PHILADELPHIA -- Four days after he tested positive for COVID-19, Radames Plaza reluctantly told his wife to call 911 because he couldn't catch his breath.
As he was loaded into the ambulance, gasping for air, Plaza was struck by how familiar -- and how foreign -- the situation felt. He had spent 22 years as an emergency medical technician, but never wore the kind of head-to-toe protective gear these paramedics used. He realized that he was hazardous material.
It was April 9, and the pandemic was roaring through New Jersey. Plaza, 53, was promptly admitted to the intensive-care unit at Virtua Memorial Hospital in Mount Holly and placed on oxygen therapy. All 30 beds in the ICU and an annex were full of COVID-19 patients on that Thursday night, weeks before case numbers would peak at the hospital.
Plaza now remembers only pieces of his 15-day ordeal, most of it spent on life support. His wife, Judy, frantic at home in Lumberton, couldn't see her husband because of the pandemic. For almost a week, she couldn't even speak to him because he was sedated on a ventilator. She got daily phone calls from the health team, often Emilio Mazza, the pulmonologist and critical-care specialist who led her husband's care. The updates sometimes relieved -- or sometimes reinforced -- her sense of helplessness, as her husband of 23 years seesawed between healing and the being on the brink of death.
Today, their story illustrates one of the few heartening aspects of the pandemic. Around the world, health-care professionals have been learning, and sharing right away -- even on social media -- their discoveries in managing a ferocious, brand-new disease with no proven therapies and no predictable course.
Plaza got sick early in that learning curve.
"We had no science at that point," Mazza said. "It was -- I don't want to say guesses -- but educated thought processes."
Plaza's blood oxygen was so low when he got to Virtua that Mazza and his team set the oxygen therapy tank to release the gas at nine liters a minute -- three times more than usual for respiratory distress.
In COVID-19 hotspots around the world, doctors had been putting patients on mechanical ventilators as soon as they needed six liters of oxygen a minute. The reasoning was sound: Don't wait for a dire emergency that will leave the medical team without enough time to don protective gear before placing a tube down the patient's throat, a procedure that releases virus-laden droplets into the air.
"You don't want mayhem with these patients," Mazza said.