“At one point, he was on multiple forms of life support,” one of his doctors, Jonathan Paladino, said by phone Saturday. “Pretty much every organ in his body was struggling.”
Greenslade beat grim national odds when he recovered from his coronavirus infection and finally left the Straub Medical Center on Friday, 24 days after he was brought in to the emergency room. The Centers for Disease Control and Prevention says 80% of U.S. coronavirus deaths have been people 65 years of age or older.
Greenslade, a resident of the United Kingdom, received a round of applause from hospital staff in a video of his discharge. Paladino, who is also the director of critical care for the hospital’s owner, Hawaii Pacific Health, said Greenslade’s recovery was the result of numerous people — including doctors, nurses, physical therapists, dieticians, and cleaning crews — working around the clock to give patients like him the best chance at survival.
“Paul was a victory for all of us,” Paladino said. “It proves a point that when you have a highly motivated, coordinated team that’s properly geared and properly educated, and deployed to battle, you win.”
On Saturday, Greenslade was recovering at a friend’s home in Hawaii Kai and said the best part of leaving the hospital was reuniting with his wife of 56 years, Karen, who also tested positive for the virus but has since recovered from only mild symptoms. He was released from the hospital the day after his birthday.
“I missed it by a day, but they made me a nice cake with raspberries and a slice of orange, which was lovely,” he said by phone. “There was some marvelous people helping me, especially the nurses and the aides. They did a brilliant job.”
He said he had to relearn how to talk and eat because of his treatment and was practicing walking around the house with his wife.
Greenslade was taken by ambulance to Straub on March 24 after walking into the Doctors on Call clinic at the Sheraton Waikiki for cold-like symptoms. The clinic staff told him his oxygen was low and that he needed to go to the hospital immediately. The last thing he remembers is getting in the ambulance.
Paladino said Greenslade was admitted to the emergency room, then moved to the intensive care unit two days later. He was placed in a medically induced coma and put on a ventilator on March 26, then kept in the coma for 11 days.
He was kept in a special area for coronavirus patients in both the ICU and telemetry ward of the hospital to protect the other patients and staff by using negative pressure and filtered air.
Paladino said there were numerous factors for Greenslade’s recovery, including his good initial health, having traveled annually from the U.K. to Hawaii for vacation, and also the lack of delay in getting him care because health professionals didn’t wait for a positive result to begin treatment.
“We threw the kitchen sink at him as far as therapies, such as azithromycin, hydroxychloroquine or the IL-6 inhibitor,” he said, referring to some still unproven treatments. It remains unknown how much they helped.
He said the team may have made one mistake by putting him on a ventilator so soon because since then some medical groups have said those put on a ventilator too early may not do as well.
“One of the most challenging things about this is the information is coming so fast and furiously that you actually sometimes have different recommendations within a 24-hour period,” Paladino said. “A therapy that you may have started in the morning, the recommendations can be changed in the afternoon.”
He said the push to get out information combined with experts clamoring for helpful information creates a situation of conflicting data like a “fog of war.”
“It kind of makes you unsure of what to do in an environment where every minute is counted,” he said. He suspects that eventually experts will find there are genetic dispositions that help people recover.
He said treating coronavirus patients in the ICU is also taxing on the nurses who have to be in the room with the patient, often for a full shift while dressed in personal protective equipment, along with dealing with the angst of becoming infected.
He said a clear plan to protect workers that is released quickly by leadership helps allay workers’ fears and confusion.
“If people feel like they know what they’re doing and they’re empowered to do it, then they perform well,” he said. “Their performance is what translates to the patient doing better.”
He said Greenslade needed life support for his lungs and kidneys and other bodily functions. Health workers also had to paralyze him to prevent any unnecessary movements that would have wasted oxygen going to his heart or brain.
“Every molecule of oxygen to him was precious,” he said. “He was 100% as vulnerable as a human being could be.”
Also at least nine people were needed to turn Greenslade over safely, despite the many machines connected to him, multiple times a day to keep his lungs functioning properly.
Greenslade was one of the 574 people who have tested positive for the coronavirus in Hawaii. The state Department of Health said there were 21 new cases Saturday, with most occurring on Hawaii island and two new cases on both Oahu and Maui.
The Health Department said a cluster in Kailua-Kona from two McDonald’s owned by the same owner has grown to 29. The cluster, which started from an employee who inadvertently infected other workers, includes 17 employees and 12 household members of the employees. Both restaurants remain closed.
Also the Hawaii Tourism Authority said 486 passengers arrived in Hawaii, including 98 visitors and 184 residents. At this time last year, 30,000 people were arriving daily.
In addition, Hawaiian Airlines announced one of its planes was on its way to Shenzhen, China, to pick up 2 million face masks and bring them back to Hawaii by Monday. Hawaiian is partnering with Every1ne Hawaii, a grassroots community group, to execute the humanitarian mission.
Paladino said Greenslade’s case was an example of why the public in Hawaii cannot let their guard down to stop the spread of the coronavirus. He said he was concerned that people were ready to move on from coronavirus.
“People need to keep their eye on the ball, realize why we’re doing this, and realize that there is an endpoint,” he said. “We’re all going to get through this, but it’s going to require patience, it’s going to require education.”
As for Greenslade’s wife, Karen, she said doctors initially did not have high hopes and she didn’t expect to see her husband again.
“It wasn’t a good time,” she said.
Instead on Saturday, the Greenslades were making video calls with family in the U.K. and Canada who were glad to talk with Paul Greenslade again.
“They’ve done a remarkable job, all the doctors and the nurses,” Karen Greenslade said. “We’re so grateful.”
Star-Advertiser reporter Allison Schaefers contributed to this report.