As I write this, the U.S. has had over 125,000 COVID-19 deaths out of 2.5 million infections (death rate=5%). The 2019-2020 season INFLUENZA deaths in the US were 34,200 out of 35.5 million infections (death rate <1%). And while the Flu is spread ONLY WHEN YOU HAVE SYMPTOMS (coughing, sneezing, etc.), you can transmit COVID-19 WITHOUT HAVING ANY SYMPTOMS whatsoever. Per the CDC, staying at home, handwashing, social distancing and wearing masks when not at home–remain the best way to prevent getting and transmitting COVID.I want to share a personal story with you. Stephanie is my niece, and she gave me permission to tell you this. She is 30 years old, a Pharmacy Technician, with mild intermittent asthma (that is, she needs her inhaler ONLY when she has a cold). She developed a high fever to 102+ approx. 4/10/2020. By the 4th day, she was coughing & a little short of breath, which continued to worsen rapidly, so that on 4/15/2020, she had to go to the Emergency Room. On arrival to the E.R., her blood Oxygen was 53 % (most of us have Oxygen levels of >95%). She was admitted, but stayed in the E.R. nearly 48 hours, as the ICU had no beds. Steph was intubated the morning of 4/17/2020, one of 52 patients on ventilators in the ICU. She received all the accepted treatments for COVID, including being positioned face down (prone) 18 of 24 hours for nearly 21 days. For nutrition, she had a feeding tube from her mouth to her stomach.
Steph remained on the ventilator for over 1 month; and on day #33, we made the difficult decision to have her undergo a tracheostomy. On 5/20/2020, she had the ventilator tube and feeding tube removed from her mouth, and underwent a tracheostomy and placement of a PEG tube (feeding tube through the abdomen into her stomach). On day # 37, she was able to come off the ventilator, though still needed Oxygen via the tracheostomy, and nutrition through the PEG tube.
Since patients are heavily sedated while on the vent, she spent the next 10 days in the hospital being tapered down from these medications.
On day # 47 (6/1/2020), Steph was transferred to Acute Rehabilitation– still needing Oxygen & PEG tube feedings. The first day she worked with Physical Therapy, she was able to take 4 steps. Her fingers and hands didn’t work well; and her voice was a hoarse whisper. Due to being prone with the ventilator tube against her right cheek bone, she developed an ulcer on her right cheek, as well as ulcers on both knees and buttocks. Wound Care Nurses cleaned & debrided her wounds (removing non-healing tissue to allow healthy tissue to grow). She was finally able to breathe without Oxygen as of 6/13/2020. Although she failed swallow evaluations twice (the swallowing reflex is lost after weeks of not being used), she was finally able to eat (pureed food first, slowly advancing to solid food.) But due to pressure against her diaphragm from the PEG TUBE, she vomited after every meal. By the time she left the Rehab, she was able to walk 120 feet 10 times. The Tracheostomy was discontinued on day #63; and Steph went home on 6/19/2020, day # 65 (still with the PEG tube).
She has now been home 10 days, and is needing outpatient wound care, and outpatient physical therapy. The PEG tube was literally yanked out on 5/24/2020; and she lost 26 lbs. during this ordeal. For 64.5 days, she was not able to be hugged by her family. For the first 33 days in the ICU, in spite of daily requests, her husband Brian was able to see her 3X (there was only one tablet for the entire ICU). Once she came off the ventilator, he delivered a tablet for her, so we could see/talk to her. At the Rehab, Brian and Steph’s parents & brother would “visit” outside with posters to encourage her, as they would catch a glimpse of each other through the 3rd floor Physical Therapy window.
Steph is here to tell her story: she is one of the lucky ones. She, and your Family Physicians and Physician Assistants at Metro Family want everyone to know that this is a very serious disease. Please take COVID-19 seriously.
Ada Marin, M.D., MPH-on behalf of Metro Family Physicians.
