Breakthrough Covid in Seniors: The Threat Nobody is Talking About
From Breakthrough to Breakdown: The Unprecedented Covid-Induced Threat for Seniors 65 and Up
After getting two Pfizer shots and a booster, you can imagine my surprise when two weeks later I experienced breakthrough Covid in seniors for myself. I had assumed that with a full load of the vaccine on board, that it was highly unlikely I would get Covid. That turned out to be a false and dangerous assumption. I contracted Covid two weeks after getting my booster, and here’s the story of how I think it happened.
I traveled to Colorado to put on an annual retreat for women. I was a bit concerned when I hit the Burbank terminal to fly to Denver. It was jammed packed, the flight was oversold and we were shoulder to shoulder on the plane. It certainly seemed like a likely place to contract breakthrough Covid in seniors! After landing in Denver on a hot September day, I found a mini-disaster at the car rental place next to the airport. There were at least 100 people in a long line snaking outside the building. Many of the customers were not wearing masks defiantly. Two and a half hours later I finally had a car. There was not enough clerical help or cars that day. When I finally got to the front desk, I asked if this was just a bad day here? The clerk said, “Oh no. It’s like this every day.” As I left my thought was, here is another example of how Covid has broken the car rental industry.
The next day I headed up into the mountains for my retreat at C Lazy U Ranch. The retreat was great until the second to last day, when I developed some sniffles and a slight cough. I assumed I was having allergies from the wind, blowing ash, and being outside all day. On the final day, I am feeling suddenly exhausted. I stop at friends for dinner and find that I need to take a nap before joining them for dinner.
The next day I head out before the sun is up to drive back to Denver. Halfway through the flight, I realize I might be getting sick. Now I have a slight sore throat and a little more cough. I land in Burbank and go directly to urgent care for an instant Covid test. I have to do this because my husband has two chronic conditions that would put him at high risk for hospitalization. That night I learn my test is negative, but I start running a slight fever. I sleep downstairs, alone with a mask on all night.
The next day I go back for a second test that is positive. The dreaded breakthrough Covid in seniors is officially happening to me. I continue to quarantine as my symptoms increase. Body aches, more and more coughing, and now a total loss of taste and smell. A couple of nights later, I wake up with intense coughing and a feeling of pressure in my chest—like someone is sitting on me. I am starting to panic now. With the vaccines and the booster on board I had believed I would be protected, but my reality was as the days wore on my symptoms were worsening. Now at day 5, I decided my best bet was the ER.
I am over 65 and have two chronic conditions—pre-diabetes and a long history of chronic asthma—that are controlled typically with a couple of inhalers unless I develop a respiratory virus. I figured the only other treatment that might stop my progression was an infusion of monoclonal antibodies. This is typically given for mild to moderate Covid for people over 65 at risk for complications.
I head out to the local ER at 7 am. At the entrance, it is just me and a young man who is screaming and cursing at the triage nurse demanding immediate care. I tell the nurse he can go first while I sit outside since I have Covid. Thirty minutes later I am in an isolation room inside the ER. The nurse briefly listens to my lungs and hooks me up to the monitors. I am complaining of shortness of breath and chest pain. Blood is drawn, an IV is started, and chest X-rays and an EKG are ordered. No one has taken a medication history. I haven’t seen a doctor yet. A couple of hours later, a physician sticks her head in the door and says you are well enough to go home as your EKG, Chest X-ray and blood work are ok.
Still no history or exam. I say, “Before I go home since my asthma has worsened so much, could I please have the monoclonal antibodies?” She says “Let me check if you meet the criteria.”
Another hour later, she pops her head in again to say, “You can get them, although it will take a few hours.” At this point, I tell her I want them. It takes an hour to mix them up via the pharmacy, 90 minutes to infuse, and then another hour of waiting for a reaction. The infusion pump monitor keeps blaring as it misfires. A nurse shouts through the door, she is too busy now to put on a gown and reset the monitor. By early afternoon I am discharged. I feel about the same, but am counting on the monoclonal antibodies stopping the progression of the infection. Forty-eight hours later, I am feeling better. Still cough uncontrollably at times, but my lungs are dry—no fluid. No fever.
My symptoms slowly subside and the asthma is controlled with standard asthma meds including-at-home respiratory treatments and prednisone. Slowly my taste and smell return. My fatigue is one of the first symptoms to resolve. At five weeks, I am able to exercise without increasing my symptoms. I still have asthma but that is not uncommon for me after a respiratory infection—which is exactly what breakthrough Covid in seniors is.
Thinking back, I can’t imagine how this would have gone for me without the protection offered by the vaccines and booster. I am grateful I was vaccinated and was able to get good care at the ER. For people like me who are older with chronic medical conditions, if you experience breakthrough Covid in seniors, you’ll need to have a plan for quarantining, self-care, plenty of meds for chronic conditions if they worsen, and good access to quality healthcare at your ER.
Bottom Line: If you are 65 or older or have family members who are 65 or older, do not underestimate the contagiousness of the Delta variant. For those of us who are 65 or older with chronic medical conditions, this can end your life in short order. If you do experience breakthrough Covid in seniors (yourself or your family), access the ER as needed, be ready to quarantine, and take care of yourself. As an asthmatic, I had a home nebulizer with my vials of albuterol as well as short-acting and long-acting inhalers. As soon as I got sick, I started pushing fluids and getting plenty of rest. I wore a mask indoors almost the entire time before I got sick but still got breakthrough Covid in seniors. I believe it speaks to just how contagious the Delta variant has proven to be.
Finally, after experiencing the Covid-induced trail of “broken systems” that include airports, airlines, car rental agencies, emergency rooms, restaurants, and hotels, I can only conclude that it marks the death of a unified governing policy defaulting to cities, states and businesses left to craft their own unaligned, uncoordinated, poorly conceived and destined to fail micro-policies. As a retired health care provider, this is the most disturbing truth about this horrific pandemic. It represents a tragic setback in our long-standing commitment to public health, a loss that could come to haunt us for decades.