A pregnant doctor has described the experience of carrying a child amid the coronavirus outbreak.
Dr Coral Olazagasti from the Zucker School of Medicine in New York discovered she was expecting on 15 December 2019 after “longing for a baby for years”.
After hearing news of an emerging virus in China, a “distant thought became a real concern” when its death toll continued to rise.
When the virus reached New York, the healthy 31-year-old started fearing for her unborn baby, who she has “already grown so attached to”.
Fuelled by a self-enforced duty to provide care, Dr Olazagasti’s “maternal instincts battled her physician instincts on a daily basis”.
Although still working, the medic has urged healthcare professionals to “change our mindset and refrain from our reflexive attitude of pushing ourselves through illness because we could end up actually spreading disease to the very patients we are trying to help”.
While we all live through this “horrific pandemic”, Dr Olazagasti reassured there is “always a light at the end of the tunnel”.
‘This, like other pandemics in the past, shall pass’
Writing in the journal Cancer Care Chronicles, the second-year haematology-oncology fellow described how she became concerned in late January when the coronavirus had been identified in 21 countries.
The strain is thought to have emerged at a seafood and live animal market in the city Wuhan, capital of Hubei province, at the end of 2019.
Latest coronavirus news, updates and advice
On January 20, the US reported its first case after a man returned from Wuhan only to develop the virus’ tell-tale fever and cough.
By the second week of February, Dr Olazagasti was facing a “three-month block of inpatient consult rotations” combined with “increasing fears of when the time would be that she would come face to face with the dangerous COVID-19”.
Early research suggests the coronavirus is mild in four out of five cases, however, it can trigger a respiratory disease called COVID-19.
Dr Olazagasti’s “medical knowledge” meant she was aware pregnancy is in itself “considered an immunosuppressive state”.
“Despite not wanting to, I started fearing not just for myself, but also for my unborn, still-developing baby who I had already grown so attached to,” she wrote.
The medic’s “biggest fear became reality” when New York reported its first case on 29 February.
“In the following days I saw the numbers doubling and the amount of cases rising in a shocking manner,” she wrote.
“My thoughts kept fluctuating between a feeling of fear and my almost-reflexive sense of altruism, which is the very reason I chose this profession over others.
“I, like many others in my profession, have over the years developed a mindset that compels me to choose work over anything else.
“Inside of my brain my maternal instincts continued to battle my physician instincts on a daily basis”.
Still working, Dr Olazagasti claimed “getting exposed to the virus is becoming more of a possibility as days go by”, with her “actively blocking” thoughts of how it could affect her baby.
With limited research available on how the infection impacts pregnancy, the medic is “choosing to believe” she is safe.
“Living and working in this era of horrific pandemic while pregnant is definitely not easy”, wrote Dr Olazagasti.
“There is always a light at the end of the tunnel, and I have faith this, like other pandemics in the past, shall pass”.
Coronavirus: Can pregnant women pass the infection to their unborn child?
While no one can rule it out, it is thought to be highly unlikely the coronavirus spreads “intrauterine”.
Scientists from Fudan University in Shanghai looked at 33 pregnant women who were confirmed to be carrying the virus.
Three of the women gave birth to babies who “presented with early onset infection” around two days later.
“Given that all the infected babies were first shown to be positive at two days, I suspect they were infected after being brought into the world rather than in the womb”, Professor Paul Hunter from the University of East Anglia previously said.
“This does not change the current consensus that transmission in the womb is unlikely”.
Tests of the women’s amniotic fluid, umbilical-cord blood and breast milk all came back clear.
“It seems more likely the three infants were infected very soon after delivery, possibly from the mother’s fingers”, Professor Andrew Whitelaw from the University of Bristol previously said.
The circulating coronavirus is one of seven strains of a class of viruses that are known to infect humans.
Others include the common cold and severe acute respiratory syndrome (Sars), which killed 774 people during its 2002/3 outbreak.
“Transmission from mother to baby of coronavirus has not previously been observed,” Professor Andrew Shennan from King’s College London previously said.
“Studies have shown coronavirus has not passed to amniotic fluid, foetal cord blood, placentas or the genital tract of infected mothers.”
Scientists from Zhongnan Hospital in Wuhan, China, found six babies born to women with the coronavirus did not catch the infection, but did have immune-fighting proteins against it in their bloodstream.
One expert stressed, however, there is no evidence these proteins went on to prevent the coronavirus infecting the newborns.
Coronavirus: What is the advice for pregnant women?
Pregnant women have been urged to be particularly careful not to catch the coronavirus, however, this may be a case of being on the safe side.
“Infections and pregnancy are not a good combination in general and that is why we have taken the very precautionary measure while we try and find out more,” Professor Chris Whitty, the UK’s chief medical adviser, previously said.
Nonetheless, pregnant women did not make up the 1.5 million vulnerable Britons who have been told to stay in their home for three months. These include severe asthmatics and blood-cancer patients.
According to the Royal College of Obstetricians and Gynaecologists (RCOG) “pregnant women do not appear to be more likely to be severely unwell than other healthy adults if they develop the coronavirus”.
Virtually unheard of just three months ago, experts are learning more about the virus every day.
“What we do know is that pregnancy in a small proportion of women can alter how your body handles severe viral infections,” according to the RCOG.
“What has driven the decisions made by officials to place pregnant women in the vulnerable category is caution.”
The Royal College of Midwives has urged expectant mothers to attend scheduled hospital appointments, calling them “essential to ensure the wellbeing of pregnant women and their babies”.
For those showing symptoms and in isolation, the RCOG recommends letting your midwife or antenatal clinic know in advance so they can make arrangements.
Some women not showing symptoms report being asked to attend these appointments alone.
What is the coronavirus?
Since the coronavirus outbreak was identified, more than 2.7 million cases have been confirmed worldwide, according to Johns Hopkins University.
Of these cases, over 750,900 are known to have “recovered”.
Globally, the death toll has exceeded 191,900.
The coronavirus mainly spreads face to face via infected droplets expelled in a cough or sneeze.
Symptoms include fever, a cough and slight breathlessness.
The coronavirus has no “set” treatment, with most patients naturally fighting off the infection.
Those requiring hospitalisation are given “supportive care”, like ventilation, while their immune system gets to work.