Editor’s Note: Justin Silver grew up in Atlanta and is the son of former Athenians Herb and Sally Silver. He and his wife, Amanda Denz, live in Truckee, CA. This account was posted on Facebook Apr. 8 and also on Medium and is reprinted here with permission.

Background

Justin is the first person I know to have COVID-19, and I thought it would be helpful to share his story and how we handled it because, sadly, I think this will be relevant to some of you in the coming weeks.

Justin is super healthy, rarely gets sick, and was being extremely cautious when he contracted COVID. The only way you’ll avoid this is staying home. The best way to prepare is to have a thermometer and a pulse oximeter. Also, just stay home. If you think you or someone you know has any symptoms, quarantine early; don’t hesitate. Also know that many people will have cases like Justin’s that don’t require hospitalization. If you get sick, it might be a drawn-out, uncomfortable ride, but the likelihood that you will be OK is very high.

First, I’ll say Justin is doing OK. I’m also OK. The last few weeks haven’t been amazing, but we’ll be fine. He’s still recovering but is on an upward trend, and I’ve been physically separated from him for long enough to be in the clear. [Amanda]

Contagion

Justin works from home, and most of his other activities are outdoors. He was also concerned and cautious about this way before most other people. This virus is super contagious, and if he can get it, so can you. The only way to protect yourself is to stay home. 

During the timeframe in which he contracted it (before the shelter-in-place was announced), he went skiing at Squaw. He didn’t even go into the lodge, but he did ride the funitel—an enclosed 15-minute gondola ride. He made one visit to Whole Foods, where he was super careful about washing his hands and not touching his face, and one visit to our local grocery store—same precautions. Other than me, he came into contact with three friends who aren’t sick but could have been asymptomatic carriers. He didn’t see anyone else or go anywhere else. He has a really good immune system, rarely gets sick, is healthy and has no underlying conditions.

My goals in sharing all of this are to convey these points: 

1) Everyone not absolutely needed in the world should stay home, like for reals. Even if you think you’re being careful on trips out, that doesn’t actually protect you.

2) If you or someone you love gets sick, know that it might suck, and it might suck for a while—like way longer than a usual cold or flu—but the majority of people will be OK in the end.

3) If you or someone you know have any symptoms, quarantine early, even if it feels overly cautious. Don’t spread it. It took us 13 days to get his test results (yes, 13 days!), and the whole time we acted under the assumption that he was positive. I’m glad we did that.

4) It would be good for you or someone in your neighborhood or community to have a pulse oximeter. And also a thermometer. If you get sick, these two tools will aid you in staying home. [Amanda]

The Beginning

It started with a dry-feeling throat and a few random sneezes. The next day some mild diarrhea, but I thought maybe it was just drinking too much coffee—no nausea. The CDC now says this is common at the onset of COVID-19. My throat felt slightly sore, but the heat was on, and I attributed the dryness to it. This is when the fatigue started.

The following day there was a tight feeling in the front of my throat, like I was very anxious. With all the stressful news and how tired I felt, the doctor thought I might just need to get some rest. I slept in the guest bedroom as a precaution, since my throat was also getting increasingly sore by that evening.

In the morning, I didn’t feel well-rested, but I still didn’t feel very sick, although there was a funny feeling in my upper chest now—some tightness—and a little bit of wheezing. I continued to sleep in the guest room, and while I did not feel much sicker, I was sleeping more and more. Some more diarrhea, but not severe.

Five days after the first symptoms, the Town of Truckee sent out an email asking residents to call, just to be phone-screened, if we had any of the symptoms on a list. I called, thinking I was just being a good citizen and that they would tell me the GI issues (a disqualifier at the time) and lack of fever (qualifier) were nothing to worry about, even though I had a mild, dry cough. I was surprised when they scheduled me for drive-through testing the next day. They called my cell phone to get demographic info and said that, due to test shortages, they would test for flu and strep first. Once I was seen, they asked for symptoms again, checked my temperature (98.9), pulse (65), and oxygen saturation (97). Next, the doctor listened to my lungs, turned around, and said, “I need a COVID test,” which came as a surprise. I asked about the flu test, and she said, “This is definitely not flu.” Coronavirus gives your lungs a unique sound, and the disease can also be seen in chest CT scans. [Justin]

The Battle

Over the next week, my symptoms worsened. It became hard to breathe and more and more painful. It felt like I had inhaled a campfire, with an intense burning behind my sternum. The cough got worse but not severe, and my temperature never went above 100, although I felt feverish and would break out in cold sweats. I had to change my sheets, which was so exhausting I had to lie down several times in the process. At this point, I was not getting out of bed at all. I was sleeping 18 hours a day and in a daze for the remaining six. There was a constant ringing in my ears, so loud it woke me up. I also woke up many times unable to breathe. 

I became unable to focus and had no appetite at all, but still no nausea. COVID boosts your blood sugar, even while fasting, so it’s important to keep eating and drinking, even though you don’t think about it. I took my temperature with a thermometer, which recorded it to my phone, so I had a log and noticed that I felt worse when it was higher, and my breathing was worse when it was lower, but that could have been correlation and not causation.

Mentally and physically, it felt like being held down by a set of waves and battered against the ocean floor. It was a struggle to breathe, with the worst coming at night and in the morning. It felt like a struggle to get to the surface to catch my breath—barely—before the next wave hit and pushed me down again—all the way to the bottom. This became very disheartening and depressing, because it would seem I had turned a corner—that moment with most illnesses where you can tell you are getting better—only to get slammed down again. And again. 

After a week, it became hard to be optimistic about a recovery. I started thinking this was how I would die and wondered what it would be like to be intubated along the way. My left lung began to fill with fluid that I could hear and feel when I rolled over in bed: pneumonia. I was by myself, and no one could come into my room. I was worried that, if I needed help, I would be too tired to alert anyone.

About halfway through the week, our pulse oximeter arrived, and I was able to check my O2 saturation. It was 91, and below 90 you need supplemental oxygen, which meant a trip to the ER. I was very focused on keeping it above 90. It probably had been lower previously, because I did not have a way to measure it when I was struggling the most. I did some postural drainage and chest percussion which seemed to do something, but I can’t say for sure if it helped. After lying at an incline, I could feel “popping” when I breathed, and after percussion it would feel like my chest was vibrating. 

I wanted to avoid a secondary bacterial infection. I did breathing exercises to keep my lungs from collapsing. The doctor wanted me to try to get out of bed to avoid blood clots. I still did not have test results, but I knew I had COVID-19 at this point. I had never been sick this long in my life.

Two weeks after my first symptoms, I could finally tell I was actually improving. The lows were higher and the highs were a bit higher, too, but I still felt terrible. Slowly, my oxygen saturation began to increase to around 95, which is when I found out that my previous readings had been really bad. I was still short of breath with a lot of pain, but I knew I was going to get better, though the ringing in my ears remained. I did not lose my sense of taste, but it did seem dull. Thirteen days after my test, I got the positive results. By this point I was already improving. They gave me an albuterol inhaler, which has helped my oxygen improve, although it leaves me feeling jittery.

I’m now three-and-a-half weeks in and am still sick, but not to the degree that I was. I still have very low energy, and my oxygen levels are not yet where they should be, but I do feel that I’ve turned a corner. I have my appetite back, and have enough energy in the afternoons to talk with people, do some work, etc. It’s been a long ride, but I think a symptom-free day is not far off. [Justin]

The Quarantine

I recognize that not everyone has a spare bedroom and bathroom, but the point is, if someone in your house is sick, try to get them into a space that is as separated as possible, as early as possible, even if it seems overly dramatic.

The day Justin’s throat started to tickle, he went to sleep in the guest room, and the next day he started using the guest bathroom only. The day after, he stopped going into the kitchen. A day or two later, when it was clear he was sick, we sealed him into the guest room, where he still is, and I sanitized the house and car. We have had zero contact since. I put food outside the door, and he waits until I leave to open the door. Every other day, I put on a mask and gloves and collect his dishes, which I carry directly to the dishwasher that is already open and soap-filled, and I wash them on high heat. Then I wash the gloves, then my hands and the faucet handle.

I have to imagine I was exposed in the first few days and am an asymptomatic carrier, but, just in case I wasn’t, this level of caution is key. In retrospect, we should have started this when his throat first started to tickle. I was lucky. I haven’t been in contact with him now for 19 days, so I am likely in the clear. Even though we didn’t have test results for most of the time, I acted as if I were exposed. I also self-quarantined so I wouldn’t spread it by leaving the house.

During this time, we video chatted often, and I tried to check in on him every few hours—especially when his breathing was bad. He was also prepared to call 911, if needed.

As Case  No. 21 in our county, we get to talk with the nurses at the county health department every day. They aren’t overwhelmed yet. They say once he is symptom-free—they’ll tell us when that is—we then wait three days. After that, he can be considered clear and can come out of the room and go into the world. I’m going to throw him a COVID graduation party. [Amanda]