USF Nurse Educator Helps Husband Survive COVID-19

When Susan M. Perry, PhD, CRNA, ARNP, FAAN, served as an infection control officer in the U.S. Air Force in the 1990s, she never predicted that the skills she was honing three decades ago would one day save her husband and herself during the COVID-19 pandemic of 2020.

A vice dean at the USF Health College of Nursing and a retired U.S. Air Force colonel, Dr. Perry had been well trained in the prevention and management of infectious disease. So, on the morning of Friday, March 13, when her husband Tony complained of a backache, sore throat, and dry cough, she took those symptoms seriously. Seeing that his temperature was just over 100 degrees Fahrenheit, she immediately took him to the emergency room at The Villages, where the couple lives, north of Tampa, Florida.

Detecting the Virus

Her actions in the days and weeks since proved to be lifesaving as he would be fighting the novel coronavirus over the next two weeks.

Although her husband’s tests for flu and pneumonia came back negative and he was cleared to go home, Dr. Perry persisted. She requested for him to be tested for COVID-19. The Perrys had traveled to the Northeast the week prior, and she didn’t want to take any chances. The medical staff gave her the testing order but explained that there were no test kits in their county.

Dr. Perry contacted Dr. Allison Hull, their primary care physician, who could see her husband the following Monday. By that time, his fever exceeded 101 F, he was having trouble taking a deep breath, and he had a severe headache. He was tested for COVID-19, but results would take several days.

By Wednesday, March 18, “His temperature was approaching 103 F but was coming down to about 99 F with Tylenol,” Dr. Perry said. “I took him back to the emergency department, because that morning when I listened to his lungs, I could not hear breath sounds clearly in one of his bases. I also heard some crackles throughout the other lobes. The emergency department staff performed a two-view chest X-ray and diagnosed him with right lower lobe pneumonia. His saturations were around 95 percent. But he still did not meet the criteria to be hospitalized. He was placed on antibiotics, and I was told to take him home and continue to closely observe him.”

Two days later, on Friday, March 20, the Perrys had another appointment with Dr. Hull, who determined his situation had worsened. She provided a prescription for different antibiotics, as well as azithromycin and chloroquine, in case his COVID-19 test came back positive. As they drove home that day, they received a call from Leesburg Memorial Hospital stating that based on his symptoms he was at high risk for COVID-19 and that he should be brought to the hospital if he was having increased difficulty breathing.

“The next morning, Saturday the 21st, his temperature was 104 F and he was unable to talk to me without coughing,” Dr. Perry said. “The pulse oximeter revealed that his oxygen saturation was 88 percent. At that point I gave him Tylenol, and an albuterol inhaler treatment, and took him to the hospital emergency department, where he was admitted. His COVID-19 test did not come back until the day after his admission, and it showed that he was positive.”

Preparing for the Worst-Case Scenario

When Dr. Perry first entered the Air Force and the nursing profession, it was the late 1980s when HIV/AIDS was a major concern and blood-borne pathogen management was critical. Starting in 1992, she served for three years as an infection control officer for a hospital and for the Air Force Academy.

“Fortunately, I received very high-level training on how to protect myself and train others to protect themselves from outbreaks. From the moment I heard there was a positive patient in Washington State, I started practicing social distancing. During our travels the weekend before my husband became ill, I wore masks and gloves from the time I got out of the parking lot at the airport until I got to my daughter’s house in Massachusetts. I washed my hands every couple of hours, when I went to the restroom, and every time I walked past the bathroom. Many people looked at me like I was crazy, but I knew that if what happened in China and Italy was indication, this country was only weeks away from the same outcome.”

Even before her husband had symptoms, Dr. Perry was careful at work—sitting more than six feet away from others at meetings and disinfecting her office space before and after anyone entered it. She became even more vigilant when he developed a fever.

“The moment my husband told me that he was not feeling well, we isolated from each other. This meant that we had separate bedrooms, separate bathrooms. We did not eat together, and his meals were taken in on disposable dishes and flatware, using a tray that I could disinfect when I brought it out of his room,” Dr. Perry said. “I was never close to him without both of us wearing masks and my wearing gloves. When I transported him to and from medical appointments, he sat in the backseat of the car, in the opposite corner, wearing a mask and I was in the front seat wearing a mask and gloves. After each contact with him, I would take off my gloves and wash my hands for 20 seconds or more. It was very difficult, but I realized the importance of protecting myself and others who were coming in contact with him.”

Precautions Everyone Can Take

The Centers for Disease Control and Prevention has a comprehensive list of ways to prevent the spread of COVID-19, but Dr. Perry has additional observations regarding everyday ways to be protected:

• Think about everything you touch. For instance, if you take out your ID at an airport, hand it to someone, put it back in your wallet, and then do the same at a supermarket, you may have just spread the virus from person to person. Wear gloves, and take extra care to wipe down every credit card, ID, etc., each time to you touch it.
• Wipe down every item you bring into your home. When returning from the supermarket, if you can, keep canned or packaged goods in the garage for a few days before bringing them into your pantry.
• For items that need to be refrigerated, throw out any packaging and wash the items with soap and water. Then store in Tupperware or Pyrex before placing them in your refrigerator.
• If you receive a delivery, leave the box outside. Remove the items while you are outside, bring the items in your home, and break down the boxes a few days later.
• When you go to the supermarket or anywhere else outside the home, wear a mask and gloves. Then wash your hands as soon as you return. If you don’t have a mask, use a scarf or bandanna. The purpose of the mask is to keep you from touching your face. “This may sound crazy,” Dr. Perry said, “but you’re not going to get that virus into your nose, mouth or eyes if you realize that there’s something covering them.”
• Stay six feet away from others. This is droplet precaution. If you are six feet away, droplets will not enter your airways. However, they can live on surfaces for various lengths of time.
• If anyone has touched a surface, wash it with a diluted bleach solution or soap and water. It’s important to leave the area wet for a while before you dry it.
• If you are healthy, stay active. Go for a walk or a bike ride. Just remember the six-foot rule.
• If you have a loved one who is hospitalized or in isolation, try to stay calm and take care of yourself. Stay off social media and limit the amount of news you watch. Read, take a walk, meditate. It is important to focus on your own self-care.
• An important note about fevers: For a fever higher than 101 F, use Tylenol to treat it. (For adults, a fever lower than 101 F can go untreated, as the body fights the infection.) You can also try a warm bath or shower. But if the patient has chills, do not use extra blankets. That can make the fever worse.

Turning the Corner

Tony Perry, age 67, was released from Leesburg Memorial Hospital on Sunday, March 29, and seems to be making a remarkable recovery. He had fortunately always been in good health, and this was his first hospitalization of his life. He was placed on experiment drugs (azithromycin and chloroquine), and those seemed to have an effect. He will likely require rehabilitation for the damage to his lungs, as well as time to get his strength back.

“He tells me that the secret to his recovery was the close attention we paid to his symptoms, engaging with the health care providers as soon as we did and as often as we did, and his understanding that while in the hospital, he needed to relax, meditate, pray, and let his body heal,” Dr. Perry said. “He avoided watching television. He concentrated on his mind healing his body. He seems to be in an extreme level of internal peace about his whole experience.”

Dr. Perry and the rest of her family have been tested for COVID-19 and those results have come back negative. She and her husband will be quarantined for 14 days as a precaution.

She is grateful for the support she received from her colleagues at the USF Health College of Nursing, and she has nothing but praise for the medical professionals she and her husband encountered at The Villages, Leesburg Memorial Hospital, and Dr. Hull’s office. “Everyone acted very professionally,” Dr. Perry said. “He was treated with respect, I was treated with respect and empathy, and everyone appeared to be calm and focused on taking care of him.”

– USF College of Nursing