They say a family that eats together stays together. We ate together, stayed together and got sick together. We got sick with Covid-19. Together. It was my family’s worst nightmare. 11 out of 17 members of my family tested positive for Covid-19, all in a span of 5 days.
We are a semi-joint family, consisting of 17 members of 4 generations, with ages ranging from 3 months to 90 years and staying across 3 floors in the same building. We were all locked in the house during the national lockdown. We followed the strictest possible rules of the lockdown. We barely left the house. We sanitized our building every day. We sanitized all the essential items bought once a week by a family member for the entire household. We met nobody from the outside and no one entered our house. But even then the coronavirus entered our home, and infected one member after the other.

HOW IT ALL BEGAN?

My uncle, a 57 yrs old healthy male was the first patient. He complained of fever, fatigue and bodyache. It was dismissed by us as just a seasonal flu. Over the course of next 3 days, his wife (54 yrs) and son (26 yrs) got sick too, with similar complaints. On the other floors, my father (62 yrs) and my other uncle (60 yrs) also got sick. Things started looking serious now. Even though in our family, it was quite a common occurrence for multiple members to get sick simultaneously, we got increasingly worried and cautious. But we decided to wait for a week, which is how long a flu usually takes to resolve. However we did isolate the patients. As soon as the first symptom appeared, the sick were confined to separate rooms, having limited contact with other members.
Over the next 4 days, my mother (58 yrs) and my grandmother (87 yrs) got fever and bodyache. This was unusual. And we were scared now. It was mutually decided that the patients would have to follow some basic isolation steps:

• The patients were isolated in their respective rooms having attached washrooms.
• The patients would only communicate with us for food, medicines and essential stuff.
• They would all wash their own clothes and utensils themselves, and also clean their rooms on their own.
• Nobody was allowed to enter their rooms. Anything to be given to them would be kept on tables near the doors of their rooms.
• Since we are spread over 3 floors, we constituted a Whatsapp group only for communicating each other’s symptoms like fever. Each patient was supposed to record their fever and report it on the group, along with any other complaint. Medicines and home remedies were discussed on the group and each person’s individual complaints were addressed through it.
• The house was sanitized through sanitizer sprays twice a day.

5 days later, my aunt who was already down with fever complained of breathlessness. When she showed no improvement, we knew it was time to get her tested for Covid-19. With a prescription from our family physician, she was tested at home for Coronavirus. Next evening, as more members were being tested for Covid at home, her report came out to be positive. It all came crashing down after that. The family was aghast and devastated.

HOW DID WE COPE?

Over the next 4 days every adult member was tested and it was found that 11 out of 13 adults were positive for Covid-19. It seemed like the end of the world for us. The lockdown, up until then, had been a very positive time for the family. We had spent all our time together; eating, playing and having fun. This was a jolt so sudden that it shook each of us to the core. But it was also time to act and decide swiftly.
My aunt was shifted to a Covid hospital the same night her result came out. And our house was quarantined with nobody being allowed to enter or leave the building. It was overwhelming for us. And as the results of other members were coming out positive, we all seemed to be sinking fast.

As the disease unfolded in the household, we were all only thankful that we were all still together. But a lot went through the household before things got under control:

• Denial to panic to acceptance: The initial 6-7 days when we had dismissed the disease as seasonal flu, were basically us being in denial. It was obvious that something was ominously wrong but we persisted in our belief that all will be well. When the results came out, there were plenty of tears and palpitations. We panicked and felt lost, alone and like untouchables. We knew we can only communicate with the outside world through phones, but can’t and shouldn’t get anyone to help us at home. We had to manage on our own. But as days passed, we accepted our situation, and tackled it with the help of relatives, friends and neighbors. We had plenty of medical advice available through our phones, and we reached out fervently to anybody we could think of. And each one of them helped.
• Fear of “what would people say”: This fear of stigma prevented us to get tested in the first place. And this was the fear we had when we came out positive. But people only said extremely encouraging and supporting things. Right from connecting us to doctors and hospitals to suggesting medicines and home remedies, from arranging delivery of essential items at our doorstep to keeping our morale up by constantly motivating us. If only we had overcome this taboo, and had gotten the patients tested earlier, we could have prevented the disease from spreading to other family members to some extent.
• Fear of life: Of course, we were scared for the lives of some of the members, whose health were seriously compromised for some days. We imagined the worst was going to happen. We had elderly to take care of and kids to shield from the disease. But Covid-19 is known to be fatal in about 3% cases in India, and that too in patients having other serious co-morbidities. So, we tried to remain optimistic and just focused on managing the patients.
• Fear from government: This was one irrational fear we had acquired. We thought we would all be dragged out of our home to some far-flung quarantine centers and we would have to live in all kinds of questionable places. But nothing of that sort happened. Contrary to what we had imagined, there was no any harassment or pressure from any government agency. The day after the first positive test came, we received a call from the local government dispensary, telling us that we will put under home quarantine for the next 14 days. During this period, we were asked to monitor our health parameters and look out for symptoms like fever, cough and breathlessness. We were told to get ourselves tested at either a government CTC or by a private lab at home at once. They would regularly take updates about the test results of the other family members, and would inquire about their symptoms. However, all the decisions regarding the treatment and hospitalization had to be taken by us, without any assistance or interference from any authority. Although, we were not told how we were going to manage to acquire the essential items for the family, we did not encounter any problems with the same, thanks to our neighbors and neighborhood shopkeepers. Items like milk, medicines, fruits etc. were acquired either from the neighborhood shops or online, paid online and were delivered in a box kept near the gate of our house.

MANAGEMENT OF THE PATIENTS:

Our house had turned itself into a Covid healthcare center. So, we took advice from 4-5 doctors for managing the illness at home. Since there is no treatment yet for the disease, the management is mostly symptomatic, i.e. medicines are given only to relieve particular symptoms, not to cure the underlying disease. Here is a snapshot of the treatment that was advocated, after assimilating all of the advice:

• Fever: Paracetamol 650 mg (e.g. Crocin 650 or Dolo 650) for high-grade fever (more than 100⁰F) and could be taken 6 hourly. Paracetamol 500 mg (e.g. Crocin 500 mg) for low-grade fever (less than 100⁰F) and could be taken 4 hourly. Ice water compresses were used if fever didn’t go down easily. Fever had to be monitored every 3-4 hours.
• Cough: Syrups like Grilinctus or Alex were helpful in providing some relief, though dry cough continued for days after fever had subsided. Lozenges like TusqD were also helpful.
• Breathlessness: Mild breathlessness was managed by nebulization with Levolin 0.63 mg. But it’ was a tricky symptom and it was decided that if the symptom persisted, then it would be advisable to get medical assistance as soon as possible. We kept a pulsoximeter by the patients’ side, and monitored his/her SpO2 every few hours (SpO2 more than 94 was considered the cutoff; if less, than we had planned to seek medical help). 
• Antibiotics: Most of the doctors we contacted recommended Azithromycin 500mg for 5 days. It might not have any effect on the Covid infection, but we complied with what was told to us. Those who could tolerate it better were given twice daily dosage, but most were given once daily dose. Some patients complained of increased frequency of motions due to the antibiotic, so they were given a probiotic like Enterogermina to manage the gastrointestinal upset.
• Hydroxychloroquine: We were told that there is no proven efficacy of the drug in Covid-19 patients. Rather, there are dangerous side effects like arrhythmia in some patients who have other co-morbidities especially heart diseases. Since most of the family members were more than 50 years of age and some were hypertensive, it was mostly avoided.  The patient who was hospitalized early on was given the drug in the hospital, and my mother was given the drug at home as she continued to have high grade fever for longer duration, and had no other co-morbidity. It could be pure chance that it did not cause any harm in these patients, nor can we be sure if it played any role in their recovery.
• Headache and bodyache got usually relieved with paracetamol, and subsided with fever itself.
• Supplements like Vitamin C (Limcee 500mg) and multivitamins like Becosule were taken every day, to help build immunity.
• Steam inhalation, twice or thrice a day, using plain water or after adding medicines like Karvol plus tablets.
• Gargles for cough.
• Home remedies: Every member tried some or the other remedy, advised by relatives and friends, like:
• Kadha: It is basically a concoction of various ingredients like ginger, turmeric, cinnamon (dalchini), cloves (laung), honey, black pepper etc, cooked in water for 25-30 mins, taken twice a day. 
• Ghiloi” tablets
• Steam inhalation with plain water or containing dalchini (cinnamon), garlic etc.
  It is hard to say how much these helped, but we knew they would at least not cause any harm to the patients.
• Regular breathing exercises
• Plenty of oral fluids like coconut water, buttermilk, juices etc.
• Adequate nutrition and fruits.

Management of Children: Our topmost concern and worry during this time were our children. I and my wife had tested positive and my 5 yrs old daughter had tested negative. My 22 months old son couldn't be tested. So we were in a very precarious situation. We were scared that we might infect our kids and what we would do if they show any serious symptoms. But we consulted a couple of pediatricians to allay our fears. Based on their suggestions, we concluded that:

• Children, especially in India, have mostly shown resistance to the disease, or at the most, mild illness. 
• Since it was not possible for us to be isolated away from our kids, the 4 of us stayed isolated together, avoiding contact with other positive members of the family.
• We practiced basic hygiene like avoiding hugs and kisses to the kids, washing hands thoroughly before feeding them, using separate utensils and hand-towels for them, avoiding feeding them anything while we were having food etc.
• We did get the kids tested, but we were also told that due to difficulty in collecting sample in children, they might have false negative results too. So, we were advised to not to repeat their tests unless they showed any symptoms.
• No medicines or supplements were given to the kids. 

Segregation of healthy members: My cousin (29 yrs), his wife (28 yrs) and his 2 kids (2 years and 3 months) were the only apparently healthy members who had tested negative. It was our collective responsibility to prevent them from getting infected. So, they were completely segregated from us in the house and were in a quarantine of their own. They could not be sent anywhere else as even they could potentially cause risk to the people outside the house.

KEY LEARNINGS FOR US:

• It is true that there is no treatment for Covid-19 infection, though several studies are underway to find a drug that can cure the infection. But in most patients in our family, it could be managed with basic medicines at home, used for any viral infection. Due to its highly contagious nature and fatality, isolation is required, but there is no escaping it. For patients who were isolated in their rooms, it was an unimaginable ordeal to be confined in a space. At some point they were all very sick, but still they had to do all the chores on their own, monitor their health parameters and be motivated enough to carry on. They took one day at a time, and tried to remain calm and patient. It all took a massive emotional and physical toll on them, but they could do nothing but persevere. Panic almost derailed our focus for some moments, but as soon as we surrendered ourselves to the situation, we realized that if the disease won’t kill us, worrying will.
• We were fortunate enough to have the financial resources to manage the situation, and to have the emotional support from all our relatives and friends. The people around us helped us get through each day, besides providing us all kinds of assistance that we needed. There is immense gratitude in us to acknowledge these facts.
• There is so much advice being circulated on social networking platforms that one tends to get confused and paranoid. It is always better to talk to medical practitioners and clarify doubts, rather than follow these online recommendations blindly.
• Covid-19 is a new disease and the world knows very little about it. A lot of questions about its treatment, vaccination, mode of transmission, re-infection, effect on children etc. remain to be answered and it might be a long time before we see any progress on that front. Meanwhile nobody, no doctor or specialist or government or analyst can fully answer these questions. So, right now our best bet is to just practice basic hygiene, social distancing and other preventive measures. Even after recovering from the infection, we ought to continue all these measures, as we cannot completely rule out the possibility of re-infection, until it is proven by studies.

CURRENT STATUS:

We had to hospitalize only one family member, who was discharged after having no symptoms for 3 consecutive days and testing negative on 11th day of hospitalization. 

My grandmother still has low-grade fever after 26 days and tested positive in her 2nd Covid test, repeated 16 days after her 1st test. She continues to be isolated and managed at home.

Rest all the affected members have recovered and exhibited no symptoms for more than 15 days.

Most of the members have tested negative on their second Covid tests (repeated after 12-14 days of first test), while a few still remain positive and will be tested again after at least 14 days of their 2nd test. Meanwhile they are quarantined at home, and segregated as much as possible from recovered members. 

We pray and hope that each one of us will soon recover from this disease completely.

Last update:

After almost a month of battling with the disease, each member of the house recovered ! Though most of the members' symptoms lasted for 12-15 days, they remained quarantined for almost 15-20 days after recovering. Their quarantine ended after they were tested negative for covid-19. 

Looking back it almost seems like a miracle now. But we continue to be cautious and anxious about the road ahead. Since there is no proof yet of a long-lasting immunity in covid patients, we consider ourselves as vulnerable to a re-infection as before. Hence we continue to take as many precautions as possible to stay safe. We were lucky once, which may not be the case again. So precautions are our best weapon right now.

Brief overview of the family:

Table 1: Details of affected individuals

S.No.	ID	Age / Sex	Symptoms	Duration of symptoms	Co-morbidities / Past History	Management
1	A1	90/m	Asymptomatic	NA	Past H/o Miliary TB Heart Disease (CAD) Hypothyroidism	Home Isolation
2	A2	87/f	Fever 99⁰F-101⁰F Headache Bodyache, Fatigue Mild breathlessness Dry Cough	28 days + (ongoing)	Hypertension	Home Isolation Symptomatic treatment
3	B1	62/m	Fever 99⁰F-103⁰F Headache Bodyache, Fatigue Dry Cough	9 days	Diabetes Mellitus Hypertension Thalessemia Minor	Home Isolation Symptomatic treatment
4	B2	58/f	Fever 99⁰F-103⁰F Headache Bodyache, Fatigue Dry Cough	13 days	Hypothyroidism	Home Isolation Symptomatic treatment Hydroxy chloroquine (for 5 days)
5	E1	33/m	Loss of smell sensation	NA	No relevant history	Home Isolation
6	E2	30/f	Asymptomatic	NA	No relevant history	Home Isolation
7	C1	60/m	Fever 99⁰F-103⁰F Headache Bodyache, Fatigue Dry Cough Altered sense of Taste	12 days	Hypertension Diabetes Mellitus	Home Isolation Symptomatic treatment
8	C2	57/f	Fever 99⁰F-100⁰F Bodyache, Fatigue	5-6 days	Hypertension Trigeminal neuralgia Past H/o Hep. C	Home Isolation Symptomatic treatment
9	D1	57/m	Fever 99⁰F-100⁰F Headache Bodyache, Fatigue Dry Cough	10 days	No relevant history	Home Isolation Symptomatic treatment
10	D2	54/f	Fever 99⁰F-100⁰F Breathlessness Headache Bodyache, Fatigue Cough with expectoration	14 days	No relevant history	Hospitalisation for 10 days followed by home isolation
11	G	26/m	Fever 99⁰F-100⁰F Headache Bodyache, Fatigue Altered taste sensation	8 days	No relevant history	Home Isolation Symptomatic treatment

Fig 1: Family Chart

Disclaimer:

I have written about this whole experience, only with a hope of reaching out to anyone who is undergoing the same situation as our family, and needs some reassurance and support to keep going. This is by no means an advocacy of any particular treatment or advice, since we only did our best to use whatever understanding we could build from various resources, and could have been wrong in many processes and methods.