After getting infected, nurse thought: 'I'm going to die'

SINGAPORE - For two weeks she could only watch office staff going home every evening from a window in her ward at Tan Tock Seng Hospital (TTSH).

This alone was enough to send Ms Noor Melati Ahmad spiralling into depression.

The then 22-year-old junior staff nurse was all alone in what was meant to be a four-bed ward. It was empty but for her, her bed and a television set.

She tells The New Paper on Sunday: "There was no human contact. I wasn't allowed visitors. I missed my family, my boyfriend.

"Even the nurses kept their distance. When they delivered food, they would simply place it at the door and knock. I felt rejected, isolated, and the loneliness was overwhelming."

It was April 2003.

Ms Noor Melati, now 31, had contracted Sars. She was quarantined lest she infected others.

She had only two years of nursing experience then and had been working at Ward64 at National University Hospital (NUH).

She knew the seriousness of the outbreak, but did not realise its severity - not even when medical staff started using more extreme protection.

"We were first in scrubs and gloves. Then we progressed to masks and then to PPE," she says.

PPE, or Personal Protective Equipment, is the specialised clothing, helmets, goggles and masks designed to shield healthcare workers from infection.

Then a patient came in - a 45-year-old vegetable wholesaler from Pasir Panjang market.

He was admitted to her ward on April 8, 2003. When he took a turn for the worse, he was transferred to TTSH.

He died four days later.

She says: "We took precautions and followed protocol closely. We wore PPE and were encouraged to shower before leaving the hospital.

"I believe I caught the virus while helping to pack the patient's belongings to send them on with him to TTSH."

The next day, her nurse manager called to inform her that she was to be quarantined.

"I felt disappointed. It was my day off the next day and I was looking forward to spending time with my boyfriend."

"I told my mother and she was worried. I also called my boyfriend. He wanted to send me off but his parents refused to let him," she recalls, tears brimming.

A few days later, Ms Noor Melati developed a fever.

"First it was 37.4 deg C and it climbed quite quickly to 37.8 deg C, then (it went) over 39 deg C the next morning. I was sent for an X-ray and then isolated, before being sent to TTSH," she says.

She was not alone. A doctor was infected too.

"It was all over the news. When my mother watched it on TV, she knew it was me and cried," she says.

"My symptoms turned very bad. I had fever, chills, rigours and was short of breath. No one pill could treat the infection so I had to take cups of medicine every day. I really thought this was it. 'I'm going to die'.

"So I called my father. We had quarrelled over something trivial, and I didn't speak to him for a whole year. But I was going to die so I sought his forgiveness."

Ms Noor Melati says that feeling rejected and isolated by fellow nurses was much worse than the infection itself.

She says: "I was one of them yet they stayed away.

"My spiral downwards got so bad I didn't have the appetite to eat. My food was mostly left untouched.

"But thinking back, the nurses were probably following directives. I don't really blame them."

Ms Noor Melati kept in touch with her family and boyfriend on the phone.

Months after her recovery, her sister revealed that her mother had cried every day.

Defying his parents' wishes, Ms Noor Melati's then boyfriend also sneaked into the hospital to try and see her.

She went on to recover.

She got engaged to her boyfriend on Valentine's Day a year later. Today, they are proud parents of two little girls.

She says: "The month-long stay at TTSH and then at CDC (Communicable Disease Centre) was the longest ever. I wouldn't wish it on anyone."

Ms Noor Melati, now an oncology nurse caring for cancer patients, says her Sars ordeal has taught her never to take a fever for granted.

She also impresses upon her daughters the importance of keeping one's hands clean.

"Dirty hands and fingernails are all it takes to spread germs," she says.

"A fever, no matter how mild, is an indication that the body is fighting an infection. We must always pay close attention."

SARS TIMELINE

MARCH 1, 2003: Two women are admitted to Tan Tock Seng Hospital (TTSH). Both friends, they had stayed at the Metropole Hotel in Kowloon the month before.

MARCH 12: The World Health Organisation (WHO) issues a global alert on a severe form of pneumonia in Hong Kong, Vietnam and Guangdong province in China.

MARCH 14: In Singapore, there are reports of six more cases of atypical pneumonia, two of which involve healthcare workers.

MARCH 15: Seven more cases bring the total number to 16.

MARCH 17: A total of 20 people are down with Sars in Singapore. Portable X-ray stations and a dark room are set up at the Communicable Diseases Centre (CDC) to facilitate Sars screening. Security guards control and register visitors.

MARCH 19: Sars patients now number 23. Face masks fly off the shelves at retail outlets.

MARCH 21: Number of Sars patients: 39, including four hospital workers.

MARCH 22: Number of Sars patients: 44. Of these, 21 are staff members of TTSH, which becomes the designated hospital for the outbreak.

More than 740 people have to stay at home for the next 10 days. Those who disregard the order face fines of up to $5,000.

Both TTSH and Singapore General Hospital (SGH) cancel non-urgent operations, and outpatient operations are scaled down. A Sars hotline - operational from 8am to 8pm - is set up.

MARCH 24: First Sars patient dies. Paediatric Sars ward set up at TTSH, KK Women's and Children's Hospital. A no-visitor rule starts in Sars wards. Intensive care units and triage stations are set up to screen outpatients with fever.

MARCH 25: Second Sars patient, a pastor, dies.

MARCH 26: TTSH's Emergency Department takes over the role of Sars screening. Five more hospital workers are diagnosed with Sars, bringing the total to 74. Nine are seriously ill.

MARCH 27: All schools - from pre-school to junior college - shut. First Sars patients discharged from hospital.

MARCH 29: Of the 86 people hit by Sars, 25 are discharged. Screening of passengers starts at Changi Airport.

MARCH 31: Airport checks on Sars are tightened. Third Sars patient dies.

APRIL 2: Fourth Sars patient dies.

APRIL 3: Fifth person with Sars dies.

APRIL 5: Sixth death: Miss Chong Pei Ling, 29, who had rushed to the hospital from the airport after returning from a trip to Hong Kong and Beijing.

WHO doctor Carlo Urbani, who had warned the public of Sars, succumbs to the virus in a Bangkok hospital. Outbreak of Sars occurs at SGH. Patients and staff are moved to TTSH.

APRIL 7: TSH cardiology medical officer Dr Ong Hok Su dies. Former Prime Minister Goh Chok Tong announces the formation of a Ministerial Combat Unit for Sars.

School closure is extended. Singapore Armed Forces scales down its overseas training, courses and conferences.

APRIL 8: Number of Sars patients: 157, with 37 probable, 74 suspect and 46 observation cases.

APRIL 11: Launch of the Courage Fund, offering financial relief to Sars victims hospitalised or quarantined during the outbreak.

APRIL 14: Secondary schools reopen.

APRIL 16: Primary and childcare centres reopen.

APRIL 17: The Ministry of Health announces plans to convert Ren Ci Community Hospital into isolation facilities in order to handle the next outbreak.

The Government tops up the Courage Fund with $1 million, awarding it Institution of Public Character status.

APRIL 20: Sars outbreak at Pasir Panjang Wholesale Market. It shuts for 10 days.

APRIL 22: SGH vascular surgeon Alexandre Chao dies from Sars.

APRIL 23: All departing passengers at Changi Airport have their temperatures checked by thermal imaging scanners before going through immigration.

MAY 7: First 40 container isolation rooms ready for operation.

MAY 11: Nurse Hamidah Ismail dies on Mothers' Day.

MAY 18: One more Sars patient is diagnosed, dashing Singapore's hope of being taken off the WHO's list of Sars-affected areas. He would be Singapore's last Sars patient.

MAY 31: WHO declares Singapore Sars-free.


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