Virologist Peter Piot, director of the London School of Hygiene & Tropical Medicine, fell ill with COVID-19 in mid-March. He spent a week in hospital and is recovering from his home in London. Climbing a staircase always leaves him breathless.
Piot, who grew up in Belgium, was one of the discoverers of the Ebola virus in 1976 and has spent his career fighting infectious diseases. He directed the Joint United Nations Program on HIV / AIDS between 1995 and 2008 and is currently a coronavirus adviser to the President of the European Commission, Ursula von der Leyen. But his personal confrontation with the new coronavirus was a life-changing experience, says Piot.
This interview took place on May 2. Piot’s responses have been edited and translated from Dutch:
“On March 19, I suddenly had a high fever and a throbbing headache. My skull and hair were very sore, which was weird. I had no cough at the time, but my first reflex was still: I have it. I continued to work – I am a workaholic – but from home. We put a lot of effort into teleworking at the London School of Hygiene & Tropical Medicine last year, so we didn’t have to travel as much. This investment, made in the fight against global warming, is now very useful, of course.
I tested positive for COVID-19, as I suspected. I put myself in solitary in the guest room at home. But the fever has not gone away. I have never been seriously ill and have not taken a day off from work in the past 10 years. I live a fairly healthy life and walk regularly. The only risk factor for corona is my age – I’m 71 years old. I’m optimistic, so I thought it would pass. But on April 1, a doctor friend advised me to do a thorough examination because the fever and especially the exhaustion were getting worse.
It turned out that I suffered from a severe oxygen deficiency, even though I was still not short of breath. The pulmonary images showed that I had severe pneumonia, typical of COVID-19, as well as bacterial pneumonia. I always felt exhausted, while normally I always buzz with energy. It was not just fatigue, but complete exhaustion; I will never forget that feeling. I had to be hospitalized, although I have tested negative for the virus in the meantime. This is also typical for COVID-19: the virus disappears, but its consequences persist for weeks.
I was worried about getting a fan right away because I had seen publications showing that it increased your chances of dying. I was pretty scared, but luckily they just gave me an oxygen mask first and it worked. So I ended up in an isolation room in the ante-room of the intensive care unit. You are tired, so you are resigned to your fate. You surrender completely to the nursing staff. You live in a syringe-drip routine and hope to get there. I’m generally pretty proactive in the way I operate, but here I was 100% patient.
I shared a room with a homeless man, a Colombian cleaner and a man from Bangladesh – the three diabetics, by the way, which is a known picture of the disease. The days and the nights were lonely because no one had the energy to speak. I could only whisper for weeks; even now my voice loses power at night. But I always had this question in my head: how will I be when I get out of it?
After fighting viruses around the world for more than 40 years, I became an infection expert. I’m glad I got a crown, not Ebola, although yesterday I read a scientific study that concluded that you have a 30% chance of dying if you end up in a UK hospital with COVID-19. This is about the same overall mortality rate as for Ebola in 2014 in West Africa. This sometimes makes you lose your scientific weight and you give up on emotional reflections. They got me, I sometimes thought. I’ve dedicated my life to fighting viruses and ultimately they take revenge. For a week, I balanced heaven and earth, on the brink of what could have been the end.
I was released from the hospital after a long week. I returned home by public transport. I wanted to see the city, with its empty streets, its closed pubs and its surprisingly fresh air. There was nobody on the street – a strange experience. I couldn’t walk properly because my muscles were weak from bedtime and lack of movement, which is not a good thing when you are treating a lung condition. At home, I cried for a long time. I also slept badly for a while. The risk that something could go wrong continues to cross your head. You are locked up again, but you have to put things like that in perspective. I now admire Nelson Mandela even more than before. He was imprisoned for 27 years but has proven to be a great reconciler.
I have always had great respect for viruses, and that has not diminished. I have spent a large part of my life fighting the AIDS virus. It’s such a smart thing; it evades everything we do to block it. Now that I myself have felt the convincing presence of a virus in my body, I look at viruses differently. I realize that this one will change my life, despite the experiences of confrontation that I had with viruses before. I feel more vulnerable.
A week after I left, I became more and more breathless. I had to go back to the hospital, but luckily I was able to be treated on an outpatient basis. I turned out to have a lung disease caused by organized pneumonia, caused by a so-called cytokine storm. This is the result of your immune defense going overdrive. Many people do not die from the tissue damage caused by the virus, but from the exaggerated response of their immune system, which does not know what to do with the virus. I’m still on treatment for this, with high doses of corticosteroids that slow down the immune system. If I had had this storm with the symptoms of the viral epidemic in my body, I would not have survived. I had atrial fibrillation, with a heart rate of up to 170 beats per minute; which must also be controlled by therapy, in particular to prevent blood clotting events, including strokes. This is an underestimated capacity of the virus: it can probably affect every organ in our body.
Many people believe that COVID-19 kills 1% of patients, and the rest get away with flu-like symptoms. But the story gets complicated. Many people will suffer from chronic kidney and heart problems. Even their neural system is disrupted. There will be hundreds of thousands of people around the world, perhaps more, who will need treatment such as kidney dialysis for the rest of their lives. The more we learn about coronavirus, the more questions arise. We learn while we sail. This is why I am so annoyed by the many marginal commentators who, without much insight, criticize scientists and policy makers who are striving to control the epidemic. It’s very unfair.
My lung images finally look better. I opened a good bottle of wine to celebrate, the first in a long time.
Today, after 7 weeks, I feel more or less in good shape for the first time. I ate white asparagus, which I order from a Turkish vegetable merchant around the corner; I come from Keerbergen, in Belgium, a community which cultivates asparagus. My lung images finally look better. I opened a good bottle of wine to celebrate, the first in a long time. I want to return to work, even if my activity will be limited for a while. The first thing I picked up was my work as a COVID-19 R&D Special Advisor to von der Leyen.
The Commission is firmly committed to supporting the development of a vaccine. Let us be clear: without a coronavirus vaccine, we will never be able to live a normal life again. The only real exit strategy from this crisis is a vaccine that can be rolled out worldwide. This means producing billions of doses, which in itself poses a huge challenge in terms of manufacturing logistics. And despite the efforts, it is not even certain that the development of a COVID-19 vaccine is possible.
Today, there is also the paradox that some people who owe their lives to vaccines no longer want their children to be vaccinated. This could become a problem if we are to deploy a coronavirus vaccine, because if too many people refuse to join, we will never control the pandemic.
I hope this crisis will ease political tensions in a number of areas. It may be an illusion, but we have seen in the past that polio vaccination campaigns have led to truces. Likewise, I hope that the World Health Organization [WHO], which does an excellent job in fighting COVID-19, can be reformed to make it less bureaucratic and less dependent on advisory committees in which each country primarily defends its own interests. WHO too often becomes a political playground.
Anyway, I remain a born optimist. And now that I’ve faced death, my tolerance levels for nonsense and bullshit have dropped even more than before. So I continue calmly and enthusiastically, although more selectively than before my illness. “
A longer version of this interview appeared on May 5 in the Belgian magazine Thing. Translation by Martin Enserink.