To date, 98 COVID-19 deaths have been recorded in Barbados, and they have mostly been linked to one or more pre-existing medical conditions in the patient. These co-morbidities have largely been identified as diabetes, hypertension, asthma or cardiovascular disease. Remarkably, in a country where one per cent of its population is deemed to be living with the human immunodeficiency virus (HIV), little has been heard about the outcome of a COVID-19 patient with this illness.
According to a recent World Health Organization (WHO) report, people living with HIV (PLHIV) are at an increased risk of becoming severely sick with COVID-19 and possibly dying, if immunocompromised. Moreover, WHO notes that overall, nearly a quarter, or 23.1 per cent of all PLHIV, who were hospitalised with COVID-19, died.
Meet ‘Jenny’ (a pseudonym), a mother and grandmother living with HIV, who contracted COVID-19, and survived to tell her tale. She shared her struggles with the Barbados Government Information Service (BGIS), expressing, chief among them, her fears of being re-infected with the disease.
‘Jenny’ has been plagued by several medical conditions all her life, including pre-eclampsia with one of her pregnancies, back in 1995. Years later, when she contracted HIV, depression set in and she was shunted aside because of stigma and discrimination from family, friends and co-workers.
“This is seven years I have been living with HIV. I had a boyfriend; he never told me he had HIV.… When I heard that he had passed on, I got a phone call from my friend who told me the gentleman I talk to passed on and I should go and get tested…. So, I went and that is how I knew I had HIV,” she said, noting she turned to praying and ensuring she followed the doctors’ orders.
Back then, ‘Jenny’, who is in her 40s, also feared dying from HIV and her other ailments, but today her anxieties now centre on dying from COVID-19.
With both HIV and COVID-19 having been “brought home” to her, she believes that in her present circumstances, where the person, from whom she caught COVID-19, still resides with her, re-infection is likely and can result in her own demise.
She further bases this on the individual’s flippant attitude – namely, their aversion to wearing masks, being vaccinated and believing that “COVID-19 isn’t real”.
“I so frighten; I ain’t telling no lies. I am so afraid that I know that I am going to catch back COVID-19. The reason I say that is because if I repeat COVID, I am going to die,” exclaimed ‘Jenny’, adding that she also has asthma, a history of high blood pressure and strokes, following heart surgery, years ago, and is aware these underlying conditions make her more vulnerable.
Acknowledging that her successful management of HIV was related to her adherence to doctors’ orders and the regimen of medication, ‘Jenny’ divulged that COVID-19 came home to her through the family member constantly “liming on the block”.
Recounting how she discovered her positive status, she said: “How did I know? – through the Barbados Defence Force. He was on the phone and he start getting on a certain way telling the people ‘wunna can’t come for me’ and getting on very rude to the people. So, I take away the phone and I asked: ‘Who’s speaking on the phone?’ They tell me they are from the Barbados Defence Force and they coming for my son because he got to go and get tested. So, I tell them they can come.
“I so frighten; I ain’t telling no lies. I am so afraid that I know that I am going to catch back COVID-19. The reason I say that is because if I repeat COVID, I am going to die.”“Jenny” speaks of her fear of contracting COVID-19 again.
“The next day he called and tell me he positive and then the COVID-19 Unit called and tell me that I have to go to the Wildey Gymnasium to get tested because he tested positive. When I went and I find out that I had COVID-19, I was in shock. I was in such a state of shock, I said: ‘Oh Lord, I went through so much; God this ain’t my time; I don’t want to die, but if this is my time…Lord, forgive me; I don’t want to be sick.’ And, I kept on praying and praying: ‘Don’t tell me Lord, I got to go on a ventilator!’…. But thank God that I didn’t have to go on the ventilator; thank you God!”
Prohibited from returning home with this positive result, “Jenny”, like others, was quarantined at the Dover Hotel, Christ Church, and later moved to the Harrison Point Isolation Facility, where she joined her son in secondary isolation.
‘Jenny’ was a fully vaccinated person when she contracted COVID-19 from her son. Indeed, when vaccines became available in February of this year, she consulted her doctor as to whether or not she should be inoculated and was among the early movers.
“He told me ‘yes’ and when the frontline workers were going, I didn’t have no appointment, [but] I went to Six Roads Polyclinic and I got my first vaccine, and then I went back to get my second vaccine,” she recalled, adding, she had “a little fever and chills” with the first dose of the AstraZeneca, but no major adverse effects.
“I got to wear a mask inside and outside. Every time I go in, I sanitise my hands at the door. I take off my mask; wash my hands- everything, and put on a new mask. If I go in the kitchen, I have on a mask, whatever I do in the house I have on a mask.”“Jenny” outlining her daily efforts to stay safe from COVID-19.
With COVID-19, her symptoms included “a bad cold”, runny nose, difficulties breathing, a weakened immune system, and wheezing due to her asthma.
“My lungs were hurting me. Sometimes I could breathe and sometimes I could not. I am telling you when you got COVID, COVID does play with your lungs and when that COVID locks off your lungs, that’s the end of you. Every morning I prayed ‘Lord pull me through’, and every day I did what the doctor tell me to do,” she said, adding that it is for this reason she believes “COVID-19 kills faster than HIV”.
Her treatment comprised regular use of inhalers and other medication. She revealed that the doctors frequently swabbed her nose; checked on the wheezing and her blood pressure, while also ensuring she continued to take her antiretroviral medication for HIV.
Pleased with the medical care she received, Jenny remains amazed that she survived COVID-19. Despite her ordeal and condition back then, she is adamant she survived because she was fully vaccinated.
“The vaccine is what saved me, I telling you. If I didn’t get the vaccine, I would not be here today to talk to you all; I would be dead. The vaccine is what stopped me from getting that sick… , I didn’t get really that sick. Thank God I here,” she declared.
Yet, with all the encouragement from Jenny, her son refuses to get vaccinated, or follow the protocols. As a result, she is forced to beef up her own personal protection, as she fears the worst.
“I got to wear a mask inside and outside. Every time I go in, I sanitise my hands at the door. I take off my mask; wash my hands- everything, and put on a new mask. If I go in the kitchen, I have on a mask, whatever I do in the house I have on a mask. When he goes outside, I take off my mask and get to breathe, but when he in there, I keep on my mask. That is how I have to protect myself from being that sick again,” she revealed.
In an effort to better understand the challenges and risks COVID-19 may pose to PLHIV, the BGIS spoke to Dr. Tiffany Jordan, who provides HIV management and prevention services, at the Ladymeade Reference Unit (LRU) in Jemmotts Lane, St. Michael.
Dr. Jordan explained that while the risk of getting severely sick is high in some PLHIV, it was lower for those who took their medication consistently and have normal functioning immune systems. However, she stressed the risk of getting severe sickness, hospitalisation or death was higher for those with poorly controlled HIV and additional co-morbidities.
Nonetheless, she acknowledged that for PLHIV generally, the risk of re-infection was “pretty much going to be the same for anyone else living without HIV”.
She advised individuals living with HIV to follow the general protocols outlined by the Health Ministry; take their HIV medication consistently, which ensures “the best possible immune system to fight any infection, including COVID-19”, and to get vaccinated.
Noting the treatment regimen for COVID-19 is the same for everyone, the medical practitioner highlighted the role played by LRU in the process.
“It is important that they continue their antiretroviral treatment for HIV during the time they are being treated for COVID-. One of the most important things that we make sure is that patients still have access to the antiretroviral therapy because it would be very important should they become infected, so we ensure that patients get medication even though they are in isolation facilities. We would have them delivered there,” she explained.
And, for PLHIV returning to households after a COVID-19 episode, Dr. Jordan is advocating there be continued adherence to protocols, by all.
Moreover, she is advising all family members to get vaccinated and encourage their relative(s) with HIV to take their antiviral medication consistently – something which has never been lost on ‘Jenny’.