undoubtedly a catalyst that encouraged many many people throughout the world to pray for her recovery. When our extended Saudi family heard about moms ill health they immediately rushed to the haram to distribute sadaqah. At the house of Allah,  they beseeched Him for mom's speedy recovery. Students at the various Islamic institutes recited Quraan for mom everyday in congregation. The late Sheikh Ayoob Patel from Malawi who took mom as his own sister, not only fasted for mummy's recovery but woke up everyday at tahajjud literally in tears begging Allah to return our mom home to us. Everyday before embarking on his daily chores, Sheikh would first do an act of sadaqah for mom. I will never ever forget the daily conversations I had with Sheikh Ayoob. He was a wonderful human being with a soft kind heart. Sheikh Ayoob was a fatherly figure as I was acquainted to him from childhood.

His conversations were not only encouraging but he always spoke words of wisdom. During one of our conversations, he asked me to explain to him what is covid and what happens to the body. Little did i know then that a few days after mom was discharged from hospital that Sheikh Ayoob himself would be admitted in a Malawi hospital for covid pneumonia. Sheikh Ayoob eventually succumbed to his illness and returned to his heavenly abode leaving behind a nation that was shattered on hearing about his untimely demise. May Allah grant Sheikh Ayoob the highest stages in jannah and fill his kabr with light. Ameen.

 In my opinion, the covid fiasco is undoubtedly a precursor of what's to come. The emergence of the antichrist, al Dajjaal is not faraway. If you have learnt absolutely nothing out of this horror movie like experience that affected almost every household within the community, it is time for you to wake up and smell the coffee. Go back to the drawing board and ask yourself, " Is my faith and firm belief in God Almighty enough to withstand what's to come? May God Almighty make it easy for one and all. May His mercy and blessings descend upon the entire ummah. Ameen. 

My tribute to a unique personality, Nafeesa foi... 17 July 2020

Indeed, the sad reality about life is that we all know that one day we have to leave this superficial world of illusion for our heavenly abode, but alas no one wishes to or wants to leave. The demise of my foi had come to us all as a great shock. I should have written this tribute two weeks ago, but i opted to write once i cleared my mind, gathered my thoughts and of course absorb the fact that she is no more. I also needed time to choose the right words befitting for a human being who not only had a unique personality but also touched the hearts and lives of many through her radiant warm smile.

For some she was known as aunty Nafeesa Chothia, to me she was Gori Foi or Nafeesa foi, the seventh child of my late Dadaji, Hafez Abdullah Mehtar (Mias Farm)and Dadi Ameena Mehtar. I must admit, as a child or even a teenager i never really knew much about her. However, as we both got older I guess we formed a bond. I am always reminded of the fact that i have a lot of her habits and personality traits inherent within me. In fact, when i called my Forgi a few days ago to check up on him, the first thing he said was, when i hear your voice, i am reminded of your foi. We both burst out in tears and thats how the conversation ended.

She was a bold, bubbly and vivacious character.She was the kind of person who always visited a funeral home to offer her condolences personally. She was always the first at a wedding home to assist. She was a people's person and hence she knew many people far and wide. She had a big heart and loved entertaining people. Everyone was welcome at her home and hence whenever jamaats from other cities or countries were in town, she would make it her duty to cook for them. She was straight forward and to the point. She never kept anything inside her heart for anyone. What needed to be told was said and then forgotten. I recall her signature trade mark clothing style coupled with pumps and her favourite red lipstick to compliment her fair complexion. She was a splitting image of her mother. Of course in winter, she had to step out of the house with her shawl. As soon as she draped it over her shoulders she was all set and ready to go.

I have a few fond memories of gori foi. I recall all the fun we had in 1998, when we went to Mauritius to attend a family friends wedding along with a few other family members. A few years later whilst i was residing in the kingdom of Saudi Arabia, i had the opportunity to make umrah with her and her kids. On that same trip, we met another family friend from Dubai, and once again that trip became a memorable one for all of us. I will always cherish those moments forever. Sunday lunch will never ever be the same at our home. Almost every second week, foi and forgi would visit. Most of the time, mom would cook her favourite dishes. She was very fond of moms fruit cake. With her around, sunday lunch always involved lots of laughter and joking coupled with reminiscing about the past. Gori foi was well travelled. At a young age she had travelled the world and used different modes of transport in other countries but not here in SA due to safety reasons. Hence, when my colleague decided to Uber her and mom home one afternoon after they enjoyed a day at leisure at a shopping centre,she found the entire experience quite hilarious. She kept on asking if she will get home in one piece. " what if the driver kidnaps us".....The one quality i admired in her was the fact that no matter where she was, she never ever missed a salaah.

She left us too quickly, but alas this is the will of God Almighty that can not and must not be questioned. Verily, He is the best of planners. I am certain that without a shadow of doubt she is in a far better place than here. She is finally in peace united with her parents and others from the family who have left this world.Whilst we all will miss her dearly, we take solace in the fact that she passed away on a blessed day, a Friday. May Allah grant her and all other marhoomeen, the highest stages in jannah.

You may have left us foi, but you will always remain in our hearts and duas forever.

Covid19 and the emergence of idiotic behaviour

I can expect uneducated illiterate people to behave in an ignorant manner, but when educated people start behaving ignorantly i am left in absolute shock and disgust. Over the last few days our medical team has had to deal with patients who were diagnosed by their physicians as covid positive. In some instances the entire household tested positive but they presented with no symptoms. In other words they are asymptomatic carriers of the virus.In other instances only one person tested positive whilst everyone else tested negative. The virus is spreading and as per our onsite physician who is also working at the various quarantine centres, its just a matter of time before everyone gets exposed to it. The majority of people will present with mild symptoms or will be asymptomatic carriers. The immunocompromised however, will have some difficulty in fighting off the virus. It has been established that good nutrition is the key to fighting off illness. Drink lots of ginger tea with honey. Increase your vitamin c, vitamin D and zinc intake. Eat lots of fresh fruits and vegetables and get lots of sleep and rest.The media has done an excellent job at creating an atmosphere of fear and anxiety. Fear and worry weakens the immune system. Let go of fear totally.Stop watching the news. The amount of people we treating for stress and anxiety on a daily basis has increased phenomenally within a short space of time.If a person within your home or community tested positive for covid 19, its not the end of the world. With proper medication, nutrition and support they will recover God willing. Thousands of people have recovered already.If you have nothing good of value to add to the persons life, the least you can do is stop spreading rumours about the person and their family. Think before you ink. It takes years to build up a business and seconds to destroy its reputation thereby jeopardising the jobs of the staff members who work there. Some patients have told us that they have received nasty messages from their neighbours. There has been instances where shops have refused to serve family members of a covid positive patient. This is pure ignorance. Nobody asks to get ill. Sickness and health is all from the Almighty.Stay in your own home and worry about your own family. Stop worrying about the next person and who should be in quarantine or not in quarantine. You don't know the health status of other people within your community and quite frankly its not your business. There are people out there believe it or not who think its fine to abuse medical professionals and doctors for treating covid patients. A friend of mine who resides in a townhouse complex has been taunted by his neighbours for treating covid patients. He is now allegedly responsible for some residents contracting the virus. Medical professionals are risking their lives to save your life. If you cant support them and encourage them the least you can do is shut your big mouth rather than bringing them down with your negativity. Now is not the time to be gossiping about those who are ill over fancy dinner dos.Now is the time to alleviate the pain and suffering of other people. Provide help and support to those who have been affected by the virus. Stop being judgemental. Stop the stigmatization associated with being covid 19 positive. If you know that your neighbour is ill, do your bit to make them feel better. Prepare a meal and send it to them. Now you being proactive rather than gossiping about them to your friends and family. Remember today they could be ill, tomorrow it could be you. May God Almighty grant everyone good health and protect us from all kinds of calamities. AMEEN. The best way to ward off calamity is to engage in activities associated with charity, for example,buy a loaf of bread and make sandwiches for the beggars on the street.

WIDESPREAD COVID-19 TESTING DOES NOT MAKE SENSE FOR SOUTH AFRICA- by Dr. Nathi Mdladla

I would like to break down the fallacy of widespread COVID-19 testing in South Africa. These are my personal deductions rooted on my training as medical doctor, a specialist in anaesthesiology and during subspeciality training as an intensivist and cardiac Anaesthesiologist. I have corroborated my assertions with readily available data in the public domain.

As of 27 April 2020, South Africa had done 168 643 tests for COVID-19. These tests had yielded 4 546 positive tests. Over that period we had 87deaths. The cost of a COVID-19 test was R1 200, which means by then we had spent R202 371 600 conservatively on testing for COVID-19. By May 1st (1st Day of Level 4 lockdown) this number was at 217 552 tests at a cost of R261 062 400. For the additional 48 909 tests done, we got a yield of 1 405 (2.87%) positive cases and an increase of deaths by 29. With this update, on the 8th of May 2020, 292 153 tests have been done - an additional 74 601 tests. This was at an additional cost of R89 521 000 spent with a yield of 2 372 positive cases (3.17%). So we have spent in total R353 583 600 in doing widespread testing. Keep these figures in mind as you read the rest of this article and make up your mind on the validity of testing everyone.

Considerations when embarking on a test of any sort in the medical sphere:

1. The indication of the test - is there any value derived from testing? You can’t test for the sake of testing. What are you going to do with the result?
2. The accuracy of a test - it must have a high specificity and high sensitivity (as close to 100% as possible) and very low false negatives (where you wrongly think there is no problem when there actually is), low false positives (where people who do not have medical problem but wrongly assigned as such)
3. It must be meaningful for wide-spread use eg. if a cure exists and where knowing the status has impact on disease/population management then the test is useful
4. It must be cheap, easy to perform and interpret
5. Requires minimal expertise in the remote population settings
6. Less invasive eg pregnancy test
7. Short processing time to allow an appropriate intervention in the shortest time

The facts about the current available COVID-19 tests in South Africa:

1. 30-40% false negative results with the serological quick tests - that is, you can be falsely reassured that you are safe with someone who is in fact positive.
2. PCR testing increases accuracy but there are still up to 15% false negatives. It is more expensive and requires highly specialized training and takes longer to perform in the state sector in South Africa (1-7days)
3. They are not cheap for such an inaccurate test - R1 200
4. They are not readily available - only specialized testing centers at the moment
5. Special training is required to be able to meaningfully get accurate tests - this negatively affects accuracy and increases the false positive rates
6. Knowing that the status is positive does not change anything for the majority of patients who are not sick as the disease is self-limiting, but is useful in those presenting with moderate to severe disease
7. And because even if it’s negative there is a possibility that this could be wrong, does it mean you can drop your guard because the test is negative? NO! So you are better off assuming everyone is positive and testing those who are symptomatic for directed management
8. If 80% of the population has mild disease that does not require admission, what is the value of knowing that people are positive when they can’t be treated and in the face of high false negatives. It would be cheaper to assume that everyone is positive and continue practices aimed at limiting spread in the general population.
9. In fact, if there is anything we can learn from widespread COVID-19 tests it’s the following:
- the disease is highly contagious but less lethal. At the moment mainly symptomatic people are being testing. So the numbers we are deriving from these results mean there is probably a higher infection rate with even less mortality than we are projecting (something like closer to 0.1-0.2% true mortality in infected people)
- the wider you test amongst the asymptomatic population, the less will be the yield with a test that is inaccurate even in the setting of active disease. So there will be a lot of false negatives and false reassurance
- because there is no cure as yet, we can not intervene specifically anyway except for making sure we can isolate and protect other people and staff from positive “known” individuals. The false negatives still mean 15-40% of the time we’ll still get exposed.

Here is what we know about COVID-19 so far from the most severely affected countries and South Africa has shown the same profile:
1. 80% of infected people have mild disease - they do not need admission of any sort and the disease is self-limiting in this population
2. 15% of infected people have moderate to severe disease that requires admission for oxygen supplementation and maybe fluid therapy
3. There is NO CURE - so even if you are admitted, the hospital does not do anything specific for you at the moment anyway. All current therapies are either experimental with no proven efficacy or supportive
4. There is a 3-5% mortality in positive patients broken down as such:
- 72% of over 65years old,
- 23% Mortality rate in 45-64year olds (76% of these have co-morbidities),
- 4.5% between 18-44years old and
- 0.04% between 0-17years old.
- the true mortality of the net was even widened more is believed to be in the order of 0.1-0.2%

I therefore doubt the value of widespread testing in South Africa for a disease with the above profile and in a population with the following characteristics:
1. an average age of 26.4 vs Italy with an average age of 46.6 or Germany (47.4)
2. We have 6% people over the age of 65 in a country of just under 60million (3.6million) vs for an example Germany with 17.9% of over 65year olds in a country of 80million (14.32million)
3. Yes I know you’ll say there is a 20.4% HIV rate in SA (12million people) from the 2019 Stats SA numbers, with 32% of these people (3million) not on treatment. We are worried that if these people contract HIV they will die in numbers.
- This is unproven, and we have the luxury of watching what has happened to the East Asian countries with an HIV burden of 4,734million during their winter where the exposure is maximum. There is no proof that HIV positive patients are dying in higher numbers there, well at least no published data. China is leading Asia with 680 000 people living with HIV.
4. It is widely accepted that the predictions guiding what we are doing in South Africa at the moment were based on a worst case scenario which does not exist anywhere in the world. We know that the assumed Ro for COVID-19 is 2.5 at the moment, that is the number of people a positive person can infect on average. Even with the 10% of the population used to predict infection rates in South Africa testing everyone makes no sense:
- This would mean 6million would have to be assumed infected
- They could therefore spread the disease to 15million people, meaning we need to test more than 25million people
- 25million tests would cost us 30billion rand
- This for a disease which is self-limiting in 80-85% of patients (20-21.25 million). That means we can prove a positive result at a cost of R24Billion where the disease will burn itself off.
- and all of this is for a disease with no cure as yet anyway

The mounting and growing concern now is the collateral damage that is caused by delays experienced from waiting for a COVID-19 test results in conditions like sepsis, bacterial pneumonia, stroke, heart attacks and other medical emergencies, that still occur even during the pandemic. All level of staff are gripped with fear from what they see on social and mainstream media about the lethality of COVID-19. There is significant stigma associated with the disease and victimization of those who are deemed suspects or PUI’s (persons under investigation) by their colleagues and superiors is rampant. This feeds into the collateral damage from people reluctant to come early to hospital for medical interventions, to staff members being unwilling to help patients until they know the COVID-19 status. We are unfortunately not counting these numbers currently and nobody knows the amount of harm, but we should tally these against COVID-19 deaths if we are to measure our efforts against the harm caused.

I hope I have made a reasonable case for the futility of widespread testing in South Africa, at least at this particular juncture. This will be gross wasteful expenditure with no real return on that investment as it will not aid the country in making any meaningful interventions nor will it aid us in limiting disease spread. It produces false security while causing maximum panic. There are way cheaper and sensible ways of dealing with this pandemic than knee jerk reactions borne out of fear. What we know from basic sciences and common sense still has a place even in a 2020 pandemic.

Dr. Nathi Mdladla
Associate Professor and Head of ICU at Sefako Makgatho University and Dr George Mukhari Academic Hospital
Cardiac Anaesthetist in Private Practice

When jealousy and wickedness overtakes the soul

I have received a number of inbox messages from people wanting to know how much of money did Ahmed Timol secondary school raise through their annual fundraising event that was held at Gold Reef city on the 7th of December 2019. The school played host to international artists Samir and Dipalee who mesmerised the audience with their magical voices and on stage chemistry.It was definitely a night to remember. I am pleased to announce that after expenses, the school raised R240 000, the highest amount ever generated from a fundraising initiative.As mentioned at the concert, the money will be used to tar a road from the school gate leading up to the newly built school hall. The initial quote to tar the road was R 400 000. Hence there is a shortfall of R160 000.This figure may now be slightly less as MTN stepped in by assisting with the grading and leveling of the ground. In other words preparing the area for the tar to be poured. The management at the school will be accepting donations throughout the year especially from students and ex students who frequented the school so that this project comes to fruition in the near future thereby benefiting the school and the community who will hire the school hall for various functions.

With regards to the concert, I wanted to mention a few things that has been sitting on my chest for a while now. I was contemplating not talking about it to avoid unnecessary issues but i think the truth must be said as is. There were many families who purchased many tickets for the concert but on the day of the event they didn't pitch up. This accounted for almost 160 tickets that I am aware of. Some people needed to attend funerals, some said the weather wasn't good so they preferred staying indoors others had emergencies and well some people said "we were feeling uneasy attending a concert at Gold reef city so we didn't attend but if the concert was hosted at the school hall we would have attended". I personally don't see the difference and logic in this statement but then again i guess its different strokes for different folks. You cant win with our Indian community. Now whatever your excuse or reason was for not attending why didn't you take those tickets and give them away to people who would have loved to attend the event. Give the tickets away to school children or orphaned kids who have not attended a live show before. Why be selfish by sitting with the tickets? If you didn't want the tickets as you knew you were not going to attend the event, then you should have simply opted to give the school a donation and not taken the tickets or ask the school management to give the tickets away. The artists traveled from so far to perform for your school, to uplift your community,the least we could have done was to make sure that the hall was completely full. The fact that the school made a profit from the event heralds the event a success. But success for an artist is seeing a hall completely full. 72 percent of the tickets sold but many people didn't pitch up.

One thing that really upset me was the fact that there were people out there who were quite livid at the fact that the school was playing host to international artists. Instead of offering help, working together making sure that the school had the full support required they opted to do anything and everything possible to bring down the event from alerting SARS about the school event and then getting video clips and facebook pages related to the event blocked by getting multiple people to report the pages as going against community standards.In fact the weekend prior to the school event it was quite stupid and idiotic to see two mega Bollywood events on the same weekend at the same time. We are not residing in India where there are millions of Indians who will support different cultural events. We are a minority group in this country so why divide the community. I know for a fact that many people would have opted to attend both concerts had they been on different weekends or a different month altogether. What do you gain by trying to upstage someone else's event? What are you trying to prove? Some will say this is business deal with it. I say this kind of behaviour is not only cattish it goes against all the principles of proper business and moral ethics. I simply lose all respect for individuals who behave in this appalling manner going through great lengths to sabotage a charity event.Success is not about being the best in your field or being the wealthiest or most well known personality.True success is all about empowering, uplifting and working together for the betterment of society. What makes me even more sad is that Indians in general never stand together. We are always trying to out do each other. Can you imagine how much more we can achieve if we were united and supported each others businesses, events etc.There can be many event management companies or organisations within the community. Why not work together by communicating in a meaningful respectful manner discussing dates of events so that they do not coincide on the same day or weekend. Why be spiteful and have your event deliberately on the same weekend or same day as someone else's event thereby creating competition and of course dividing the community. Choose another day or month so that everyone's event gets the full support of the community especially a charity event.This is the premise of true business ethic. It's so much more rewarding being a part of someone else's success rather than running someone down. Think about it. For those of you who wish to pledge a monthly donation to the school I have attached the school's banking details. Remember, if you wish to leave a legacy behind when death comes knocking at your door, then do as much good as you possibly can. People will remember you for the way you made them feel, for the way you touched their hearts. Your wealth and status will be forgotten, but your good deeds and acts of kindness will be remembered forever.

IF I SHOW NO INTEREST IN YOU, HERE'S THE REASON WHY

The kind of people I choose to stay away from:

1. Two faced individuals. Sadly there are many such people out there. Choose your friends wisely.

2. People who are sneaky using you for their own hidden agendas and ulterior motives
3. People who enjoy seeing others fail in life or go down the wrong path.
4. People who are jealous and cant see the good and success in others
5. People who are always grumpy, complaining about everything. They never happy nor content with what the Almighty has bestowed upon them
6. People who treat their friends better than their own parents.
7. People who abuse others either mentally,verbally or physically
8. People who have no heart towards those who are poor and impoverished.
9. People who discriminate against others based on race, faith, skin colour, caste
10. People who are judgemental. People who act as thou they are holier than Thou.
11. People who befriend you to compete with you. My clothes are branded. Yours are not. I drive a BMW. You drive a bakkie. Not interested in such idiotic behaviour.

The kind of people I enjoy interacting with:
1. People who are way smarter and more intelligent than i am. Gives me an opportunity to grow and learn
2. People who love to read. Conversations are more exciting as many different topics can be discussed
3. People who have philosophical, out of the box ideas about life
4. People who travel extensively
5. People who have good intent and pure clean hearts. People who are non judgemental and simply accept you the way you are.
6. People who go out of their way to help others selflessly without expecting anything in return
7. People who are kind and compassionate to their fellow beings
8. People who uplift and empower others.
9. People who write.
10. People who acknowledge your successes and are genuinely happy for you from within their heart. People who continue to motivate and encourage you to reach for the stars and beyond