The life of every Oregonian has changed.
Yet for the vast majority of us, the COVID-19 virus remains an abstraction.
Yes, most of us are stuck at home, venturing out in masks for exercise and groceries. Many of us have lost our jobs. All of us wonder how long the shutdown will last, and how it will upend our well-planned but now chaotic futures.
Still, the virus is a blur at the edge of our vision, a plague we hope will stay off our doorstep. That's the essence of what makes COVID-19 so pernicious: uncertainty.
Although COVID-19 has brought Oregon to its knees, the number of people who have actually tested positive for it is tiny: about 2,000 at press time out of a population of 4.2 million. State health officials estimate the number of people who've actually contracted the disease is closer to 8,000, which is still less than 0.2 percent of the population. And most of those who have tested positive—about 96 percent—survive.
Little wonder that for many of us, the disease doesn't seem quite real.
That's not true for the three people who tell their stories in the following pages. For them, COVID-19 is vivid, immediate and part of their every day.
In prior coverage of the pandemic, WW has examined the workplaces and workers on the front lines of fighting the virus. This week, we wanted to understand what it's like for those who confront it in a different and more immediate way—because they test positive, or take someone to the hospital when they're too sick to walk, or intubate someone who can no longer breathe. These three people are in close quarters with the one thing most of us are desperate to avoid.
In recent days, calls have grown to reopen the state of Oregon for business. It's hard to measure to what extent that demand is pragmatic or whether it's foolish. Lives are being ruined by the shutdown as well as by the virus.
But it's important to know the risks of reopening the state. That's what these stories show.
No matter when Oregon reboots, the experiences you'll read about in the following pages are going to become more regular in the coming months. Oregon may return to normal—but encounters with the pernicious virus will be part of the new normal.
We asked each of the three about the reality COVID-19 brought to their lives. Their answers have been edited for brevity and clarity.
Crabb, 49, works at Oregon Health & Science University, where the hospital has a floor just for COVID-19 patients. A self-described computer nerd who works in IT in the School of Dentistry, Crabb doesn't interact with patients at all. It didn't matter: She was among the early wave of confirmed cases of the virus, testing positive March 22. For Crabb, the uncertainty of COVID-19 is about whom she might have infected: elderly relatives and friends, co-workers, or scores of people she doesn't even know.
Only about 1,700 of Oregon's 4.2 million people have tested positive for the virus. Crabb is one of few who can describe what it's like.
I was the most scared when my wife walked into our bedroom with a spiral notebook. She was afraid I could die.
She said, "Write your passwords down."
For computer nerds like us, passwords are everything. I said, "You know, you're not wrong." I was very sick.
That day came after I had thought the worst was over.
It started in March. I had been feeling a little rough, but I felt really sick on the 19th. Then the 21st, my fever spiked to 103 and I started coughing. It was a dry, heavy cough, not productive. I thought: Shit. I have it.
I'm a systems application analyst in the dental school at OHSU. I've worked at the university since 2001. When I got sick, I was already working from home, but they told me to come in for a COVID-19 test on Monday, March 22.
At that point, they had set up drive-thru testing for employees. My wife drove me in our blue 2017 Subaru Forester.
Was I scared? Yes. But I was super-concerned because my mother-in-law died suddenly on March 18 and I'd been around her and her oldest and best friends, staying at her house. I was pretty sure I had it, and I was afraid I'd infected them.
Who else might I have given this thing to?
We got to OHSU first thing after it opened at about 8:30 am. I was like the third person in line. They had a booth set up outside. One person in personal protective equipment approached the car. They knew who I was. A tech came forward and put a swab in my throat.
The test results take some time, and my doctor told me we also needed to rule out the flu. I went to ZoomCare on Mississippi and did that.
When I got home, I started calling people I'd been around to warn them I probably had it. The call from the lab came at 11:30 Wednesday night. I thought, wow, they've been working all day and all night. The wait was OK—there wasn't much suspense because I was pretty sure I had it.
I did a lot of thinking about how I might have gotten it. I remember reading a lot on the MAX Yellow Line train on the way home. I think that's where I got it. In February and early March, I was watching on the train every day as more and more people on the train were ill. There were so many people coughing. I thought, "We don't know enough about the disease. It must be here." And I was thinking, "This train—it's a petri dish."
Tuesday and Wednesday, I actually felt a little better. I still had a fever, but I was bringing it down with Tylenol and taking massive amounts of vitamin C and D. But I was feeling well enough to work part of the time. I was like, "Woo-hoo! I'm done with it!"
On Friday, March 27, the seventh day I had it, things went downhill fast.
I woke up with a raging headache. I was having a little difficulty breathing. I felt I like my chest was in a vise. We have a pulse oximeter, a device for measuring oxygen in the blood. If I was paying attention, I could keep it up in the high 90s. If I didn't pay attention, it would drop. My doctor said it was important to keep the reading up over 93.
My fever went back up to 102. And everything ached: It's like what people who've had chemo or are immunosuppressed tell you: Your body hurts all over and can't move. I didn't lose my sense of smell, but everything I put in my mouth tasted old and moldy, flat and sour. It was awful.
My wife is like me: a typical computer nerd. She's very shy. She talked to the advice nurse three times that weekend. But when she called my doctor's office, that's when I knew how concerned she was.
All I could think about was, please let me sleep. I just want to sleep. I think out of a 72-hour period, I must have slept for 60 hours. I was zombified.
Late Sunday night and into Monday, my fever cleared up and the pain went away. I have not had a fever since March 30 or the 31st.
I've been clear from the quarantine since March 7. The first thing I did when I could leave the house was to take our dogs, an 11-year-old Aussie-Siberian husky named Rufus and 5-year-old husky-timber wolf mix named Tonks, to the dog park out by Portland International Raceway.
I can't wait to go hiking again. I've already missed three camping trips. It's killing me that the season is closed. But my recovery is pretty slow. I'm tired, 14 or 15 days after all symptoms cleared up. There's a big cardiovascular impact: I'm getting winded on a half-mile evening dog walk.
For me there are a couple of takeaways. The first is, there's no way my wife doesn't have it—she took care of me every step of the way—yet she's been totally asymptomatic. There must be a whole bunch of people out there who have it and don't know it. That's really dangerous, and people really don't seem to understand that.
Second, this virus changes everything in our society. We are culturally used to a flu that knocks you out for maybe three days. We don't think about viruses in terms of a 12-to-14-day illness. If my experience was typical, employers and everybody else will have to adjust because on a regular basis, this is like a 14-day flu. Think what that means for people's jobs and their lives. That's pretty staggering.
Laas, 50, is a firefighter and paramedic at Tualatin Valley Fire & Rescue with 25 years on the job. He's trained to run toward danger, whether it be to enter a burning building or pull a victim from a still-smoking wrecked vehicle. But now, the most routine call for medical assistance—that's most of his calls—could result in an exposure to the virus. (About 8,000 firefighters around the country are currently quarantined according to the International Association of Firefighters.)
That's an especially fraught prospect for Laas, who is recovering from throat cancer. He discussed how his work has changed—starting with the COVID-19 case he remembers most vividly.
We'd responded to the same location three times that night already.
The Elmonica MAX platform in Beaverton. Different patients, each with possible COVID symptoms. But this woman was in a wheelchair, suitcases along with her. She'd probably been riding the MAX train until the last run of the night.
We got there at 4:30 in the morning, about a week ago. Metro West Ambulance was there just before us. I see them walking with this woman in a wheelchair, and her feet are dragging on the ground. So we hop out, we run over there. She's unconscious, unresponsive, severe respiratory distress, audible wheezing. She's really sick. Her oxygen saturations are bottomed out and she's in severe distress.
I have to do an interosseous line on her—that's just basically drilling into her bone so they can give her fluids. Just get her oxygen saturation up. We could either do it on scene or just boogie to the hospital. As we rolled into the hospital, she had to be paralyzed to be intubated. I would be surprised if she survived.
How did this woman get walked by for hours like that? She had been there for three hours, and people walked past her several times. She wasn't making noise. She wasn't making trouble. She was quiet. She was unobtrusive. She was an older black woman staying out of the way, not causing any trouble. So people just thought she was sleeping, and she was getting sicker and sicker and sicker the whole time.
And she just kind of got forgot.
I went off duty for a cancer treatment in March 2019. I had throat cancer, and I went through surgery and radiation. Last month, I came back on the line after being off for about a year.
Things have changed quite a bit. Pretty much every medical call we go on, the entire time we are wearing a fully encapsulated Level B hazardous materials suit. Imagine a coverall. Plasticized. It's basically heavy duty Tyvec.
Hot: yes. Sweaty: yes. It's essentially like wearing a fully encapsulating Gore-Tex rain suit, with a hood, on a sunny, 70-degree day. No pit zips and you can't unzip to let it breathe. Oh yeah, and we are, most often, wearing a full face mask with filter—which has a certain degree of breathing resistance.
In the early days, it really freaked patients out. They knew things were changing.
Normally, we really pride ourselves on making connections with people. And a lot of what we're doing now is: "Come outside. We'll meet you at the front door."
Then we walk them out to the driveway or a sheltered spot, if it's raining. We have portable chairs. Metal and plastic foldout chairs. And that allows us to bring people outside and sit them down so we can do an assessment on them. Two shifts ago, we had a cardiac arrest and we just grabbed the patient, brought them straight outside, and worked the cardiac arrest in the front driveway.
Everything you bring into a house you have to assume has a certain level of contamination.
Last night, April 17, we were inside a house to help this elderly woman that fell down and had very fragile skin. She was bleeding everywhere. There was no indication of any COVID symptoms whatsoever. But the one of us that actually made patient contact— picked her up and put her on the stretcher—came out, and we have 1-gallon garden sprayers that are filled with a bleach solution. Head to toe—bleach-solutioned her down. Doffed all of her gear into a bag, let it soak for 15 minutes. Saturated in bleach.
But our usual connection with our patients and their families is very different. We're taking your mother to the hospital. You can't go to the hospital. You can't get in the ambulance with us because there's the potential of cross-contamination.
I just have straight conversations with people. I say: "We're taking them to the hospital. They will likely not let you see your wife, your husband, your grandmother, whatever. She could be in there for several days. So take a second."
People are scrambling. They're nervous. It's hectic. And I just started slowing it down: Nothing's going to change in the next minute, right? Let's take 60 seconds. Make a connection with your loved one. Let's just do this right.
According to my oncologist, nine months post-radiation, I don't have a significantly suppressed immune system. I would probably get sick more readily than I did prior to all my treatment. So am I worried? Absolutely. And I'm very cautious.
On a day-to-day basis, we're doing a job. And I'm still working. That fact is not lost on me. I feel really privileged.
Yes, there's a hazard, no doubt. But what we do is hazardous in general. It's either this, or it's on a freeway with cars whizzing by at 50, 60 miles an hour in the dark or any night, or it's hanging off the side of a building or going down into the ditch to pull somebody out. We're not heroes for this. We're just trying to take care of people.
Dr. Maxine Dexter
For Dexter, 47, who works in the intensive care units at Kaiser Sunnyside in Clackamas and Kaiser Westside in Hillsboro, the situation is different: Unlike Laas, she can be sure when she reports to work each day she'll be in contact with patients diagnosed with COVID-19. She's a critical care pulmonologist and treats the most severe cases. (Dexter is also running for the Democratic nomination in Oregon House District 33, which covers Northwest Portland and parts of Beaverton.)
For Dexter, the uncertainty is of a different kind: whether her patients will survive and whether, if they are going to die, they will be allowed any kind of closure with their loved ones—or whether, for the sake of safety, they must die alone.
The person was so sick that it went pretty fast.
In early March, I was covering our COVID unit. We had had someone who had been doing poorly for a while. They were older and had other diseases, and those are the patients who are having the hardest time surviving this. And their family, with a lot of discussion, had decide they wanted to let them go.
That conversation is normally one you have in the room, with the family able to see their face. But if you had COVID, there was no visitation. We had to have that conversation by phone. Not everyone is technologically savvy enough to do a Zoom call, so most of those conversations are over the phone.
And the person was Catholic, and their family really wanted us to try to figure out how to deliver last rites. We did what we could. The priest couldn't come in. The church apparently has made other mechanisms acceptable. The priest is on FaceTime, and was able to give the sacrament as much as they could. There was no holy water, none of that. But it was as good as they could get.
I wasn't in the room. To save personal protective equipment, our nurse was in the room with the patient. And she called the family and did FaceTime before they passed.
I was standing there watching her as she turned off the blood pressure medicines that were keeping the pressure up, and watching their heart rate. It slowed down right away. I looked at the nurse—who's the baddest-ass, most amazingly resilient nurse I've ever worked with, the person you want any time stuff is going badly—and she was crying.
She looked at me and said, "I can't imagine how we're going to do this."
She said, "I was able to be in this room when the person passed. We are going to, over and over again, have these patients alone when they die. And no one's going to be able to hold their hand."
At that point, we were still preparing for the surge. So we're looking at each other through the glass as this person dies, knowing that their loved ones want to be there and can't be. This person is dying and has no one they know or recognize at their bedside. And that this is not only as good as it's going to get, but that it's so unacceptable from where we are at this point in our careers. We would never choose that for a patient.
So I think that's really been the most profoundly upsetting parts of this: the distance that patients have had to have from their families, and feeling like, when we get busy, these patients might die alone. And how awful is it to have anyone in that situation.
We never got to a point where we couldn't deliver care. It was all hands on deck, so we added shifts we'd never added before.
I think the worst part was when we weren't sure how things were working. Doctors, we're data-driven, scientifically based professionals. There's no data behind this telling us how to manage it. There's no experts in this. We were being told things on the calls that were our best educated guess that are really not true. We didn't think asymptomatic spread happened. This has been humbling in so many different ways.
We are used to being able to find the right answer. And there's no right answers right now.
I'm not someone who's afraid of stress. You don't go into critical care if you don't like being stressed. Usually, things are under control and manageable, and then there's always the chance that, forgive my French, that shit's gonna hit the fan. And that's part of what you like about it. I can't imagine fighter pilots like to always have sane, calm situations. There are some of us that choose more stressful careers.
And yet the stress of not knowing how to control my situation is something I've never signed up for. That has been what has been draining. That's what's been emotionally depleting. Not knowing if I can take my kids in my car because I had COVID all over my hair and my neck and I drove home. Does that mean it's in the car? My kids haven't been in the car that I drive since this all started. I can't come in the regular door because my shoes have been in the hospital, and I have to put my clothes in a separate washing bin and separate washing machine.
We drew the line at me not coming home. Some people maintained distancing to such a point that people are living in a separate house or in a trailer in the driveway.
My husband is also a physician. We're a two-doctor family. Just the other day, we were actually just hanging out in our bedroom on different devices, texting our family members, making sure they knew where they were in the line of taking care of our children.
And we had to have the conversation with our kids who are 13 and 16. Do you go live with your cousins or do you stay in separate cities? We had that conversation, and our daughter looked at me, and she was like, "Are you gonna die?" They took it all in stride, and then she was like, "Wait a second, is this real?" And I think that was the moment that I was like, yeah, I guess I don't know.