Vax * 2 + COPD + COVID + 76 =
September 24, 2021 4:31 AM   Subscribe

So my dad is 76, only recently quit smoking after years of COPD, and is double vaxxed but has just tested positive for COVID after 10 days of feeling shitty but not seeing his doctor because he's an idiot. He's getting monoclonal antibody infusion today, and they are talking about hospitalization.

I don't have the brain to read through medical journals right now and calculate odds.
It's my mom and not me who's talking to his doctors, so I just want to know where to pitch my expectations. This is really bad right? I should just assume he's going to die a horrible death isolated in an ICU and prepare us all for that?
posted by DarlingBri to Health & Fitness (12 answers total)
First of all, big hugs from an internet stranger. You're getting the information filtered through your parents and they are understandably freaked out. Is it possible for them to add you so that you can hear it directly from his doctors? Are you near them, geographically? If you're not, can you get there easily?

I'm not a doctor. I think you should be hopeful that the antibodies will work since his breakthrough case sounds mild and it was caught early.
posted by mareli at 5:02 AM on September 24, 2021 [3 favorites]

Ugh, I'm sorry. Yes, it's not good, but it's a LOT less bad since he's vaxxed and getting treated. He absolutely has a fighting chance.

But of course there is a chance that your dad might die from this. Personally, I don't feel like the "odds" are useful in cases like this - ultimately the person you love is going to make it or he's not. You may want to encourage your parents to talk about how aggressive they want to go with his treatment, when and how she would make a decision about taking him off a ventilator, etc. (even if he pulls through with COVID, these are decisions she may need to make at some point in the future). If there's anything they need to do to get their affairs in order, they should go ahead and do it.

In the meantime you try to be prepared for both/all possibilities - prepare for his death, prepare for his continued life, prepare for a potentially long and/or incomplete recovery period. If doing all this sounds dissonant and upsetting, it is! But I haven't been able to figure out an alternate way of living through a loved one's life-threatening illness. It's just really fucking hard.

I hope the antibody infusion works wonders and your dad feels better soon.
posted by mskyle at 5:17 AM on September 24, 2021 [13 favorites]

I should just assume he's going to die a horrible death isolated in an ICU and prepare us all for that? No. Because he's vaccinated, he has a good chance of recovery. The Case Fatality Rate for people 65-80 is hard to pin down, maybe someone else will have that information, but my googling says it's probably in the single digits. It varies by location. You can't really prepare for the emotional effect of the worst case scenario, though you can make sure close family and friends are informed, and get emotional support. He's getting good treatment, it's been mild so far, so I would prepare for the best.

Anecdata: a friend's parents are in their 90s, got Covid before the vaccine was available, it was touch and go, ICU/ Ventilators, etc., they both survived with no long term effects. I hope your Dad is okay.
posted by theora55 at 5:35 AM on September 24, 2021 [12 favorites]

This is not good. It is not yet really bad.

In terms of of the odds, most people who are hospitalised with Covid survive. For example, in Wisconsin in July 2021, the relative rates of hospitalisation and deaths suggest that well over 95% of fully vaccinated people who were hospitalised survived. Even in ICUs, more than half of patients survived in the UK during the worst peaks in spring 2020 (before we had monoclonal antibody infusion and nobody was vaccinated). Fewer people die now than they did then.

I think preparing for the idea that if he is hospitalised he will be isolated and if he gets really sick it will be an unpleasant experience despite the best efforts of medical staff. Ways to make sure he can connect with the outside world and know he is loved will be helpful regardless of what happens.

Otherwise, do what is helpful to you. If it is helpful to you to prepare for the worst then prepare for the worst. If it is helpful to you to hope for the best, then hope for the best. If you need to support other relatives more closely affect, make sure you draw on the support of others for yourself.
posted by plonkee at 5:41 AM on September 24, 2021 [9 favorites]

All my love and support goes out to you.

If you do start googling and reading journal articles, please remember that population level odds or risks are not individual level risk. If a smoker in a population has a X% chance of getting lung cancer, that does not mean that your friend, a smoker, has an X% chance of getting lung cancer.

Getting monoclonal treatment is a step in the right direction and that’s great that he’s getting it. That’s a huge help.
posted by raccoon409 at 6:18 AM on September 24, 2021 [2 favorites]

Best answer: I'm sending you and your parents many get-well wishes! If he does end up requiring a ventilator know that people with COPD are often slower to wean from the support the ventilator provides - this is the case for any respiratory illness, not just Covid. Can you ask your parents to allow you to interact directly with the healthcare providers, so you don't have to rely on whatever your mom relates to you? This will help lighten her load by sharing the task of updating you and any other family, and will give you more of a sense of control, which is helpful and even therapeutic for worried family members.

You probably know that monoclonal antibodies work best when given early in infection, so if his infection is already 10 days old it may be less helpful, but still worth administering. Keep in mind that he is in a much better position because he is FULLY VACCINATED. Sending him and the rest of your family lots of support across the internet!
posted by citygirl at 7:33 AM on September 24, 2021 [2 favorites]

Anecdata, but my mom is in her late sixties, overweight with heart disease and diabetes, and got Covid in March 2020, before we had a vaccine or much information at all. She was in the ICU on a ventilator. She made a full recovery. I would say your dad has an equally good chance of being fine because he is vaccinated.

That said, it's really, really scary. Take care of yourself. <3
posted by epanalepsis at 9:42 AM on September 24, 2021 [4 favorites]

Hang in there and just pray. Keep in mind if he's on the antibodies treatment he's not THAT bad off.

Some of the "worst" COVID symptoms require going onto full life support, i.e. an ECMO machine, that breaths and pumps blood for you. Your father is nowhere near that.

Was just reading a story where a Florida man, ex-COVID-denier, got his entire family infected, but he was so bad he needed an ECMO machine, and there are none within a few hundred miles. Then a hospital 1200 miles away in Connecticut offered him a spot. He spent 22 days on ECMO, and survived. He's now pro-vax.

I've seen cases of COVID where the patient died in days... and in case of a 4-year old, in HOURS upon feeling bad. Your father has survived this long, and is getting medical care. That's a GOOD prognosis. Remember, vaccination reduces severity of symptoms even if one had a "breakthru" infection.

So best wishes, and don't worry TOO much. That just gives you ulcers. Focus on stuff you CAN control.
posted by kschang at 11:44 AM on September 24, 2021 [3 favorites]

Response by poster: Thanks all for your considered words. I appreciate the good thoughts, rational thoughts and encouraging anecdata.

I did calm down over the course of the day and found this study on survival rates in COVID patients with COPD:

Patients with COPD had higher rates of hospital admissions (62% vs 28%). The mortality rate of patients with COPD was 15% compared to 4% in patients without COPD.

That is a much, much lower mortality rate than I was expecting, so I no longer feel like the worst case scenario is inevitable. My parents are in NJ, one sister is in RI, one sister is in NY, and I'm in Ireland. I'm focused on giving my mom advice about protecting herself (she's testing negative) and getting groceries to the house. That's about all I can do -- the chances I'm flying to the US right now are sub-zero.
posted by DarlingBri at 12:11 PM on September 24, 2021 [5 favorites]

Best answer: I'm glad you are feeling more hopeful, and it truly is a reasonable point of view. Maybe you or your siblings could suggest to your mom that she gets a booster ASAP to improve her resistance to infection, if she was previously vaccinated with Pfizer. That's a concrete thing she can do to protect herself.

Sending lots of hugs.
posted by citygirl at 5:45 PM on September 24, 2021 [2 favorites]

Can you ask your parents to allow you to interact directly with the healthcare providers, so you don't have to rely on whatever your mom relates to you?

To add onto this, many hospitals have online systems where you can see a patient's latest test results, notes from doctors, and so on. Your mom (who may not even know the system exists) would have to help get you access, but if you could, it would help -- I've had access with both of my parents and I could see what drugs they were given, current blood pressure and oxygen levels, and so on. Some of it will be in medical jargon but it's way better than getting second-hand info from a justifiably emotional person.
posted by mmoncur at 10:12 PM on September 26, 2021

Response by poster: Update: my dad is now recovered, and my mom was able to get a booster and continued to test negative. My sisters and I arranged doorstep deliveries of groceries.

I'm really grateful to you all for being the people I could turn to when I had to be the grownup in the family. Thanks!
posted by DarlingBri at 2:51 AM on November 1, 2021 [2 favorites]

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