COVID-19 Hits Home: Three Oʻahu People Who Contracted COVID-19 Talk About Their Illness and Long Recovery
The number of coronavirus cases in Hawai‘i just surpassed 4,000, with more than 2,000 of those cases recorded in the past two weeks. As O‘ahu scrambles to halt the runaway surge in infections, three island residents share their COVID-19 experience.
On Friday, March 13, Steve Ching boarded an airport shuttle bus in Sun Valley, Idaho, where he had been skiing. He felt “perfectly fine” after he returned home to Niu Valley. A few days later, he started feeling under the weather—jet lag or dehydration, he guessed. Then on Wednesday night, March 18, his health took a turn. He had a dry cough, some difficulty breathing and a fever.
Worried that he had COVID-19—many Seattle residents had fled to Sun Valley to escape the virus that had turned Washington state into the first hot spot—Ching called his doctor, Ernie Yim, who sent him to The Queen’s Medical Center for testing. Under the lights of the tent set up outside the ER, Ching was the only one waiting to get swabbed. There were only 16 confirmed coronavirus cases statewide. Just hours before, Honolulu Mayor Kirk Caldwell announced stay-at-home orders for Oʻahu. It would be another week before the state would also go into lockdown.
The test for influenza came back negative and Ching went home. The next morning, the Department of Health called. His COVID-19 test was positive. The DOH explained what should happen next: He and his wife, Kori, were to quarantine for two weeks or until his fever and symptoms abated, whichever was longer.
Ching began tracing his steps since returning from Idaho. He alerted the golf club where he had played on Saturday. He notified the law firm where he’s a partner. Both facilities closed and cleaned while Ching recuperated at home.
While acknowledging that his age (he turned 68 while he was sick), childhood asthma, and a few prior bouts of pneumonia put him in the high-risk category, Ching’s relatively manageable symptoms—milder than his usual winter bronchitis—convinced him the disease was not to be feared.
—Steve Ching, COVID-19 survivor
“This is nothing. I’m almost pau. Hey, you know what, COVID? If this is all you got, then bring it on,” Ching remembers thinking. “Then it was like total bachi.”
On March 25, “I just fell off a cliff.” His fever spiked, he had chills and sweats, every joint in his body ached and breathing became difficult. “We take something like 20,000-25,000 breaths a day without even thinking about it,” Ching says, “but I had to remind myself to breathe.”
Ching was admitted to the new COVID-19 ward on the ninth floor of Queen’s, where engineers were still constructing negative pressure rooms to keep air from patient rooms from flowing out into hallways. Kori was not allowed in.
It was early in the pandemic, and promising treatments such as remdesivir, dexamethasone and convalescent plasma were not yet readily available. Instead, the doctors focused on relieving the symptoms: Tylenol for the fever and body aches, steroidal inhalers to open up his airways, and antibiotics in case a bacterial infection developed.
“They offered me oxygen and there was a ventilator next to my bed, but they said, ‘You don’t want to go on the ventilator,’” Ching says. “It was the sickest I have ever been in my life, and because of the lack of science, it was frightening.”
After one night, his condition stabilized and he was released. Still, for the next three-and-a-half weeks, Ching stayed in bed for 16 to 18 hours a day, sliding in and out of sleep as he battled fever, chills, sweats and achy joints. When he was awake, he was consumed with the uncertainty of his recovery.
Ching also developed COVID toe, which turned a couple of his toenails blue, as well as a condition called “fizzing,” which made his skin feel electrified. The most unnerving part, he says, was the difficulty breathing.
—Steve Ching, COVID-19 survivor
“If you were to take a deep breath right now, you can fill your lungs, right? COVID guys can’t. They can go about halfway,” he explains. “I also had some neurological stuff—the smell and taste issue. I had distorted vision at one point. For about four weeks after recovery I couldn’t write because my hands would shake the whole time.”
State epidemiological specialist Lauren Usagawa contacted Ching every day. He didn’t feel like talking, so he updated her every morning by email. Dr. Yim and his wife, Brenda, a nurse, called daily to listen to his breathing and monitor his fever. Ching’s wife, Kori—“she was my Marianne Cope”—made sure he wasn’t fighting the illness alone. Ching consciously ate to keep his strength up, but still lost 10% to 15% of his body weight.
Around week three, Ching’s fever finally dipped and he thought the worst was over. But the next day his temperature spiked again. It wasn’t until Day 35—April 23, when the mayor announced the extension of O‘ahu’s stay-at-home order through the end of May and Hawai‘i cases had reached 596—that his fever subsided.
For the first time in more than a month, Ching went outside into the sunlight. “I walked four houses down my street and I thought, I gotta turn around because if I go one more house, I don’t know if I can make it back. I felt totally exhausted,” he remembers. In spite of the unrelenting fatigue, he continued to venture out daily, extending his walk by one or two houses each time. “It was a big achievement to make it around the block. I felt really good about that.”
Steve Ching donated plasma to help treat other covid-19 patients.
Photo: Courtesy of Steve Ching
Ching says two things about the virus still strike him. First is its intensely infectious nature. When he reflects on his trip to Idaho, the only time he remembers being anywhere near someone exhibiting symptoms was on the airport bus. “If he was the carrier, then that is amazing—that a guy sitting 40 feet behind me, coughing three or four times, could infect me.” And two, that the post-recovery effects can be ongoing. “Here we are, middle of July. I’m sleeping 10, 12 hours a day,” he says. “I’ve gone back to my regular activities, but I don’t feel 100%, and I’m very tired at the end of the day.”
In recent weeks, researchers have turned their attention to the long-term effects of COVID-19. As more people contract the virus and recover, a large proportion—more than 87% in a study of hospitalized Italian patients—continue to experience persistent and debilitating symptoms, flare-ups, or even new symptoms. A study by the Centers for Disease Control and Prevention reports that even 35% of adults who were not hospitalized still had not returned to normal health within two to three weeks of testing positive. That includes 1 out of 5 young adults age 18 to 34 with no chronic medical conditions.
Dr. Leo Pascua, a 60-year-old Wahiawā pediatrician, contracted the new coronavirus in March during a trip to New Jersey for his daughter’s engagement party. After developing sepsis and being intubated for 10 days, he recovered enough to return home. It’s been three-and-a-half months since he tested negative, but he still experiences joint stiffness and is monitoring a blood clot that developed in his leg—one of the COVID-19 complications that led to the death of Broadway star Nick Cordero in California in July.
Thirty-eight-year-old Waikīkī bartender Coby Torda, who spent 69 days in the hospital—and six weeks on a ventilator—before being released on May 29, is still trudging down the long road to recovery. He remains on oxygen to aid his respiration. His mom, Peggy Torda-Saballa, says it is a slow and agonizing process but that she is proud of his determination to regain his health.
Because so much is still unknown about the disease that was recorded for the first time in November 2019, “long haulers,” those who have struggled with it for weeks or months, are finding empathy and comparing notes in online support groups such as Survivor Corps, a Facebook group that has 90,000 members and is growing. Among the sobering scroll of personal stories are discussions about a variety of lingering symptoms: fatigue, body aches, shortness of breath, difficulty concentrating, inability to exercise, headaches, difficulty sleeping, anxiety and memory loss. Members share photos and ask each other if they have diarrhea, tinnitus, rash, hair loss, tremors and more.
—Steve Ching, COVID-19 survivor
Aug. 13 marked Day 135 for Survivor Corps member Angie Smith (whose name has been changed to protect her identity). That’s how long it has been since the 40-year-old marketing consultant from Kapolei felt her first symptoms. On Feb. 29, she and her 4-year-old son both developed sore throats and headaches, a few days after they had shopped in the same aisle in a big-box store as a woman who was “coughing like she was dying.” Her 35-year-old husband, who was shopping with them, came down with the same symptoms on March 1. At the beginning of March, when the state’s capacity for COVID-19 testing was only 250 individuals a week (testing in July frequently topped 2,000 a day), she was denied a test because she hadn’t traveled and wasn’t considered at-risk.
Initially, Smith wasn’t overly concerned, thinking she had the flu. About three weeks in, she was cleaning the bathroom sink and noticed she couldn’t smell the bleach. “Did you replace my bleach with water?” she asked her husband. “No, you need to open a window,” he replied, overwhelmed by the pungent odor.
Severe diarrhea started in week four and didn’t end for two-and-a-half months. Her doctor thought she had a stomach bug and told her to stay hydrated. Her son had the same orange diarrhea. After two months of weekly telemedicine appointments that yielded no improvement, she went to a gastroenterologist, who ordered a battery of tests to see if it was stomach cancer. How could it be stomach cancer, Smith thought, when two other people in her household had the same sickness? It wasn’t until she scheduled an echocardiogram that her cardiologist acknowledged she likely had COVID-19. He concluded, “If it looks like a duck, and walks like a duck … it’s a duck.”
If we don’t make serious changes now, our sacrifices will be in vain. If you have a question about the Stay at home, Work from Home Emergency Order, call the hotline at 768-City, or send an email to email@example.com. Together, we will overcome this. ——— #honolulu #hawaii #covid19 #coronavirus #spreadalohanotgerms #spreadalohanotcorona
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Smith’s symptoms piled on: Her ears bled. She had heart palpitations. Her hands shook so much she couldn’t hold a cup of water. Her toes hurt. She felt sparks that traveled from her legs to her arms to her face. She experienced phantom smells, like burning wires and sour breadfruit. Her eyes became sensitive to light.
“I call it whack-a-mole disease because it pops up one place and your body, attacks it and then it pops up somewhere else,” she says. “This does not feel like anything I’ve ever experienced. This feels like an alien disease.”
In the week of July 4, when revelers gathered in droves and Hawai‘i hit the 1,000-cases milestone, Smith asked Survivor Corps members about remedies for painful toes. Her fatigue and weakness remained overwhelming.
“We can’t go out for pizza. We can’t go to the beach. We can’t go see Grandpa,” she says. Her doctors were telling her she just had to ride out the symptoms, which left her deflated. “Are you kidding? There’s nobody who’s going to treat me on this island? I really feel like nobody cares.”
Other Hawai‘i residents join a chorus of voices on Survivor Corps venting about not having a positive test to help inform treatment as they continue to fight their illness. They fall into a larger group of long-haulers who weren’t sick enough to require hospitalization and are now stranded in a state of purgatory: They don’t know why they are still sick, whether they’re contagious, or when they will get better. And they can’t find doctors to treat them.
Dr. Yim and his wife, Brenda, a nurse, called steve ching daily to monitor his recovery.
Photo: Courtesy of Dr. Ernie Yim
Smith shares the details of her experience because she believes there are others in Hawai‘i struggling with the same challenges. But like so many local residents who have contracted the virus, she’s worried about the stigma. What will her neighbors think? Will it scare her clients away? What if her husband’s employment is impacted?
“There’s a long history of stigma for certain infectious diseases,” says Dr. Tarquin Collis, chief of infectious diseases for Kaiser Permanente Hawaiʻi. While some stigmas stem from associations with risk factors that prompt moral judgments, like HIV or hepatitis C, he says the stigma attached to the novel coronavirus is more akin to that of Hansen’s disease or Ebola.
“It’s not like you do anything particularly crazy to get COVID. It’s just that people are terrified of catching it from you,” Dr. Collis explains. “Fear-based stigmatization is fairly natural—fear is a very base instinct, and it’s probably protective evolutionarily.”
In March, Dr. Collis sent an email urging staff at Kaiser to fight stigmatization, especially because some of the hospital’s own would likely get sick. Collis says that doctors have learned that the infectious period for COVID-19 is quite short—a four- to seven-day window. Communicating such information and educating the community, he suggests, is the most effective tool for dismantling fear.
“If they’re cleared by the DOH—and trust me, they’re using very, very conservative guidelines about when you can return to regular life—then let’s welcome them back,” Collis says. (The health department says isolated people can stop quarantining after 72 hours without a fever and seven days after symptoms begin. He also advises people to avoid assigning blame, emphasizing, “no one chooses to be ill.”
While most recovering patients have kept a low profile, there are some who talk openly on social media to urge others to act responsibly. In mid-July, online clearinghouse Hawaiʻi Updates 808, run by a Big Island web developer and designer who posts Hawai‘i-specific coronavirus infographics, shared a Facebook video uploaded by Honolulu resident George Ma from his ICU bed at Straub Medical Center.
“COVID-19. I got hit. … Just wanted to let you know this COVID-19 is no joke,” Ma says between labored breaths. He urged friends to share his updates and warned young people who might feel “untouchable” that it only takes one mistake. Fortunately, Ma, a personal trainer in his 40s who works with patients who have Parkinson’s disease, responded well to treatment and went home on July 25 after 11 days in the hospital. But weeks later, he posted on Facebook that he was still experiencing fatigue, insomnia, involuntary shaking and a "COVID fog."
Just as Ma was being released from the hospital, Hawai‘i saw a record number of cases (55, 60, 73) for three days in a row. The following week, as Hurricane Douglas barreled toward the Islands, those numbers jumped to triple digits (109, 124, 123). One week later, the numbers surpassed 200 positives a day and on Aug. 13, the daily count hit 355 For a long time, the Islands’ low number of per capita cases diminished the perceived threat. But as of July 31, Hawai‘i joined Alaska, Missouri, Montana and Oklahoma as the five states with the highest percentage increases in new cases over seven days.
Today, we mark the third straight day of record-breaking #COVID19 cases in our state, and we are now under a hurricane warning. Please plan with your family to stay safe during this time, but please remember that the virus is still out there. Continue wearing a mask and keep your physical distance as much as practical while sheltering from the storm. #coronavirus #douglas
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Another grim indicator is the escalating positivity rate (even though more tests are being administered, a greater percentage is coming back positive, indicating more widespread infection), which reached 10.5% on Aug. 13. The threshold that the WHO recommends before reopening and relaxing restrictions on public life is 5% or lower for at least 14 days.
To put Hawai‘i’s numbers into context, it’s useful to compare infection rates that have been adjusted for population. On Wednesday, Aug. 12 , the seven-day average of new cases per million people climbed to 120.6 in Hawai‘i versus 32.94 in New York, the country’s former epicenter that squashed its curve in June. By comparison, Florida reported a seven-day average of 320.3 cases per million people—and saw one COVID-19 death every 7 minutes that same day. To reverse the dangerous trajectory of Hawai‘i’s curve, Mayor Caldwell reclosed O‘ahu beaches and parks on Aug. 8.
—Angie Smith, COVID-19 survivor
Hawai‘i Department of Health Director Bruce Anderson attributed the state’s recent surge to multiple clusters associated with large gatherings or people “just hanging out with close friends.” The struggle to get Island residents to continue distancing and wearing masks—while so many long to socialize with friends and family after months of isolation—is real. In the wake of pandemic fatigue, it’s easy to cast off an invisible threat that isn’t personal.
And many cases—a recent South Korea study showed 30% of infections were entirely asymptomatic—may remain invisible. According to Anderson, other jurisdictions have reported that up to 10 times more people have been infected than have been identified, and this could be the case in Hawai‘i as well.
“We know from experience with other diseases that there are always more people who are infected than we may identify for a variety of reasons—not seeking medical care because of mild symptoms, lack of access, cost of care, reluctance to be identified as infected because of perceived stigma, or other reasons,” says state Epidemiologist Dr. Sarah Park.
However big or small, the threat remains imminent, underscored by the disproportionate illness rates for Pacific Islanders, who comprise only 4% of the population but account for more than one-third of the cases locally, according to the Department of Health. In addition to living in large multigenerational households, cultural traditions, many of them centered around big gatherings, are major contributing factors.
Andrea Keesey participated in a uh antibody test.
Photo: Courtesy of Andrea Keesey
At the beginning of April, Andrea Keesey was sheltering in place at her Waialua home with her boyfriend, Kris Butler. As a behavior analyst, she works with kids with autism. But she was laid off from that job, and the last day of work for Butler, a Waikīkī concierge, was March 21. They had just fostered four puppies with parvo, a highly contagious virus that affects an animal’s stomach and small intestine, which was keeping them busy. Out of the blue, on the same day, they both developed body aches and fevers. Keesey was short of breath, Butler was coughing.
Their fevers and other symptoms persisted for two days. Keesey, who has asthma and knows what it’s like to have trouble breathing, tried not to panic. Her inhaler gave her a sense of security, even if it didn’t offer much relief, and she ordered a nebulizer. They drank lots of peppermint tea, diffused essential oils and took ibuprofen.
On April 10, Keesey emailed her doctor. She described her symptoms and asked for a COVID-19 test. She received a call back immediately, and the next day she was on her way to Kaiser Permanente’s Honolulu clinic, where drive-thru testing was being done. Her test came back positive four days later. Since Kris had the same symptoms, they assumed he had contracted it, too. (Later, a blood test showed he had the same level of antibodies as Keesey).
The couple traced their comings and goings over the past couple of weeks. They hadn’t visited any friends, and the only contact with others they had outside their household was while grocery shopping. One of their housemates is a teacher who stopped working when schools shut down in mid-March. Another housemate is a medical technician in the ER at The Queen’s Medical Center-West O‘ahu. Neither housemate showed symptoms—the teacher later tested negative and the med tech never got tested. Keesey and Butler are not sure how they got sick.
Close friends and family sent supportive messages while the couple self-isolated. For the first few days they were so tired they mostly slept and watched a lot of television. (“We got into Tiger King,” Keesey says with a chuckle.) For seven days, they didn’t leave their bedroom, which has an attached bathroom, except to get food out of the refrigerator or heat up some light meals—butternut squash soup and grilled cheese sandwiches, veggie burgers with rice.
“I’d let our roommates know—I texted them—hey, I’m going to the kitchen to grab some stuff,” Keesey says. “When we cooked, we were cautious of what we were touching. We wore our masks and then sanitized everything before we left.
“I definitely had some panicky moments,” the active 30-year-old says, remembering one night in particular when her chest was tight and she couldn’t sleep. But her experience with asthma taught her to sit up, do breathing exercises and remain calm. “I imagine someone who’s never had breathing issues and starts to feel any tightness in their chest might start to panic. And then you make it worse because your heart’s racing and then you really are having trouble breathing like in a panic attack. Most people at that point would probably have gone to the hospital.
“When I had the fever, I was, like, OK, this is coronavirus, it’s fine. And I know they said shortness of breath was one of the things [to expect], but when it was actually happening, it was like, ‘Oh, whoa, this is real. This is a real thing. This isn’t my asthma,” Keesey says. Four days after her symptoms disappeared she went surfing and as she paddled out she could still feel tightness in her lungs. Thankfully, three months later, she says her breathing is back to normal.
“At the beginning of the shutdown when I did get it, I was being very cautious. Everyone was more worried then, and I was social distancing. But somehow I got it,” says Keesey, who was offered a job at a school starting August and is debating whether it would be safe. “Now I feel like it’s almost a worse situation because we have more cases and we’re all so desensitized.”
She worries about the imprudent behavior she sees. “People are like, ‘Why do I have to limit myself? Why can’t I live my normal life?’ But in order for the spread to really stop, we have to make these hard choices. We all need to do this. It has to be a collective effort.”
—Andrea Keesey, COVID-19 survivor
“The genius of this virus is the effective way that it travels from host to host. It can’t go on its own—it needs us to provide legs and wings,” says Ching, the 68-year-old Niu Valley COVID-19 survivor. “People can be asymptomatic, or people can be like me and be down for weeks. And it doesn’t kill everybody—because if it did, then if you got it and you died, the virus would be gone.”
Recently he met a bunch of friends at a park. When he got out of his car, he put on his mask. None of the other three did. “They scoffed and said, ‘Of all people, why do you have a mask on? You don’t need to worry. You’re flooded with antibodies,’” he says. “I said, ‘Hey, I’m wearing the mask out of respect for you.’ The lightbulb went on, and they all went to get their masks.”
Ching notes that the pandemic has shined a spotlight on the collectiveness of humanity. “When you have something like this that affects everybody—and by definition, pandemic affects everybody—if you live your life out of individualism, that’s not the effective way to fight this. It has to be a collective fight,” he says, echoing Keesey’s sentiments. To do his part, Ching has been donating his plasma—a simple action that’s helped to save lives, like those of Ma, the COVID-19 survivor who spent 11 days in the hospital. And he recognizes that it’s not just the people who get sick that are affected—it’s also the people hurt by the shattered economy. To that end, he donates to nonprofits that help those who are hungry and struggling.
More than anything, Ching’s experience gave him a razor-sharp perspective on the ephemeral nature of life. He says a song Willie Nelson wrote sums it up: “Live Every Day Like It’s Your Last, and One Day You’ll Be Right.”
If you have tested positive for COVID-19, have laboratory documentation, and have been symptom-free for 28 days, you can donate your convalescent plasma to help treat severely ill patients. Contact Blood Bank of Hawaiʻi at COVIDplasma@bbh.org or (808) 848-4706.
If you have tested positive for COVID-19 within the past 60 days, you can participate in a UH study that measures antibodies to evaluate the immuno-prevalence of COVID-19. Email firstname.lastname@example.org or call (808) 989-2043 for more information.