Ka Wai Ola - Office of Hawaiian Affairs, Volume 37, Number 10, 1 October 2020 — Not the Flu [ARTICLE+ILLUSTRATION]

Not the Flu

'Ōiwi īalk About C0VID-19

Maile Alau Having survived C0VID-l9, Maile Alau is an outspoken advocate for personal responsibility. "The instance of transmission between people wbo are botb wearing masks is almost zero. So wear a mask." ■ Photos: Courtesy

Shane Valdez "Everyone wbo survives C0VID-1 9 sbould donate their plasma," says Shane Valdez. "Survivors develop antibodies whieh ean be used to help otbers fight the disease. It's an opportunity to help save otbers."

Chasity Peters Peters' parents, Darrellane and Jobn Flores, in 2016. Warns Peters, "This tbing is real and ean be passed easily. Don't be foolisb. You ean sbow aloha without putting yourself, or your 'ohana, at risk."

Charlie lona (L to R) Brotbers Claudney "Pu" lona, Claude lona, Eddie Bissen and Charlie lona in Las Vegas in 201 9. It was the last time Cbarlie saw bis brotber, Eddie. Cbarlie has channeled bis grief to educate others about C0VID-1 9.

By Puanani Fernandez-Akamine The first weekend in August, Maile Alau and her 'ohana were moving into their new home. Saturday was a busy day spent moving boxes and furniture. On Sunday the work continued but as the morning wore on, Alau started to feel unwell; her throat was scratchy and she had started coughing. She ignored her symptoms, intending to power through, but by 1:00 p.m. she felt so weak that she had to lay down and sleep. Alau awoke on Monday morning with a fever and body aches. She called her doctor and they were on a tele-med-ieine eall when Alau realized she could no longer smell the diffuser on the table next to her. Her doctor scheduled a C0VID-19 test for her the next day. On Wednesday Alau learned she was positive. Later that day she went to the emergency room because she was

having trouble breathing. The doctor ordered a chest x-ray and checked her oxygenation, whieh was fine at 97%. Her chest x-ray seemed clear and Alau was sent home with an oximeter and instructions to return if her blood oxygen levels dipped helow 92%. "It eame on really quickly," said Alau. "There were probably seven days of really high fever and super horrible fatigue. Icouldn'ttasteorsmell. I could not breathe. I was laying in bed panting like I ran a 5k. Then the fever started going down but my cough, whieh had gone away, eame back with a vengeance and I started coughing up blood." Alau called her regular doctor again. Her doctor reviewed the x-rays taken when Alau visited the emergency room the week before and found a few tiny spots that had been missed, indicating pnuemonia. Alau was prescribed a course of antibiotics. Although Alau's husband, Jason Teaney, also tested positive for COVID-19, he never had any symptoms. And

Alau's 14-year-old son and their housemate were negative. "It's weird because we hang out together and we eat together," said Alau, who is not even sure how she heeame infected. By the end of August, Alau was well enough to resume working from home. Her fever and cough had subsided, although the fatigue persisted into September. Eight weeks after being diagnosed, Alau's lungs are still not working right. "I used to be able to walk three miles easily. Now I'm up to about three-quarters of mile before I have to rest." Shane Keli'i Valdez is a surgical nurse and a selfdecribed "super O.C.D. germaphobe." So when he tested positive for COVID-19 on August 26 it eame as a shock. "At work we are so careful and diligent about wearing our PPE. And I'm the one with Clorox wipes constantly wiping doorknobs, handles and code buttons. But the one plaee I let my guard down was at home," said Valdez. Valdez lives next door to his parents. His mother is ill, so he does the grocery shopping for both households, going between the two homes. His cousin also lives in the home, so when her boyfriend tested positive for COVID19, Valdez' first eoneem was for his parents. He wanted them tested immediately but was told that they should wait a few days because it might be too early. But Valdez got tested right away since he was over at the house every day and often cooked for his parents. When his test eame back positive, his fear was for his mother. "I was just so worried that I had given it to my mom and that she would not survive it," Valdez recalled. "So those first five days were pretty nerve wracking. I couldn't even focus on myself; compared to my parents, my chances of survival were greater. So, when my mom's test result eame back negative it was a huge relief to our whole 'ohana." Valdez was fortunate to have very mild symptoms. But that is an important part of the story that he wants to share. "At first I had a little bit of a headache - but it could have been caffeine withdrawal from not having coffee that morning; I was a little short of breath - but I've put on a few pounds because I haven't been exercising. The symptoms are vague, so they are easily dismissed." About a week after his diagnosis, the headaches got worse and his lungs weren't working at capacity. He had an oximeter at home and was monitoring his blood oxygen levels, whieh were low, but not dangerous, at 91-92%. But the day his oxygen saturation dropped to 88% he got nervous. "I'm a medical professional but I wasn't sure when to seek medical help," Valdez admits. "Any nurse would put you on supplemental oxygen if your sats are 88%, but I didn't want to occupy a hospital bed for a little bit of oxygen in my nose. There were more critical patients needing care." The next day his oxygen levels were up to 94-95% and for the most part he felt okay. He returned to work in midSeptember, but his oxygen levels have continued to hover between 95-97%. His doctor says that may be his new baseline. SEE N0T THE FLU ON PAGE 21

NOT THE FLU

Continued from page 20 Three years ago, Chasity Peters' mother suffered a massive stroke that has left her confined to a nursing home, unahle to walk or speak. It has been extremely difficult for the family. "She loved to sing," said Peters about her mother. "She was a stay-at-home mom, caring for the six of us kids and then 15 grandkids. She was the rock of the family always praying for everybody, always there to listen. For her to go through so mueh and still be here with us is a testament in itself." The 'ohana has been unable to visit Peters' mother since nursing homes were locked down in March; their contact limited to video chats. In early July, Peters' father got a eall from the nursing facility asking for consent to have his wife tested for COVID-19. The family assumed it was routine. When they received another eall a few days later saying she was positive, they were shocked and angry. "It was a roller coaster of emotions," Peters shared. "My mom's condition put her in the high risk category. One of the reasons she's in a nursing home is because she lived on a respirator when she first got sick. Everything hit the fan. For the first two to three days it was the blame game: How did this happen? Who messed up? Who gave it to her? Honestly, that was the hardest thing - the rage." They later learned she was infected by a nursing facility staff member. "I couldn't sleep. My dad couldn't sleep. It was super scary. We kept calling to find out what was happening," said Peters. "Everyone just got on their knees and prayed." Remarkably, Peters' mother was asymptomatic despite her serious medical conditions. "Our family is 100% blessed and thankful," Peters reflected. "We believe God answered our prayers. We don't understand why she' s still here on Earth while others are not." Charlie Iona lost his brother, Eddie Bissen, to COVID19 in early April. Bissen, a limousine and Uber driver in New York City, was 63 years old. He was most likely infected with the virus by one of his passengers. "I was browsing Facebook and saw a post by my brother saying he contracted COVID but was doing okay," Iona recalled. "So, I called him and said, 'Hey what's going on?' He told me he had a high fever - between 103-104. Too high. I told him that until he was over it, I was going to eall him every day. That was on March 29. A Sunday." The following day when Iona called his brother didn't piek-up. On Tuesday, Iona received a eall from Bissen's girlfriend, Mary Freda. She told Iona that Eddie was in the hospital and that she had never seen him look so scared. Freda promised to keep Iona updated. She also had COVID-19 but her symptoms were mild. The next day Freda called saying Bissen would be dialyzed (on dialysis) 24 hours a day and that the doctors were trying hydroxychloroquine. But hydroxychloroquine therapy was quickly discontinued after it adversely affected Bissen's heart. Then the dialysis filter began getting clogged because Bissen' s blood was so thick. "That' s

the first time it was revealed that he had blood clots," said Iona. By Friday, Bissen was in a eoma and on life support, not responding to any kind of stimulus. For two long days Iona waited for news about his brother. Then early Sunday morning Iona got a eall from Freda. "At first I couldn't understand her, she was crying so mueh," Iona said. "She finally told me that the doctors had taken Eddie off life support to determine whether there was any brain activity, and that he passed away within a minute. He was already brain dead."

Nearly ten months into the pandemic, a great deal has been learned about this highly contagious and potentially deadly virus. But even as researchers race to develop a vaccine, mueh about the disease remains unknown, not the least of whieh is why some people get so sick and otbers do not

The way C O V I D - 1 9 affects people ean seem random. While kūpuna and those with chronic illnesses are the most vulnerable and account for the majority of deaths, there are glaring exceptions. Young, healthy people, including ehildren, have also died from COVID-19. As of press time, more than 3 1 million people

worldwide have been infected with the virus, and nearly one million have died. Deaths in the U.S. have surpassed 200,000 people, and COVID-19 is now the third leading cause of death in America. Dr. Jordan Kalenakai Lee, an ICU physician with The Queen's Medical Center, says it's important for people to understand that COVID-19's mortality rate is only part of the story. "COVID-19 is a 'novel' virus, meaning the human body has never seen it and doesn't know how to react. So, it turns up the immune system and goes unchecked, whieh leads to a lot of multi-organ damage: the heart, the lungs, the blood vessels, the brain," Lee explained. "It ean cause strokes. And the majority of hospitalized patients develop a form of acute respiratory distress syndrome." Lee notes that 15-20% of people infected with COVID19 require hospitalization. Of those who are hospitalized and recover, most will have permanent heart or lung damage. A smaller number will suffer strokes or experienee some loss of cognitive function, or early dementia. Although infection rates continue to soar, new medical therapies are resulting in better outcomes for the sickest patients. However, there is no cure for COVID-19 and a safe, widely available vaccine is months away at best. Given the unpredictability of anyone' s individual response to the disease, the fact that it is highly contagious, and the risk it poses to our kūpuna, it is in the best interest of our lāhui to reduce the spread of the virus and avoid getting infected. Reducing community spread of COVID-19 is also critically important to ensure that sufficient hospital beds are available and so that health care professionals are not overwhelmed. "During the height of the second wave in August, our hospital was near capacity," said Lee. "Our COVID ICU was full and spilling over into other ICUs when hospitalizations peaked. Thankfully they have started to drift back down." Continued Lee, "Hospital beds and ventilator capacity is not the issue. It's staffing - particularly nurses to care for critically ill patients - not just for COVID-19, but for every critical patient admitted, whether for heart attack, trauma, strokes. . .onee the heahh system gets strained it ean affect the quality of care all patients receive." According to Lee, hospitals are cooperating to share the COVID-19 patient load and FEMA has flown in relief critical care nurses for two weeks to help offset the nursing shortage and to allow Hawai'i nurses time to recover after working muhiple double shifts. At this point, preventing the spread of COVID-19 is key. And because of our family-oriented culture, and our many multi-generational households, difficult behavioral changes are required. "Living in Hawai'i, we hug and we honi. Aloha is just ingrained into our psyche," reflects Lee. "To be isolated and not touch is really hard for everyone, myself included." Regardless, restraint is important. Adds Alau, "If there is a ehanee you could hurt somebody, wouldn't you do whatever was needed to avoid that? If we elaim to have aloha, if we elaim to care about our lāhui, then we have to do what we need to do to protect them. Period." ■

ln an effort to inform, educate and change behaviors, after his brother's death Charlie lona partnered with Mel Rapozo, to co-host a nightly show they eall C0VID Discussions. The show runs Monday through Saturday at 7:00 p.m. and streams live on their individual Facebook pages. Both men are retired poliee officers with backgrounds in investigation, and over the pastsix months have hosted a remarkable array of guests including physicians, politicians, government officials and coronavirus survivors. They use their popular platform to provide first-hand information about the disease from experts and survivors, and to debunk rumors and conspiracy theories.

Dr. Jordan Lee specializes in pulmonary and critieal care and emphasizes the need to get control over C0VID-1 9. "Unfortunately, the disease will probably happen in cycles and we'll open and close, open and close, unlil we reach some kind of herd immunity or there is a vaccine."