COLUMBUS, Ind. — Being among the first isn’t always what it’s cracked up to be.
Just ask Karen McMichael, 66, a retired information technology specialist who said she was among the first to contract COVID-19 in Bartholomew County.
In this global pandemic, being among the first victims in a region is especially frightening because there are too many unknowns that leave too many unanswered questions, Bartholomew County Health Officer Dr. Brian Niedbalski said.
For McMichael, the most significant frustration was the five weeks of waiting to be tested for COVID-19. It was six weeks after her symptoms first appeared that McMichael was told she had the dangerous virus, she said.
In addition to her age, McMichael has medical issues that include diabetes, as well as recently-diagnosed mild asthma, she said. Another recent discovery was that she was in an early stage of chronic obstructive pulmonary disease (COPD) caused by inhaling second hand smoke, she said.
She had also suffered through three previous cases of anaphylactic shock, which is an extreme, often life-threatening allergic reaction to being given a substance intended to create antibodies.
Due to her high-risk factors, the western Bartholomew County woman felt she should have been a prime candidate for immediate testing.
While Niedbaski didn’t argue her point, he said the real problem for early COVID-19 patients like McMichael was that nobody was prepared for what was coming, he said.
“We really didn’t have any reliable test to begin with,” Niedbalski said. “And when more effective tests became available, we didn’t receive many of them.”
Early in the pandemic, county health officials and medical facilities explained because they had few or even no tests, those with symptoms were urged to call before coming in to the hospital or a doctor’s office so officials there could take precautions. Those who had minor symptoms were urged to report them to their physician and to self-quarantine.
Contact tracing
When asked how she might have contracted the disease, McMichael provided two possibilities. The first is that she may have contracted it during a round-trip flight to the Washington D.C. and Baltimore areas. She flew back from the east coast on Jan. 22 — one day after the first U.S. case of COVID 19 was reported in the United States.
While her symptoms didn’t surface for more than a month after her return (more than twice what physicians say is the maximum incubation period), McMichael said she feels there are still too many unknowns to exclude the possibility of widespread variables in incubation periods.
The other possibility was that she caught it while socializing with a friend who works with a man that returned to Columbus after a business trip to Wuhan, China. Both the friend and the friend’s co-worker did develop a brief unknown illness, she said.
As for McMichael, her symptoms first emerged Feb. 29 during a family visit to Kentucky, when she was awakened by violent coughing. Over the next few days, she found herself unable to hold down food and began to experience loose bowel movements.
The following week, she saw a nurse-practitioner who diagnosed the problem as a respiratory infection. McMichael was assured she didn’t have the virus because her symptoms didn’t match those for the disease. In addition, her fever was low-grade while those with COVID-19 have a high grade fever, she said.
It is true that neither diarrhea nor vomiting were initially considered symptoms of COVID-19 at that time, Niedbalski said. It was only later that researchers confirmed those two symptoms might emerge in some people with the virus, the physician said.
Three weeks after her symptoms first surfaced, McMichael began suffering from an excruciating chest pain that “feels like you’ve been hit by a mallet repeatedly,” she said. It wasn’t long before the pain spread to her back, she added.
When she tried to make an appointment by phone at a local medical facility, an employee who answered the phone said the doctor wasn’t seeing pulmonary patients (like COPD) in order to protect them from the virus, McMichael said.
After explaining her fever was low-grade, the woman on the phone instructed her not to go to an urgent care center, the emergency room or her physician’s office, she said.
Even though symptoms worsened during the fourth week, McMichael said she didn’t seek medical attention because she felt she had been “brushed off” a week earlier.
“When you are that sick and in that much pain, you know how much you can ‘get on edge’,” McMichael said.
On the fifth week, her 23-year-old son, Daniel McMichael, also began showing symptoms of the virus, and both slept nearly all the time, she said. While the mother said her son also has issues that might cause complications, he seemed to completely recover in about one week, she said.
While the son made a quick recovery, Karen McMichael said she suddenly woke up during the fifth week to find herself spending hours struggling to get air into her lungs. Additional symptoms included extreme exhaustion, pain in the vicinity of her liver and severe headaches.
Unable to reach anyone at her physician’s office, McMichael called PromptMed, the urgent care center at 2502 25th St. in Columbus. After describing all of her symptoms, she was told to go to the emergency room to take a test for the virus.
One week later – and six weeks after her symptoms first appeared – Karen McMichael received confirmation that she had COVID-19.
“From then on, all the medical personnel have been right on the ball,” she said. “Everybody started calling, including the Bartholomew County Health Department and Columbus Regional Hospital. The COVID-19 follow-up people would also call at least twice a week.”
While she was declared virus-free three weeks ago, McMichael said she is following guidelines for high-risk patients and remains in quarantine until at least May 24.
Not out of the woods yet
When asked how she’s doing now, McMichael said she is far from being fully recovered.
“If I go outside, the slightest dampness or cold will get into my lungs,” she said. “I start coughing. Just going out for a drive exhausts me, so when I get back, I have to take a two- or three-hour nap.”
Widespread testing has often been cited as a major requirement for bringing the virus under control. That’s one reason why McMichael doesn’t understand why she had to wait until she was literally gasping for air for them to test her.
“Testing supplies had been so limited that they were being reserved for people needing hospitalization,” said Niedbalski, who said he found it particularly frustrating when Bartholomew County was unable to acquire the supplies needed to fight the epidemic.
As the weeks of the pandemic have gone by, the state has stepped forward to begin offering community-wide COVID-19 testing, including a site in Columbus, which has been operating for two weeks. Free COVID-19 tests are being offered in Columbus, by appointment, and around the state at an estimated 50 sites. The testing is for those who are experiencing COVID-19 symptoms, those who have been exposed to someone who has tested positive, or those who live with someone who has tested positive.
Individuals who are at high risk because they are older than age 65, have diabetes, obesity, high blood pressure or another underlying condition, or those who are pregnant, live with a high-risk individual or a member of a minority population are also encouraged to get tested, according to state health officials. To find a testing site, visit coronavirus.in.gov and click on testing sites. The website registration site is Lhi.care/covidtesting.
Early in the pandemic, Columbus Regional Hospital officials set up a triage call center at the hospital and encouraged local residents to call if they had symptoms so that their care could be directed to the appropriate setting. The call center continues at 812-634-1123. Those who call will be screened and directed to a location for testing.
The Columbus Community COVID-19 Task Force also set up a web site early in the pandemic to list local contact information and direct those needing testing to appropriate locations. That web site is covid19communitytaskforce.org.
McMichael emphasized she knows the local medical community was doing what it could.
“I understand this is new and they had to work it out,” McMichael said. “I greatly appreciate everything they have done for me since they found out I was positive.”
Too early to reopen?
McMichael does think there should be a database that cross-references the names of those with positive tests to those who come in for treatment.
The state has announced that in addition to the state testing sites, it is contracting with a firm to do statewide contact tracing for individuals who test positive for COVID-19.
McMichael expressed strong concern that many Indiana counties, including Bartholomew, are trying to reopen their economies too soon. But she seemed even more worried that too many Hoosiers are not taking COVID-19 seriously.
“As a survivor, believe me. You never want to get this,” McMichael said.
Besides all the painful symptoms she’s enduring since late February, McMichael will have to go through several tests to find out if the novel coronavirus has permanently damaged any of her organs.
Impaired lung function from COVID-19 can negatively affect organs such as the heart, kidneys and brain with significant health impacts that may last long after the virus is gone, experts have reported.
On top of those worries, McMichael said she’s also concerned about the 20% of her medical costs she’ll have to pay out-of-pocket that Medicare won’t cover.
While the western Bartholomew County woman says she’s conscientious about not wanting to spread her illness, it’s obvious to her that not everybody is like that.
“I have a friend that I love to death, but when she gets sick, she will come around me,” McMichael said. “When she told me she’s certain she doesn’t have the virus, I replied: “How can you say that? You could be asymptomatic. People often don’t show symptoms for weeks.”
Niedbalski also feels that not enough people in south central Indiana are taking the COVID-19 threat seriously.
With government reopens the economy in phases while many are still not wearing masks, the county health officer is concerned about the possible consequences that may emerge in restaurants and dining areas.
“Some people have a ‘wait and see’ attitude, but I’ll guarantee you this virus is still out there,” Niedbalski said. “All of us still need to do our part to prevent the spread.”
