Dr. P. Ravi Shankar
IMU Centre for Education
International Medical University
Kuala Lumpur, Malaysia

I was scared.

I had read many articles about the nasal swab procedure to obtain samples to detect coronavirus disease19 (COVID-19). Nearly all of it was uncomplimentary. A writer mentioned it was like getting hit at the base of the brain with a sharp probe through the nose. Another compared it to what the ancient Egyptians did when they drew out a mummy’s brain through the nostril.

The process of COVID testing was going smoothly. People were paying the fees, completing the required paperwork, and getting swabbed. I had just landed in Kuala Lumpur, Malaysia from New Delhi, India, and the process was a mandatory part of the arrival formalities along with a two-week quarantine; traveling had suddenly become a complicated process. Soon it was my turn to be swabbed; I tried hard to push the scary images away from my mind and took my seat, and the swabber explained the process to me. He explained that they would be using a separate disposable swab for each person. He also mentioned there would be some discomfort. I was directed to look up, relax and breathe slowly through my nose. The probe was unwrapped and was gently inserted into my nostril and hit the back of my nose. Soon another swab was taken from the back of my throat. The process was over.

Tears started to well up, my nose started to run, and there was an uncomfortable feeling at the back of my nose. This continued for a few minutes and slowly subsided. I comforted myself with the thought that I was doing my part in the fight against the pandemic. Testing can be an important measure to check if someone may be infectious, but I doubt that nasal swabs are likely to be popular and widely accepted.

After the swab it was a long wait to be transferred to the designated quarantine hotel. There was a holding area where we sat down to wait. Luckily food and drink were provided. People were kind and willing to listen and help. The wait dragged on.  It was after 11 PM before people started leaving the holding area to go to their hotels. We were finally led to the baggage claim area, where our baggage was arranged neatly for pickup. We rushed in small groups to the buses, which were waiting to transport us to the hotel. Our luggage was hosed down with a sanitizing liquid and put in the hold. The bus ride was short; we were to be quarantined in hotels near the airport, which dismayed some of my fellow passengers, as they were aware that the rooms at these airport hotels were small and congested—and we were to spend a fortnight in quarantine.

It was past midnight when I finally completed the formalities and checked in.  The building had traditional hotel architecture, with a narrow, carpeted corridor and rooms on both sides.  My room was small, with a queen size bed, a worktable, and a flat screen TV. The room was air-conditioned, which was a relief, and the bathroom was clean. The only chair was located outside the room so that food and drinks could be placed on it during our quarantine, in order to minimize our contact with the hotel staff; a packed dinner already sat on it. I later brought the chair into the room so that I could work seated at the table. Fortunately, the Wi-Fi signal was strong, and I was in a room close to the router. I really missed having a fridge in my room; I don’t find water at room temperature very appealing.

My room overlooked the hotel courtyard with a restaurant below. One of the major problems with the room was there was no telephone to contact the reception and room service. They had a chatbot service to contact them and order room service, but the artificial intelligence system got easily confused. I was never able to use it successfully. I was new to the country and did not have a SIM card for my phone, so my communication options were very limited.

I later read that in some countries persons under observation were allowed to go out of the room and use the hotel facilities if their COVID test was negative; some countries even allow persons to go on sightseeing tours. I had no such luck. My days quickly settled into a routine. I used to wake up and do my language lessons. Then I caught up on emails and work before having breakfast. Then a hot shower. I continued working on my laptop and catching up on news. Around eleven I used to take a break and watch some television before having my lunch. After lunch it was siesta time and then it was further work in the evening. I used to look down through my window on the open-air restaurant in the courtyard. People had their food under tables with parasols in the enclosed courtyard. Passengers came and went dragging their luggage along the wood paved walkway. I, however, remained confined to my room. After dinner I would watch some more television and read e-books on my Kindle before it was time for bed.

Life at the hotel was very regimented.  The major issue was I was confined to my room all the time. I felt depressed at times and fine at others. Due to the internet, I was able to get my work done and communicate with others virtually. I was also aware that this was a mandatory process to safeguard public health and I had come mentally and physically prepared to be quarantined. We were provided three meals a day: breakfast at around eight in the morning, lunch before noon, and dinner at around seven. We were provided two bottles of packaged drinking water daily. Toiletries were delivered periodically. There was no bathtub in the bathroom, so I had to make do with a shower; life is all about compromises. We were confined to our room the entire time. The doors were opened only to pick up food and then sometimes I exchanged a few words with my neighbor across the corridor. They informed me that we will hear from the authorities only if our COVID tests were positive and if that was the case, then they would transport us to a hospital.

We received periodic visits from the health team, who put a quarantine band on my wrist and informed me what I could expect during my quarantine, and we had to update our status on the app daily. We were asked if we had any symptoms like cough, breathlessness, or fever. An antibody test would be done either on day 13 or 14 using a finger prick. This was a major relief for me as I did not want to go through the nasal swab again. If the antibody test was negative we could be discharged either on day 14 evening or day 15 morning.

Monotony set in; the days started to drag. Sometimes I felt it difficult to pass the time.

Little did I know that with a few variations I would be working from home for most of the subsequent year. I used to sit by the window watching the scenes unfolding below. People came and conversed while wearing face masks and following physical distancing. They ate and then either went to their rooms or to the airport to catch their flights. A few domestic flights and international flights had resumed. Clouds gathered by the afternoon every day and there were occasional peals of thunder. We did not get a visit on day 13 and we assumed that we would be tested on day 14. The floors below us had been tested on day 13.

The food was tasty, and they gave us a menu for the whole week. A lot of plastic was being used for packaging the food, which troubled my conscience. The food was nearly always on time and served by hotel employees in full protective gear. I could understand the risks they were taking and were grateful to them for supporting me during my quarantine. However, this was something I was not used to and had only seen in the movies. I felt more isolated and had to dive deep within me to gather my strength. We were on the fourth floor and the service started from the lower floors, so the food was no longer piping hot by the time it reached us, but it was still warm. They always served us with courtesy.

Day 14 finally dawned.

Today we would know our fate. Around half past ten in the morning the medical team started making rounds. I was told that if the antibody test result was positive I would be informed within two hours. If I did not hear from the team then all was well, the test was negative, and we could check out in the afternoon. A very tense two hours trickled by. As the hotel lobby was small we would be processed in batches. The wait seemed very long especially when freedom was so near. I went down to the lobby and cleared my charges; my wristband was ceremoniously cut and I was handed my release order and the results of my tests. I noticed that my status in the app had changed from high risk to low risk. I was free; it felt good to be in the evening sunlight and breathing open air after a fortnight of confinement. I had been shown remarkable kindness by the people I interacted with during my swab and quarantine. Despite being in white body gown, blue booties, blue gloves, face mask and face shield they  showed empathy and concern through their facial expressions, body language, their voice, and their gestures. Wearing protective gear for long periods of time is difficult and we must appreciate their dedication. Kudos to these frontline warriors for keeping us safe and for for their courage and perseverance in the fight against an unrelenting foe!

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