He was admitted on April 11 because he was having difficulty breathing. A week later, he was in critical condition.
Culture Spotlight

‘It was like celebrating a miracle’: The day PGH discharged its first pediatric probable COVID case

Of the COVID patients in PGH, this boy’s journey with illness started years earlier—hence the joyful tears that accompanied his exit from the hospital early this week. By BAM ABELLON 
ANCX | May 16 2020

On May 11, a boy, barely four feet tall, exits through one of the swinging doors of the Philippine General Hospital (PGH) in Manila. He is on a stretcher, his upper body elevated to an almost sitting position. As health workers wheel the kid out, cheers ensue from the hallway—from people covered in full PPE. Many have tears in their eyes: doctors, nurses, a priest, and other hospital staff. There are gifts, balloons, and confetti. Clearly moved by all this, the kid rubs his eyes, and wipes his tears.

The scene was captured on video by Dr. Jonas del Rosario, spokesperson and coordinator for public affairs for PGH. It was taken the day the hospital’s first pediatric probable COVID-19 case was discharged. But Michael, not the kid’s real name, has had a far longer journey than most COVID patients here. He has been in and out of PGH since he was seven years old because of a chronic kidney disease. This illness and the various drugs that come with it are some of the reasons Michael appears like a seven-year-old child. In fact, he is already 18.

 

“He’s a very popular kid”

Michael was diagnosed with a kidney problem when he was five years old. A few years later, he started undergoing dialysis, which will be a perpetual part of his life. For convenience, the dialysis is sometimes administered at home, but there are days when the treatment is delayed for various reasons, like lack of supplies, or when the kid gets exhausted from the repetitive process and refuses treatment. The disease had already affected his heart.

Michael was discharged on May 11. His friends at the hospital cheered for him on his way to the exit.

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Michael, who belongs to a poor family, was in the PGH so often it was decided he should just study at the hospital’s school for chronically ill children.

“He’s a very popular kid,” Dr. del Rosario tells ANCX. “Sometimes, sa mga programs namin, he will sing, dance. Nakakatuwa ’tong batang ’to, very bubbly, very happy.”

On April 11, Michael was admitted again to the PGH because he was having difficulty breathing. The doctors thought the symptoms were linked to his kidney disease.

“It was nothing new to him,” Dr. del Rosario says. “Because when he is not on dialysis, fluid accumulates. When your kidneys are sick, you can’t urinate. Dialysis will remove the excess fluid. When dialysis is delayed for some reason, or not done enough, fluid accumulates. Sometimes this can affect his breathing.”

Michael (not his real name) is the first pediatric probable COVID-19 patient of the Philippine General Hospital.

So Michael underwent dialysis. But a few days later, his breathing problem worsened. It was then the doctors called for a chest X-ray where they discovered he had developed pneumonia. Pneumonia is one of the most common symptoms in patients who are COVID-19 positive. The boy was immediately moved to the PGH COVID-19 facility. He was swabbed for the Reverse transcription-polymerase chain reaction (RT-PCR) test, and the result showed he was negative. It was through his computed tomography (CT) scan results that the doctors learned he was a probable COVID-19 patient.

A week into treatment, the boy was in so much respiratory distress he had to be intubated, and connected to a ventilator. As days went by, his condition became critical.

He was transferred to a pediatric intensive care unit (ICU) where he stayed for more than 20 days. Once during that long stay, the doctors removed the tube, thinking he was getting better. But they soon found they have to put it back again.

While in quarantine and undergoing treatment, Michael continued to have dialysis three times a week. His body had to endure anti-viral medicine, antibiotics, and other medications all at once.

“You have to understand that when you are intubated and you have a COVID-19 pneumonia, there’s a chance you will not make it,” Dr. del Rosario explains. “Being intubated is a risk factor for death. It’s so hard to get them back. Everybody was praying for him.”

 

“Pulling them out of death”

It’s hardly surprising his recovery was celebrated like a miracle.

“These moments are uplifting,” Dr. del Rosario says of Michael’s recovery. “You can just imagine, this patient has so many problems. There are so many doctors who took care of the boy—nephrologist, ICU doctor, cardiologist, pulmonologist, countless nurses, technicians. It can be very tiring. Whenever we send someone off, specially those who are really critically ill, ang saya. Imagine, you were able to pull them out of death, you are able to rescue them from further deterioration. It’s like one life saved is worth all of the troubles that we encounter and experience. It’s a motivation: ‘Okay, go tayo ulit. We’re doing something right.’”

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Before he was discharged on May 11, Michael wrote a letter thanking his doctors. He even had the energy to cheer up his roommates who were younger than him. “He was telling the two kids,” says Dr. Del Rosario, “‘Don’t worry. I am your guardian angel.’”

Michael is now back home with his family. He needs to go back to PGH in a week for follow-up check-ups.