In her 60 years, nothing has brought Rita Lawlor closer to death than COVID-19.
On Friday, March 27, the former hospital nurse laid as a patient in a hospital bed as an infectious disease doctor told her, "We gotta get you through the next couple days."
Over the weekend, she fought for her life. Isolated from her family, she battled excruciating shortness of breath — or as she and others call it, “air hunger” — and watched as her oxygen-level readings dipped to dangerous lows as she hovered on the precipice of ICU admission and ventilator intubation, which she knew would significantly reduce her chances of survival.
In the thick of her bout with coronavirus, she remembers thinking, "Oh man, is this what going to see Jesus is gonna look like?"
Lawlor, whose only preexisting condition is being a little overweight, said she came within a razor’s edge of critical condition. She was lucky enough to be able to return home to her children.
“It was a wild ride,” she said in a recent interview with Phoenix New Times.
On Monday, Governor Doug Ducey announced the acceleration of Arizona's reopening. Now, restaurants and coffee shops can have dine-in service with physical distancing measures, and barbers and salons can open as soon as Friday. As Arizona and the rest of the nation works toward reopening, millions of people will be forced to weigh the risk of getting seriously sick — as Lawlor did — against the benefits of going back to work.
Old age and certain conditions — diabetes, lung disease, and severe asthma — make people more vulnerable to serious COVID-19 complications. But experts like Felicia Goodrum Sterling, a virologist at the University of Arizona, stress the unpredictability of the virus.
Goodrum Sterling is a self-proclaimed “virus enthusiast."
“This virus is truly impressive,” she said of the novel coronavirus. “I really don't know of a virus that can run the entire spectrum from completely asymptomatic to death.”
It’s this range of outcomes, she said, that makes the virus so prolific and frightening.
"There are also people who are popping up with severe disease that we couldn't have predicted at all," Goodrum Sterling said. "I think everybody should consider themselves at risk for severe disease, and take it very, very seriously."
According to CDC data, as of May 2, fewer than 8 percent of the United States’ coronavirus fatalities involved people younger than 55.
Yet while older people are at an elevated risk, Goodrum Sterling warned that nobody should feel invincible.
Those with heart or lung issues are susceptible to serious complications because the virus likes to bind to those organs' cells via their ACE-2 receptors, said Jessica Lancaster, an immunologist at the Mayo Clinic. These receptors happen to be a good fit for the virus’ spiky shape, and once they’re bound to them, a dangerous inflammatory immune response can occur that makes breathing difficult.
Those who are elderly, overweight, or have diabetes tend to have chronic inflammation throughout the body. These folks, according to Lancaster, are at greater risk of suffering from life-threatening levels of inflammation after COVID-19 infection, in part because they naturally start closer to that dangerous tipping point.
Near the Edge
When Lawlor left the Valley in mid-March for a wedding in Colorado Springs, Colorado, she was concerned about the virus, but not particularly worried about her own vulnerability to it.
“I have no medical problems, I am not diabetic, I do not have high blood pressure or heart disease, I have nothing. I take no routine medicines. I’m overweight, and I’m 60,” she said. “It is so unpredictable. That's such a big piece of fear."
A few days after she got home from Colorado, Lawlor started feeling achy and developed a fever and the chills. But it was the shaking, she said, that concerned her the most.
Less than a week after developing a fever, she felt short of breath after getting up to take a shower. On March 22, the day before she went to get tested, Arizona had just 152 confirmed COVID-19 cases.
After her test came back positive, she was admitted to the hospital. From that point until she was released a week later, her only human contact was with health care professionals fully decked out in personal protective equipment.
The virus had penetrated deep into her lungs, which had become stiff from inflammation. The organ, which usually contracts and expands with the ease of a balloon, was nearly incapacitated, the site of a crowded battle between immune cells and virus.
On March 27, Lawlor’s illness came to a head.
She suffered a coughing fit, and her blood oxygen readings dropped to a dangerously low level. A nurse rushed into her hospital room, cranked the device pumping supplemental oxygen into her nose and mouth to its maximum levels, and held her hand. She cracked the door open and called her shift leader into the room, which Lawlor said she knew from her time working in hospitals was translation for: “Oh shit, we might get in trouble here.”
“I never thought a gloved hand would give you comfort, but let me tell you, it did,” Lawlor said. “Unbelievable.”
As the nurse stood by her side, her oxygen levels started rising.
But in the hours after the incident, she felt afraid it would happen again. At one point she started crying, but forced herself to stop when she realized it would rob her of precious oxygen.
Isolated in her room, Lawlor remembers thinking about her five children, the youngest of whom is 15: “What if something happens to me? We still have kids at home for goodness' sakes.”
She texted her family members when she had the strength, as her air hunger made it difficult to talk to them. “They were so frightened,” she said.
Thankfully, she got through the critical days without requiring ventilation, and she started improving on March 29. Despite the fact that visitors were strictly prohibited, she said she never felt alone. Friends rallied with food for her family, and she was comforted through prayer and the diligence of the medical professionals around her.
'Wear a Mask'
Lancaster advises people who have the COVID-19 risk factors outlined by the CDC to have plans in place should they start feeling ill. Bolstering immunity, social distancing, and hand-washing are good practices, but people should know who they will call and where they will go if they feel they may be infected. Timely treatment can be the difference between success and failure.
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Even as Lawlor enjoys her family, freedom from supplemental oxygen, and the comfort of her own room, she still experiences some shortness of breath. According to her doctor, she likely suffered scarring on her lungs from her battle with COVID-19, and only time will tell how they will heal.
Drawing on her personal experience with the virus, Lawlor encourages everyone to do what they can to slow its spread.
“Wear a mask,” Lawlor advised. “I wouldn’t wish this on anyone.”