JAKARTA: When Dr Handoko Gunawan took a look at his patient’s lung X-ray, he immediately suspected he was dealing with a COVID-19 case.
The X-ray image showed what he described as infiltration shadow with ground-glass opacity in both lungs, and the patient was battling a high fever, dry cough, low blood cell count and low lymphocyte count.
However, the hospital Dr Gunawan worked for is not a referral hospital for COVID-19, so he could not carry out a swab test on the patient. Up until early March, the test could only be conducted at one laboratory in Jakarta for the whole country.
The 79-year-old lung specialist told the patient to get tested elsewhere, but the patient came back saying that two referral hospitals in Jakarta at that time were full, and that he was only classified as someone being “closely monitored” for COVID-19.
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Dr Gunawan continued to treat the patient without personal protective equipment (PPE).
“I am a lung specialist. That’s my job,” he told CNA.
“I continued tending to the patient as much as I could. A stupid and careless act if you think about it – it is infectious. But he is a patient, and I continued to treat him,” he said.
The patient later passed away, and Dr Gunawan could never prove that the patient indeed contracted the coronavirus.
He went on to handle several patients with similar symptoms. He suspected they too had been infected but was unable to test them for COVID-19 because of a lack of resources.
“COVID-19 patients don’t have a sign on their foreheads that say ‘COVID’. We handle a patient, and after several tests, then we realised this is most likely COVID. But it could be too late already, we could have been infected,” he said.
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When COVID-19 cases first emerged in Indonesia, hospitals were not aware that all patients should be screened upon arrival at the emergency rooms, hence paramedics were not equipped with PPE, Dr Gunawan said.
“At that time it was hard for hospitals to imagine that paramedics need to wear a hazmat suit of 1 million rupiah (US$61) only for one usage,” he said, adding that the procedure now is for every healthcare provider in the emergency room to don PPE.
As of Wednesday (Apr 1), Indonesia reported a total of 1,677 cases, with 157 deaths.
“I’M NOT A HERO”
Dr Gunawan said he only wore the hazmat suit once when handling a COVID-19 suspect patient.
A picture of him in the suit went viral online, with people hailing him as a hero who threw himself into the frontline despite his age.
He refused to be called one.
“Oh, no, I’m not a hero. The heroes are those doctors and paramedics who have passed away during the pandemic.
“The heroes are the nurses who are still tending to patients while crying (out of fear) but because they took an oath before they entered this profession, they continued carrying out their duties,” he said.
“I’m just a cheerleader,” he added.
Dr Gunawan’s family had told him not to treat COVID-19 suspect patients as he might get infected.
“They were worried. They knew there was a high risk but I was sworn in as a doctor. I don’t want to put aside my oath just like that.”
Dr Gunawan has four children and five grandchildren, the youngest of whom is in elementary school.
“I said: ‘Let’s just leave everything to God. If God gives me health, we can unite again one day. But if not, then that’s life.’”
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He said all doctors and paramedics are serving patients despite the high risks - some are even not protected with the right gear - simply because they have to do their job.
“Several nurses shivered with fear when they had to visit patients suspected of having COVID-19,” said Dr Gunawan, who works for three private hospitals in Jakarta.
“They told me: ‘But doctor, I’ve got children.’ Then they surrendered themselves to God.”
DOCTOR TURNED COVID-19 SUSPECT
One day in mid-March, Dr Gunawan felt unwell. He was immediately taken to a COVID-19 referral hospital in Jakarta and was admitted into an isolation room.
“I was a COVID-19 suspect,” he said. “I was coughing, had high fever and difficulties breathing. I felt nauseated and vomited.”
He was treated for COVID-19 and was prescribed various medications from bird flu to malaria medicines, he said.
During his eight days in the hospital, swab tests were conducted on him every two days. An X-ray scan was performed every day, so was a blood test.
“It was unpleasant,” he said.
Dr Gunawan had to share the isolation ward with another patient, a doctor six years his junior who was severely sick.
“He kept screaming. He couldn’t eat, he vomited and was restless,” he recalled.
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When his COVID-19 tests returned negative, he was discharged and placed under isolation at home for 14 days. Still bothered by a cough, he has to keep a safe distance from his children and grandchildren until the middle of next week.
“I cannot hug and kiss my children. I really want to hug my grandchildren,” he said.
Once his isolation period is over, the doctor, who also suffers from diabetes, is not allowed to go back to work.
He said a new regulation has been introduced by the Indonesian Medical Association to bar doctors over 65 years old to handle COVID-19 patients.
Dr Gunawan said he will instead spend his time sharing his experience with his colleagues and friends.
He urged people to stay home and practise social distancing.
“Be careful. COVID-19 is everywhere. You do not know whether the person you encounter has COVID-19 or not, so just assume everyone you meet has it.
“That’s the way to deal with a pandemic. Everyone has COVID-19 unless otherwise proven. The best way to deal with it is to stay at home,” he said.
For those diagnosed with COVID-19, Dr Gunawan’s message to them is to not be discouraged.
“You can recover,” he said.