COVID is No Joke

“Better late than never.” -Unknown (only as it refers to the return of blogging…not getting COVID)

It has been 9 months since my last post. The same amount of time it takes to gestate a human life. But no, that’s not why I’ve been MIA.

We all know how difficult the last 2.5 years have been in the seemingly never-ending battle against COVID. As a physician, I was very aware of the dangers of the disease and jumped at every opportunity to protect myself and my family. This meant vaccines as soon as they were available and boosters thereafter. My young son even wore a mask daily to preschool, and was the only child in his class to do so. The bane of my existence was the constant delay in vaccines for the under 5 crowd. This meant that the youngest member of our family could not access the best line of defense against COVID, but I reassured myself with the fact that everyone else was vaccinated and young children tended not to get seriously ill from it. Then the Omicron wave began…

We made it through Christmas with the family thanks to rapid COVID tests (my husband’s grandmother is nearly 103). We even made it through January with two different rounds of school closing down due to positive cases in my son’s class. Cases were starting to decline and I continued to hope and pray we would make it through yet another wave unscathed. We had a family vacation planned with my in-laws in mid-February that had been postponed from fall 2020 due to the virus and everyone was looking forward to a brief reprieve from the stress of daily life.

During the time I’ve been MIA, my son began to experience increasing challenges at home and at school. He had experienced similar behavioral challenges the year before at preschool, though at the time we had chalked it up to a poor environmental fit, especially since he was thriving for the first few months at his new school. My instincts as a Child Psychiatrist (and mom) kicked in when he began having the same types of challenges in his new school. We were also getting more challenging behaviors at home and my now three year old had STILL never consistently slept through the night. I had been noticing “red flags” since my son was very young, but his language skills and social motivation had always been reassuring. Now, though, based on my gut instincts (and the urging of one of my residents, whose area of expertise happened to be neurodevelopmental disorders) we spoke to our pediatrician, who agreed an evaluation was warranted. In January of this year, psychological testing confirmed two things: our child is extraordinarily bright, and he is on the Autism Spectrum. In the midst of processing this new information and trying to figure out how to best support our son, one week before our long awaited vacation, he developed a barky cough.

I knew that cough- he had Croup, an upper airway viral infection that causes narrowing of the airway. In older children and adults, the airway is sufficiently large that this merely causes a sore throat and/or laryngitis (losing one’s voice). However, young children have narrower airways, and in severe cases, Croup can be life threatening. Having dealt with many cases of Croup as a pediatrician, though, I knew what to expect and how to manage it. That first night he was sick, I swabbed him for COVID and the test was negative. We sat outside in the cool air when he awoke with a coughing fit at 10 pm. This helped, but he still had quite noisy breathing. My husband was very concerned and wanted to go to the ER, but I checked his oxygen levels (which were fine) and reassured my husband that we could manage through the night until we could get in to see his doctor the next day. On the outside, I was cool as a cucumber. Inside, though, I was actually quite nervous about how much our son was struggling and the fact that it was so early in his illness. I also had been reading reports of COVID causing croup in young kids during Omicron, so I didn’t trust that initial rapid test. I spent the rest of the night with my son in our bed so I could monitor his breathing.

We survived the night, and the next morning his pediatrician confirmed: 1) this was a severe case of croup, so it was a good thing we were there to get steroids to decrease the swelling in my son’s airways and 2) it was due to COVID. Bye-bye vacation plans…

As any parent knows, when your child is sick, they tend to become extra clingy (and often exclusively want mom). By the time we got the positive COVID test, he had already spent >24 hrs practically attached to me and an entire night breathing in my face. I figured I was guaranteed to test positive for COVID, a distressing thought given I had underlying conditions that put me at higher risk of severe disease, but prayed that my three prior doses of the vaccine would ensure only a mild case (and prevent Long COVID, for which I was also at high risk). Sure enough, a day later I tested positive and another day after that, I developed symptoms.

The first day or two of illness was fairly mild for me, but things quickly went downhill. My asthma flared and I couldn’t even move without triggering a severe coughing fit. My whole body ached and a new type of headache emerged. My oxygen levels dropped several percent, though not to the point where I would need hospitalization. I was put on steroids for my lungs and I became eligible for the new antiviral medication, though unfortunately not until day 5 of my illness. After starting the antiviral, my symptoms stopped worsening, but I remained too ill to do anything other than cough my way to the bathroom for several days. My husband also eventually tested positive, but after a few days of cold-like symptoms, he was back to normal. He had received his booster less than 2 months earlier. It had been 5 months since mine, and, as we would eventually learn, protection from Omicron drops off precipitously after 3-4 months.

To be continued…