1st April 2021
Dr Salib couldn’t sleep the night before he got his first dose of the Covid 19 vaccine; his excitement was loaded with relief as he had almost died from the illness in March last year. “They told me after I was admitted to St Vincent’s last March that the next 36 hours could go either way.” Describing how Covid “dismantles” the body, he volunteers that if he gets it again “I will die.” It’s a stark statement but perfectly balanced with his conclusion that the vaccine is a lifeline: “ I know if I get a second dose of Covid my body won’t take it – my body was on the floor last March. So the vaccine really is a saviour.”
A Consultant Radiation Oncologist with St Luke’s Radiation Oncology Network for the past 31 years, Dr Osama Salib was shocked when he was first diagnosed: “I didn’t initially suspect Covid because at that time it was still not very common.” With his fever building and problems walking, Dr Salib managed to get to St Vincent’s University Hospital ED on March 18th: “They were very good – within a couple of hours of arriving, all my bloods were taken and I was on a holding ward for suspect Covid cases – that was on the Wednesday night.
“On the Thursday night they told me I was Covid positive and they transferred me to the designated ward. I was very weak – If I walked from the bed to the toilet in the room I had to sit down for a few minutes and for over a week I couldn’t stand in the shower.” While not on a ventilator, he was on continuous oxygen. At that time there really was no specific treatment for Covid. However, in consultation with colleague Prof Paddy Mallon (Consultant in Infectious Disease) he agreed to engage in a trial involving an experimental treatment regime. Prof Mallon had been liasing with collegues in Italy where at that stage the disease was endemic: “The advice was to put me on a drug called Toxiluzimab which is normally used for Rheumatoid Arthritis and Leukaemia.
“So they came to me in the room and said you have 36 hours – you can go either way. My markers were going up and overall it was a very poor prognostic outlook. They wanted to put me on an infusion that they had not used before. They told me I could die because of severe infection and there was a long list of possible side effects – but there was no choice. I put my arm up and they started the infusion – that was on Monday March 23rd.”
Within 36 hours his temperature had normalised: “I had had a temperature for ten days by then. So they saved my life. St Vincent’s gave it to eight patients that first week. Out of the eight, seven avoided ventilation. That was all of course before they had the research, treatments and anti viral medications they have now.” The results of the St Vincent’s trial were published in May.
Discharged eleven days after admission, Osama describes how he was “wheeled out” out of the hospital escorted by the medical team. “I couldn’t even walk at that stage – I had foot drop on my right foot – I couldn’t bend it to walk. They discharged me because they knew of the ongoing risks of remaining in hospital.”
Reflecting on his time in St Vincents, Osama describes the care he received as “excellent.” On discharge, he was still extremely weak and required extensive follow up care including having his oxygen saturation levels monitored remotely through a machine supplied from the hospital and a mobile phone app. His foot began to return to normal by the end of May, and he started walking again but he continued to have ongoing heart health issues. He remains on some medication: “I wasn’t able to return to work until June 15th. I work between St Luke’s Rathgar and St Vincent’s University Hospital and everyone was very supportive on my return. There was a transition period allowing me to return with support to ensure that I was doing what I was able to do. I remain on the heart tablets to keep my pulse down.
“ I still get a lot of left side chest wall pain. But all my CT scans have been clear to date. I am back working full time but I have to look after and manage myself. I spread out my work so I do some office and paper work at the weekend to ensure I am not overdoing things during the week. Longer term, no one really knows. The more we live with Covid the more we learn. No one knows what will happen to us next year or the year after. I know I am fine because I have had a lot of tests and scans but I am a cancer specialist and I know the reality of immediate acute issues and side effects but there may be issues further down the road that we don’t yet know.”
Vaccine has been a gamechanger
So for Osama the vaccine has been a gamechanger: “I couldn’t sleep the night before I got the first dose of the Pfizer vaccine on January 7th and I then got my second dose on January 28th. In between I was taking every precaution to make sure I didn’t get a temperature because I wanted to be sure I could get the second dose – the relief was amazing. We were all euphoric getting it. It was our first reason for cheer in a long time – it meant that the fear was lifting. Of course nothing is perfect but this is as good as it can be. Naturally however, we are continuing to take the same precautions in terms of restrictions and measures.”
Although relieved at his own survival, Osama was always conscious of the impact of the disease on his cancer patients. He was particularly shocked however, when, three months after his discharge over the June Bank Holiday, he was watching the Six One News when they featured a segment entitled ‘Ireland Remembers’ showing photos of individuals who had died from Covid: “I was so shocked and upset when I saw a patient of mine whom I had treated for three different cancers over 14/15 years. He had lung cancer 15 years ago, and we got him out of it, five years later he had prostate cancer and we got him out of it and almost three years ago he got cancer of the oesophagus and again we got him out of that. And he was fine – he was just coming back to see me every six months. So when I saw his picture I was very upset.”
The following Tuesday he rang his patient’s wife expressing his sympathy and sadness: “And at the end of the conversation she said ‘and Dr Salib I am delighted to see you have recovered’ to which I asked - how did you know I had been ill? She said she had seen my name on the namecard on the door next her husband’s in St Vincent’s – it turned out he was next door me in hospital. He had died while I was there. We were beside one another - I was in Room 2, he was in Room 3. It was so sad because we had become friends over the years while I was treating him – we knew one another by first name. Covid really dismantles people.”
However, the affable and highly regarded Dr Salib is affirmative now as he looks forward: “There are many people to thank for my own survival but I just wanted to particularly mention the wonderful people who carry out the cleaning in the hospitals – they really are heroes. Overall, though I have to say that I only really started to breathe seven days after I got the second dose of the vaccine – that’s when the 95% immunity is realised.”
For now he continues working and remains upbeat. He knows how close he was over those 36 hours last March and looks forward to living each day, working and taking all the precautions he knows are essential.