Life under the spectre of Covid-19

JORDAN MOSHE

Cohen is the voice of coronavirus in South Africa. Her team has been working around the clock to safeguard the public, striving to make sure that we remain healthy and kept up to date on the latest developments.

She is the head of the Centre for Respiratory Disease and Meningitis at the National Institute for Communicable Diseases (NICD) in South Africa, where her daily duties effectively put her at the coalface of coronavirus. As a result, her routine and personal life have been turned upside down over the past few weeks.

“It has been a totally absorbing experience,” says Cohen, a specialist in microbiology and viral disease. “We’ve had to clear our schedules, effectively put our lives aside, and focus entirely on the demands of the outbreak. We’ve pulled in people from across departments, and we’ve been absorbed into a single effort.”

It all began in December, when she and her team first got wind of the virus in China. “We picked up information about a cluster of pneumonia cases which seemed quite worrying. They were all said to be linked to a live market in Wuhan, China, and it seemed at the time that they were caused by a zoonotic disease, one which typically starts among animals, crosses the species barrier, and affects humans. These types of events do happen occasionally, especially in China.

“We were worried,” Cohen says. “As epidemiologists, we want to understand the extent of the possible threat posed by something like this, whether it can spread through close contact or through animals only. So, we continued to monitor reports for evidence of human transmission, and by January, word of household cases emerged.”

As the disease became a global concern, the institute’s departments began establishing laboratories and dedicating research to the outbreak. Staff who returned to work in January had their hopes of a quiet transition dashed when their routine changed dramatically.

“An event like this wipes you out,” she says. “We tend to use January to catch up on papers and projects but had to clear our schedules completely and take on training, managing adjustments to the health system, communication with professional medical organisations, and engaging with the media.

“The idea of a new disease is frightening, and it comes with demands that need to be addressed.”

With her routine interrupted indefinitely, Cohen says all her professional plans for the year have been suspended. The changes have also had an impact on her personal life, and while she strives to maintain a healthy work-life balance, she has experienced understandable strain.

“Balancing family and work is always difficult, but something like this affects one’s life entirely. When the outbreak was declared, I worked for two weeks straight. Our team is regularly left exhausted, and you feel like there’s no break from work because you devote yourself to the disease completely.”

Cohen was raised in Corlett Gardens in Johannesburg, and attended Sandringham High School, located across the road from the NICD where she works today.

“My mom is a doctor, and she used to take me on her rounds of the infectious-diseases ward at Rietfontein Hospital (today Sizwe Hospital) when I was a medical student,” she told the SA Jewish Report this week. After studying medicine at the University of the Witwatersrand (Wits), she became fascinated with infectious diseases, and found her professional calling.

“I really didn’t want to be confined to a laboratory. Just like clinical medicine restricts the number of people you can see in a day, it can be quite restrictive,” she says. “I chose to go to London and study epidemiology, a field which teaches you about who gets certain diseases and why.

“Because of the scope it offered, it became my passion. It allowed me to make an impact on public health at a broader level instead of being limited to one patient at a time.”

After completing her master’s degree in the United Kingdom, Cohen returned to Johannesburg and took up a position at the NICD as one of four staff members in a very small epidemiology department. She went on to pursue a doctorate at Wits, and was subsequently appointed head of the Centre for Respiratory Disease and Meningitis at the institute.

“The NICD was established with a public-health focus,” says Cohen. “Its aim wasn’t just to diagnose diseases but to understand who can get them and why, adopting an integrated approach which uses research to reduce and control them.

“When I first joined the institute, there weren’t many people trained in epidemiology. It was an exciting prospect to work on a range of diseases and make a difference.”

Cohen says that a key aspect of her job is to balance the control of epidemic respiratory diseases which typically cause death in South Africa (primarily via illnesses like pneumonia) with monitoring and responding to emerging pathogens.

“There’s always a high possibility of new pathogens emerging where respiratory diseases are concerned,” she says. “One of the centre’s roles is to monitor across the country for the presence of new respiratory diseases. We’re part of a global network which shares information about new diseases, and are always reviewing reports of anything unusual.”

While Cohen says her routine has normalised somewhat since the outbreak, she admits to being out of her comfort zone, as she is the type of person who appreciates a set schedule into which she can insert work and family. “I like my structure,” she laughs. “I’ve been working in this job for more than ten years, and the outbreak has made me do things I wouldn’t normally do, from constant engagement with the media, to being at work more.”

Fortunately, she says her family and friends have been exceedingly understanding and supportive of her work. This includes her wife (who also works at the NICD), nine-year old daughter, and twin boys aged six.

“Because our time is so restricted, my wife and I have had to negotiate sharing responsibility for caring for our children,” says Cohen. “We’ve explained to them what we’re doing, and why we have to be away so much. I always talk to my kids about my work and disease in general, and I know I can rely on my wife as we share responsibility at a very difficult time.”

While South Africa is still unaffected by the virus, Cohen says she has learned much from the changes caused by the outbreak.

“Having a team to work with makes all the difference,” she says. “You discover what it means to do your best, to manage under very difficult circumstances, and that you can pull through only by working together. I work with excellent people, and while we’re all feeling stressed, we still take over for one another when we need to.

“We’re individuals trying to live, work, and handle a virus outbreak at the same time,” she says. “But we’re in it together, and that makes all the difference.”