Freddy Fernandez was hardly there, on his couch in his Missouri home, his baby in his lap, gnawing at the pulse oximeter he uses to check his oxygen levels after a months-long battle with COVID- 19.
The 41-year-old father of six spent five months hospitalized a four-hour drive from the couple’s home in the southwestern Missouri town of Carthage under the most intense life support system available. He nearly died several times and now, like so many others who have survived COVID-19 hospitalizations, he has returned home changed.
While more than a million people have died from COVID across the United States, many more have survived stays in intensive care that left them with anxiety, PTSD and a host of health issues. . Research has shown that intensive therapy starting in intensive care can help, but it was often difficult to provide because hospitals were overflowing with patients.
“There is a human cost that the patient pays for survival in ICU,” says Dr. Vinaya Sermadevi, who helped care for Freddy throughout his stay at Mercy Hospital St. Louis. “It’s almost like going to war and having the consequences.”
Freddy’s memories of those long months come in snatches – times when he regained consciousness, hooked up to breathing machines for him, clinging to life. Sometimes he asked for his mother, who died of COVID-19 in September 2020.
He missed the birth of his daughter and the first four months of her life. He may never be able to return to his construction work. Her other young daughter is terrified of leaving.
His partner Vanessa, 28, was still pregnant with Mariana last summer when the delta variant hit. She was vaccinated at the request of her obstetricians. Freddy too was warming up to the idea of the vaccine at the end of August, but it was too late. He had come down with COVID.
The Mexico City native, who came to the United States about 20 years ago to work in construction, was so ill he ended up in St. Louis, nearly 270 miles from his two young daughters; Vanessa’s 10-year-old son, Miguel, who considers Freddy his father; and three other children with his ex-wife – boys aged 10, 8 and 7.
It was a dark time when many people hoped the pandemic was over, but the delta variant flooded the healthcare system again. Fulfilling shifts was a daily battle and death was everywhere, Dr Sermadevi recalled.
In some ways, Freddy was lucky. Despite all the talk of ventilator capability, what was missing most during the delta push was something called ECMO, or extracorporeal membrane oxygenation. It is used when a ventilator is not enough, pumping blood out of the body, oxygenating it, and then returning it.
Mercy Hospital St. Louis only had the equipment and staff to care for three ECMO patients at a time. And on September 3, Freddy became one of them.
Vanessa gave birth to Mariana on October 13.
Away from her fiancé, Vanessa logged video calls with Freddy’s doctors the same day she brought the newborn home. The news was not good – Freddy was suffering from infections and not recovering well.
A lung transplant, Sermadevi said, seemed like his best option, but it was a long shot.
“And there is a chance that Mariana will grow up without a father,” Sermadevi recalled telling the family.
Some of the most important keys to critical care recovery aren’t medical. Visits from parents, as well as physiotherapists, occupational therapists and speech therapists, have long been shown to make a difference for the sickest patients.
COVID-19 has upended these practices in many hospitals as families have been kept apart to prevent the virus from spreading.
Fears of infection, as well as lack of staff, also often meant less physiotherapy, which proved to speed up recovery.
When Freddy’s family arrived, it made all the difference.
Her bedroom has been transformed, photos of her family pinned to the ceiling. Freddy’s family held his hand when he was in respiratory distress, talking to him. He needed less sedatives and painkillers because, Sermadevi said, “that was it for him.”
“We would just hear such love at the bedside,” she said.
Once he got off the ECMO machine, Freddy began to recover. His lungs slowly improving, he soon got up and tried to walk. Ultimately, the discourse on lung transplantation was tabled.
On February 9, he returned home, 167 days after arriving at the hospital in his hometown.
All Vanessa could think of was “finally.” Freddy had never met his baby. He hadn’t seen any of his other children either. Their interactions were limited to Facetime and photos.
Melanii was shy, briefly hugging him with his older brother Miguel, before clinging to his mother.
Vanessa kissed the baby then put him in Freddy’s arms. Now, days away from turning 4 months, Mariana smiled at him.
Freddy relied on a walker and a wheelchair at first. He couldn’t sit or eat by himself.
But now the wheelchair is abandoned on the back steps of the house. He can circle the block by pulling a portable oxygen canister behind him on a cart. He is about to be able to carry his oxygen in a backpack, which would give him more freedom.
Vanessa returns to work, life returns “a bit to normal”.
They want to wait until Freddy gets better to get married.
Yet they don’t know how much he will improve – or how quickly.
This is the story of so many people, who are alive but forever changed, says Sermadevi, who has watched his progress from afar. Some nurses have even become Facebook friends with Vanessa.
“It’s sad and joyful at the same time,” she admits. “And it’s very difficult to reconcile.”