WATFORD CITY, N.D. — The memory plays over and over in Gabby Glazer’s head.
She walks to the bassinet holding her 3-week-old son to find his recently rosy face has turned blue. She picks him up and sees his eyes are darting back and forth.
“That’s when we knew something was really wrong,” Glazer said.
The 21-year-old first-time mother didn’t completely lose her composure until blood started flowing from the nose of little Thomas Goedeck IV on the way to the hospital in Watford City.
As soon as the child arrived at the emergency room on Sept. 3, a team of about 10 medical providers rushed to his aid. Dr. Maria Marchenko, a pediatrician who does not normally work in the ER, immediately took over dual roles, directing the staff response while managing ventilation for the tiny patient, rhythmically squeezing a plastic bag to keep oxygen flowing into his lungs. (Due to health care privacy standards, Marchenko was not able to disclose the identity of her infant patient in Watford City from earlier this month, but Glazer confirmed the doctor worked on Thomas.)
Glazer felt like she couldn’t breathe either. Every time a medical worker came to speak with her, she broke down all over again.
The team in Watford City believed Thomas was likely suffering from a respiratory virus common in babies, but an expert in newborn care, who called in from Minot, suggested they may be observing complications from COVID-19. The team quickly administered a test. It came back positive.
By that point, everybody in the room had been exposed, and Marchenko, one of the first people in her hospital to get vaccinated, had been in intensely close proximity to the child.
But there was little time for thoughts of their own safety. The team pressed on.
After sustaining Thomas with a manual ventilator, Marchenko intubated the child, an intricate and highly difficult task on such a small patient. Thomas was diagnosed with a collapsed lung and pneumonia — all caused by COVID-19.
“It is remarkable how much damage the virus already managed to impose on his lungs,” Marchenko said. At two different points, she recalled, the team nearly lost the baby because of falling oxygen levels in his blood. “He was very, very sick.”
Thomas’ near-death bout with COVID-19 is an extreme case of the devastation wrought by the latest surge of the pandemic. Health officials say the highly contagious delta variant is hitting North Dakota children harder than any strain before it.
About 30% of the state’s detected COVID-19 cases are now coming in those younger than 20 — up from about 18% during previous waves of the virus. So far, North Dakota has recorded one COVID-19 death in a child, a 17-year-old from Parshall in October, and currently one child is hospitalized in the state. But pediatric wards in some other parts of the country have taken on unusual stress with the spread of delta, and hospital administrators in North Dakota project the worst of the recent outbreak is still to come.
Ten hours after Glazer’s waking nightmare began, a Sanford Health medical crew took the baby from Watford City first by ambulance to Williston and then by plane to Fargo. Deciding he needed more specialized care, Sanford sent the infant on to the University of Minnesota Masonic Children's Hospital in Minneapolis, where he barely clung to life 600 miles from his parents.
At one point, the baby required CPR after his breathing machine accidentally shut off. Desperate doctors treated him with remdesevir, a drug seldom used on young children with COVID-19.
Little Thomas still can’t breathe on his own as of Friday, Sept. 24, but he has survived — something his mother says is “truly a miracle.” His father, Thomas Goedeck III, said the boy is improving every day and doctors are hoping to get him off of the ventilator soon, though they say he must relearn how to breathe and eat before leaving the hospital — a process that could take several weeks.
Marchenko marveled at the news of her former patient’s incremental recovery in Minneapolis. She said it’s a wonder he made it through.
“He is a very strong little person,” she added. “Even at his age, he was fighting.”
The delta difference
The deadly coronavirus disease that decimated nursing homes and strained hospitals during the first year of the pandemic came with a silver lining: Children did not seem to catch or spread the virus at the rate of older age groups, allowing schools to stay open with relative success, said Dr. Tracie Newman, a Sanford Health pediatrician and Fargo city health officer.
But the delta variant has changed the virus landscape, Newman said. Kids do contract the strain that originated in India and pass it on to others.
On a national level, COVID-19 cases in children have soared over the last few months as schools resumed classes, and though early data suggest deaths and serious illnesses among children remain infrequent, Newman said the extremely infectious nature of the strain means the sheer number of cases requiring hospitalization can overwhelm medical centers.
North Dakota has only seen a handful of children recently hospitalized with the virus, but Newman worries those rare outcomes could become more numerous as the state hits its predicted peak in infections around the beginning of next month. Looking past the current health crisis, Newman is concerned that children who recovered from even mild cases of COVID-19 could suffer long-haul symptoms, like headaches, brain fog and fatigue, though she added more research is needed on the subject.
During previous surges of the pandemic, McKenzie County Healthcare Services, where Thomas was initially treated, didn’t accept COVID-19 patients. But as the delta wave has taken hold in North Dakota and McKenzie County Healthcare has caught up with virus treatment resources and know-how, the small western hospital has adapted to provide on-site care for a handful of virus positive patients at a time.
Sam Perry, a senior director for MCHS, said recent weeks have been especially hard on the facility, as beds at larger medical centers in places like Bismarck and Minot have filled up and the Watford City team has been forced to stretch its hours.
The biggest difference in this increased demand, Perry said, has been in the wider range of patients coming down with the virus.
“We’re not just seeing the COPDers who are 70 plus,” he said. “We’re seeing individuals who are weeks old all the way up to end-of-life now that are getting it.”
Marchenko returned to work earlier this month after getting over a mild case of COVID-19 herself, the result of a breakthrough infection contracted when she was caring for Thomas. The pediatrician, who began practicing in Watford City just months into the pandemic, has become a passionate advocate for vaccination in her new community, where she holds out hope that many people can still be moved to get the shot.
To Marchenko, cases like that of her infant patient underscore the importance of a collective investment in vaccination. She stressed that healthy people must recognize the importance of immunization not just for their own protection, but for the protection of their most vulnerable neighbors — a category that includes the very young as well as the very old.
The elder Goedeck and Glazer, who both recovered from COVID-19 infections in the last month, have not been vaccinated and don’t plan to seek the shot.
The 25-year-old father said he’s not anti-vaccine and believes immunizations have helped eradicate diseases like polio and measles. However, he thinks the development of the COVID-19 shot was rushed and more clinical studies are needed.
The automotive service technician also laments that politics and mandates have muddied the national discussion on vaccines, saying “the country doesn’t need that right now.”
Glazer said she’s skeptical because she doesn’t know how the jab would affect her, but she added she would get vaccinated if it became a condition of seeing her son.
While they haven’t wavered on the contentious vaccine issue, both parents said little Thomas’ close call and their own infections have given them a greater awareness of the virus’s severity.
As she sat passenger on the nine-hour drive to see her son, Glazer said she’s worried for other children who catch COVID-19 and hopes Thomas’ story will make other parents mindful of the danger the virus can pose.
Goedeck said researchers are taking note of his son’s bout with the illness and the treatment he received because it’s so rare to see a case “that bad and that young.” The couple said they hope the medical field will gain insights from their son that will help other kids.
With the financial support of the Watford City community, Glazer and the elder Goedeck traveled to Minneapolis to see their son after two weeks apart. Glazer, who will remain in the Twin Cities until her son is ready to come home, feels relieved to be by his side. She said her boy looks healthier, more alert and is “trying to smile through the tube in his mouth.”