As he left his bed, Rob Little felt as though he was drowning.

It was April 9, and he had already been sick with COVID-19 for six days. To this point Rob had mostly struggled with a persistently high fever. But it suddenly broke, and he wondered if he was turning a corner.

Later in the day, however, he started coughing. The cough worsened, and followed him to bed. Unable to sleep, Rob went to his living room where he thought he’d spend the remainder of the night.

From the bedroom, Rob’s wife Kristina found herself listening carefully to the sound of her husband’s lungs. Kristina was also infected, and had shared Rob’s fever. She had noticed his cough develop, but he could still eat and hold a conversation. A cough was predictable, she decided, but not unexpected.

But as the evening wore on, Kristina noticed Rob’s cough turn into a hack. It sounded panicked, like he was struggling to breathe.

Kristina eventually drifted off, only to be woken by Rob at around 4 a.m. He wanted to go to the hospital.

“When I dropped him off, I looked at him and said, ‘Hey, see you tomorrow.’ I figured they’d give him a bag of IV fluids, maybe a little oxygen.”

She wouldn’t see him again for nearly a month.

At Nelson’s Kootenay Lake Hospital, staff used a pulse oximeter to measure Rob’s blood-oxygen level. A typical test result in a healthy person comes back 95 to 100 per cent saturation of oxygen in the blood. A person with a lung condition like asthma may have a reading of 90 per cent.

Rob’s blood oxygen tested at just 68 per cent.

“They didn’t know how I was conscious,” he says.

Wet sponges

Until the spring of 2021, COVID-19 infections were relatively low in Nelson.

From March 2020, when B.C. began its lockdown, to the end of the year there were just 53 total cases in Nelson’s local health area, which includes Salmo and parts of the Slocan Valley.

But cases began to rise in late March 2021. The BC Centre for Disease Control said there were 13 new cases in the area during the week Rob first felt symptoms. The following week there were 20. As of May 29, there have been 120 COVID-19 cases in the Nelson area this year.

Rob first felt symptoms on April 3, went for a test the same day and found out he was positive on April 5. One day later, Interior Health announced an exposure at Nelson’s Rosemont Elementary, where Rob and Kristina’s children Myelle and Tyre attend.

Eight-year-old Tyre tested positive but was asymptomatic. Myelle, 10, had a fever but recovered after three or four days. COVID-19 was much worse for their parents.

Kristina drove Rob to Kootenay Lake Hospital in the early hours of April 10, but he was moved again to Trail’s Kootenay Boundary Regional Hospital. Nelson’s hospital doesn’t have an intensive care unit, and Rob was told there were better respiratory options in Trail.

When he arrived, Rob was laid down on his stomach to help his lung expand, an uncomfortable position he would have to get used to with an IV in his arm and tubes up his nose.

Any time he tried to move out of position, the drowning sensation returned, his blood oxygen levels dropped and an alarm blared throughout the ICU.

“We’ve all had a wet sponge that you take out of water, you put down and half the sponge is dry and the bottom half is wet,” he says. “So if you roll over all that fluid flows through your lungs again.”

For the next two weeks that’s where he stayed, waiting for the sponges to squeeze dry.

Existing

At home, Kristina was doing her best to hide how scared she was.

She panicked when a doctor called close to midnight to say Rob was in the ICU, and the next day tried to remain calm in front of her children despite still struggling with the virus herself.

But there was no hiding from the calls. Kristina grew up in Nelson, and Rob is among the city’s more public business people as manager of The Adventure Hotel, but they also try to keep their home life private. So Kristina soon found herself overwhelmed as the phone rang with more frequency.

It became worse when her own isolation period ended. She didn’t want to be seen in public and felt as though she were being stared at if she went downtown. Instead of shopping for groceries in Nelson, she drove 40 minutes to Castlegar just so she wouldn’t run into anyone she knew.

“I know everyone was just caring, but it was a lot,” she says. “It was a lot.”

As the days dragged on, Kristina noticed the toll of isolation and Rob’s absence on Tyre and Myelle. They couldn’t go to school, and were cut off from their friends and grandparents. Even after she recovered from the virus, Myelle complained of an upset stomach and wanted to be with Kristina at all times. Sometimes she cried, but couldn’t tell her mother why.

They settled into a repetitive routine. Kristina described it to friends as though they were in the movie Groundhog Day.

“I said, we are literally just getting up and existing. We’re repeating the same day over and over. We’re existing, we’re not living. We’re not making any plans. It felt like a weird dream.”

The short end

Rob’s condition was improving when he woke up on April 24. He could stand on his own, and his doctors were considering sending him back to Nelson.

But that night his blood oxygen levels started dropping again. A CT scan showed he’d developed a blood clot in one of his lungs.

During the pandemic blood clots have mostly been associated in rare cases with the COVID-19 vaccine AstraZeneca — Rob became sick before vaccines for his age group were available in B.C. — but they can also occur when a person is immobile for long periods of time. Clots in lungs can also be fatal unless treated right away.

The news about the blood clot shocked the family. Kristina had been preparing for Rob to come home. Now she didn’t know if he would at all.

It was during this time, as he returned to lying on his stomach for days, that Rob became scared to move. He also felt painfully alone. He was surrounded by medical staff and was grateful for it, but they were “all wearing spacesuits” whenever they came into his room. He missed his family. He missed golfing and cooking with his kids.

“I thought I wasn’t leaving,” he says, “and I’ve never faced that in my life.”

To stay sane, Rob made small routines that could be done from bed. For 30 minutes each morning he rolled his shoulders, or awkwardly watched TV. He became practised at regulating his breathing.

His medical team, meanwhile, still didn’t understand why Rob had become so much sicker than anyone else in his family.

Rob was a former smoker, but had quit in 2015. His doctors told him his lungs were healthy. It was speculated he was carrying a higher viral load, or amount of virus, in his blood than the rest of his family.

In an Oct. 30, 2020, article titled “SARS-CoV-2 viral load is associated with increased disease severity and mortality,” published in Nature Communications, researchers said they found a correlation between detectable amounts of virus in blood plasma and the severity of the disease in hospitalized patients.

Interior Health, in an email to the Nelson Star, said it isn’t clear why COVID-19 impacts some people more than others.

“We don’t know everything yet, but COVID-19 can affect different people, even otherwise healthy people, in different ways. That is why we are encouraging everyone to get registered and get immunized so that collectively we are protecting those most vulnerable and those who may face more significant symptoms and complications from this disease.”

No one knows why the virus attacked Rob with the severity it did. Rob’s doctors, nurses and respiratory therapists, all of whom he is quick to praise, were stumped.

“They couldn’t give me a real reason as to why me besides drawing the short end of the stick,” he says.

At home, the work begins

Kristina found out Rob would be returned to Nelson on May 4. The family made it to the Kootenay Lake Hospital parking lot just in time to see him wheeled out of an ambulance.

The next day, Kristina brought Rob home. He’d been in a hospital 26 days, and was too weak to dress himself without her help. Rob also needed oxygen, was prescribed a heavy dose of the steroid prednisone for six months, and couldn’t walk more than a short distance without losing his breath.

Myelle and Tyre arrived home from school to find their dad seated at the kitchen table. They weren’t allowed to kiss him, because the family still feared for his immune system, and were also hesitant to hug him too tightly.

“Having him at home put their minds at ease, but they were still scared,” says Kristina. “It wasn’t normal.”

With her husband home, exhaustion finally overwhelmed Kristina. She was still dealing with a nagging migraine from the virus, and saw now her care for Rob was only just beginning. There may also be a need, she added, for the family to receive mental health support.

But Kristina has also allowed herself to appreciate the people who brought the family groceries, flowers and wine, who offered to walk the family dog, who stopped by the driveway to check in. Some people who were on the fence about getting vaccinated, she says, have gone through with it after learning about Rob’s ordeal.

A month later, Rob has returned to work. He is still medicated, but can get around without oxygen. He’s thankful no one at the hotel was infected because of him, and has started to relax a little.

Her husband, Kristina says, is still a workaholic. But he’s willing to let go of the little things in a way he never could before.

It will be a long time before Rob has fully recovered. If there’s any positive outcome from nearly dying, he hopes it’s that people in the Kootenays take the virus seriously.

“This isn’t the flu, this isn’t a joke,” he says. “I’m living proof.”

The word living, in his case, is the important part.

@tyler_harper | tyler.harper@nelsonstar.com

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