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Baylor College of Medicine

A Cautionary COVID-19 Tale

Master
Heading

July 2, 2020

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My message today is a little different.  Generally, my comments are directed to the Baylor Community, and I hope they may have broader applicability.  Today’s message is squarely directed outside of Baylor.  Please share it widely, and share it today.

You do not need me to tell you the SARS-CoV-2 situation has substantially worsened over the past week – every media outlet in the nation is covering that story.  We are in the midst of a major surge.  Our affiliate hospitals are working hard to make sure there will be beds available to meet the demand, staffed by qualified healthcare providers.  We are prepared, but clearly are in for a challenging couple of weeks.  As we manage increasing volumes of patients, and especially as we enter the holiday weekend, the most important thing we can do is work to slow the spread of COVID-19.  That is why I think the story of Frank and his family is so important.

Note: I changed the name of the main person in this story to Frank Wilson and left out some details, not at his request, but to allow this story to be told without intruding on the privacy of anyone involved in this story. The story is real, the people are real, the impact on their lives is real.

Frank Wilson and his extended family have lived in the same town for more than 40 years – three generations.  They are a close-knit family in a close-knit community.  They enjoy a pace of life that is at least a half step slower than a city like Houston.  This is the story of SARS-CoV-2 in a place far removed from the intensity and complexity of the Texas Medical Center.  It is a story of good people in a safe place.

The Wilsons planned to spend their Memorial Day the way they spend most holidays and many weekends – enjoying a family gathering at their favorite picnic spot.  This celebration took on a little more significance, as they were coming out of the coronavirus induced lock-down.  As regional leaders mandated a partial shutdown of the economy, they suffered along with the rest of the state and the country – lost shifts at work, cancelled family events.  Now public officials were reopening the economy, and life was trying to regain its normal rhythm.  There was nothing more normal for Frank than a family picnic.

What did he think of all the coronavirus warnings?  “I thought it was all a big hoax – the government trying to take control of things”.  He knew people in other parts of the country had the virus, but he did not personally know anyone who had it.  He didn’t even know anyone who knew anyone who had it.  The response of media and civic leaders seemed overblown.  “It was a big nothing.”  Thankfully, it seemed now it was behind us.  We were opening back up.  We had beaten the virus.

This Memorial Day was like countless other similar holidays – an opportunity to unwind and relax with family.  It would become a day – that would lead to a week – that would change their lives forever.

The first warning sign.  Frank’s mother became short of breath.  Her symptoms were severe enough they felt compelled to get her checked at a local emergency room.  She was evaluated and told that she was suffering from a “broken heart.”  She was still mourning the recent death of her husband – Frank’s father – and it seemed reasonable that her symptoms were anxiety related.  All were relieved it was not the virus.

Memorial Day was Monday, May 25.  Tuesday passed and was uneventful.  

Wednesday, Frank went to help a friend tune up the engine of his car.  Towards the end of the day he didn’t feel well.  That night his temperature went up and he called his boss to say he would not be at work.  He went to the hospital and got the COVID-19 test.  Results the next day – positive.  He had the virus.

Thursday, Frank’s wife developed similar symptoms.  She went to the hospital, and was sick enough to be admitted.

Also on Thursday, Frank’s mother-in-law became ill.  In retrospect, she had not felt right since mid-May, but had already had a negative test for COVID-19.  She went to the hospital, and was admitted.

Friday, Frank’s sister became ill. Like his wife, she went to the hospital and was admitted.

By Friday evening, his mother’s condition had worsened to the point he sat at her bedside all night.  He did not realize it at the time, but this would prove to be the last night she would spend in her home.  On Saturday, he took her to the hospital, and she was admitted.

Thus ended a week from which the family is still struggling to recover.

Frank was lucky.  He did not need to spend time in the hospital.  However, he tells me it was the worst thing he has ever had.  “It was ten times worse than the worst flu.  I had terrible stomach pain, and couldn’t get my breath.  It felt like a bomb was going off in my chest.”

His wife’s condition was severe enough that it looked like she would need to go on a ventilator.  Fortunately, with a combination of regular proning (face-down positioning that improves air exchange in COVID-19 patients) and high levels of supplemental oxygen, she avoided the ventilator and was discharged after about a week.

His mother-in-law’s condition deteriorated, resulting in a prolonged ICU stay.  She is profoundly weak and continues to undergo intensive rehabilitation.

Frank’s sister also wound up in the ICU, and required extracorporeal membrane oxygenation (ECMO).  This is used in patients whose lungs are so badly involved that they cannot effectively exchange oxygen between the airways of the lungs and blood, which is much like slowly drowning.  The patient’s blood is drained out of the body, infused with oxygen and replaced.  Thankfully, she recently improved to the point that she is off ECMO, although she remains hospitalized.

Frank’s mother was the most critical of all.  She was admitted to the ICU and received the best and most aggressive treatment possible, at the finest medical center in the world.  She participated in the convalescent serum trial, receiving antibodies from another patient who had recovered from COVID-19.  Despite heroic efforts, she passed away. 

This is a true story, as told to me by Frank – real people, real events. After seeing the devastation the virus brought to people he loves, his instinct is to do all he can to help others.  He wants to donate his plasma so someone might benefit from his antibodies.  Most importantly, he wants people to know the threat is real, and that everyone must act responsibly to protect each other – to protect people like his wife and sister and mother.

Our most important weapon to control the viral invader is our own safe behavior.  Mask when in public places and when exposed to others.  Practice physical distancing all of the time.  If you have any symptoms, do not go to work or places where you could infect others.  Assume everyone you meet has the virus and is infectious, even if they had a negative test.  

Importantly, for the upcoming July 4th holiday, celebrate with your immediate household – not with your extended family, and certainly not as part of a public crowd.  Celebrate at home if at all possible.

Please share this message broadly.  The following link can be used in any social media posting: https://bit.ly/2Zoadec.  The Wilson story is tragic, but will at least have some meaning if others learn from it.

I wish you all a safe, happy and healthy July 4th holiday.

Thank you all.

James McDeavitt, M.D.
SVP and Dean of Clinical Affairs
Incident Command Center Commander