First Patient Diagnosed at Cook Children’s with COVID-19 Goes Home. How Early Preparation Made the Difference.
The first patient to be diagnosed with COVID-19 at Cook Children’s is recovering at home after being discharged from the hospital over the weekend.
Menachem Mandel received positive test results on Tuesday, March 24, several days after traveling to Fort Worth from Toronto. The 18-year-old returned home to his family in Texas after his school was shut down due to COVID-19.
“I woke up last Wednesday and I didn’t feel sick but I felt a little tired,” said Mandel in a phone interview from his hospital room, prior to his release. “I went to the airport and got my flight. Once on the plane, I started feeling more tired and a little hot. That got me worried. But when I got home, my temperature was fine.”
The teen said he’d had headaches recently, but he attributed them to the stress of the way the world was changing and not knowing what was going to happen next because of the global pandemic.
Several days after arriving home, Mandel came down with a fever. From there, he said his health began to deteriorate until he ended up in the hospital.
“Once the fever hit, I started noticing symptoms that I’ve never had before. My muscles felt weak. For example, I tried turning on a light and it felt weird to do it. It felt like my muscle was disconnected from my body,” Mandel explained. “I was very, very weak. I tried walking back and forth to the bathroom and I was practically falling over.”
Mandel’s parents took him to see Walter Halpenny, M.D., a pediatrician at Cook Children’s Southwest Harris Parkway. His office, like all Cook Children’s locations, has enacted new procedures to prevent the spread of COVID-19. Staff donning personal protective equipment (PPE) met the family at their vehicle in the parking lot. From there, Mandel was given a mask and escorted inside where he was carefully examined by Dr. Halpenny and a nurse, also protected by PPE. Dr. Halpenny ordered a full respiratory panel and the Mandel family was sent home to wait for the results. Unfortunately, Mandel began feeling worse overnight.
“I went back home and went to sleep and when I woke up my temperature was 105,” said Mandel. “My parents called the doctor and he said to wait it out overnight."
That morning, Dr. Halpenny instructed the family to go to Cook Children’s Emergency Department where a chest X-ray and a CT scan would be performed. Despite not yet knowing Mandel had COVID-19, emergency room staff at Cook Children’s were prepared for Mandel’s arrival. For more than a month, these frontline health care workers have been actively preparing to care for suspected COVID-19 patients.
“We’ve worked diligently to align ourselves with best practices learned from other institutions that have seen high numbers of COVID-19 patients,” said Corwin Warmink, M.D., medical director of Cook Children’s Emergency Department. “Every step of our operation has been examined to see where we can minimize risk to our patients, families and to our health care workers.”
When Mandel and his family arrived, they were again met by staff dressed in PPE. They were given masks and taken to a special exam room designed for infectious patients.
“We’ve separated our emergency department into areas for patients who may be infectious and those with other complaints, such as injuries,” Dr. Warmink said. “This patient was identified as high risk immediately and brought straight back to our COVID-19 risk area. All staff wore appropriate PPE throughout the visit as we take no chances with potential COVID-19 exposure.”
At this point, Mandel’s oxygen saturation level was down to 92%. Results of the CT scan were also alarming.
“The CT scan showed patchy pneumonia all over his chest,” said Dr. Halpenny. “It was a little scary to look at.”
Doctors in the emergency room determined Mandel needed to be admitted to the hospital. In addition to having a high fever and severe weakness, he was also coughing up blood. Since Mandel screened high risk for COVID-19, he was admitted to a section of the hospital specifically dedicated to treating patients suspected of having the virus. Hours after being admitted to the hospital, the lab that performed the respiratory panel for Mandel notified Dr. Halpenny that he was also positive for COVID-19.
“It is almost unheard of in our area to receive COVID-19 test results that quickly,” said Dr. Warmink. “Most test results are taking up to 10 days to be returned, but that is slowly improving.”
For Mandel, the results were not unexpected. Before his school in Toronto closed, a cook in the cafeteria had tested positive for the virus.
“I knew in the back of my mind that there was no way I didn’t have it,” said Mandel. “It wasn’t that surprising. There’s just too many ways I could have gotten it.”
He would spend the next five days on the COVID-19 floor at Cook Children’s, receiving oxygen and other treatments to help his body fight off the illness.
On Sunday, March 29, Mandel walked out of the hospital with his parents by his side. He will be isolated at home, but says he’s looking forward to getting back to a normal routine.
As for Cook Children’s staff, they’re relieved to know their preparation paid off.
“The biggest take away for us is that by preparing, drilling and educating our staff, we are ready to help COVID-19 patients,” said Dr. Warmink. “Successful evaluation and treatment of COVID-19 doesn’t happen by accident. We’ve spent hundreds of hours planning for these type of events. Cook Children’s is in a fortunate situation to be relatively well supplied and supported for this pandemic.”
Dr. Warmink says COVID-19 is a frightening disease, but with proper planning and supplies, as well as support from the community, we can get through this.
“I can’t emphasize enough to respect social distancing rules and to practice diligent handwashing and avoid touching your face,” said Dr. Warmink. “These are our best weapons against COVID-19 currently. There is no quick and easy solution, but some painful steps taken now will keep our community from experiencing the nightmare that is occurring in other parts of the country and the world.”
He also adds that health care workers at Cook Children’s are proud to stand ready and prepared in the battle against COVID-19.
“We are the ‘front line’ of this fight, but there is no other place any of us would rather be,” said Dr. Warmink. “This is the profession we chose and we love what we are trained to do.”