On receiving news of her daughter’s Covid-19 diagnosis, the wave of shock that hit a mother in Dubai was eerily familiar.
Karin Voyatjes felt exactly the same way two years ago when she learnt that Alexa, now 5, had cancer.
With her daughter still undergoing treatment for acute lymphoblastic leukaemia, a type of blood cancer, Ms Voyatjes worried how ill her girl could become from the coronavirus.
“It was such a shock because it was the last thing I expected. She wasn’t sick at the time,” said Ms Voyatjes, from South Africa, of her daughter's Covid-19 diagnosis in August.
“The following day the rest of the family all went for tests. My husband and my son tested positive.
“My husband had mild flu symptoms. My son, 6, was totally asymptomatic. I would not have known he had Covid-19 at all. Not a sneeze, not a fever. Absolutely nothing.”
Alexa eventually developed symptoms. Her oxygen levels were stable throughout, but a second chest X-ray revealed a concerning pattern in her lungs, so doctors put her on antibiotics as a precaution.
She tested positive for about six weeks, which is normal for people who are immunocompromised, but eventually beat the virus.
“It was a very stressful period, but luckily everyone was okay,” Ms Voyatjes said.
Alexa, who is now approaching the end of her lengthy treatment for leukaemia, has come a long way.
Ms Voyatjes, who posts on social media regularly to raise awareness about childhood leukaemia, said the early days of her daughter's treatment were hard.
Only three years old at the time, Alexa struggled to understand what was happening to her.
“She’s quite a feisty, outgoing child. She rebelled against the treatment. She [was] making herself vomit in the car,” Ms Voyatjes said.
“They put something under her skin to give direct access to an artery, which is how they insert the chemotherapy.
“During the first few months, she didn’t want it to be touched. She would cry and scream, make herself vomit and take her clothes off rather than have it done.”
It was hard for her mother to watch.
But she coped by focusing on how the treatment could save her life.
“You sort of have to disconnect yourself from the emotional side, because you are allowing your child to be tortured, in a way,” she said.
“It’s a really strange thing to go through as a parent.”
The family sought the help of a psychologist with experience in treating children with cancer. The doctor helped Alexa overcome her anxiety.
“You could treat her with something to calm her down or tie her to the bed, but the long-term effects of that would be worse. It’s a long journey," Ms Voyatjes said.
"So you can’t really use a short-term fix at the beginning. It’s better to treat the core problem.
“She’s absolutely amazing now. The doctors are amazed. We have a routine and there is no protest.”
At the time of the diagnosis, Alexa was ill but there were no major red flags.
She had a fever from tonsillitis that week, a few bruises on her legs, and a more concerning one behind her ear, which could not be explained by any injuries.
A doctor decided to run some tests, which initially suggested she was suffering from a blood clotting disorder.
“The paediatrician who ran the tests said we had to go to the emergency department,” Ms Voyatjes said.
“We agreed to stay overnight after doctors re-ran the blood. The next morning, I had to sign a disclaimer for an emergency blood transfusion and platelet transfusion.
“Her blood count dropped so significantly overnight that it was actually quite dangerous.”
Next week, Alexa will start the final cycle of her treatment, which is expected to end in February.
She has been back in school since September and is enjoying being with her friends again.
Ms Voyatjes hopes sharing information online will help others spot the early signs of the illness in their children.
Results from Alexa’s blood tests are good, and they will soon learn whether she is in remission.
With her treatment set to end in a few weeks, the family is planning a celebration – but the pandemic does not make it easy.
“I don’t think we will be able to do much to celebrate at the end of two and a half years of treatment,” Alexa's mother said.
“But it will still be an amazing day.”