Starset Society

TSS EXCLUSIVE: STEM Q&A with Dr. John Wheeler – Dispatch from the frontlines of the battle against COVID-19

by Karma Lei Angelo

I had a unique opportunity to interview Dr. John Wheeler, a primary care physician in New Hampshire, and his family about COVID-19–something that also hit close to home for them. Dr. Wheeler was one of the first doctors in the state to see a COVID-19 patient in March. Weeks later, he contracted the virus himself. I was also able to get perspectives from his wife (a nurse by trade) and his three sons (as a middle schooler, high schooler, and college student).

Hi, Dr. Wheeler. Please tell us a little about what you do. 

I’m a primary care physician for a family practice in southern New Hampshire. Basically, I provide care for all ages from cradle to grave. I also serve as Medical Director and Physician at two nursing homes and a hospice agency. 

You were one of the first doctors in the State of New Hampshire to have a COVID-19 patient. What can you tell us about that experience?

I was exposed to one of the first five patients here in New Hampshire. This was back at the beginning of March, the first week. At the time, we didn’t know a lot about the virus. When we knew the patient was likely positive, I was told by the State to self quarantine. I had to stay home for two weeks from the day of the exposure. I didn’t show any symptoms, didn’t have to take a test unless I showed symptoms. That was my first direct exposure. 

And all was well for weeks after until my exposure on Good Friday [April 10] with another patient. I actually came down sick with COVID-19. I would consider myself an expert at it by now. 

What was it like to be sick with this virus?

Had it about three weeks ago and it’s unlike anything I’ve ever experienced. I had two rounds of it. I was sick for several days, started feeling better, and thought I was over it. Then I was sick a little longer.

During the first round every bone and muscle ached. I lost my sense of taste and smell. That was one of the initial symptoms. Had this weird Pine-Sol smell that was constant. Wouldn’t go away. Everything smelled like Pine-Sol. I had a low grade fever, chills, and body aches. I would wake up drenched from the fever. Almost like getting out of the shower, just soaking in sweat. Had headaches, felt light-headed. That lasted about four days. Then I had a reprieve for like a day. I went back to work. 

Then Round Two started. I had shortness of breath, diarrhea, and the body aches. That lasted another four to five days. Touch was awful, though. The lightest touch would hurt, the hypersensitivity was shocking. And I could not get comfortable. I could not sleep. When I did, I was having vivid dreams. My O2 status–my oxygen level–was 91% at rest and would drop down to 86% with any exertion. I would recover back into the nineties because I’m healthy. The fever finally broke on Day 9. The rest of the symptoms slowly abated. Grand total of me being sick was twelve days. 

This past Monday [April 27], I started developing this terrible itch. It lasted from Monday through Thursday. Didn’t have the rash, just the itch. My dermatologist thought it was part of the virus. There have been at least seven rashes related to this virus. The most common one is chilblains. That’s what they are seeing in kids who get the coronavirus. Their fingers and toes turn a bluish-red hue. 

How are things now that you’re recovering?

Sleep is still an issue. My appetite is back, but that took a long time to come back. I’m still fatigued. I lost ten pounds. I’m back to running again. I was able to run one mile, but typically I run about five miles. I’m not 100% back yet. The hospital has tested me a few times. I tested positive three times last week [Week of April 27]. Finally tested negative today [May 3]. I will get tested again tomorrow. And if I test negative tomorrow, I can start seeing patients again. 

How did this affect you mentally?

There is definitely a psychological component to this. Not mental, but you just…more irritable, more on edge. I don’t know if it’s because of fear or I don’t feel mentally all there. I’m not depressed, but there is something there…It definitely affects you mentally. In fact, there was a woman, a doctor, in New York who killed herself. I mean, it’s in my facility, my nursing homes I work in. Every single person tested positive. I had twelve people die in the last two weeks. It will probably knock out a few thousand people. This is way beyond the flu and we don’t really know much about it..It’s very isolating, even for my wife. But I’d be curious to see how the psychological aspect of all this plays out. 

How has your family addressed your exposure? How have they felt the last couple of months? 

My wife is a nurse by trade so this stuff doesn’t scare her. She knows all the precautions, and you still don’t want to get it. She would come in to bring me food and medicine and wouldn’t stay in for more than three minutes. She had a special hook in the washroom where she would hang her face mask and throw it in the wash every other day. She’d wash her hands, wipe down the surfaces and doorknobs, wash the sheets. She came up and sprayed disinfectant. She was OCD about wiping down all the handles. I didn’t come out of that [bed]room. The only time I came out was to drive down to the hospital to get tested. But I didn’t touch anything in the house. Grabbed my keys, opened the door with a paper towel, threw that in the trash can outside. And when I came back home, I didn’t touch anything. I wore a mask as I walked through the house. 

I think my sons are fearful about my health and my risk of getting it, especially my oldest. They have not been tested for the virus, but they also haven’t shown any symptoms. But they will be tested for antibodies. They haven’t gone anywhere. They self-isolated and stayed away. If they were exposed and were asymptomatic, they would pass it on to others, but they have been responsible enough to stay home. 

How have your sons been doing with remote learning? 

I think they all have done really well. My oldest is in college and he locks himself in the basement. My youngest has been a little rebellious. But they have adapted rather well. However, after being home the last three weeks–and I’m never home–I’d go crazy. They are just stuck here. You can only shoot so many hoops, go on so many bike rides. I think it’s really challenging for them at times. Yeah, they can see their friends on Zoom and Google Classroom, but that physical and social connection is gone. 

How has your practice changed since having patients who tested positive for COVID-19?

The office is a very sterile site now. All the pictures, the wooden visitor chairs–gone. There are no more magazines, no brochures anywhere. The rooms are just bare as can be. There are two greeters at the door now. They have the chairs in the waiting room set up. They call the patients back and don’t allow anyone to go with them. When you go into the examination room, if you have to have someone, then the staff will let them. But otherwise, they can’t come in. 

How can local hospital networks and local/state government officials better prepare for a future pandemic?

We have to make sure we have access to testing. And, more importantly, to PPEs. We have to have access to that. I do think that now that we have experienced a pandemic once, we will know how to squash it in the future. We definitely need more preparatory access to equipment. And we need an emergency plan as a society. 

Any advice for people who have difficulty social distancing for work or family reasons?

From someone who’s had it? As difficult as it is, it is imperative not just to prevent you from getting it, but to prevent you from getting it and transmitting it to populations at high risk. I got it. I was sick as a dog. I got over it. Someone in a nursing home–their chances are not good. The advice I’d give: you gotta make it work. 

We are starting to see states reopen and we’ve seen protests pop up across the country. What do you predict or foresee happening if we reduce social distancing and quarantining too soon before the country is safely on the downslope of the pandemic curve?

You are going to see a spike. Without a doubt, you are going to. It’s inevitable. But I also understand we have to at least open the world again. I don’t think this is going away. We have to learn to adapt. We have to develop a new norm. We have to open the world again, but we have to do it in a controlled and safe way. I think [New Hampshire Governor, Chris] Sununu has done a great job. He’s doing it in a really gradual way. You can’t just open it up all of a sudden like other states. We never really had a surge here. We are dispersed, not densely populated. 

Is “herd immunity” a realistic scenario with COVID-19?

Well, they tried doing it in Sweden, but you hear mixed things. But from what I understand, it doesn’t work. It could work in a small country, but not like the United States that’s so spread out. We might find out if it does work in the future. Who knows? There needs to be more data and studies on herd immunity and whether it’s valid. 

What are your thoughts on the use of facemasks–of any kind–in public? Do thin facemasks help, even minimally? Or are they just a good deterrent from touching your face?

I think they do work, even the thin ones to a degree. I think right now, there is no harm in wearing a mask and we should be wearing them in public. It will help minimize exposure. But people who drive around in their cars with masks on are weird. 

There is heated debate on prophylactic treatment with azithromycin and hydroxychloroquine. In your opinion, if you could, what are your thoughts on this type of treatment? What preventative measures would you recommend for most patients?

They’ve shown studies on how hydroxychloroquine doesn’t likely work, but I’ve seen some patients who were given hydroxychloroquine and azithromycin. There has been debate if it’s effective and safe and there’s been some anecdotal debate if azithromycin is effective. There is a new antiviral drug being tested, but I can’t remember the name of it. Ultimately, we need a vaccine. All these medicines are just there to treat it. It’s like Tamiflu. It shortens the course of the virus, but it doesn’t kill it. 

With mutations likely, do you think this pandemic could get worse before it gets better? 

It could. That’s what they are saying. 

Do you recommend everyone get tested for antibodies? 

I’m going to get tested for antibodies and I think everyone should get tested. It will give you a better idea of how many people were exposed to it and had it–especially those who never showed no symptoms. 

I had the opportunity to sit down with the rest of the family and hear their thoughts on the pandemic, what they witnessed firsthand, and how they felt during the quarantine. 

Twelve-year old son (in middle school): 

I’ve been amazing. I’ve shown no symptoms whatsoever. Can I tell a story? So my dad showed symptoms and tested positive. I stayed away as far as I could. I wore a mask when I saw my dad. I was playing Xbox with my friend and told my friend that my dad had the coronavirus. And when we were playing, I invited him to play basketball at my house. He said, “I thought your dad had it.” And I told him it took like eleven days for him to recover from it. And now everyone thinks me and my brothers have the coronavirus, but it’s been more than two weeks. We don’t have any symptoms. I think people are just a little too crazy and need to calm down and it will be okay. And that’s it. 

Sixteen-year old son (in high school):

I’m a little pissed off right now. You have to tell people you are exposed. The school work is a lot easier because I feel I learn better this way online. My grades have improved. I excel with a tutor with one-on-one help. I’ve been hanging out with only one kid until my dad had the coronavirus. That was the only kid who knew. The social isolation is needed, but I don’t love it. We wish it wasn’t in place. But it has to be. I saw my dad every day and had to use a mask just to look in the door. I understand the reasons. We should stay home, we have to stay home. That’s why I’ve kept my distance. 

Nineteen-year old son (in college):

I don’t want to say anything negative. I’m a little annoyed. It’s been a month. I don’t have it, I wear a mask, I’m not sick. I haven’t gone near my friends. I was exposed three weeks ago and I warned my friends. Didn’t see them for two weeks. If I was asymptomatic, I’d be past that right now. I hope I can see my friends soon. I was scared at first, and I had to tell my friends. I know what’s going on with it. I also know I’ve gone past the “catching it” phase. I haven’t hung out with anyone. 

Christie, John’s wife and a nurse by trade: 

From what I witnessed, it’s kinda like the flu, but not the flu. And it’s super contagious. The second John said his patient was positive, we masked up. Odds are we are in the age group we will be fine, but we just don’t know. Everytime I came out of the bedroom, I washed my hands. I took his empty plate and put it straight into the dishwasher. I’d use my foot to open the dishwasher door and put the dishes straight in without touching anything. Then I’d wash my hands. Tried to touch the least amount of stuff. Sanitized everything I touched. Zinc and Vitamin D are helpful, they say, so we made sure John took vitamins. We all took Vitamin C and I was loading up on elderberry. 

It’s unsettling, just the whole thing is unsettling…At first, I kept thinking “Did we expose our friends? What about our son’s tutor? We had seen our friends on Easter, so did I just expose them as well?” Everyone was six feet away, but in my mind, I’m wondering if I exposed them. Time kept passing and no one has been sick. John’s been out of quarantine for over a week now. And we are fully released, technically. The chances are we would have already had it by now. By this point, we would still be shedding dead virus cells and there would not be a high risk of transferring it to anyone. I did read about the virus spreading to pets. So I kept my dog out of the room with John as a safety measure. It’s just unsettling… 

I mean, I feel like I’m the typical mom: I’m the captain of this ship, and if the ship goes down, we all sink. You have to soldier through it. I was trying to stay positive. When I used the pulse-oximeter on John and saw that he was 92% laying in bed, it was concerning. The normal range is between 95-100%. And, he didn’t tell me in the middle of the night when it dropped into the 80s so that I could go sit with him. We are generally laid back, and I didn’t want to scare the kids. I kept everything in, didn’t want to panic. You don’t want to add to the pandemonium of everything happening around you. At least with me, I was definitely worried, but hopeful and positive.

 

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