Lying in his isolation bed in the intensive care unit (ICU) of Memorial Hermann-Texas Medical Center, Anthony Garcia could not believe he was one of the thousands of Houstonians that ended up in the hospital battling COVID-19. The husband, father of two, and friend to many had a lot of time on his hands to rest and think.
“I was scared, and all of the what-ifs came to my mind,” said Garcia. “What if I don’t get better; what if I don’t get to go home?”
But the biggest what-if on his mind was, “What if I would have gotten vaccinated? Would things have gone differently?”
Garcia caught COVID-19 in February 2021, a month after vaccines were available to health care workers, but not to the general public.
Now recovered, he is one of many patients at the UTHealth COVID-19 Center of Excellence clinic, where they treat patients still suffering from the lingering symptoms of COVID-19. “Long-haulers,” as they are generally called, face a long road ahead to recovery. The center was established by The University of Texas Health Science Center at Houston (UTHealth Houston) to provide the latest in treatment, research, and education. Leading the center’s clinic is Bela Patel, MD, professor and chief of the Division of Critical Care at McGovern Medical School at UTHealth Houston.
“I spent two weeks in the ICU fighting the virus, eight weeks recovering at home with a portable oxygen device, and now I am treated by a pulmonologist at the clinic,” Garcia said.Sara Waters, MD, assistant professor of pulmonary medicine at McGovern Medical School, works at the Center of Excellence and knows the struggles patients with long COVID, as it’s commonly called, experience. She and her colleagues treat post-COVID-19 syndrome, aiming to restore lung function, improve quality of life, and address multisystem complications from COVID-19.
“I have been seeing patients since the clinic opened in September 2020,” Waters said. “All of the patients in the clinic are long-haulers, and many we are seeing now were unvaccinated.”
Waters believes the most significant barrier to vaccination is a misunderstanding about the symptoms of the virus and the vaccine itself. Before his infection, Garcia also held that thought.
In fact, Garcia — a health care worker who had access to the vaccine since late 2020 through his position at UTHealth Houston — chose not to receive the vaccine after his wife, a nurse, witnessed her co-worker experience an adverse reaction following her first dose.
“My wife had a co-worker who was COVID-positive but did not know it when she got the vaccination, and my wife saw her have a nasty reaction, and that shaped her outlook on the vaccine,” Garcia said.Following that experience, the Garcia family made their decision to wait to receive the vaccine until they could learn more about it and encouraged other family members and friends to do the same. Without the internal protection of a vaccine, his family vowed to do all they could to avoid getting the infection.
“We took all the precautions. Masks, handwashing, good hygiene. We even set up our garage as a dressing room for my wife so she could change before coming into the house after work,” Garcia said.
Those precautions were enough until Winter Storm Uri hit the state of Texas in February of 2021.
Garcia’s wife, an essential worker, was sequestered at her workplace for two days, where she shared a temporary living space with eight other nurses, rotating shifts for sleep as they stayed prepared for patients that could show up during the storm.
A few days later, she got a call. Two of her co-workers tested positive for the virus.
Two days later, his wife found out she also tested positive for the virus, and she had passed it to her husband.
Soon after, Garcia realized he could not taste his food, a common symptom associated with COVID-19 infection.
Garcia returned home to wait out the virus with his wife and a portable pulse oximeter device — an at-home version of the pulse oximeter used in hospital telemetry. The pulse oximeter measures the level of oxygen in a person’s blood.
“With the machine, we were able to monitor our levels and determine how serious the situation was,” Garcia said.
Doctors and co-workers at the medical school advised against this approach and encouraged the Garcias to seek treatment at the monoclonal antibody infusion suite at Memorial Hermann-TMC. Eventually, on March 9, they heeded the advice, since Garcia’s comorbidities — hypertension, pre-diabetes, and high body mass index — placed him at a higher risk for developing a severe COVID-19 infection.
While his wife received the antibody infusion, Anthony discovered that he no longer qualified for the therapy because his pulse oxygen levels had dropped from 95 to 80. Instead, he would have to be admitted to the ICU.
In isolation, Garcia was separated from those he loved the most. His family and friends were replaced by doctors, nurses, and therapists who treated him around the clock with therapies that included a machine that provides four times more oxygen per liter than the standard oxygen device. Nothing seemed to work, and a pulmonologist informed him that if his oxygen levels didn’t improve, he would have to be intubated.
At that point, “things became very real,” Garcia said. “I asked for a chaplain to visit me, and we prayed. After that, my only thought was ‘How can I be an active participant in a positive outcome?’”
His connection to the outside world came through digital channels, video calls with family and friends, and online church services via livestream, including an Easter service where he said it was “surreal” to hear his name read during the congregational prayer.
“After church, my wife called to tell me that it took her 45 minutes to get out of the church. She said that everyone came up to her after the service and told her they were all praying for him to pull through.”
After a few days that felt like much more, Garcia’s condition improved enough for him to be discharged from the hospital. He was sent home to recover with a supplemental oxygen device and telehealth appointments with Waters.
Eight weeks later, he no longer had the active infection, but his breathing issues continued and he became a patient at the COVID-19 Center of Excellence under Waters’ care.
Waters currently works with Garcia to improve his lung function. The infection caused by the virus attacked his lower right lung, and until this day, Garcia wonders if this all could have been avoided if he received the vaccine sooner.
“I had friends come down with COVID, experience milder symptoms, and be back to work in two weeks. I had no idea my experience would be this bad,” Garcia said.
Studies have shown that mild symptoms and a speedy recovery is not the case for many COVID-19 survivors. A survey conducted by the Office for National Statistics in the U.K. found that approximately 1 in 5 COVID-19 survivors still have symptoms after five weeks, and 13.7% report symptoms after 12 weeks. The symptoms, ranging in severity, can stick around much longer, and patients working with Waters and the other specialists working in the clinic know this firsthand.
“People think because there is so much mild disease, that they will have a mild case,” said Waters. ”You can have a mild case and still experience a host of symptoms a year after recovering.”
The recovery for his lungs was not the only lingering symptom from his infection. Garcia also sought treatment for brain fog, cardiac issues, and survivor’s remorse.
“There are so many people who have been in a similar situation as me and did not make it out of the ICU,” said Garcia, who lost family members who were also not vaccinated.
Garcia has since become an advocate for the vaccine, telling his story to unvaccinated friends, co-workers, and anyone else who will listen.
“If there is any way to prevent this, the biggest thing would be to get vaccinated,” said Garcia. “If I can help one person make that decision, that would be worth me being rolled into the emergency room that day.”
Waters believes prevention is critical in slowing the spread of the virus.
“Our priority is on preventing these cases from ever occurring, and that starts with our community and not at the doctor’s office,” Waters said. “People view doctors as fixers, but the fix is in everyone’s hands. It’s not something we can cure on our own.”
As far as his vaccination status? Garcia got the shot as soon as he could and looks forward to making a full recovery one day.