Icelandic Isolation
I anxiously looked out my hotel window waiting for my ride. ‘Twenty minutes to four hours’ I was told. That’s quite a range. Normally I would find that unacceptable, however I wasn’t waiting for a taxi or an Uber. I was waiting for what was described to me as an ambulance, and my destination was not the local emergency department. I was to be transferred to the local ‘quarantine hotel’, as I had tested positive for covid and was mandated to quarantine for anywhere from 10-14 days.
To say this revelation came as a shock to me would be a vast understatement. I have been on the front lines of the covid war since March 2020, when the first patients began falling ill, well before we had a firm handle on exactly how this virus was spread and certainly before we had any real clue how to treat these patients. March 2020, when we first realized just how woefully unprepared for a global pandemic this country truly was, when for the first time in my three decades of emergency medicine, I was faced with the horror that the one used N95 in my possession had transformed from trash to my most prized possession overnight.
There isn’t a frontline healthcare worker out there treating covid patients that won’t tell you they weren’t terrified, and I would be lying if I tried to tell you that I wasn’t. At 51 years old, mildly overweight with hypertension and type 2 diabetes, you bet I was worried. Like so many others in my profession, I turned to the internet to see how many times I could wear my N95 and still be protected, and not surprisingly, nobody had done a study about this. All any of us could find was the statement ‘single patient use only’, something that, until this point in history, seemed as obvious as the ‘contents are hot’ printed on the McDonalds coffee cups.
Like anyone else who tests positive, I retraced my footsteps to figure out where I picked this up. As a healthcare provider, I was one of the first in the country to be vaccinated with my first Moderna shot taking place the morning of Christmas eve 2020, with the second one being exactly 28 days to the minute after the first (hey, I’m a rule follower). Even after vaccination, I made sure I wore my PPE with every single patient, and while off the clock I did my best to social distance and was very conscious of basic hygiene. In my head, I went through my days leading up to my positive test. I had just come off a 48-hour shift and recalled on day 1 I went on a call with a ‘regular’ patient who was well known to local paramedics for the 2-3 packs of cigarettes per day that she smoked, even an N95 was of little use keeping the smell out of my lungs. I recall starting to cough while on scene, and that cough continued for a solid 24 hours. That, combined with my usual fall allergies, made this cough of little concern, even when I visited the local urgent care for my pre-flight covid test. Not surprising at the time, the test came back negative. I had a second cold test done just before my flight, which also came back negative.
Two tests in 24 hours, both negative, a vaccine, no known exposure and a well explained and getting better cough. I got on my flight at Logan to Reykjavik, mask in place, with absolutely no concerns for covid. Arriving in Iceland, a nation with a better than 80% vaccination rate and a requirement that visitors either be vaccinated or quarantine, I felt as though the situation was low risk. Even with the highly contagious Delta variant, under the circumstances, I wasn’t at all concerned. The required negative covid test to return to the United States was, in my mind, merely a formality. I had followed all the requirements and, even with my full vaccination status, was conscious of the global pandemic and wore my hospital grade surgical mask while indoors, including on the 100% vaccinated tour bus for a trip around the Golden Circle. Saturday, our third full day in Iceland, was the earliest we could be tested for our return flight, and since we had already scheduled our day to be exploring Reyjkavik, our tiny group scheduled our rapid tests.
One by one, the test results were emailed to each of us. First, the two women we were traveling with, then my wife, all within 30 minutes of each other. Me? Nothing. Yes, I was having some issues with my email connecting, however I was certain it was just a setting on my brand new phone that I hadn’t fully set up, and of course I was routinely looking at my Spam folder. Yet, nothing. The emails were arriving in my inbox with regularity once I connected to WiFi – the Food Network (Five Star Turkey and Zucchini Burgers? I’ll have to try that), Traeger Grills (someday I’ll get one), Norwegian Cruise Lines (I’ll have to remember to book that Northern European cruise at some point) – but nothing yet from Iceland. Of course, my travel companions jokingly told me it was because I was positive and they were going to keep me in Iceland for 2 weeks. If only it had turned out to be a joke. Fast forward to 10pm local time, in between beers being delivered and the best fish and chips I’ve eaten, it arrived. Subject: positive covid test.
How? How did this happen? I’ve been asked how I felt when I found out. You can probably imagine the range of emotions I immediately felt. First, of course, denial. There’s no way. I’m vaccinated, I’ve been careful. I have no symptoms. The initial email didn’t help either, all it said was that I needed a follow up PCR test. Of course, I went right to Dr. Google and searched for ‘Rapid covid test – false positive’. What happened next was predictable. There were of course way more reports of false negatives, but as a human, I went to the one link that told me that a false positive was a possibility – granted, 0.4%, but to quote the great Lloyd Christmas, ‘So you’re telling me there’s a chance!’ I went to bed hoping for the best and yet refusing to prepare for the worse, because the worse would be unthinkable. Testing positive for covid at home? A pain, but not a huge deal. Testing positive for covid in a foreign country and being stuck there for up to 2 weeks? Terrifying.
Not surprising, I didn’t sleep well that night. Talk about not being able to shut your brain off. I already made the decision that no matter what the outcome, getting the PCR test was a top priority. In an ideal world, it would come back negative and I could enjoy the rest of my vacation, but if it came back positive then my quarantine clock starts. 10 days from the time of PCR diagnosis if symptom free, or 3 days beyond symptom resolution added onto the 10 days. There was no time to waste, so I made the decision that my organized tour to hike up to Fagradalsfjall had to be cancelled. This ‘should’ have been an easy decision under the circumstances, yet here I was, debating the decision. 0.4% chance of a false positive versus the opportunity of a lifetime, the possibility to witness an erupting volcano up close and personal. Now, the choice was made, but I have to confess that as a healthcare provider who has seen both young and old suffer the horrible effects of this pandemic, including death, the very fact that I debated this is a source of personal shame. I’m well aware that there was only one answer: lock myself up until I know for sure I’m not contagious, be it through a negative test (my 0.4% hope) or through the proper quarantine period.
With my tour cancelled (evidently it was too foggy to see anything that day anyway), I hopped into a cab, mask in place, and returned to the testing center, only now I entered the PCR line versus yesterday when I joined the rapid test line. I felt a severe sense of anxiety, and when the nurse collected my test, there was zero doubt that she obtained the right amount of specimen by spending a full 15 second scraping my brainstem. ‘All set. You will receive an email in 24 hours’. Deep down I hoped for the best, but then I started to question if I could taste my dinner, or if it was just overwhelming anxiety. Twenty-four hours later I had my answer. Positive. My brief Icelandic holiday was about to turn into a long, lonely and stressful quarantine.
Fast forward. I’m now alone in my hotel room. My wife and two travel companions, negative tests in hand, were already on board the plane home. I patiently waited for a call from ‘somebody’. I had emailed the nurse who sent me the ‘congratulations, you have covid’ email, but at this point had no other information. I intuitively knew enough to quarantine, and I certainly had accepted the fact that without a negative covid test there was no way I was going to be let on my flight home. My tiny hotel room – many are notoriously small in Europe – seemed even smaller as I nervously paced from the window to the hallway and back. Finally, at 1055am, the phone rang. All the caller ID said was ‘Iceland’. I quickly answered to find a nurse from the National Hospital who would be coordinating my care for the next 10 days. To summarize, in broken English, I was asked about symptoms, dates of quarantine, and was told that I was going to be picked up by an ambulance and taken to the prison hotel that would be mine. The good news? It was all going to be paid for by the Icelandic government, including 3 meals per day. The bad? 10 days from the time of diagnosis, no exceptions. Not only no exceptions, but no contact with anyone. No quick walks, no exercising, nothing. Ten… days… alone. In a hotel room. My anxiety was suddenly through the roof.
Am I in a spy movie? Or on my way to quarantine?
The phone rang again. This time it was the front desk. ‘Your ride will be here in 8 minutes. Be in the lobby with your belongings’. The initial phone call from the nurse was at 1055, by this point I had lost all sense of time. It may as well have been 8pm, but in reality, it was just a few minutes past 1pm. I made my way to the lobby and was told to wait outside where I continued to glance left and right looking for what I thought an Icelandic ambulance would look like. To my surprise, it wasn’t anything close to what I was looking for.
The non-descript white van pulled up in front of the hotel, the only reason I knew it was for me was the driver was donned in head to toe PPE – an N95 mask, a full face shield, disposable gown, and even surgical booties. He motioned to me to get in, and I quickly moved my suitcase and my anxious body to the single row in the back of what would have normally been outfitted as a 13-passenger tourist van. A pane of plexiglass separated me from the driver; he quickly informed me that we were only going 3 minutes down the road. I chuckled to myself at the entire situation as I felt as though I was in a grade B Hollywood action movie, a spy who was scooped up by an international government who were taking me to the interrogation room. Honestly, it may as well have been, as I still had no idea what the plan for me was.
My question was quickly answered. My fears about being tossed into a small fleabag motel were alleviated as we pulled up to the ultra-modern Foss Hotel. As soon as I saw the sign for the onsite beer garden and gym I thought this won’t be so bad after all. But alas, the revolving door was blocked off with police tape and there were multiple ‘no entry’ signs placed.
My driver told me to head in where I was met with another person also donned head to toe in PPE. I suddenly realized just how uncomfortable my patients were feeling when I dressed the part, and while we all ‘get it’, the lack of human interaction was more obvious than it had ever been to me. I can only imagine what an elderly woman with dementia feels like when she ends up in a hospital, completely alone and being cared for by people who cover every square inch of their body in protection. Check in was quick, uncomfortably so in fact. ‘Here’s your key, walk with me to the elevator, I’ll press the button for you. Room 909. Don’t leave, lunch will be delivered shortly, if you need anything, call the front desk’. No beer garden, no exercise room, no laundry facilities. Just me, my phone and a suitcase of dirty laundry.
My quarantine accommodations.
I entered room 909, my home for the next 10 days. Two single beds, a television, a full bathroom, a small but empty fridge and a million-dollar view of Reykjavik. 10 full days, all to myself. I regretted my last-minute decision to travel light and leave my computer at home, I was disappointed that the three books on my ‘to read’ list were on my nightstand. Television consisted of several Icelandic channels including one with seemingly non-stop high school soccer as well as a multitude of British television channels. I immediately decided on the one showing American television; unknown to me at the time it only showed Law & Order, NCIS, Murder She Wrote and Columbo. This wouldn’t be so bad except that the programming for week 2 were reruns of the shows on week 1. Seriously, there have been over 1100 episodes of all different flavors of Law and Order and I’m watching the same episodes from 1998 over and over again? Yes, this was going to be a long week.
The food was tolerable but institutional. Within 10 minutes of my arrival there was a knock on the door. Another PPE clad human holding a take-out box and a bottle of water. Lunch. That’s all I can say at this point, simply because I honestly had no idea what I was about to sink my teeth into. There was a well-done piece of meat – lamb perhaps – on top of a bed of rice, a small salad (ok, I’m being kind. A handful of dressing-less shredded lettuce) and a small piece of cake. While it wasn’t horrible, it also wasn’t what I was looking forward to 3 times a day for the next 10 days. I now fully understood my dad’s last few years in the nursing home where all he had to look forward to was what the next meal was, and I absolutely get his frustration when something was put in front of him that was less than tasty. This entire situation made me fully realize just how special those moments where when I would pop by for lunch with a pizza or a fully loaded Italian sub.
I truly tried my best to not order delivery, the food wasn’t horrible and getting food from the AHA app was certainly not going to be cheap in a city already known for expensive dining out. While I did manage to tolerate the food mostly – Swedish meatballs, salmon, chicken breast with a non-descript yellow sauce – along with the handful of lettuce and small dessert, there were times I had to order out. A delivery of soggy ‘fried’ and unidentified protein necessitated in immediate order of a pepperoni, mushroom and cream cheese pizza while a lunch of mushy fish cakes caused me to angrily order a bacon double cheese burger with fries. To this day, I have no regrets, even though each order set me back over 5000 Icelandic Krona (roughly $40 USD). Breakfast was a different animal – the same, basically every day. A slice of salami, a slice of ham and a slice of cheese. A roll. Two mini croissants. A couple of cucumber and tomato slices and a hardboiled egg. For a guy with the well-known designation as the BaconMedic, this was not an easy situation.
The days slowly dragged on. I thought of Red’s quote from the movie Shawshank Redemption: ‘Prison life consists of routine, and then more routine’. My routine was waking up to wonder if my breakfast had been delivered – meaning left at my door. Then, a shower, as television was useless to me until 9am when NCIS started, anything earlier would have consisted of Murder She Wrote. Law and Order was the highlight as Detectives Briscoe and Green went on duty at 11am. Lunch generally showed up promptly at noon, often hand delivered by another PPE clad person which allowed me the amazing 5 seconds of human interaction as I said thank you which was quickly followed up by the obligatory ‘you’re welcome’. More Law and Order until 5pm at which point NCIS was back on, then the 6pm dinner delivery with 5 more seconds of human interaction. 9pm was an exciting time for me, as Law and Order was back on, but this time SVU – in my opinion the best series in the franchise.
Watching the planes….dreaming of freedom.
Of course, I didn’t only watch television. I looked out the window and watched the planes approach the Reykjavik Domestic Airport (IATA: RKV) from across Faxaflói bay; small domestic flights from around the country and Greenland landed here a couple of times per hour. Using my favorite app, Flightradar, I was able to identify planes coming in from smaller Icelandic cities with names I had never heard of and would most likely butcher if I tried to pronounce them, such as Grímsey, Vopnafjörður, Þórshöfn, Gjögur, and Bíldudalur. Of course, I took the time to read about all of them, and my next trip to Iceland has these places on top of my list. Clearly, having done the Golden Circle and South Coast twice now, it was time to consider a rental car for some serious Icelandic exploration.
The days dragged on. Routine. Followed by more routine. Trying to identify each building seen from my window. Watching boats come and go. Watching families walk by 9 stories below as well as along the bay. Seeing the now tiny but still beautiful and ever color changing Harpa, a building I was fixated on just days earlier when I was a free man. Being locked away, be it in prison or a quarantine hotel, gives a person a lot of time to think. Inevitably, my thoughts turned to covid. I’ve been outspoken on social media on some of my thoughts, and this entire situation dug those opinions up once again. Now, I was on the other side of the pandemic. Had my thoughts changed at all, or had my resolve only been strengthened. So here we go, in a stream of consciousness sort of manner.
First the vaccine. This had been on my mind the entire time. Did it fail? Or did it do exactly what it was supposed to do when faced against the highly contagious Delta variant? In my opinion, whether my cough was covid or not, I’m high risk and barely got sick, if at all. So, I’m crediting Moderna with a huge win, but the timing was horrible for me.
More vaccine: as humans, we all want covid over. We are impatient, and we refuse to accept the fact that it may take years to get it under control. Thankfully, because of an amazing scientific and medical community, combined with ‘evil Big Pharma’, we managed to develop a highly effective vaccine that will speed the end point of the pandemic up; but that ultimately depends on immunity. Vaccines are the key, as is natural immunity – and thankfully, we now have both.
Mutations: The Delta variant is nothing more than a mutation of the original virus, and it’s not surprising that we have it, and we should certainly expect more to come. Will they be more or less deadly? Will they be more or less contagious? We just watched Delta completely decimate a mostly unvaccinated India, and the numbers of really sick unvaccinated versus not so sick vaccinated people in the United States is scary. This goes back to immunity. I keep hearing Dr Zubin Damania (aka ZDoggMD) in his video page telling people that we all have a date with the coronavirus or the coronavirus vaccine.
End point: There is none. Between mutations and the inability to get 100% immunity for the entire world means that covid isn’t and never will be a zero-sum game. It’s here, and it’s here to stay, so we have to identify an end point. For those of us who are vaccinated, the end point has mostly arrived. Yes, I understand how odd it sounds from a fully vaccinated guy who had a breakthrough (with minor illness) and is stuck in a hotel room in foreign country, yet honestly, knowing there are a large number of people out there refusing the basic defense of a very safe and very effective vaccine, I’m having a difficult time feeling bad for any of them who end up with covid.
Vaccine choice: This is hard for me. As a libertarian, I have been torn since day 1. No, I don’t feel comfortable with the government telling me what I can or can’t do with my body, and I am prochoice, so fundamentally I have an issue with any government healthcare mandate. Yet, knowing just how contagious this virus is, as well as how deadly it is, I absolutely see that side of it. As a libertarian, you should be able to do anything you want without government interference AS LONG AS IT DOESN’T NEGATIVELY AFFECT OTHERS. Walking around in public with asymptomatic covid without a vaccine may be a death sentence for someone. That is not the libertarian way, and it is not the human way. As a frontline ER nurse and paramedic, I have looked at these vaccines and the numbers are good. They are safe. They are highly effective. Yet, here we are, well past the point where we should be having another deadly wave, especially when mass vaccination in this country has been available for months now to anyone who wants it and doesn’t have a medical restriction. Yet, I also understand the mandate issue. I hate it. I hate having government tell me what I have to do, even when I know that medically its absolutely the right thing and the only thing that is going to end the pandemic. What bugs me is we may lose millions more lives out of sheer stubbornness, yet I still totally understand the issue of personal freedom and liberty.
I have many more thoughts that were bouncing around in my brain as I looked at the city from my 9th floor prison cell, but these were the big ones. Was I angry? No. Frustrated, of course. But I get it 100%. The fire isn’t out, and it’s going to continue to burn until humanity in general commits to putting it out. In the meantime, NYPD went after killers, SVU went after rapists, NCIS took care of more naval crimes than I ever thought could take place, and Angela Lansbury did whatever the heck she did while I was in the shower.
Meanwhile, my flight home had been booked and I took the opportunity to upgrade to First Class as a special treat, taking off on the foggy morning of September 2 for the just over 5-hour flight home. The joys of travel are still with me and my wanderlust is a strong as ever, unlike many who had just endured being locked away in a foreign country, I was busy planning my next adventures. Barcelona in October? The Caribbean in November? How about Peru in January? And let’s not forget the biggest one of all, the BaconMedic Birthday Extravaganza in March. Is covid a thing? Of course. Is it dangerous? You better believe it is. Do I have any regrets that I traveled during a global pandemic? Not one. I did what I was supposed to do, rolled the dice and lost. Yet, at the end of this adventure I came away still healthy with a bunch of new amazing experiences that I have been extremely fortunate to have had. So yes, I will continue to travel while be cautious and taking appropriate precautions.
Did I enjoy my trip to Iceland anyway? Yes! It is an incredible country with beautiful scenery, great food, and volcanoes—what isn’t to love. Stay tuned for my next blog to hear more.
