It was supposed to be an adventure-filled trip to Egypt, with the Archaeological Institutes of America, visiting the ancient ruins and the pyramids. But on a cruise somewhere between Luxor and Aswan, Monica Yeung-Arima suspects she and her husband contracted the COVID-19 virus.
Yeung-Arima, who is in her 60s, and her husband were not alone. All of their other travel companions have contracted the disease, but it took a deeper hit on her, she said. Yeung-Arima has underlying health conditions that put her at high risk, she said.
"People should know and learn about the symptoms and get checked right away," she said this week while recovering at home. "The highest fever I had was 102. It was mostly 100-point-something, but it felt like when you have a very high fever. Your whole body aches." She also had a cough that became increasingly worse.
When she and her husband returned to their Palo Alto home from Egypt on March 3, she felt ill, isolated herself in a bedroom and didn't go outside.
Two days later, she sought a medical evaluation as her symptoms quickly escalated. Doctors met her in the parking lot at Palo Alto Medical Foundation's urgent care clinic and whisked her into a room for an exam. "You park and they bring you in instead of you wandering around in the facility," she said. (As of last week, PAMF started respiratory clinics in a tented exam room set up in the parking lot while patients sit in their vehicles.)
PAMF tested her for all of the other viruses she could possibly have contracted, including influenza, but initially she wasn't tested for COVID-19. After returning home, with her tests negative for other viruses, on March 6, they told her she should be tested for the disease. "But it didn't happen," she said. "The government needs to do a better job to make the test available for people."
Yeung-Arima, who has marginal asthma, wrote a letter to her doctor that Monday, March 9, and insisted they test her for the virus since she met all of the criteria. The test came back positive. X-rays had also shown she had pneumonia.
Yeung-Arima and her husband were sent to Stanford Hospital. After about six or seven hours, they were placed in isolation rooms. Yeung-Arima received another COVID-19 test, this time with Stanford Health Care's new FDA-approved test kit, which is processed at the hospital laboratory.
That test was the "saving grace," she said. "They turned it around in a very impressive 24 hours," she said.
Her husband was treated and released after three nights and continued his recovery in quarantine at home. But Yeung-Arima's condition grew worse. She was coughing all of the time, she said.
She was also very much alone. Visitors were not allowed and no one could deliver anything to her. Doctors and nurses came in only when needed to avoid unnecessary contact. Yeung-Arima said she was impressed with the level of care and the precautions they took. Her care team wore goggles, gloves, protective hazmat suits and masks. Each time they left, they took everything they'd brought in away. They disinfected every piece of equipment in a sealed chamber between her room and the hall. Doctors, nurses and staff also removed all of their protective gear in the compartment and wore new sets each time they entered her room.
Antibiotics and other treatments did not help her get better. Yeung-Arima's husband is retired from biopharmaceutical research company Gilead Sciences Inc. He learned of a small trial by the Foster City company using the antiviral drug remdesivir, which was developed to treat Ebola. Researchers were testing if remdesivir would help COVID-19 patients.
Yeung-Arima was accepted into the randomized trial. For five days, she received intravenous treatments using the medication. Three days into her treatment, she began to feel better, she said. She finished her last dose on Thursday.
When she was released from the hospital on Friday, the hallway was empty and silent. She returned home with a list of criteria to monitor. She must use a finger oximeter to measure her blood oxygen level, which must be at minimum 92% to 93%, and can't have a fever. She will remain quarantined until this Tuesday.
She still coughs. "My lungs are not going to recover in one day," she said. "I'm not recovered completely and I'm not supposed to go out, but in spirit, I'm fine," she said. The infection ruined her appetite, and during her first week at the hospital she didn't feel like eating anything. In the past two to three days, her appetite has improved, and she is looking forward to having a desire to eat again, to nourish and heal her body, she said.
"I know I will be back in business after that."
Editor's note: On March 22, Gilead Sciences issued a press release stating that "an overwhelming demand" for remdesivir has necessitated the company to work to expand emergency access to the drug, which it had previously been offering primarily through clinical trials.
"This approach will both accelerate access to remdesivir for severely ill patients and enable the collection of data from all participating patients. We recognize the urgent need and are working to implement expanded access programs as quickly as possible, with the continued support and collaboration of regulatory agencies."