Peter Piot is a virus hunter who has changed the shape of medical treatments for some of the nastiest viruses to emerge in our time, including Ebola – which makes people haemorrhage to death and spreads easily – and HIV-Aids which tends to be a slower killer. Dr Piot, a colleague of South African Aids researcher Dr Gita Ramjee, who was among the first reported deaths from Covid-19 in South Africa, shares his harrowing tale of fighting this disease. What’s not commonly known is that the body can continue to deal with the virus long after it no longer registers a presence in a blood test and can cause permanent damage. – Jackie Cameron
By Thulasizwe Sithole
Peter Piot, 71, one of the giants of Ebola and AIDS research, is still battling a coronavirus infection that hit him “like a bus” in March, says The New York Times.
“People think that, with Covid-19, 1 percent die and the rest just have flu. It’s not that simple — there’s this whole thing in the middle,” he is quoted as saying.
“This is the revenge of the viruses,” said Dr Piot, who is the director of the London School of Hygiene and Tropical Medicine and described as a legend in the battles against Ebola and HIV-Aids. He was a colleague of Dr Gita Ramjee, a well-known South African AIDS researcher, who died of Covid-19. Dr Ramjee was an honorary professor at Dr Piot’s school and had led a symposium there before falling ill, says The New York Times.
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Piot gives The New York Times a moving and scary account of what it’s like to experience contracting Covid-19 and become seriously ill from it. After he finally left hospital, he discovered that the virus does new things to your body even though it goes undetected in the blood.
Piot says he “underestimated this one – how fast it would spread”. His mistake was to think it was like SARS, “which was pretty limited in scope. Or that it was like influenza. But it’s neither”.
In 1976, as a graduate student in virology at the Institute of Tropical Medicine in Antwerp, Belgium, Piot was part of the international team that investigated a mysterious viral hemorrhagic fever in Yambuku, Zaire, now the Democratic Republic of Congo, says the media outlet.
To avoid stigmatising the town, team members named the virus “Ebola” after a nearby river, it says.
Later, in the 1980s, he was one of the scientists who proved that the wasting disease known as “slim” in Africa was caused by the same virus that was killing young gay men elsewhere, notes The New York Times.
Dr Piot has “no idea” where he picked up the infection.
“Although medical conferences in the Boston area that week were turning into super-spreader events, Dr Piot almost undoubtedly did not get infected there,” he says.
“Back home in London, he spoke to audiences of 30 to 250, attended a 50-person birthday party and had dinner or drinks in five restaurants in London or Cambridge.”
Aside from avoiding hand shakes, he took no particular precautions. “I really don’t know where I was infected,” he is quoted as saying.
“Although there were then already many confirmed cases, Britain did not officially go into lockdown until March 23, when there were 335 confirmed deaths.
“Dr Piot and his wife, by contrast, began working from home on the 16th. The evening of March 19 he began feeling feverish and developed a headache.”
Each day he felt more tired, his fever hovering at about 38 degrees as Covid-19 hit him, he says, like a bus. “Extreme exhaustion, like every cell in your body is tired. And my scalp was very sensitive… That’s a neurological symptom.”
It was a new feeling. Despite all the time he has spent in mosquito-riddled climes, “I’d never been seriously ill in my life,” he says. A regular jogger and apparently healthy he joked, “This is the first time in my adult life I didn’t drink wine for a month.”
At the time, it was almost impossible to get tested; the few kits available were reserved for hospitals, says The New York Times.
On March 26, he finally managed to get a test.
“It was positive, and his fever kept rising. Although he did not feel short of breath, his oxygen saturation was only 84 percent, dangerously low.
“An X-ray showed fluid in both lungs in a pattern that suggested bacterial pneumonia.”
His blood tests “were really bad,” he tells The New York Times.
“His levels of C-reactive protein, which indicate inflammation, and of D-Dimer, which indicate blood clots forming, were both very high,” says Dr Piot of how he “instantly changed from doctor to patient”. He was put on oxygen and sent upstairs on a gurney.
That same night it was reported that his South African associate Dr Ramjee had died of Covid-19. Dr. Ramjee was an honorary professor at Dr Piot’s school and had led a symposium there before falling ill.
Dr Piot describes struggling with his own fears. “All you can do is lie there thinking, ‘I hope it’s not going to get worse.’”
He got intravenous antibiotics and high-flow oxygen, and was roused every two hours for checks on his a blood pressure and other vital signs.
“I was particularly anxious that I not be put on a ventilator,” he tells The New York Times.
“Ventilators can save lives, but they can also do a lot of harm. Once you’re on one, your chances of surviving are the same as of surviving Ebola — about one third.”
Finally, Dr Piot says, his oxygen saturation came up to 92 percent. He was discharged on April 8.
“They wanted to call me a taxi, but I said no, I wanted to breathe the now non-polluted air in London.”
He took a train home.
“It was a shock, like Stockholm syndrome,” he tells The New York Times of his survival. “When I got home, frankly, I started crying. It was so emotional.”
And, in a little understood factor about Covid-19, the health problems do not necessarily end when you test negative.
When Dr Piot got home he soon realised “his body wasn’t through with the disease”.
“Before the hospital released him, he had tested negative for the virus. But now something else was going on — a delayed immune reaction.”
Gradually, he became short of breath and, on April 15, Dr Piot’s heart started to race to 165 beats a minute and the percentage of his blood oxygen dropped to the mid-80s again.
He went to the University College Hospital where he had a chest X-ray.
This time, instead of distinct bacterial masses on each side, “my lungs were full of infiltrates, and they were a real mess. It’s called ‘organising pneumonia.’”
“The tiny sacs that grow like bunches of grapes throughout the lungs were oozing signalling proteins – he was having a ‘cytokine storm’.
“Those drew voracious white blood cells into the spaces between the air sacs so they threatened to block the paths oxygen normally takes to his red blood cells. His doctors thought about re-hospitalising him – an outcome he dreaded.”
A doctor who specialises in difficult pneumonias put him on an intravenous steroid to reduce the inflammation, along with an anticoagulant to prevent blood clots from his atrial fibrillation, reports The New York Times.
Last week, a PET scan, CT scan and bronchoscopy showed that parts of his lungs have not completely cleared, it continues.
The steroids appear to be working, but taking them for too long can have side effects, including muscle wasting, weakening of bones and diabetes.
Dr Piot may have to take anticoagulants for the rest of his life, he said, and parts of his lungs may permanently be scarred.
“But you can live with that,” he added, shrugging.
“If you get this cytokine storm while you’re acutely ill, you’re finished,” he said. “But I had three stages – first fever, then needing oxygen, and now the storm.”
“People think that, with Covid-19, 1% die and the rest just have flu. It’s not that simple – there’s this whole thing in the middle.”
His doctors have not let him go back to work yet.
“All they say is, ‘Rest! Rest! Rest!’”
“I’m now in Flemish what we call an ‘ervaringsdeskundige’ – an ‘experience expert.’ Someone who is put on an advisory panel not because you’ve studied a disease, but because you’ve lived it. That’s me. And now I’m thinking about what to do with the rest of my life,” he adds.
