RICHMOND — Two weeks ago, Lucy Fox thought her father was going to die.
Carter Fox, 80, was on a ventilator and couldn’t talk. The coronavirus sent his oxygen levels plummeting. Medical staff ordered the family out of the hospital to avoid spreading the disease, which has claimed nearly 38,000 lives as of Tuesday morning, according to Johns Hopkins University research.
They couldn’t see him or talk to him or hold his hand and tell him they loved him. They scribbled their goodbyes and hand-delivered them to the hospital, praying their notes would find their way to their dad’s bedside.
“Please know that you are not alone. We are with you.”
“I don’t want to say what comes next… Be strong. Rest. Breathe. Sleep. I love you. We love you.”
“It was totally terrifying for those first 24 hours,” Lucy, 52, said. “Nobody knew what was going to happen. The doctors told us that he was in the highest risk group possible. We thought it was a death sentence.”
On Monday, March 16, their dad became the first patient to test positive for coronavirus at VCU Medical Center.
His health was failing fast and nobody knew what to expect.
Just one day earlier, Lucy and her siblings, Baylor, 47 and Faulkner, 56, were asking their parents for updates in a group text as Carter waited for test results at the hospital. It was March 15 and they weren’t even thinking about the coronavirus.
All they knew was that their parents had just returned to Richmond from Florida, where they typically spend their winters. Hospitals were expected to fill up there. The state now has almost 5,000 confirmed coronavirus cases. Their parents’ doctor advised them to return to home.
“My parents follow rules down to the letter,” Lucy said. Carter was the CEO of paper manufacturer Chesapeake Corp. from 1980 to 1997 and is known for his sound judgment and care for others.“If somebody would have told them, don’t cross state lines because you could spread it, they wouldn’t have.”
The couple hopped an Allegiant Airlines flight back to Richmond.
They went to dinner at a friend’s house and saw the political-satire group The Capitol Steps at Westminster Canterbury in Henrico County, where they are longtime residents. Carter felt weak.
This was before the calls for social distancing, before the alarm bells were ringing that anyone who traveled out of state should quarantine themselves for 14 days.
Still, the virus had shown what it could do — especially to seniors. It was raging by early March at a long-term care facility in Washington state, where it had infected 81 residents and killed 23 by mid-month, according to the Centers for Disease Control and Prevention.
That was across the country and far from their minds when the couple went to the doctor March 12 about Carter’s persistent weakness. He had no fever, no cough, no shortness of breath. Carter had been dealing with Parkinson’s disease for years, but otherwise he was fit and able.
The next day, they went to get blood work done and Carter fell in the middle of the lobby. That was a sign, Carol said, that something was very wrong.
She rushed her husband to the in-house healthcare facility at Westminster, which was going into lockdown due to the coronavirus. One week after they had returned from Florida, the nurse called to report that he had taken another bad fall. He couldn’t get up and he couldn’t stand.
“I said, ‘We’re going to the hospital,’” Carol decided.
At VCU Medical Center, doctors and nurses were rushing in and out of their emergency room in gowns and masks, constantly taking his temperature and checking his oxygen levels.
“Dad said, ‘I think they think I have the coronavirus. There are all these doctors here,’” Lucy said.
She thought he was joking. “Of course you don’t have it,” she texted back.
But he was deteriorating quickly. The doctors scanned his lumbar and his head, for the fall, and took an X-ray of his lungs.
By evening, his oxygen levels still weren’t up. The X-ray revealed he had pneumonia in his lungs. The doctors hurried him up the Intensive Care Unit where Carter and his wife were isolated from everyone else on the floor.
“They made me put on the protective gown and a mask,” Carol said. “It looked like a raincoat.”
Carter was tested for the coronavirus around midnight. At 4 a.m., the doctor came into the room, looking pained. Carter’s test results still weren’t back, but the doctor didn’t like how low Carter’s oxygen levels were.
“The doctor said he wanted to get him on a ventilator right now, to get ahead of this thing, before it became an emergency,” Carol said.
Hospitals in New York, Italy and elsewhere have faced shortages of the machines, which help keep people breathing, as the number of infections surges past capacity. Virginia has more than 8.5 million people and 2,000 ventilators on hand, according to the Virginia COVID-19 Unified Command Joint Information Center.
Before Carol could process what was happening, the hospital told her to pack Carter’s things and leave.
Cell phone, wallet, clothes. She had to warn Westminster, which had been on lockdown since March 11, when someone had tested positive dozens of miles away. She had to call the kids.
“You need to come now,” she told them. “Something is really wrong with your dad.”
Faulkner was in quarantine after returning home from overseas. Lucy drove up from North Carolina. Baylor rushed down from Rhode Island.
By the time they arrived, they couldn’t see their father at VCU or their mother, who was now in quarantine at Westminster Canterbury.
All they could do was wait and wonder whether their dad was still alive, unable to see him or hold his hand; or comfort one other.
All they could do was stand six feet apart and wait.
“Fifteen hours came and went. We heard on the news that there was one confirmed [coronavirus] case in Richmond being treated at MCV. We were like, ‘That can’t be Dad.’ But it was,” Lucy said.
On Tuesday morning, March 17, Carol received confirmation: Carter had tested positive. He was on a ventilator, heavily sedated, at high risk for mortality.
A doctor friend of Faulkner’s said that at best, their dad had a 10% chance of survival.
“Nothing was normal. That’s what stands out about the coronavirus,” Lucy said. “Normally, when your elderly parent goes to the hospital, you go there too. You wait, you ask the doctor what’s happening.”
The Fox children made contact with Susan Richards, a nurse manager, who helped put them in touch with their dad’s nurses: Morgan, Kate, Erin, Mykala, Reed and Elizabeth.
“They were so incredible,” Lucy said. “We started faxing letters to the ICU and they read them to Dad. Then they papered the walls with them. They took such good care of him. Risking their own personal health.”
The nurses said that the breathing tube was uncomfortable and making their dad agitated. Carter’s grandsons sent jazz standards that the nurses played for him.
“Who has time for this? We’re in a pandemic. It was the kindest sweetest thing,” Lucy said, her voice thick with tears.
Meanwhile, Carol was working with the CDC and the VDH to retrace their steps. Everybody they had come into contact with had to go into a 14-day quarantine. Unfortunately, that meant all 288 people who had gone to the performing arts center to see The Capitol Steps. 48 Westminster staff members also had to go into quarantine.
Staff put notices under all residents’ doors notifying them that a resident had tested positive and not to come out. All meals would be delivered to Westminster’s 870 residents going forward.
“One sweet person called me and said, ‘Don’t feel guilty.’ But of course, I felt guilty,” Carol said.
Baylor returned to Rhode Island where he teaches oceanography and climate modeling at Brown University. Even with all of the strain, the family retained a sense of humor about what was happening to them.
“It was like being in a crazy sci-fi movie,” Lucy said.
Her brother decided to bring his mother’s dog, a Havanese, back with him since his mother was on lockdown. The dog was handed off by a Westminster staff member in a HAZMAT suit. Baylor was so worried about contamination, he doused the dog with hydrogen peroxide in the parking lot.
“I was worried I was going to bleach him,” Baylor said.
But he had a family at home: a wife and two teenage sons and he didn’t want to infect them. When he returned to Rhode Island, he quarantined himself in one room of the house for a week.
Finally, after almost a week in the ICU, their dad turned a corner.
His oxygen levels were up. He was taken off the ventilator. He could breath. He had a video conference with the family on Zoom.
“MCV saved my dad’s life,” Lucy said.
Carol said that she never doubted for a minute that her husband would pull through. “I knew he was getting such good care,” she said.
Her children never told her their terrible concerns. “Hope until the very last minute seemed like a good thing,” said Lucy, who is a social worker.
On Friday, March 27, almost two weeks after checking into the hospital, Carter was transported from VCU Medical Center to the 24-hour health care facility at Westminster.
“He’s a little disoriented,” Carol said. “This was a major, major illness. It’s going to take a long time to recover.”
The Fox family reached out to the Richmond Times-Dispatch to share their story. While Carter’s health continues to improve, he was unable to participate in an interview.
“My main takeaway is that the health care system is great if you can get access to it,” said Baylor. “We were lucky to have this happen early on so that the hospital had the capacity to handle this.”
Middle-of-the-road projections assume that 40% of the U.S. population will become infected with the coronavirus over the next six months and that hospital emergency rooms and critical care units will be overwhelmed according to Dr. Ashish Jha, director of the Harvard Global Health Institute.
Peak severity here will occur May 17, according to University of Washington projections. On that day, analysts predict Virginia will have 329 intensive care beds available and need 223 more. The research indicates more than 2,000 infected people will have died in Virginia by Aug. 4.
“Speaking with my scientist hat on, this makes it clear to me that we need to make sure we don’t overwhelm the health care system. It made me much more determined to stay home and isolate from my family,” Baylor said. “Save the hospital beds for the people who really need it. It means trying to stay distant, so that everyone will have as good care as he had.”
Carol doesn’t know when she’ll be able to see her husband again. First, he has to have two successful negative tests. But she can wait, she said. She’s just so happy to have her husband back on the Westminster premises, a few feet from her door.
“We’ve been married for 57 years. In all that time, we’ve never slept apart,” she said.
She ordered a new mattress that’s lower to the floor to make it easier for him to get in and out.
“It’s all ready for him.”