Debbie Donaway of Salisbury battled Covid-19 and has lived to tell the story.

Donaway, the Executive Director of Salisbury Urban Ministries, a nonprofit that operates in the Church Street neighborhood and provides assistance with food, medications and other necessities for those living in poverty in Salisbury, is well known throughout the community.

People have been hoping and praying for her recovery -- for many, she is the first friend to stare down a Coronavirus diagnosis.

At the onset, Donaway didn’t know what was wrong.

On May 23, her husband of 44 years, George Donaway, left her outside the Carroll Street entrance to Peninsula Regional Medical Center for what she thought would be a quick exam before heading back home.

“You have to be dropped off alone at a tent out in front of Peninsula Regional Medical Center,” she said. “I walked up to check-in, they started asking questions and I said I had to sit down first.”

 After assessing her condition, including her blood oxygen level, she was admitted.

“The doctor came in and said they were going to keep me,” she said. “That was so unexpected. I thought I would be hydrated and sent home.”

How did this happen?

Unlike many who contract the virus, Donaway knows exactly how she caught the virus.

“My parents were receiving home health care,” she said, “and in May a new caregiver came to help them out.”

That person worked at her parents’ home a couple of days before calling out sick for what she described as allergies.

“The next day we found out it wasn’t allergies,” Donaway said. “It was Covid. With that person out of the picture, I stepped in to help with evenings – using masks, hand sanitizer and distancing.”

On Thursday of that same week her stepfather was rushed to Peninsula Regional Medical Center and the diagnosis was Covid-19.

The next day, May 15, their primary care physician wanted both Donaway and her mother tested.

“I went to Mom’s house,” Donaway said. “We were going to take her to be tested, but I couldn’t get her motivated. The virus had kicked in. I was afraid she would fall, so I called an ambulance.”

Her mother tested positive.

By that Sunday, Donaway was starting to feel ill. The next day, her test results from Friday came back negative for the virus.

“I stayed home all week thinking I’d kick it, but instead I got worse and worse,” she said. “My parents were on oxygen and doing OK. As I got worse, George talked with a nurse practitioner friend who said, ‘If Debbie’s not getting better you need to get her to the hospital.’ By Saturday I couldn’t even dress myself; I couldn’t breathe.”

George later said he had been told she had pneumonia with Covid-19.

Hospital admission

Donaway was admitted to PRMC that day. At that point she had experienced gastrointestinal distress, a fever that spiked to 102 but came down with Tylenol, and difficulty breathing, which was the worst symptom. She had no body aches, no nausea, maybe an occasional headache, she said.

“The advantage for me was getting admitted in May, because of how much they had learned between March and May,” she said. “

At PRMC she was completely isolated, mostly in a room by herself. She couldn’t leave, and no one could enter except nursing staff and doctors. No visitors whatsoever were allowed in. Every time anyone did go in, they would re-gown and re-glove.

Donaway said she saw no indication of any shortage of PPE, or personal protective equipment.

For the next three weeks Donaway was moved around the hospital, first to Layfield Tower’s 5th Floor, which had been earmarked for Covid patients. She was moved from there to a ground floor conference room that had been converted for use by Covid-19 patients on ventilators. Donaway was never on a ventilator, but she did receive high-flow oxygen, a relatively new therapy that uses a nasal cannula to administer pre-warmed, high-intensity oxygen to patients with severe cases of Covid.

Donaway said the room looked like the inside of a space station, with staff in extreme PPE that reminded her of spacesuits.

“They were covered head to toe, wore airpacks on their backs and clear face shields,” Donaway said, “so they are not even breathing the same air as patients in the room. They are in constant motion.”

Access to the room, she said, requires going through another room like an airlock or holding room. The precautions are extreme, but apparently successful.

“One nurse told me no one had caught Covid while working in that area,” Donaway said.

A nursing station sits in the middle and patients are positioned around the perimeter. Each patient is under the staff’s watchful eyes, constantly.

“They responded to every twitch,” she said. “It was more intense than an ICU, with nothing but dividers between patients, no separate rooms, no bathrooms, just dividers with a bedside commode for those who were able to use them. Many had heart monitors, IVs and other tubes, wires and devices attached.”

Her doctor would meet daily with pulmonology, infection control and the nurses who were caring for Donaway to discuss her overall condition and progress. There was daily bloodwork.

Many treatments

Donaway received an array of treatments, including plasma with antibodies, and a new and costly drug called Remdesivir. It’s not officially CDC-approved, but according to the FDA website the agency has authorized its use for treatment of suspected or laboratory-confirmed Covid-19 patients who are hospitalized with severe disease.

“We were waiting for the remdesivir to arrive,” Donaway said. “A nurse ran over to me smiling, and told me she had just talked to a pharmacist and the drug was here, delivered by the National Guard to PRMC. The nurse said the pharmacist could not believe the National Guard would deliver a drug like that.”

After that, the next treatment was an old standard: prednisone, which she still takes at home as she continues her recovery.

“It really helps a lot,” she said.

She was given multiple antibiotics.

“I am so full of antibiotics and meds, I think if a mosquito bit me it would die immediately!” she said, laughing. “Each treatment made a difference, although one came on the heels of another. But I was getting better.”

Then the bottom dropped out.

Recovery and relapse

“I almost went home before relapsing,” she said. “I had been moved back onto a regular floor, but suddenly they were rushing me to ICU. I knew something was wrong but had no idea what it was. Turned out they thought I might have a blood clot in my lung.”

In ICU, it was like starting all over again.

“They kept pumping in meds. Physical therapists, occupational therapists and pulmonologists visited me there. It seemed every couple of hours someone else would come in,” she said.

Finally, on June 16, she was well enough to be released.

“They wanted me to go to Anchorage, where they do rehab for Covid patients,” she said. “But I told them I needed to be home, my mental state required it and I preferred to be at home, with therapy and supervision of course.

Family members

Throughout her hospitalization, Donaway was vaguely aware of the situation at home, but just barely.

Her husband recovered from Covid-19 at home, alone but under a doctor’s supervision.

“His main symptom was a cough,” she said.

Their two adult sons took over monitoring their father’s needs, making sure he had what he needed and taking care of chores like grass-cutting and shopping. They also took calls from their parents’ health care providers when he was coughing so much it was impossible to talk.

“My oldest son, Michael, my daughter-in-law and sometimes one of my sisters would make calls for him, let him listen in on a conference call and speak when he was able to,” she said.

Home at last

Finally, after 24 days at PRMC, Donaway was back home after opting out of rehab at Anchorage. Her doctor allowed her to continue her recovery at home, with therapy and home health workers.

“George had to do a lot to help,” she said, “I couldn’t have come home if I had been alone. I still don’t have enough oxygen to get to the kitchen for a bowl of cereal.”

She had been told for every day spent in the hospital, you lose three days of strength.

“Just to get off the sofa was a struggle at first,” she said. “We sleep upstairs, and when I try to go upstairs, I don’t have the strength in my knees and hips. George helps.”

Even so, she has no regrets about going straight home.

“Recovery is just a long, hard process,” she said. “My family has been on top of it, searching the internet for information, talking with my doctor, advocating for me constantly.”

She worries about the possibility of infecting someone else.

“Right now I am hyper-vigilant,” she said. “I do not want to be responsible for someone else getting this. I don’t want anyone else to go through this the way my family and I did. It is not the flu. George is recovered but still tired. He works now but naps more. It affects you for a long time.”

A friend of Donaway’s who contracted  it before Donaway did has a heart condition as a result. Donaway is still learning what her family went through.

“One night the doctor called George and told him I was seriously ill,” she said. “My sisters had a sense it was touch-and-go for a while. I never knew it, I just knew I was laying there and couldn’t do anything. Yet I never thought ‘This is it.’ I don’t recall ever being afraid.”

Thoughts and prayers

“I don’t know what people do or where they turn if they don’t believe in something bigger than themselves,” she said. “When you are that sick, you can’t do it by yourself. I couldn’t have survived without knowing God was taking care of me.”

When she was sickest, she said she experienced something she never had before. It happened after a request for prayers on her behalf had been on Facebook.

“It was like God or an aura or something,” she said. “I could feel something that was  more than myself, moving me to where I needed to be. Whatever it was, prayer or God, when I would be try to do something, I’d just think ‘Thank you, Jesus.’ ”

Something else Donaway said people should be aware of as they recover is post-traumatic stress syndrome, or PTSD, which can strike after the trauma of being so ill.

“Pay attention to that,” she said. “When I was first home, and even before that, I would cry, not because I was sad, but just because of overwhelming emotions.”

On masks

“If you saw a loved one suffer through this illness,” she said, “you would want to wear a mask. I think they don’t realize it’s not just something you get sick with and recover in a few days.”

Donaway doesn’t want anyone to have to go through what she went through.

“First,” she said, “there’s being quarantined and isolated. George had to be home alone and sick for 14 days. My parents were in the hospital and rehab, and I was in the hospital 24 days. It’s just a horrible, lonely and difficult experience. And for me, it’s not over.”

She doesn’t understand, in light of all that, how anyone could see wearing a mask as an inconvenience.

“It’s not really about you,” she said.

And finally, she said despite having her phone and social media available, it was hard having no physical contact with anyone, and she had no strength to type anything back.

“I knew people were posting on Facebook,” she said, “and I would read some of it. I really appreciate all the thoughts and prayers, but at the time I just didn’t have the strength, dexterity or thoughts to respond. I still get tired easily. But I really appreciate those prayers and thoughts.”