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Julio closed his eyes without knowing that he had the coronavirus. It was a Spain, that of February 27, that did not imagine what it would begin to face a few weeks later, that ignored that at that time the epidemic was already spreading like wildfire, while the authorities observed some dozens of cases with the belief that everything was under control. control. He opened them almost two months later, not knowing where he was or what had happened to him. After 57 days in intensive care, he returned to his room on Wednesday; He was one of the first covid-19 patients to need an ICU in Spain, and the one who spent the most time there due to the SARS-CoV-2 virus.
The long stay of Julio Lumbreras, 65, in the intensive care unit of the Torrejón hospital, in the Madrid region, is the story of how the disease progressed throughout the country: from initial ignorance to subsequent uncertainties and experimental treatments; The drama of the families of the sick and the rays of hope, which also appear in the greatest health crisis in a century.
Julio had not been to Italy or China, nor had he maintained contact with anyone who had traveled through those countries, as Sergio, one of his five children, reports. On February 19, when she began to feel ill with flu-like symptoms, it did not occur to her that she might have the disease. Neither did his GP, who, after listening to him for a few days and noticing breathing problems, sent him to the hospital to have an X-ray of his lungs. The diagnosis: an early stage of pneumonia. Antibiotics and home.
It kept getting worse while taking a medicine that was not helpful against a virus. Two days later, he was barely able to stand up, so his family decided to take him to the hospital. He had lost much of his breathing capacity. They left him for observation the night of February 26 and the next morning they decided to intubate him. His life was in grave danger.
“It was a long process, full of uncertainty and anguish,” Sergio says by phone. “When he was intubated, we thought it would help his breathing for a few days, but we never imagined that it could take so long. It is a complicated process that aggravates the confinement, because we are a great family that spends a lot of time together. [A quarentena] It prevented us from seeing or keeping company with my mother, which was terrible, ”he continues. According to the Spanish Ministry of Health, coronavirus patients who need an ICU generally spend between 20 and 28 days in this room. “It is very rare that someone is under the age of 10,” explains Gabriel Heras, a team member who assisted Julio.
Despite everything, the Lumbreras family considers themselves lucky. Heras is the director of the HU-CI project for the Humanization of Intensive Care, and the Torrejón hospital is one of the few that allows relatives to visit patients, which is why Julio’s wife, Yolanda, has spent every afternoon with her husband since he was admitted “If we accept that patients suffer and die alone because we do not have a PPE [equipamento de proteção individual], we have to reflect on the type of society we are, “says this doctor, who admits that he was about to throw in the towel after a month without improvement, and even informed Julio’s family that it is most likely not recover.
But that would be later, in late March. Before, it was still necessary to discover that the reason that brought Julio to the hospital was SARS-CoV-2, a virus that, when he entered, had not even received this official name (during the first weeks, it was provisionally called NCoV-2019) . In little more than a week, from the first symptoms to admission to the ICU, everything that was known about the epidemic evolves at a dizzying rate. People were beginning to suspect that it might be more widespread than previously thought, and all those hospitalized with severe pneumonia started getting tested. Although everything indicated at that time that Julio’s case was caused by the coronavirus, it was negative in the first two tests. But the bilateral pneumonia and symptoms were so similar that medical management decided to insist. A sample was taken from the depths of the lungs, and there was the pathogen that turned the world upside down.
“It evolved little by little, with steps forward and backward”
Julio, a car dealer salesman who retired two years ago, had several factors that are often associated with most fatal cases of coronavirus. In addition to being a man and over the age of 60, he had chronic obstructive pulmonary disease, the result of many years of smoking, although he had been smoking for eight years. He also suffered from hypertension and was taking medication to combat it. He is a big man. Or at least it was before the almost two months in the ICU consumed him. Almost 100 kilos that complicated all movements.
Despite having received virtually all the experimental treatments that have been tried since the beginning of the disease, nothing seemed to be as good as pronation. Spending 17 hours a day upside down improved her ventilation. But the days of a mechanical respirator passed the bill to their lungs, which were becoming increasingly rigid due to the pressure the machine was putting on them. “It was very frustrating,” reports Heras, one of his doctors. “When we put the fan on, the idea is to get it out as soon as possible, but it didn’t progress. Zero Fortunately, other organs were not affected, otherwise it probably would not have come out alive, ”he says.
In search of solutions, they were given corticosteroids. And it’s not clear if it was because of this or because he was already beating the virus, but it started to improve in early April. The 12th, Easter Sunday, was negative. “He evolved little by little, with steps forward and backward,” sums up his son. Soon after, the sedation was removed and he came back to life, until the mechanical ventilator was removed to apply less and less invasive techniques that would help him breathe, while he recovered his speech, realizing what had happened.
He is still stunned, according to Sergio. On Wednesday, when he returned to his room, after applause from the entire team that treated him, the news began. Naturally, they spoke of the coronavirus, of the thousands of cases and deaths it leaves on the road. “He pointed at the television, as if to say, ‘Look, look, did you see what’s going on?'”
After two months, Julio has a long way to recovery. Experts call it post-ICU syndrome, a variety of physical and psychological sequelae that accompany the patient during the first few months. Losses in motor and cognitive skills that, in this case, add to the fact that one wakes up in a very different world from the one that remains when you close your eyes.
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