MOUNT VERNON – Dan Wilson doesn’t scare easily.
He spent 22 years in the Air National Guard, flying fighter jets and transports. He once fell off a 100-foot waterfall and lived to tell the tale. He’s battled myelodysplastic syndrome – a form of blood cancer – for years. In the early stages, doctors believed he had leukemia.
“I’ve had some near-death experiences,” the 72-year-old Mount Vernon resident said with a laugh.
But this was different.
On the morning of March 23, Wilson lay on his back at Knox Community Hospital, overcome by viral pneumonia and a 103-degree fever. His oxygen saturation levels were low. He felt lethargic, dull. He coughed so much it became hard to talk.
Wilson had COVID-19. He was Knox County’s second confirmed case, and its first hospitalization.
Laying in that hospital bed, Wilson confronted mortality.
“I was sick,” he said, “very sick.”
Unable to visit her husband in the hospital, Dorie Wilson began calling family friends. She reached out to two doctors – one the family saw regularly in Knox County, and another she considered a family friend. Both told her that without aggressive treatment, Dan’s outlook was grim.
“If we don’t get him on this medication, Dan is gonna die,” one said.
That medication was the controversial combination of hydroxychloroquine, taken with a combination of Z-Pak and zinc sulfate.
The clock was ticking. For many, the novel coronavirus was still just a concept – an ambiguous force that had disrupted daily life. State and national leaders called the virus “the invisible enemy.”
For the Wilsons, it was becoming increasingly real.
March was supposed to be a sunny getaway for Dan and Dorie.
The couple scheduled a month-long trip to The Villages, a central Florida community where those 55 and older can enjoy a number of amenities, including golf, shopping and entertainment.
“It’s like Disneyland for adults,” Dorie joked.
The Wilsons, celebrating their 20-year anniversary, arrived in early March and planned to stay through the end of the month. That changed when Dan began exhibiting symptoms.
On Friday, March 13, he started coughing. He acquired a fever four days later.
Dan had a chest x-ray done shortly thereafter, and the results were troubling. The scan showed “fuzziness” in one of the lobes in his right lung – a telltale sign of COVID-19.
“They would’ve tested me, but they didn’t have the test stuff,” Dan recalled.
He tried to order a test through a primary care doctor in Florida, but that didn’t work either.
As Dan’s symptoms progressed, Dorie became increasingly worried. It had been a week since President Donald Trump had declared a national emergency in response to the pandemic, and thousands of Americans were testing positive for the virus each day. The Villages had begun to shut things down – first restaurants, then recreation centers.
The Wilsons were stuck indoors, and the clock was ticking.
“We were really concerned about being stuck in Florida…” Dan said. “We wanted to get out of there.”
On March 20, one week after Dan began exhibiting symptoms, the Wilsons jumped ship. They made the 14-hour trek home over two days – Dorie drove 98 percent of the way, she said – and pulled into the KCH Urgent Care Center late Saturday night. They didn’t stop at home, Dorie added; they didn’t have time.
Doctors gave Dan another chest x-ray, which showed pneumonia and increased fuzziness in his right lung. When Dan’s flu test came back negative, they tested him for COVID-19 via a nasal swab. The test was sent immediately to the Ohio Department of Health, which was able to deliver results within 24 hours.
“They put me on the fast track,” Dan said with a laugh.
Knox Public Health received Dan’s test results Sunday night. He’d been diagnosed with COVID-19.
By the time Dan tested positive, the coronavirus was still a novel concept in Ohio.
Due to a lack of testing, the virus was largely hidden – on March 23, less than 100 people tested positive in Ohio (that number would increase ten-fold over the next month).
Knox Public Health sent a press release the following morning, detailing the county’s latest confirmed case. It was Knox County’s second case in 48 hours; its first involved a 28-year-old woman who worked in Franklin County. She had not been hospitalized.
Outside, the public wondered whether Knox County would soon experience a surge in cases. State health officials predicted the worst was yet to come.
Inside, on the sixth floor of Knox Community Hospital, Dan Wilson felt as if the worst had already arrived.
“It was almost like I was just really going through the motions,” the Croton native recalled. “For the first two days, I didn’t even wash my face or brush my teeth, any of that. It was just sort of blasé – didn’t watch much TV.
“I don’t know what to say. It was just a funny existence.”
Dorie was unable to see Dan in person, and she felt the hospital did not communicate adequately with her during those first few days. When she could get her husband on the phone, he could barely talk without coughing. Both she and Dan felt the hospital lacked a plan for treatment; Dan’s symptoms seemed to worsen by the hour, and he said the only thing he’d been given was antibiotics.
KCH declined to comment on individual cases due to privacy concerns. The hospital also could not comment on “specific clinical decisions that are made related to various conditions or treatments,” Marketing Director Jeff Scott said.
So, Dorie decided to take the matter into her own hands.
“She’s very aggressive when she’s got something to do,” Dan said with a laugh.
“He says aggressive and it almost sounds negative,” Dorie responded. “But the bottom line is that, if I have to get something done, I’m going to do it.”
Dorie has a history of getting things done. A Baltimore native, she came to central Ohio after college to work with Les Wexner and The Limited. She was there during the early days, working directly with Wexner on marketing initiatives. Her team would design everything from hang tags to store layouts.
The job was rewarding, but also demanding. She would receive calls late at night – sometimes after 2 a.m. – asking her to come in and finish a project.
“It was demanding, a very demanding company to work for,” Dorie said. “But that’s because Les Wexner was a very driven man. He expected that from everyone else, too.”
Decades later, it was with this determination that Dorie pressed for answers.
She called the Wilsons’ family doctor, Dr. Jonathan Hardin (also employed by KCH), that Monday morning. She explained Dan’s symptoms and asked him for advice.
“Dan has underlying medical problems that really were playing into this in a very negative way…” Dorie said. “He already has to take shots for his low white cells every week, for his immune system, so I knew that was a problem.”
Dorie had also done her own research. Four days earlier, Trump had touted hydroxychloroquine, an anti-malarial drug, as a potential remedy for the novel coronavirus. She wondered if this could work for Dan.
“I needed to get some answers and basically get them fast,” Dorie recalled.
Hardin agreed that hydroxychloroquine, taken with a combination of Z-Pak (which functions as an anti-inflammatory) and zinc sulfate (which helps clean out the lungs), could give Dan a chance. He suggested they act quickly.
“Looking at Dan’s hospital records, he said, ‘Look, we need to get him on this medication,’” Dorie recalled. “‘If we don’t get him on this medication, Dan is gonna die.’”
Dorie ran this theory by another doctor – a family friend in Michigan who knows Dan’s medical history – and he agreed. He echoed Hardin’s sentiments about dosage, timing and prognosis.
When Dorie asked KCH about administering the drug later that day, she said the hospital physician seemed hesitant. For all its fame, hydroxychloroquine was – and still is – largely unproven in clinical trials. The drug is typically used to treat malaria and lupus, and the Food and Drug Administration sent mixed signals by appoving its use and also cautioned its use to treat COVID-19 in April because it has been known to cause “serious heart rhythm problems.”
“What (the hospital physician) had told me was because of Dan’s blood disease, that chloroquine can affect the bone marrow production of the bloodlines,” Dorie said. “So he didn’t want to do it.”
Still, Dorie pressed ahead. She’d already asked doctors about how this drug would interact with Dan’s myelodysplastic syndrome, and given the limited dosage they’d recommended (he was only scheduled to take pills for five days), she felt comfortable moving forward.
“Talking with the doctors, talking with his hematologist and such, no one thought that was an issue,” Dorie said. “Everyone thought that the risk was worth taking, based on where he was in the process of this virus.”
Dan was in full support.
“The side effects – there are some,” Dan said, speaking about hydroxychloroquine. “But like anything in medicine, the benefit much outweighed the risk.”
Dorie connected the KCH physician with her medical sources via speakerphone, and they talked about the prospect of using hydroxychloroquine. The hospital physician eventually ran the plan by the hematologist (given Dan’s medical history), and it was approved.
Dan was given his first dose of hydroxychloroquine, in combination with Z-Pak and zinc sulfate, on Tuesday afternoon. Less than 24 hours later, his fever had broken.
Over the next few days, Dan’s coughing began to subside. He was off oxygen by Friday, and he completed the recommended five-day hydroxychloroquine stint on Saturday. After a final check-in on Sunday, Dan was released, free to head home – finally – after a month that began in Florida and ended in a hospital bed.
Dan laid low over the next few weeks. He went back for a follow-up lung x-ray in late April and the results came back clear. He was freed from the virus.
“Luckily,” Dan said, “I am one of the survivors.”
In his lowest moments, Dan said he leaned heavily on his faith. He said he experienced somewhat of a religious awakening through it all.
“Because of my faith, I was confident that somehow things would work out,” he said. “And there were a lot of prayers going on.”
Now, Dan is back to his normal routine. He said Monday that his breathing has returned to normal and he’s begun to exercise again. A retired pilot (Dan flew commercial after his stint in the military), he’s back to flying twice a week. Dan celebrated his 72nd birthday on Sunday – something that, for a few days in late March, seemed uncertain.
“I’d say I’m pretty close to normal…” he said. “I had a chest x-ray three weeks ago and it had pretty much cleared up. I’ve recovered.”
It’s unclear how impactful hydroxychloroquine was in Dan’s overall recovery; he was also receiving other treatment during that time, and multiple factors likely contributed to his rapid turnaround.
KCH had treated four patients for COVID-19 as of Monday, Scott said, and all have required unique methods of care.
“Every individual is unique, and KCH physicians work with each patient to determine the best, most appropriate plan of care for his or her needs,” Scott said in a statement.
While he acknowledged the risk of treating patients with hydroxychloroquine, as “recent studies have confirmed a risk of significant side effects with little underlying benefit to COVID-19 patients,” Scott said KCH continues to work with each patient to explore all available treatment options that may be beneficial.
The debate rages on about this particular drug, as other studies, including one published on April 28 by the American Association of Physicians and Surgeons, have offered more optimistic results. Indeed, the National Institute of Health launched the most recent study on the drug on Thursday.
As time has passed, Scott said the hospital’s ability to treat patients with COVID-19 has continued to improve. The hospital continues to follow the latest guidance and recommendations from Centers for Disease Control, the Food and Drug Administration, the Ohio Department of Health, Knox Public Health, and other local, regional, and statewide clinical partners.
Given the timing and severity of Dan’s case, Scott said the hospital was proud of the outcome.
“We are pleased that our clinicians were ultimately able to agree on a plan of care that satisfied this patient, even in the uncertain early stages of this pandemic,” Scott said, “and we are thrilled that the patient has had a positive outcome.”
The Wilsons are thrilled as well. Calling from their Mount Vernon home on April 23, they recalled vividly the fear and uncertainty that plagued the month prior. That fear permeated the entire family – including their children and grandchildren, who Dan and Dorie haven’t seen since the pandemic began.
“I need to hug them so bad,” Dorie said. “It’s not even funny.”
While things started off rocky at KCH, the Wilsons seemed content with their overall care.
They noted the nuance of the situation – “nobody’s truly an expert” on the novel coronavirus yet, Dan said – and praised the doctors and nurses who helped Dan recover. Dr. Julie Costello, the KCH pulmonologist, played a particularly important role in the process, Dan said.
One of the Wilsons’ biggest takeaways from this experience was the importance of planning and patient support. Every family should be planning for how they would respond if one of their loved ones tested positive for COVID-19, Dan said.
And every patient should have an “advocate” – someone who can communicate with healthcare professionals and search for possible solutions, like Dorie did for Dan.
“She’s my hero,” Dan said.
The Wilsons also believe people should be taking the virus more seriously. Dorie admits that when they arrived in Florida in early March, “we were just as bad as everyone else.”
“There was no concern whatsoever…” she continued. “It didn’t seem like it was affecting our little world down there at all.”
Dan didn’t realize the virus’ potential until he had it. His warning to others is short and sweet:
“I’m telling you," he said, "if you go in and you end up with a full-blown viral pneumonia with this virus, I would not like to take my chances without doing anything.
"If you do get the full-blown effect of this thing, it’s pretty nasty.”
Dorie shared similar advice.
“I think it’s really important that people know,” she said, “that they need to be prepared for the worst.”