OPINION: The Horror of Living With Coronavirus Asymptomatically

I was terrified when I tested positive for the novel coronavirus. How can a doctor be a patient and a provider at the same time? How could I protect my family? In between sobs, I told my husband, “You can intubate me – just don’t let me die.”

Little did I know that – while certainly not as traumatic as falling ill – living asymptomatically with coronavirus in the United States would come with its own horrors.

I was exposed to a colleague who was asymptomatic but tested positive, so I did what I felt was responsible and got tested. I did not think anything would come of it; after all, I had no symptoms, and I was so careful. When I got the call that I had tested positive, I froze. I had so many questions but could not vocalize any of them.

I knew that I was supposed to be rational; it’s the mantra I follow every time I walk into an exam room. Yet, as the patient, I was barely able to tread water and stop myself from being pulled by the riptide of “what if.” What if I gave my husband and our puppy the virus? What if I got it from the store? What if my headache or sniffles turn into something worse?

I became consumed by all things coronavirus to the point that I believed it was because of “people like me” – the asymptomatic ones walking around infecting everyone – that the disease was proliferating. While I am lucky not to have experienced symptoms, asymptomatic disease is still disease. The symptoms are just hidden: feelings of guilt, isolation, fear of infecting those you love, fear of potentially getting sicker.

Once you have the disease, you realize that the only reason to wear a mask and quarantine is to protect others. I traced back my contacts to make them aware so they could decide if they wanted to get tested or self-quarantine. I struggled with the reception of this news by my friends and colleagues. While they expressed genuine concern about my health, many surprised me with frustration that I decided to get tested and their adamant refusal to be tested themselves or self-quarantine. Their comments made me feel that I did not deserve to be symptom-free – that I brought this stress upon myself. People told me I was recommending the use of scarce resources to test young, healthy, asymptomatic people, and that we can’t quarantine everyone anyway.

The moral, social and epidemiological responsibilities are difficult to uphold when you feel so alone in navigating these uncharted territories. I experienced so much frustration, shame and defeat that one friend had to tell me “You do not have to apologize for having this disease. You did not do anything reckless.” This is the burden of the asymptomatic: They are carriers but feel nothing, and are therefore some of the most dangerous transmitters of disease. Regrettably, those who carry the burden of being asymptomatic too often feel that they have to hide the fact that they tested positive.

It doesn’t have to be this way. Recognizing asymptomatic carriers of the coronavirus is a critical part of breaking this vicious cycle of infection. We must support those who, despite having no symptoms, protect the greater good by following quarantine. If you test positive without symptoms, know that you can make a difference to protect those around you with the safeguards of quarantine, proper hand hygiene and protective masks. If you know someone who is asymptomatic, applaud them for protecting you and don’t make them feel that the onus of disease lies in their hands alone.

As a physician, it is incomprehensible to me that some refuse to take steps to protect one another. Wear masks proudly, without judgment. This disease can no longer be treated in hospitals alone. Everyone must become a caregiver.

– – –

Shah is a physician who recently graduated from fellowship in gastroenterology in Dallas and will be starting practice in Arizona.