One travel writer describes the difficulty he faced getting swabbed for COVID-19, despite traveling from a high-risk location - which could potentially put his family and community at risk

By Brian Freedman
March 25, 2020 05:11 PM
Courtesy Brian Freedman

Brian Freedman is a Philadelphia-based wine, travel, spirits, and food writer who recently traveled to Egypt with Chef Hamdy Khalil and his business partner Mary Cullom of Arpeggio BYOB in suburban Philly to write about the country and its food, and to film a reel for the travel-food show he’s developing. The journey was cut short, however, by COVID-19 – and he had no way to know that leaving the country in time wouldn’t be the most difficult challenge he’d face.

It seemed so harmless at the time: A drunk 70-something German tourist in a garish hieroglyphic-print blouse stopped me in the lobby, slurring her words as she told me, in broken English, that she was Cleopatra and I was her new husband, “Ramses the Eighth.” Before I knew what was happening, she hooked her arm through mine and dragged me to her equally boozed-up travel companions sitting in a circle of chairs on the dance floor of the bar. I could see spittle arcing from her lips in the beams of light from above as she told them in rapid-fire German about what I imagined to be her plans for our royal wedding.

This was the final night of a four-day cruise of the Nile from Luxor to Aswan. Meanwhile, the story of the COVID-19-infected boat MS Asara, which was following the same route as our ship (but in the opposite direction) was about to break.

Less than a week later, my traveling companions and I were hurriedly packing our bags and planning for an early-morning departure from our New Cairo hotel for a hastily rebooked flight home. I’m now home with a tight chest, a throat that’s on fire, severe exhaustion and chills and, miraculously, a coronavirus test working its way through the local Philadelphia medical community, its verdict set to be delivered early this week.

The trip wasn’t supposed to end like this.

I had arrived in Cairo on March 1st, part of a small group that was accompanying Chef Hamdy Khalil and Mary Cullom, co-owners of Arpeggio BYOB, a Mediterranean restaurant in suburban Philadelphia. After a quarter-century of business, they wanted to place more of a focus on the cuisine that Khalil grew up with as a child and young man in Egypt. We started the tour in his hometown of Abassa, an hour outside of Cairo where his extended family still lives—and where they gave us a welcome that first night worthy of the royalty I was sure to become after my wedding to Drunk German Cleopatra—and continued along the towns and villages of the Nile between Luxor and Aswan, culminating in an in-depth exploration of the street food of Cairo. Seeing it all through Khalil’s eyes, listening to him work his way through which dishes he’d be adding to Arpeggio’s menu back home, and how he’d tweak them to make them his own, was fascinating, the stuff of food-writing dreams.

But then we got word that several passengers from the Asara had tested positive for COVID-19, and soon after that the number had multiplied. Everything shifted—imperceptibly at first, and then all at once. Had we been in any of the cramped, 4,000-year-old tombs with those passengers in the Valley of the Kings? The coughing, sneezing, jostling swarms of visitors at the various temples along the way—Luxor, Karnak, Abu Simbel, and others—suddenly seemed more menacing than any millennia-old Pharaonic curse.

Still, we journeyed on—we had eating and exploring to do. If we were infected, we reasoned, then we wouldn’t know for up to two weeks. In hindsight, the social-responsibility logic of this was suspect at best, but part of the nature of travel is to live outside of your comfort zone as you pass through to a deeper, more true understanding of the world and yourself. Knowing what we know now, I think we may have decided differently.

Our concern about the virus – at that point, not yet declared a pandemic – faded as we continued on the trip, until I received an email from the United States Consulate in Cairo. I had signed up for the State Department’s Smart Traveler Enrollment Program (STEP) in order to let the government know that I was in the country in case anything went sideways while we were there, and to stay informed of any issues affecting my travel that I should know about. Personally, I was thinking that terrorism would be the main concern, or some sort of government crackdown, since there had only been a single “official” case of COVID-19 in Egypt before I left the United States.

The new email informed us that the “global health risk” posed by COVID-19 was “high,” noting, “on March 7, the Egyptian Ministry of Health announced 45 confirmed cases of COVID-19 on an Egyptian cruise ship on the Nile River on its way to Luxor, Egypt.”

I read the email to my colleagues, and we all agreed that we should probably have the discussion we’d been putting off: Whether we should stick around, and continue on to Sharm El-Sheikh as scheduled, or head back home. We started digging through the news online to see what else we could find. On March 4th, Israel had announced mandatory quarantines for travelers from Germany (as well as Austria, France, Switzerland, and Spain)…and the majority of passengers on our Nile cruise had been German (not just my royal septuagenarian wife-to-be).

The signs weren’t looking good, and general consensus was that the situation in Egypt was worse than the local authorities were letting on. We also couldn’t be sure that a presidential tweet wouldn’t instantaneously halt our ability to get back into the United States. We decided to book flights for the next morning.

It was a smart decision: As we were going through security at Cairo International Airport, I received another email from the State Department’s Smart Traveler Enrollment Program, stating that Saudi Arabia would be requiring any travelers from Egypt to take a test for COVID-19, and that other countries would be restricting travel from Egypt. It seemed that we were leaving at exactly the right time.

I had no way of knowing, however, that the real difficulties would come only once I was home on American soil.

Courtesy Brian Freedman

Physically getting back into the country was disconcertingly easy, despite the fact that Egypt seemed to be a hotspot for new infections (and that my tour group in particular had been seeing the same sights as the infected boat). No one took my temperature at JFK. No one asked if I’d been in contact with or in proximity to an infected person. I told the Customs and Border Patrol agent I’d been to Cairo; without looking up, he asked: “Any other countries?” I said no. “Welcome home,” he replied, and waved me through, giving it no more attention than if I told him I’d just come from a weekend in Orlando.

Out of an abundance of caution, I called the University of Pennsylvania Travel Medicine clinic from the airport to ask if I should self-quarantine or isolate myself from my family. I use them for all of my pre-travel immunizations and prescriptions, and trust them completely. They told me that official CDC guidelines were that I should monitor myself, but that there was no need to book a hotel. Just don’t get too close to the family, I was told.

The next morning, however, I woke up feeling like a head cold was coming on, and given where I’d been, I wanted to be as proactive as possible. This is where the breakdown in the system really began. And its lynchpin, as is so often the case, was with a single person who just didn’t seem to care.

I called my primary care physician’s office out of an abundance of caution, and my (now-former) doctor got on the line and immediately seemed put out to have to deal with me. He read off the official list of questions used to determine who was or was not eligible for a COVID-19 test.

Did I have a fever?

Did I have a cough?

Had I been to China, Iran, South Korea, or Italy?

When I tried to tell him that I hadn’t been to any of those four countries but that I had been in Egypt, on a Nile cruise, he cut me off, telling me that if I kept on interrupting him the process would take too long.

A few minutes later, the call was over and I was left in my living room, sniffling and a bit achy, with my wife and two daughters—six and nine years old—scheduled to come home in the next couple of hours.

My symptoms worsened for the next several days until finally, Thursday, the pain in my throat and the chills I was experiencing were too much to ignore. I signed up for an appointment at the local RiteAid Redi Clinic, and at 8:30 a.m.l was seen by Dana Wallace, the family nurse practitioner who has helped me out with countless minor illnesses before.

As soon as I told her where I had just come back from, she locked down the clinic without hesitation, tested me for flu and strep (both negative), gave me an N95 mask (and donned one herself), and immediately started calling the CDC, the local board of health – anyone she could think of to try to get me tested. She was appalled that my doctor had brushed me off the way he had. Ninety minutes later, I went home with her cell phone number and a promise from the local health department that they’d be in touch with me by the end of the day to determine if I could be tested.

By mid-afternoon, none of us had heard from anyone, so I decided for a hail-Mary pass: I texted a friend who’s an anchor at the ABC affiliate here in Philadelphia to see if they were working on any stories about testing difficulties. An hour later, I was being interviewed via video Skype for a piece that would end up airing during that evening’s 5:00 broadcast.

Even that didn’t help get me tested. Finally, desperate and terrified for my wife and kids, I called my primary care physician’s office again the next morning, explained to the receptionist what the other doctor had done (or, rather, what he had not done), and asked to speak with any other doctor on duty that day.

A little over an hour later, I was getting my nose and throat swabbed by a quasi-hazmat-suited nurse with a rolling medical cart from the (dis)comfort of my car in the ambulance bay of the emergency room at Lankenau Hospital.

“We would have obviously liked [the process of determining who gets tested] to work neat and clean, but real life happens,” Dr. Laura Picciano, Attending Physician of Internal Medicine (and my new primary care doctor), said. “In the beginning, we had limited resources for test kits, and we need to practice solid clinical judgement.” She was able to fight on my behalf due to my unusual circumstances, but not everyone might be so lucky.

My results are expected early this week. [Editors’ note: Freedman eventually would test negative.] Even if I test positive, I’ll most likely be fine: I’m a healthy 43-year-old who runs marathons and has the means to make sure I’m eating well and taking care of myself as I fight whatever this bug is. My kids have no chronic or underlying medical conditions, and neither does my wife. I know how lucky I am, how lucky my entire family is.

Still, I’m painfully aware that I’m not representative of the population at large. And we are still in the early stages of dealing with this crisis. “I do believe that, based on the velocity of the virus, we will see an uptick in cases,” Dr. Picciano noted. “We will see more strain of our precious resources, more deaths and morbidity. I do believe that will happen.” Still, she argued, the United States is in a better position than many other countries that suffered outbreaks before us, because we can see what worked and didn’t. “We have to enforce [social distancing and quarantining when necessary] and work together as a community … We have to be mindful of our neighbor who maybe doesn’t have the immune system of a 20-year-old.”

Fortunately, she is confident that we will win the battle against this virus. And I’m confident that I’ll be on the road again, eating everything and anything interesting I can find around the world. “We’re ready for it,” she told me. “All of us [in the medical and health services communities] have really put our other lives outside of work on hold because we know we might need to be there for patients.”

As I lay here on the couch, though, I keep on wondering about my would-be wife in the Cleopatra garb from the ship. How is she doing right now, a 70-something smoker from a hard-hit country?

I’ll never know, but I wish her the best.

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