From diagnosis to hospitalization: A Glen Ellen man’s COVID journey

Twelve days ago, Glen Ellen physician Jerrold Kram tested positive for COVID-19. He and his wife Lily Hu, who believes she is also suffering from the disease, had been recuperating at their Glen Ellen home and hoping the worst had passed. But yesterday, Kram took a turn for the worse and was placed on a ventilator in isolation in the intensive care unit at a Santa Rosa hospital. The couple walked the Index-Tribune through his journey.

Kram, 74, is a critical care and pulmonary specialist who also treats sleep disorders out of the California Center for Sleep Disorders in Alameda and the greater East Bay.

On March 16, he woke up with a light fever, body aches and a headache and thought he had the flu.

The next morning, he got up feeling better, but when the same symptoms resumed Tuesday afternoon, he and Hu, 64, thought it would be a good idea to request a COVID-19 test, especially since Kram cares for patients on ventilators at several Bay Area nursing homes.

They started with their family doctor, who directed them to the Sonoma County Public Health department. A public health nurse told Kram to go to Sutter Hospital in Santa Rosa as soon as possible. Less than half an hour later, a nurse was waiting for him to do intake in a tent. She gave Kram a chest X-ray, flu and blood tests and the coronavirus test.

“We were so impressed with those first responders and can’t thank them enough,” said Hu, noting that Kram’s testing was expedited because doctors go to the front of the line for tests.

Within 24 hours, a public health nurse called to confirm that Kram had tested positive for COVID-19. The county followed up with a call to document a “thorough” history of Kram’s recent movements and points of contact.

Hu posted on Facebook on March 19 that Kram was “feeling fine, we are keeping our fingers crossed and hope for the best.” She decided not to get tested.

“I didn’t think it was worth wasting a test on me, since I live with him and I just assume I have it as I have similar symptoms, just milder,” she said.

On March 20, Hu sent an update to family and friends and were overwhelmed by words of encouragement, kindness, love and offers to help. The couple have been married for 12 years, and split their time between Glen Ellen, where they have been recuperating, and an apartment in Oakland.

The couple is well known at Sonoma Golf Club and dozens of local friends are following their updates on Facebook.

The couple’s closest friend, Glen Ellen neighbor Bridget Duffy, who is also an MD, was on the phone with Lily when Jerry got the call that his test had come back positive. Duffy said his diagnosis was “like a dagger” to her heart.

“I was devastated both as a friend and as a doctor,” she said. “When one of your own goes down, it hits really close to home.”

After learning of the diagnosis, Hu and Kram began passing the days sleeping, staying in separate rooms and drinking lots of liquids.

“It’s boring as heck, but better than the alternative,” said Hu. “Jerry has no appetite and I stress eat.”

By March 21, Kram’s fever had receded and he seemed to be on the mend.

“As of this morning, we are pretty sure we will not die from COVID-19,” Hu wrote in an update to friends. “We are feeling more human.”

But Kram took a downturn on March 22. Both she and Kram felt exhausted and Hu woke up with chest congestion.

“Someone described this journey as like a wave,” said Hu. “I’m not quite so poetic but some days are, in fact, worse than others.”

Kram had a bad day again on March 23.

His fever spiked to 102 with really bad chills but he took Tylenol and felt better. With cough syrup he was able to have an uneventful night. He had a light breakfast and went back to sleep. He also started daily doses of hydroxy-chloroquine and Zithromax.

“We are keeping our fingers crossed and hope for the best,” reported Hu.

On March 24, Hu posted that Kram was not improving and she was getting “officially worried.”

Every few hours, Kram took his temperature and used a simple at-home finger test to monitor his oxygen level. His oxygen level was down to 90, his coughing was relentless and all he wanted to do was sleep.

“We talked about going to the hospital, and we agreed that he will not be the hero when the time comes,” wrote Hu.

Hu was coughing more; she said she had congestion but no fever. When awake, Kram passes the time by watching the news on TV. “When I can’t stand it any longer, I’ll change the channel to HGTV,” said Hu.

On March 25, Hu posted that Kram was not getting better but also not getting worse.

“I’m thinking to myself, we can do this,” said Hu. The first couple of days were fine but by the fourth and fifth day, he got progressively, exponentially worse.”

“Please, please, stay safe everyone,” wrote Hu. “This (crap) is truly nasty.”

Kram said his symptoms include shortness of breath, difficulty talking and violent coughing. He has also been pretty foggy and confused at times. The couple tried drinking lots of tea, having been told that hot liquid is better than cold.

When asked how these symptoms compare to the flu, Kram said that he has never felt worse in his life.

“He’s a real healthy guy,” said Hu, adding that her husband works out regularly with a trainer, plays golf and eats healthy.

“We’re no spring chickens, but we feel younger than our age and we’re healthy, but he really got hit over the head with this.”

Hu and Kram have talked at length about exactly the point at which he would need to go to a hospital for help breathing, but he was not at that point yet.

“With my pulmonary training, I’m well-aware of what it feels like not to be able to breathe and it is truly unpleasant to be on this end of it,” he said.

His advice to the community: “Stay home! Take this seriously and don’t be cavalier about it. We’ll only get through this if we all work together.”

Neither Kram nor Hu had left the house in 11 days. When asked what they were doing about food and groceries, Hu laughed and said: “I am Chinese. I have so much food in the house we couldn’t possibly get through it all.”

This week has been a series of ups and downs, Kram said. One day he was feeling better and the next, much worse.

Hu sent a note to friends saying that she was no longer scared.

“We think he’s turned the corner and are quite sure he’ll beat this,” she wrote. But within hours of that optimistic post, Kram’s fever spiked to 102.1.

On March 27, when Hu spoke to the Index-Tribune, Kram had been awake for about an hour and then went back to bed, exhausted, tired and short of breath. He was now 10 days in.

When reached by phone on Friday, Kram said he wasn’t convinced that the worst was over. Twenty four hours later, Hu emailed the Index-Tribune from the parking lot at a Santa Rosa hospital. Kram’s fever was over 101 and he was having a hard time breathing. By Sunday morning, he had been intubated and told he would be sedated, and wakened just once a day. Hu is at home, getting updates from her husband’s critical care doctor.

His last message to friends before being sedated was, “I love you all so much. Talk to you on the other side [of this.]”

Bridget Duffy said that if anyone can beat COVID, it should be Kram.

“Jerry has a huge heart and always looks on the bright side of everything,” she said. “His will to live is tremendous.”

Kram has no idea how he might have contracted COVID-19. The couple returned from a trip to Florida on March 3, and he was busy that week seeing patients. He has seven offices across the Bay Area and also sees patients in Bay Area nursing homes.

Kram believes he was one of Sonoma’s County’s first confirmed cases of community spread of the novel coronavirus.

Of the 903 tests for COVID-19 conducted in Sonoma County by March 27, 5 percent have come back positive.

On March 29, there were 58 cases of COVID-19 confirmed in Sonoma County.

Email Lorna at lorna.sheridan@sonomanews.com.