“The weather is warm,” Patrick Dalton tells me as we connect via Zoom and I check his audio levels. “It’s a nice day outside.”
This would be a fairly unremarkable observation for most people. But Dalton doesn’t take a nice day for granted. He’s still readjusting to life outside a hospital room, more than two months after COVID-19 nearly killed him. Dalton is 24 years old. He’s athletic. He is not among the highest-risk groups for COVID complications -- the groups some maintain are the only people who should worry about the virus. The novel coronavirus didn’t get that memo.
Before Dalton got COVID, he says his family had been paying attention to the news coming out of virus hot spots, such as Italy and New York City. He and his family limited their travel. They stayed home as much as they could. But the virus found a way in, and it infected everyone.
Dalton still isn’t sure where he contracted the virus. He and his wife, Bailey, attended a concert about three weeks before he got sick, but the incubation period of COVID-19 is usually four to five days, with two weeks at an outside maximum.
The illness was characteristically capricious in its effects. Patrick's mother, Felicia, experienced milder symptoms, such as a persistent cough, and fatigue. His brother Alex lost taste and smell, had a bad fever and developed a persistent, painful headache. Bailey's sense of taste and smell diminished. And his dad Tony felt fine. His case was likely asymptomatic, like one-third or more of novel coronavirus cases nationally. Patrick was by far the sickest.
“I started feeling bad two or three days before I went to the hospital,” Patrick said. “By the time March 30 rolled around, I was trying to go to bed and I couldn’t breathe without coughing violently. It got to the point where I was coughing so hard it made my nose bleed. I’ve never had a cough like that before.”
And then it got worse.
“I went to the Tennova hospital in Turkey Creek, and I was in there for maybe an hour and a half that I remember. And then the rest, I don’t remember anything.”
An X-ray revealed Dalton had pneumonia in both lungs, in addition to the novel coronavirus. He was put under a medically-induced coma and spent two weeks at Turkey Creek. His condition did not improve, so he was moved to St. Thomas West Hospital in Nashville on April 12. There he was connected to a machine pumped blood out of his body, oxygenated it, and sent it back into him. It was, in essence, Patrick Dalton’s heart and lungs for more than a week.
“I don’t remember anything until early May. So the whole month of April is gone,” Dalton said. He could receive no visitors – not that he would have known. But it was tough for Patrick’s family. Medical staff at St. Thomas West kept them briefed via video calls.
During his long hospital stay, Dalton’s own immune system became a threat to his survival. The body’s immune response normally fights microbial intruders in a proportional way. But for reasons not well understood, in a small number of COVID cases the immune system spirals into a furious, relentless attack called a cytokine storm. The internal storm can savage ordinary body tissues along with the unwanted virus, degrading vital organs.
“My lungs had already healed from the pneumonia, but they took a lot of damage from that cytokine storm, so I had to heal from the pneumonia and that,” Dalton said.
The virus and the associated cytokine storm also apparently hit Dalton’s muscular system, destroying valuable muscle tissue. The former Christian Academy of Knoxville* football standout weakened dramatically during his hospital stay. Levels of a telltale chemical that signals muscle damage, creatine phosphokinase (CPK), rose dramatically in Dalton’s body. Normal CPK levels in a healthy person range from 10 to 120 micrograms per liter.
“Mine was at 8,900,” Dalton said. “So pretty much all the muscle I had in my body was gone when I woke up.”
It was only after Dalton came out of the coma in early May that he learned what he’d been through. It didn’t match up with his own perceptions and it took a while for the ordeal to sink in.
“That was pretty scary,” he said. “I woke up, and for the most part I was still really sedated. I couldn’t feel all the aches and pains. But once they weaned me off…it’s like I could feel everything that had been done to my body while I was asleep.”
He was discharged from St. Thomas West May 14. Hospital staff applauuded as he was wheeled out of the building on a gurney, and his family smothered him with hugs. He was sent to a Knoxville rehabilitation center to begin rebuilding the muscle he lost. He got to come home May 27. Dalton still goes to physical therapy three times a week to force those muscles to regain motions he once took for granted, such as walking. He’s getting around okay now, though he says he’s still very tired and feels like he hasn’t caught up on sleep – an irony he acknowledges after having spent five weeks in a coma. But he’s reunited with his family. And his dogs, who were overjoyed to have him home again.
Dalton is going through this alien, intensive recovery as many others in Knox County are ready to shed the restrictions of safer-at-home orders and go back to social behavior as it was known before the pandemic began. When I asked Dalton what he thought of that, he paused for a moment before responding.
“I don’t really know where I am on that,” he said. “I want to see things go back to normal. That would be great. The odds of people getting as sick as I got are still really low. But I’d recommend trying to be as safe as possible.”
* - The inital version of this story misstated Dalton's high school alma mater. It is Christian Academy of Knoxville, not Farragut High School. WUOT News regrets the error.