[FRONTLINERS] An Iligan doctor's 'elaborate nightmare' battling coronavirus

Dr Leonell Quitos is the sole infectious disease specialist in Iligan City, Northern Mindanao. At 33 years old, Quitos finds himself on the front lines to protect Iligan's more than 340,000 residents against the COVID-19 pandemic. After getting exposed to his 3rd COVID-19 patient, Quitos developed mild symptoms and was forced to undergo self-quarantine. He fears for his life and hopes he would be strong enough to see his 8-month-old baby grow up. This is the story of Dr Leonell Quitos, told in his own words.


Every time I wake up, I wanted to think that this is just really an elaborate nightmare. I wanted everything to end. Even now that I am under quarantine, that’s what enters my mind every time I wake up. 

I have to disclose this: I’m on self-quarantine after taking care of 3 confirmed cases. I became symptomatic. But with the mercy of God, I'm now on my 7th day without symptoms. 

On March 7, a patient was referred to me and we classified him as SARI or with severe acute respiratory illness. The patient initally denied having any history of travel. When he was referred to me for infectious disease consultation and co-management, I convinced the patient to tell me if he really had no history of travel.

The patient eventually admitted he came from Pasig. He also went to Greenhills. So that’s when we opted to label him as a patient under investigation (PUI) and transferred him to the Northern Mindanao Medical Center for testing, isolation, and management. He tested positive. I think he’s the first confirmed case in Mindanao. He is PH40. 

PH492 is another confirmed case whom I’ve been taking care of for more than a week. Our problem here was the results of his swab test took a long time to come out. My exposure to him was quite long as well. He turned out to be positive. The good thing is that the patient’s condition has improved. He no longer has symptoms but he is just undergoing facility quarantine now.

The 3rd case is Patient 1466. PH1466 was referred to me and she came to my clinic. When she arrived, I saw she was very symptomatic. She had cough, difficulty breathing, weakness, body pain, fever, and sore throat. When I saw her, I insisted she immediately be admitted to the Northern Mindanao Medical Center in Cagayan de Oro. Her X-ray results showed she already has pneumonia compatible with COVID-19. On March 28, her test results came out positive. 

Those were my 3 exposures. The problem is, days after my exposure to PH1466, I developed a sore throat, then severe headache, and then body pains. I never had fever but I felt feverish. When I felt the symptoms, I told my wife and my child they should temporarily move in with my in-laws for now. 

Denial, I think, is a very natural thing for us to feel. I initially told myself, "Maybe this is just stress." But on the day I started having a severe headache, I felt feverish, experienced body pains, that’s when it started to sink in that maybe I acquired something.

To tell you the truth, I really cried because I didn’t know how to tell my wife that maybe I am symptomatic already. Our baby is just 8 months old. He's still so very young. I was so scared that I could already be a carrier, that I might have infected them in some way. Both of my parents are elderly too. They’re both hypertensive and diabetic. I was so afraid.

I isolated myself. I just stayed in my room. They would just give me food and water. That was so difficult. I think more than the symptoms, the emotional struggle was harder to deal with.  

I am an infectious disease specialist. This has been going on and on in my mind every time I see a patient who is infectious. That’s why it’s hard. Even before COVID-19, whenever I see patients referred to me because they have tuberculosis or other infectious diseases, I would get paranoid that I might bring the virus at home. 

We are very fortunate to have a local government unit (LGU) that is very supportive of the needs of the medical community. When we recommended to put up a COVID-19 center, they immediately moved to create it. And then when we requested for personal protective equipment, they called on the supplies officer and made an emergency purchase for our request. 

We are very fortunate here in Iligan City because our LGU is very responsive. They were also responsive when it comes to the community quarantine. I think the implementation of the enhanced community quarantine in Iligan was very timely too.

We have now resorted to telemedicine. This was made possible through joint efforts of the members of the Iligan Medical Society. We also talked to Dr Geohari Hamoy, one of the consultants of telemedicine at the Philippine General Hospital. He’s from Iligan.

We have already strengthened our triage in all our hospitals here. All hospitals have an electronic medical record or EMR. So when a patient is screened and is labeled as a PUI, his or her data will be entered into the EMR, which is centralized. Now that I’m on isolation, I am the one manning the command center now. The data they will input can be accessed by my computer. And then that patient will be referred to our dedicated COVID-19 center. 

 

The biggest challenge now is the diagnostics. Only a few supplies were allocated to us for testing. That’s our problem now. We can’t really test anyone here in our city. As much as possible, we want all PUIs to be tested to give us a chance to really capture the extent of the infection. But the only PUIs we were able to test were the severe cases.

Another challenge is that we have a lack of manpower. We needed 6 doctors in the quarantine facility, but right now we only have two. There’s still an active effort to look for more doctors. Some of the doctors can no longer enter Iligan because of the lockdown. They cannot come back here yet.

To be honest, the hardest part is you can’t give up. There have been many times I wanted to give up because of the burden, the fear, especially now that we’re just starting my family. I really wanted to give up because I want to be alive for my family.

But that’s the hardest part – you can’t give up. Maybe that’s one of the noble things about being a doctor. You really have to sacrifice a lot for the good of the people. – Rappler.com


Editor's Note: Rappler interviewed Quitos on March 31, 2020. All of his quotations have been translated to English.

TOP PHOTO: A HERO. Dr Leonell Quitos, wearing his complete protective gear against COVID-19, poses for the camera. Photo courtesy of Quitos

Mara Cepeda

Mara Cepeda writes about politics and women’s rights for Rappler. She covers the House of Representatives and the Office of the Vice President. Got tips? Send her an email at mara.cepeda@rappler.com or shoot her a tweet @maracepeda.

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