She’s only 27 — and COVID-19 nearly killed her. She wants her to story be a lesson
Kris Obligar was lying in a hospital intensive care bed, terrified and crying. She couldn’t breathe, and her condition was deteriorating fast.
Just hours after the 27-year-old Sacramentan had managed to walk haltingly into the Kaiser Permanente Medical Center on Morse Avenue in early July, doctors were telling her they possibly needed to perform an emergency tracheotomy on her – cutting a hole in her throat.
“I thought ... I might die,” the Sacramento speech therapist said. “My mind and body went into panic mode.”
She wished her mother could be there to hold her hand. But no family members were allowed by her side, not that day, nor any of the other 18 days she would spend in intensive care to treat her coronavirus infection, much of it in a drug-induced semi-conscious state on a breathing machine.
She is, perhaps, lucky. Although she spent weeks with a tube in her throat, the tracheotomy didn’t happen because her lungs responded to treatment. She’s recovering now, sequestered in an upstairs room of her sister’s Arden Arcade area home, but is still barely able to talk and gets winded when she walks up a flight of stairs.
She wants her story to be a lesson.
Five months into the coronavrius pandemic, it’s still true that older people typically get worse cases and have far higher death rates from COVID-19. But it’s also clear that far more younger people are getting infected by the virus than their parents and grandparents.
In Sacramento County, the 20-29 age group has emerged as the most infected group, followed by those in their 30s. And in some instances, those cases have been life-threatening.
For Obligar, the events of the last month were as unexpected as they were horrifying. She doesn’t know where she caught the virus. But her parents got it at the same time. Ironically, it was Kris who ended up in intensive care, while her parents sat at home with mild symptoms worried for their daughter’s life.
Obligar, a speech therapist for children and California State University, Sacramento alumna, had been taking precautions. She would social distance with friends at the park, wear a mask to the store and elsewhere, and order takeout rather than sit at restaurants.
The worrisome days of early spring waned, though, and it appeared the virus was under control in Sacramento.
“The world began ‘opening up’ and so did I,” Obligar said. “I can’t give an exact moment in time, but I can tell you that it did come with being more lenient and open to going out.”
One day in early July, “I remember feeling short of breath and could do nothing to satisfy the lack of air. I didn’t officially know if I was ‘positive’ but I had all of the symptoms.”
Obligar was taken to the hospital via ambulance on the Fourth of July. She was tested inside a COVID-19 emergency room tent, but was sent home. Three days later, she returned with renewed breathing problems.
She was hooked up to oxygen, but was still unable to breathe. Within the six hours of being in the COVID unit, doctors sedated the panicked young woman, then inserted a tube down her throat, connected to a ventilator machine that would do the breathing for her.
Obligar spoke to The Sacramento Bee this week mainly through texts because her voice is hoarse and will take time to recover.
“Every day I was sedated felt like I was going to die.”
COVID-19 and 20-somethings
Most people who die from COVID-19 are elderly. Sacramento County statistics as of Thursday show that 91 of the county’s 126 deaths occurred among people age 70 and older. Only eight have occurred among people under age 50.
But younger people by far are more likely to catch the virus. While the huge majority of those cases are relatively mild, there are some worrying signs that virus’ effect on the body could be long-lasting.
It’s prompted some health officials to warn young adults that staying free of coronavirus is not just about avoiding passing it on to your parents, grandparents and other loved ones. It’s also about managing your own long-term health.
“I feel like most people think that having ‘2’ or ‘3’ in front of their age is a silver bullet and going to protect them, and that is simply not true,” said Dr. Vanessa Walker, a critical care physician at Sutter Roseville and medical director of Sutter’s regional electronic ICU system. “This isn’t an in-and-out thing, just out of work for a week, and back to business as usual.”
Some recent research suggests COVID-19 could affect more than the lungs on a long-term basis.
“We don’t know what the long-term outcomes will be,” said Walker. “This is going to be knocking out our young vibrant population for multiple weeks, with possible long-term health effects that we as as a society are going to be paying for down the road.”
A study published July 24 by the Centers for Disease Control and Prevention found that 20 percent of people between the ages of 18 and 34 with no chronic underlying medical problems were still sick from COVID-19 three weeks after testing positive.
“COVID-19 can result in prolonged illness, even among young adults without underlying chronic medical conditions,” the CDC said in its report.
Two studies published this week in JAMA Cardiology found that some people who have recovered from COVID-19 show abnormal heart imaging findings.
Dr. Robert Wachter, chairman of the Department of Medicine at UC San Francisco, says that suggests young people who don’t take precautions could be risking longer-term health issues. “We are becoming increasingly aware of long-term consequences.” In a worse case scenario: “If you are 25, you have 50 or more years of higher risk with a damaged heart.”
Underlying conditions, diabetes
There may be an explanation for Obligar’s more serious case. She has Type 2 diabetes.
Diabetes is considered among the handful of underlying conditions that can turn a case of COVID-19 into a nightmare. Also on the list of underlying health issues that have been linked to the worst cases: obesity, asthma, heart and lung conditions, hypertension, lupus, and rheumatoid arthritis. A recent UCSF study also found that smoking can cause someone to have a worse case of COVID.
Obligar said her diabetes is well managed. She is healthy and very active.
“I can’t say that it puts me more at risk of getting it, but I can say that it did put me in more danger when I fell ill, especially during the first stages,” she said. “With any sickness, diabetes can increase your instance of complications.”
While older people are more likely to have underlying conditions, some younger people do as well. In some cases, they may not be aware their health is compromised.
“Your housemates get the sniffles and you end up in the hospital,” Sacramento County health officer Dr. Olivia Kasirye said. “You may have hypertension and may not know about it.”
Diabetes is particularly prevalent. More than 34 million Americans have diabetes – about 1 in 10 – and approximately 90 to 95% of them have Type 2 diabetes. Type 2 diabetes most often develops in people over age 45, but more and more children, teens, and young adults are also developing it, according to the CDC.
Another case of COVID-19
The younger age groups include more working people, many in the service industry, who cannot afford to stay home. That puts them at higher risk.
But there is another reason, health officials say, that younger people are more likely to catch COVID-19. They socialize more, assuming that they are less likely to get a bad case.
Branko Zlatar, 23, of Sacramento, is blunt about the urge many young people feel to gather with friends at bars, clubs, beaches and restaurants. Otherwise, “it feels like my youth is being stolen from me. That is why people my age ignore it. I don’t want to waste time indoors when I should be out living life.”
That attitude cost him. He got COVID-19. He doesn’t know where, although he had recently been with friends in a crowded bar where someone reportedly had the virus. One day, he went to work coughing. His boss sent him home
“Once night-time hit, it hurt to breathe,” he said. “I had a headache. I was sweating. My lungs hurt with each deep breath. I thought I could actually die. This might be it.
“The next morning, I woke up. It didn’t hurt anymore.”
He took a coronavirus test the next day, but thought he probably had some other illness, not the virus. So while waiting for the test results, he went out again with friends. His test came back positive. Meanwhile, one of those friends tested positive. He felt guilty and posted a warning to friends on Facebook. He has since donated plasma, which, if it has antibodies, could be used by hospitals in treating others with COVID.
“I want people to know it is real,” Zlatar said. “A lot of people don’t take it seriously.”
Like Zlatar, Obligar does not know where she got the virus. It likely was, like many cases, passed from family member to family member, at a time when no one felt ill.
Isolation, an ICU, a ventilator
Obligar says being on a ventilator, alone, in a drug-induced semi-conscious state, was as bad an experience as she has ever had.
“It is so difficult to describe the amount of isolation I felt in there,” she said. “I couldn’t hold my mom’s hand or say I love you to anyone before anything happened.” She said the kindness of her nurses helped immensely. “I had the best nurses I’ll forever be indebted to.”
Among patients who have been put on ventilators, she may have been lucky. When the virus first hit in March, health professionals moved quickly to hook the most ill patients to the breathing machines. But hospitals soon discovered that people they put on ventilators often died.
In the months since, hospitals have developed treatment protocols that rely on intermediate steps, including a new therapeutic drug called remdesivir that was not available to patients in March and April. That drug, as well as the steroid dexamethasone and convalescent plasma, now help strengthen weak lungs and are proving more successful than simply using a ventilator.
“In the beginning of this, especially in New York, everybody had a breathing tube and a mechanical ventilator and that apparently made worse the lung inflammation, and now we know that’s not the way to go about it,” said David Lubarsky, head of UC Davis Health, which operates the UC Davis Medical Center in Sacramento. “We really changed our treatments.”
Being intubated and placed on a ventilator is a deeply disturbing experience for many patients.
“We don’t do that lightly,” said Dr. Dean Winslow, an internal medicine and infectious disease specialist who cares for COVID-19 patients at the Stanford University Medical Center. “You have to sedate someone to put them on a ventilator. We sedate people pretty heavily, and they have to be in the ICU. There are risks of it in your wind pipe.”
It could have been worse for Obligar. Doctors talked about opening a hole in her neck directly into her throat. If her lungs hadn’t improved, she said, she would still be in the hospital today with a tracheotomy.
Hugging relatives
The COVID-19 pandemic risks have been a hard thing for many young people to get a grip on, given that older people are the hardest hit group.
For Micah Buchman, 30, a legal assistant in Sacramento, the virus seems real, but then again, “like a far away idea, like turning 80.”
She and friends gather most weekends at someone’s house to share dinners, watch movies and talk. “We hug,” she admitted. They don’t wear masks during their get-togethers. “It’s not really on our minds. I mean, we’re worried about our grandparents, and older people.”
Buchman, who wore a mask when she stopped to talk to The Bee this week outside a market, said she has been thinking a bit more about the virus lately. “It’s getting more serious. I thought it would blow over in a couple of weeks.”
Dr. John Belko of Kaiser Permanente in Sacramento, a pediatric infectious disease specialist, laments the fact that messages about COVID-19 have been confusing and often associated with vitriol and politics.
“It does amaze me. Our society has become so polarized,” Belko said. “It used to be that people did what the right thing was for the common good. It is not just about you and your individual choice. It is for all of us. It amazes me the vitriol out there. After 20 years in practice, I should be cynical. H1n1, you could have a rational discussion.”
Tito Martinez, 26, of Davis, a climate change consultant, has come to some conclusions based on his reading of science. He is still willing to go out to outdoor restaurants and take his Corgi to the dog park. But when he does, he wears a mask, and believes it is a moral responsibility to be as concerned for others as he is for himself.
“I don’t want to feel guilty about the possibility of me making things worse,” he said this week while meeting up with his girlfriend and cousin for dinner. “I came from a STEM major. I don’t know if that’s why. I believe in science. I think it is effective to take precautions. You listen to authority figures who represent your ideals. The authorities at the CDC, I take them very seriously.”
Obligar, who was released from the hospital last week and called it one of the best days of her life, still has a ways to go toward recovery. It will be another month or more before her voice is back. She needs therapy for her throat. She finds it hard to walk and talk at the same time.
Her friend set up a GoFundMe fundraiser to help with the family’s medical bills. “Be an advocate, share Kris’ story. and WEAR A MASK,” the page read. “Please take this seriously.”
Obligar is aware some young people don’t believe COVID-19 is a serious risk. She asks them to put themselves in her place three weeks ago.
“Are you ready to walk into an ER by yourself and not come out for two weeks?” she said.
To lie there, cut off from your family with a tube down your throat not knowing if you have a future.
“It may not take you or your family members where it took me, but is that worth the risk?”
This story was originally published July 30, 2020 at 2:17 PM with the headline "She’s only 27 — and COVID-19 nearly killed her. She wants her to story be a lesson."