Kristen Vardanega became an expert in living in quarantine months before everyone else.
When the 26-year-old was confined to a hospital room last fall, she found a way to pass the time. He listened to all the episodes of the podcast “This American Life” and took long naps, which is all he had energy for. He used to wash his hands often and wear a medical mask before entering the corridor.
It was a stark contrast to his daily life in Bozeman, where he studied public health at Montana State University and spent as much time outdoors as possible.
But she had no other option.
Vardanega was diagnosed last fall with acute lymphoblastic leukemia, a rapidly growing tumor that affects a person’s blood and bone marrow. He underwent chemo, immunotherapy and a bone marrow transplant. It has wiped out much of his immune system.
Vardanega was told that during the treatment she was so immunocompromised that she could not go out for fear of inhaling some microscopic particles that could cause an infection. She was told that such an infection could kill her.
“I didn’t think it was real when they first told me,” said Vardanega. “They said to me, ‘You can’t leave your room without a mask, you can’t go out without a mask, you can’t leave the hospital.” So that was my reality starting on that Friday when they started infusing chemo. “
Vardanega was diagnosed on October 8th and started treatment two days later. In January he was in a state of weak remission. In February, he obtained a new bone marrow from an anonymous donor. In March, his body was starting to rebuild his immune system.
Around the same time, the COVID-19 pandemic hit the United States.
Still in bulk
Experts have warned that people over the age of 65, with pre-existing or immunocompromised conditions are more vulnerable to the virus’s contraction and exhibit severe or life-threatening symptoms.
As the rest of Montana goes through a reopening plan, vulnerable people are still being asked to stay home. This means that people like Vardanega will be on the alert for as long as the disease spreads.
“I haven’t been to a grocery store since 2019. And I probably won’t go to the grocery store before there is a vaccine (COVID-19),” said Vardanega.
Vardanega’s immune system is so weak right now, it’s legally disabled. She considers herself lucky to live with her partner, Taylor VanRoekel, who can carry out all her errands. But he still needs to go to doctors’ appointments and still wants to ride a bicycle and play tennis.
And since they live together, VanRoekel’s show is his show. Given the widespread community transmission of COVID-19, neither is isolated from the risk.
This risk increases when people abandon social removal practices, gather in large groups, do not wear masks and spread the virus among themselves.
“I still depend on other people being considerate, and that’s what scares me to reopen,” said Vardanega.
92 million others
Vardanega said being in the hospital has opened his eyes to how many people are sick.
The Kaiser Family Foundation published a report in April that about a third of adults in the United States are at greater risk of serious disease if they contract COVID-19 because of their age or medical condition. They are more than 92 million people.
Of the 92 million, about 55% have a higher risk because they are over 65 years old. The rest are vulnerable because they live with pre-existing conditions, which vary widely in severity.
In Montana, there are more than 317,000 adults, or 39% of the state’s adult population, at higher risk, according to the report.
Agnieszka Rynda-Apple, an immunologist and assistant professor at MSU, said that in some cases, being vulnerable to disease is a fact. People who have diabetes, hypertension or asthma know they are at a higher risk for infection. But there are other people who have underlying conditions and don’t know it yet.
COVID-19 has proven to be a complicated disease even for people who have a functioning immune system, said Rynda-Apple. Otherwise, healthy patients are experiencing a wide variety of symptoms and reactions that have been unpredictable. This is only aggravated for the most vulnerable people.
Since Vardanega underwent chemotherapy and a bone marrow transplant, she remained with weakened defenses against this complicated disease.
“You are not completely defenseless, but your immune system is very vulnerable,” said Rynda-Apple.
The difficult part
Vardanega said that the most frightening part of having cancer was not the possibility that he could die. He was sick, not having the strength to use the stairs, the desire to sleep all day, the nausea.
Now, he hears about some people, especially young and healthy people, who believe that since they don’t risk dying from COVID-19, it’s not a big deal. He knows it isn’t.
“The mortality rate (COVID-19) doesn’t show real suffering … getting sick is the hard part,” he said.
Vardanega was healthy and active and never suspected of having cancer when she started feeling under the climate last September.
It seemed like the onset of a cold. She was tired and the lessons were overwhelming. After a small fall while mountain biking near Big Sky, his legs were covered in bruises. He knew something was wrong.
Vardanega made an appointment at the MSU student health clinic thinking it might be mononucleosis, and that a doctor’s message would force her to rest outside the classroom. When she got there, she joked with the therapist who had searched Google for her symptoms and the results said she had leukemia. Both laughed.
“And then two hours later he held my hand and cried. He said ‘There is definitely something very wrong with you’ “, Vardagena.
A blood test revealed that Vardanega’s white blood cell count was around 150,000 – the normal count for a healthy woman is between 4,500 and 11,000. She was told to take her blood sample to the emergency room.
A doctor from Bozeman Health Deaconess Hospital told Vardanega that he probably had leukemia. Within hours, he was on a Medevac plane with VanRoekel, bound for the University of Utah’s Huntsman Cancer Institute.
As soon as she arrived at the institution, medical staff punctured her hip for a bone marrow biopsy. They confirmed his diagnosis around 3 in the morning
VanRoekel said that the diagnosis brought about a sense of relief because leukemia is a curable tumor. He thought she might be terminally ill.
But then came a wave of uncertainty. Since the cancer was so acute, he would have had to undergo out of state treatment. How could the couple abandon everything and move to Salt Lake City for treatment? And how would the disease progress?
VanRoekel said he could barely eat or sleep the first week in the hospital.
“You’re just looking for something to check on,” said VanRoekel.
Some things worked. He was able to work remotely and remain in the hospital. The couple found friends to sublet their apartment in Bozeman. And the treatment of Vardanega has started.
VanRoekel said that he let go of things he could not control and became obsessive about what he could. He constantly washed his hands, wore personal protective equipment while he was in Vardanega’s room and absorbed all that the doctors said.
After Vardanega completed chemotherapy and immunotherapy treatments in Utah, the couple decided to move to UC Davis Medical Center because their parents live near Sacramento. It seemed like a way to regain some control and be close to the family. Vardanega had her bone marrow transplant there in February, a procedure that required more chemotherapy and radiation in advance and intense post-treatment.
The transplant wiped out Vardanega’s immune system and gave her a brand new one that needs time to develop. Although it is a successful procedure, it could not have come at a worse time.
The news was swirling about the spread of a new coronavirus that emerged in Wuhan, China. It wasn’t long before COVID-19 gained pandemic status.
Cases started popping up in the United States and spread quickly. The first case of community broadcast in the United States, which means that a source could not be traced, was confirmed in Solano County, California.
The patient was admitted to UC Davis Medical Center, where Vardanega was still recovering from her transplant.
Vardanega was able to move to her parents’ home in the first week of March, which was far more isolated from hospital diseases.
At the time he was anxious about the virus. But soon it dissolved into disappointment.
“I felt like I had finished the treatment and so I was returning to normal life, everything will be fine in a couple of months and I will start to recover my old life,” said Vardanega. “And then the pandemic happened.”
Vardanega was also frustrated when she heard how some responded to the mandates to stay home. People complained that they had to quarantine and wear a mask, but those requirements seemed like a small price to pay for staying healthy.
“This doctor told me, Kristen, if you want to go out in the corridor or you want to go out, you can simply wear this mask. I was like ‘Fantastic. I am so happy that there is this piece of packaging that I can wear so that I can feel the breeze on my face during this hospital stay. This is a miracle, “” he said.
Vardanega said he understands that the pandemic has been a challenge for everyone and why people feel uncomfortable living with restrictions. But she also doesn’t want to live under blockade and the spread of the virus makes it necessary.
VanRoekel experiences the same frustration and anger. He said that when the virus arrived, he was convinced that officials would take control of the situation and prevent further spread. He has lost the confidence that will happen.
“I am much less fearful of the disease now that our response does not contain the virus,” said VanRoekel.
First, VanRoekel said, officials were supposed to wear a mask in public a long time ago. He said that the strength of a society should be measured by how well it cares for its most vulnerable members.
“Our leaders, our elected officials, work for us, for their constituents. It doesn’t matter whether a data-driven public health mandate will be unpopular, “said VanRoekel.
Governor Steve Bullock issued a statewide warrant for a mask on Wednesday.
In the meantime, Vardanega is doing everything possible to protect himself. Work from home and only leave for cycling and exercising. He will likely ask to bring all his lessons to online college in the fall. He has strict rules for friends who visit and does not see those who have had a possible exposure to the virus.
Vardanega said he is just as uncomfortable living this way as anyone else is in quarantine. It is not a sustainable lifestyle. He can only hope that people make personal decisions that curb the spread of COVID-19 and allow it to return to a semblance of normalcy.
“The logistics of life don’t offer me the opportunity to stay home indefinitely,” Vardanega.