Dr. Bob Wachter, the chair of the department of medicine at UCSF, has been tweeting about COVID-19 for nearly two years, sharing regular updates with his views on the state of the pandemic in San Francisco and worldwide.
Over the weekend, Wachter’s Twitter account with 245,000 followers got a little more personal when he revealed that his son tested positive and had symptoms. In a series of 25 tweets, he touched on many of the issues around the omicron surge, including the scarcity of at-home tests and testing appointments and the supply shortage of treatment options for symptomatic patients.
With his son’s permission, Wachter posted details about his 28-year-old son as a sort of case study. Wachter, 64, assumed his son has omicron and did the calculation for his chance of serious illness. With the omicron variant, most cases in the vaccinated population are milder than with previous variants. Wachter deduced his son had a 0.3% chance of needing hospitalization. “I knew, deep down, that odds of a bad case were low,” he wrote. “But when it’s your kid, you freak out a bit.”
Wachter shared that his son caught the virus last Monday while watching a movie with a fully vaccinated friend at home in San Francisco. Wednesday morning, 36 hours later, his son woke up feeling awful, with a sore throat, dry cough, muscle aches, chills, no taste and smell abnormalities. A Centers for Disease Control and Prevention study suggested omicron’s incubation period is just three days.
The doctor told his son to stay home, drink fluids and take Tylenol or Advil. Local pharmacies were sold out of rapid tests, but Wachter had one stashed away at home.
“He came outside (I wore an N95) & we ran it, w/ a nasal swab,” Wachter wrote. “It was negative. I was a little reassured, though he was not – ‘Dad, it feels just like I felt after my… vaccine,’ he said. He seemed sick enough to be infectious; I wondered if he’d be an example of the newly reported problems with false-negative rapid tests in the first days of an Omicron infection.”
A call was made to the UCSF COVID hotline to get a PCR test and the soonest an appointment was available was four days.
“I heated up some chicken soup, bought an oximeter (97%, whew – though his heart rate was 120: concerning) & told him to call me if his symptoms changed or his O2 sat fell <95%," he wrote.
Even though his son had an initial negative test, the next day it became clear the odds of Wachter’s son having COVID were high — the friend who the son watched a movie with called to say she tested positive.
Another test was done, but this time Wachter advised his son to swab both his nose and throat as early reports indicate that swabbing both “improves yield for omicron” versus the nose alone. This time, he tested positive. “We cancelled the PCR test (now 3 days away) since the diagnosis seemed secure. So one more case omitted from the public #’s (which makes skyrocketing case counts even more amazing),” Wachter wrote.
Wachter posted the news on day four of his son’s case, stating that “flu-ish” symptoms had subsided but his throat still “hurt like hell.”
Wachter said the plan is to test on day five, and his son will leave isolation and wear a KN95 mask if he tests negative.
The California Department of Public Health’s quarantine guidelines ask people who test positive to isolate for at least five days. They can end their isolate on day five if they test negative, or wait until day 10 when you can leave isolation without a test.