The first swab

Issue: BCMJ, vol. 63 , No. 1 , January February 2021 , Pages 45-46 Back Page COVID-19

A primer on what needs to happen if a family member tests positive for COVID-19.


13 November 2020

Did you know that you may have to stay home for 24 days if one of your children tests positive for COVID-19 and you can’t isolate yourself from your family?

One morning in August, I was snoozing in bed when my youngest son woke up with abdominal cramps. Small muscular feet pounded down the hallway, the toilet lid slammed against the tank, and a rapid-fire machine-gun type of bowel movement ensued.

Gone are the days when I would blame the activity on an excess of cherries and pull the comforter over my head. In COVID-19 times, new dramatic physical symptoms put me on high alert.

The pestilential child in question is typically kissed and hugged many times each day. Much to his chagrin, everyone in the family began keeping their distance. He insisted that it was safe to hug my knees, so I let him. Last I checked, knees don’t have mucous membranes.

The familiar fragrance of Lysol rose through the air as I disinfected every surface. And I whipped out the thermometer to confirm he didn’t have a fever.

He ate breakfast with no further gastrointestinal distress. I started to relax.

Then he sneezed. Not once or twice, but 10 times in a row, burying his face in the crook of his tiny elbow every time.

Doctor-moms tend to be either underreactive or overreactive when it comes to any symptoms their children exhibit. I am the underreactive type. I never think my kids are sick. This time I decided to behave like a patient and I tapped on my BC COVID-19 app to complete the self-assessment tool on behalf of my son. It became clear he would need the dreaded nasal swab to rule out COVID-19. This story unfolded before the lovely gargle test was an option for my son.

I called the COVID-19 line to book a swab for him, dialing five times only to hear, “The line is very busy, you will be disconnected now, but try your call again later.” Over the past weeks, the number of calls and requests for swabs has increased dramatically. Since our experience, the Vancouver Island Health Authority doubled the number of staff managing the phone line, and a separate line was created for health care professionals. This has shortened wait times significantly.

On my sixth attempt, I got through. I often wonder what sadistic creature chooses the music for the waiting-on-the-phone nightmare intervals. Imagine a loose-lipped flautist struggling to play while a hamster screams inside the barrel of the instrument and you’ll have an idea of the auditory assault I endured for 2 hours and 15 minutes. During that time, I spoke with three different people. I was booked in by a clerk, who requested my son’s personal details. I was interviewed by a nurse, who confirmed that he needed a swab. Finally, I spoke with another clerk, who provided him with an appointment time.

At last, we drove to the white tent at our local hospital where we were greeted by the kindest public health nurse in the world, rocking her PPE. We stayed in the car with the windows open while she chatted with us briefly. The little fellow was belted into his car seat (no escape route!) and I sat beside him holding his head and arms still as the nasal swab was inserted. His face registered real discomfort at the end of the swab, and afterward his eyes watered and his nose ran. He looked peeved and requested Kleenex. I had promised him freshly baked chocolate cupcakes if he could get through that swab without moving his head. The lovely nurse sent us on our way with a number to call 24 hours later to get the result. In the meantime, we would stay at home so as not to potentially expose anybody else.

At home, my little son was greeted as a hero. “I’m the first person in the family to get swabbed!” he announced proudly. But he also told everyone the hard truth: “It hurt a lot.” And I began to wonder if my children would report invisible symptoms next time, now that they knew a test might be required. Would they tell me about a sore throat? Or muscle aches and pains? I decided they needed some small motivation to report symptoms—something to help them get through the test if it was needed. I told the kids that each of them could expect to get tested two or three times over the next 6 months. This is life in a pandemic.

A new house rule was created: Every time someone gets a COVID-19 test, chocolate cupcakes will be baked. And only the swabee gets to lick the batter bowl. A chorus of approval greeted this suggestion. Clearly, I don’t bake enough.

My little son’s swab was negative and we were relieved.

I took the opportunity to thoroughly understand what would happen if a family member became COVID-19-positive. I communicated directly with our hardworking North Vancouver Island public health officer and was surprised to learn that if one of my children tested positive for COVID-19, I would have to stay home for 24 days—not 14 days.

Let me explain.

For the first 10 days, I would stay home with my COVID-19-positive child during his infectious period. My own 14-day quarantine would begin after the last day of possible exposure from my child (his day 10 would be the last day of causing infection in others). If you are able to isolate away from your family, then your quarantine time would be 14 days rather than 24. This rule applies across Canada.

My eyebrows went up when I realized the implications of 24 days at home—no direct contact with patients for me, no school for the kids—perhaps more than once over the coming months.

After I had numerous conversation with others, I was amazed how few people are aware of this number, including doctors. I suspect that if the second wave pummels British Columbia, this 24-day stay-at-home order may need to be reviewed for health care professionals if there is a struggle to find coverage for hospitals and clinics. For now, an isolation period of 10 days for COVID-positive cases and an incubation period of 14 days for close contacts are the numbers that apply to all citizens across Canada.

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This article has been peer reviewed.

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Dr Ruthnum is a care of the elderly family physician in Comox, BC. She does both inpatient and outpatient geriatric medicine consultation.

Mandy Ruthnum, MD, FCFP. The first swab. BCMJ, Vol. 63, No. 1, January, February, 2021, Page(s) 45-46 - Back Page, COVID-19.



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