Shireen & Yacoob

Brief Outline:

Shireen and Yacoob both contracted Covid19, and both were admitted to hospital. Shireen made a quick recovery. Yacoob spent 6 weeks in intensive care. While they were in hospital their shop was sold, as was their apartment that was above it. Interviewed in September 2021.

Background:

Yacoob has run an African food shop for the past 30 years. Shireen works as an interpreter in the local hospital. They have three adult children, one of whom lives with them. Ethnicity: British Asian (Burmese).

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Onset

When Yacoob developed a cough in January 2021, he asked his son who works as a GP to arrange a PCR test for him. The test result came back positive. Yacoob, who tells me he has never been severely ill in his life, began feeling weaker and was short of breath. His wife Shireen also felt increasingly unwell. She had a temperature and diarrhoea.

At this point, Shireen had had her first Covid vaccination and Yacoob was scheduled to get his first jab in the following days. When we speak (September 2021), they have both received two doses.

Their son had Covid at the same time. He did not require hospital admission. His recovery from his infection is ongoing; it is possible that he has long Covid.

Admission to hospital and the intensive care unit

On day 4 or 5 their symptoms had become so much worse, and their son decided to call an ambulance. Both were taken to hospital and discharged the same day. Both were later re-admitted to hospital: Shireen was admitted to the general ward, but Yacoob was so poorly that he had to be admitted to ICU and be ventilated.

When both Shireen and Yacoob were in hospital, their son was overwhelmed with the shop. Only Yacoob knew the ins and outs of his shop. Even Shireen, who was discharged before Yacoob, did not exactly know the ways the shop was run. In a panic their son decided to sell the shop. This meant that the house above the shop, in which he and his parents had lived in for 20 years, was also sold as well, so that Shireen and Yacoob moved into temporary housing when they were discharged from hospital.

Time on the ward

Yacoob was on the ventilator for three days and was then weaned off it. He was discharged from ICU onto the ward. He stayed here for another 6 weeks. Whilst Shireen was still in hospital too, Shireen and Yacoob were able to see each other. When she was discharged home these visits stopped. She and her family members were not allowed to visit Yacoob, but they did FaceTime. Their son brought food Yacoob liked to the ward for a number of days.

When the doctors made their rounds, Yacoob called his son to listen in, which is how he stayed updated. He then passed this information on to Shireen and other relatives. Yacoob received physiotherapy every day. He appreciates the care he received: “they looked after me so much”.

Discharge from hospital

Although Yacoob was not entirely well yet, their son insisted that he and his mother would take care of him at home.

At home, Yacoob had difficulties sleeping and eating. His eating pattern changed long-term because he is no longer active. Yacoob had difficulties walking long distances.

4 months after his discharge he walks two hours each day, but he still feels not back at the level of health he was previously. He feels that ‘compromise’ is important: God has given him life and has taken something out. Yacoob accepts this and describes it as his fate.

Bereavement

Shireen and Yacoob lost many family members to Covid, mostly in Pakistan and Burma. In hindsight, this made being critically ill particularly worrisome, and many family members have since said that they, based on their experiences of loss, had not expected Yacoob to survive.

Follow-up care

Yacoob has received follow-up care from respiratory clinicians: an x-ray has been done, which showed that his lungs have improved after 3 months.

A physiotherapist visited him at home but concluded that Yacoob did no longer need such support. A carer was also not necessary, nor was speech therapy. The fact that the flat they are living in now has a walk-in shower is very helpful.

Looking back, Shireen and Yacoob found the suddenness of the onset particularly difficult to come to terms with. Now their main challenge is that they do not have a permanent home and no income from the shop. Everyday life continues to be fraught with anxiety for both Yacoob and Shireen: “we are not safe yet” Shireen says, indicating that Covid is still a health risk.

Shireen and Yacoob developed symptoms in short succession. Shireen spent 8 days in hospital on a general ward, and Yacoob spent 3 months in hospital, including 6 weeks in ICU.

I went for my first vaccine. When I came back, I was fine, and he was fine. In the same day my daughter gave birth, the first child of a grandson. So, at nine o'clock, we got the news that she had a baby boy, and he was fine, and we went to bed about 11 o'clock and after half an hour, all of a sudden, he starts coughing. And coughing a very different way. So, I was particularly conscious of him, and he was coughing, coughing, coughing about one and a half hour, then he was fine. In the morning, I asked my son to go for his Covid test, appointment Covid test, and he had this in the afternoon. I took him there, he had his Covid test, and we got a result on the 15th in the evening. But since after the 15th, on 15th in the morning, he felt not strong enough, but he was fine. In the evening we got a result that, he has got a positive result. Then we had to close down the shop. And the same day I started a little bit of symptoms.

My symptoms were not coughing, just weakness and didn’t want to eat and I have got this diarrhoea problem. I've got so much diarrhoea and I've got to urinate so many times I have to use the toilet for the urine, and he has got the coughing and he's getting, he doesn't want to eat, and he feels dizzy, and I've got a temperature. My temperature didn’t go down, because one of my son’s is a GP. So, he was assessing by Zoom and everything. He asked my other son who is the eldest one, who lives with us. So, he's telling him to take the, all the, you know, oxygen air and everything he did, but it's getting worse and worse, instead of getting better. We are taking paracetamols but can't eat anything.

His son found Yacoob lying on the bathroom floor and called an ambulance.

After I think four or five days, my son came by his feet, he wears all his PPE and then he called an ambulance and the ambulance people came and they said, all right, we went both together to the hospital A&E and then they checked on my husband and they said he's fine.  They check it again and said he’s fine, he has been discharged.  For me they said you have to stay.  But after four hours, they discharged me as well.

But instead of getting better, every day we are getting worse. My temperature doesn’t go down and he has got the oxygen levels, don’t, my oxygen levels also not normal. But my eldest son was with us so always he has to keep an eye across. Every room we stay in each of the room, but we can't eat anything. And the second time also Sunday, it was, he got so much high temperature. My son, again, called an ambulance and the ambulance people came, and they checked him, and they checked the oxygen and they said everything fine, they will get the fever down, no need to go to the hospital.

The third time, the last day, he didn't know, when he woke up, he didn't know, when my eldest son woke up, he found that my husband, he is lying in the bathroom, he doesn't know where he is, so he has to carry him and then we call my other son, and he called the ambulance. When the ambulance people came, he was not in a very good position. So, when ambulance people came, he tried, they tried to take him. But when my other son asked the ambulance people, can you check my mum? So, when they checked me, they said, she's worse than him. So, we both, the different ambulance, we would go into you know, [name hospital]. I had got the serious, all those days I’ve got the serious stomach pain, at night I was screaming, screaming, screaming. So many times, I have to go to the loo. And then we had been admitted then.

Shireen had lost many family members to COVID-19 in Pakistan. Based on this experience, she feared that her husband would not survive.

Can you say a bit more about what it's like for you when [partner] was in hospital?

Shireen: I was I was very emotional at that time. I was very emotional; it was hard for me to control myself. I was worried about like my children were giving me so much, telling me he will be back, he will be back, but I was quite emotional. I don't want to, sometimes my son arranged for the face time, but I don't want to see him with the seat back on the bed, lying on the because. I was quite emotional, and I was quite worried all the time. I was crying, crying, crying, but you can't help it, you can't help it.

Yacoob: The problem is that during that time, you know, you lost, how many, his sister, four children he lost.

Shireen: So, because all this in the family it happens and all of a sudden it happens to us, so I was shocked that something, how it's going to happen again, this one and this one. So, the first pandemic in my family, about four person in the family had been, one go just about just about 15 days, ten days, five days, just apart.

Yacoob: And they are all younger than me.

Shireen: All very young.

I am so sorry to hear that. So that was early on in the pandemic?

Shireen: Yes, the first pandemic.

Family in Pakistan?

Shireen: Pakistan. All of a sudden, each one, one by one, one by one. And one of, he has go onto the ventilator in ICU and after that he didn’t come back. So, it was in here also in that January, the second pandemic was very bad.

Yacoob: Because at that time, my time, people think if you are in the ventilation, you got less chance to survive.

Shireen: And that time was the peak time, so it was so bad.

Yacoob: If you weren’t on nasal ventilation then it was very, less chance to survive. So, they took it more serious, that one.

Shireen: That’s why, because my son was so panicked that he was thinking that if you live upstairs on top of the shop when he comes back, he wouldn’t listen to us, he will go down, so it's better to move from here. He was so panicked, and he had got the very bad, he has got the long Covid symptoms, coughing. He is only at that time 35, now he is 36. So still, it's a very tough time because one of the son’s he can't visit during Covid. He’s the only one he has to do everything. My daughter can't visit because she had a baby and this Covid, we had Covid so nobody, you know. So, it was a very, very tough time for me.

Shireen and Yacoob were both admitted to hospital. Whilst she was on a ward, he was in ICU.

So, when you were admitted to hospital, were you at any point together in hospital or were you separate?

Yeah. No, I am in the female unit, not far, but I want to visit so the nurse took me there. When I’d been discharged, he was ground floor, it's not in the ward, and it’s a different place. I forgot the name. So, they took me there in the last week, even though we talked over the phone, but he was not able to speak; a couple of weeks I couldn’t talk to him because his breathing, he can't even speak. If he speak too much his got a very bad breathing problem. So, I don’t want to speak to him. Only my son, who went to the doctor with rounds, so he spoke with them.

Shireen’s son was the designated contact person for the doctors, as she felt his training as a GP gave him the appropriate knowledge to understand what was said.

And so, your doctors were in touch with your son. Can you tell me a bit more about what that looked like?

Shireen: Yeah. It was very friendly, the doctors, even though when I was in the hospital and the doctors come round, so my son asked me when the doctor comes round just ring me so they can, so what is the condition and what [inaudible] and he passed them, and they told him everything. …And, you know, the doctors were, never did, never refused to speak, what my son asked them they gave him the answers and everything. They never refused. And when I got out and he’s, when doctors come on the rounds, every day, even the physio, every day physio comes round so they give him, he tried to contact my son and then my son ask everything, his condition and everything. Then my son give him the doctor said, the physio said like that. So, he knows every time he contact the doctor, anything he get confused so he asked them to do this phone thing.

Okay. And so, did the doctors call your son at a particular time in the day?

Shireen: No, when it comes to a round in the ward. Yes, if sometimes my son thinks…

Yacoob: Mostly, when the doctor come round and checking me there, so I put the phone to my son to talk to him because you know, when doctors say something, which is no my knowledge much, so they keep talking to my son, all the time.

Shireen: Yes. But when he’s not feeling better, I mean, he's not in a good, my son sometimes phoned the ward nurse and asked how his condition is and everything.

Yeah. So sometimes, you called your son when the doctor came and sometimes your son called the doctors to find out. And is this your doctor, your son who is a GP?

Yacoob: GP.

Shireen: Yes.

When Shireen and Yacoob were in hospital their son gave up the shop, they had run for 30 years. As their housing was linked with the shop, this meant that had to find new housing, and get used to retired life.

So [I] have been discharged. But before he [Yacoob] was discharged. My oldest son, who was, we were living in the flat above the shop, he doesn't want to stay anymore there. So, he just, by an emergency, he just rented out this flat, the one we are staying there. Because that one is that you have to take the stairs and all this, so he said it's not good for both of you, so he just rented out this flat. When he came down, it takes him about two months, two months, nearly three months.

He [Yacoob] discharged February 26th, March, April, May every day a little bit better. And then he couldn't, it's very hard for him breathing. After a few steps, he walk, he get very easily tired.

Then we have to wind it up, all our business. It's a big shock, it was a big shock for us because it was 30 years business and it was a good running shop, but for his health and for his age, we have taken a decision. And we winded up everything, in March, we just gave this the owners the shop, and we just move in here. It was a very big nightmare for us. But now after that, April, May, June, he, every day, he goes for a walk about two hours walk. Two hours walking slowly, slowly, slowly, slowly, and now he’s getting better.

But there’s a very good, all the staff, the hospitalised doctors, everybody was very, very helpful for us. They did it quite a lot. So, it was a big nightmare, big nightmare. Trauma. I was in the hospital, and he was in the hospital and the children doesn't know anything about [the shop]. So, it was a very big, it was, I don't know how to explain that it was a big nightmare.

But now he gets bored because he used to work from morning 'til evening now, he has nothing to do. So, he is getting bored. That's the thing. So, you don't know the life is going on, but this is a temporary flat. We have to look for the house, but still, we couldn't find it. I don't know what to do. It's a Covid, for this Covid just upside down, everything, life had totally changed because the business, everything we have to survive. Everything, we survived everything. But you can't help anything. One thing we got, because sometimes we thinking it was a real nightmare. He was not in a condition that he will come back. It was where he was a very bad condition, but God help it, God help it.