Gaualofa Nua has been fighting for his life for the past six weeks, the most severe complications of the coronavirus having blindsided the 45-year-old construction industry worker, who had no previous medical conditions.

The Ewa Beach resident, who goes by Lofa, was diagnosed with COVID-19 after returning home from a construction expo in Las Vegas. After developing a 103-degree fever that wouldn’t go away, he tested positive for the virus and was admitted into the hospital on March 26. Within days, he was in the intensive care unit at The Queen’s Medical Center with viral pneumonia — his lungs filling up with fluid — a complication of the disease.

But that was just the beginning of his life-threatening ordeal. As his condition worsened, he developed multiple blood clots, his lungs collapsed and the right side of his heart started to fail to the point that his heart stopped twice and he needed to be revived by CPR.

He was placed on a ventilator — which provides oxygen for patients unable to breathe on their own — on three different occasions and became Hawaii’s first COVID-19 patient put on a cardiopulmonary bypass machine, known as ECMO (extracorporeal membrane oxygenation), for patients whose lungs and heart are failing. The machine pumps and oxygenates blood outside the body in place of those organs.

“I was coughing and having trouble breathing. I could hear them talking as they tried to pump the fluid out of my lungs as my lungs collapsed. I was told my heart stopped a couple times and they were able to bring me back, so it’s been a crazy ride,” said Nua, who woke up from a medically induced coma last week and is now breathing on his own.

He described himself as “healthy as an ox” before the infection.

“I just feel blessed I had a second chance in life. I’m looking at life in a whole new aspect now, cherishing my family way more. I’m just grateful to be here,” he said. “It’s been a hard time trying to go through this by yourself with nobody around. All I want to do is give the most greatest gratitude to Queen’s Medical Center and thank (everyone) for all their prayers and their blessings.”

On death’s door

With no other options left, the ECMO machine was “essentially a last resort,” said Dr. Stephanie Guo, an ICU physician at Queen’s.

“He was on death’s door multiple times,” she said. “His pneumonia progressed while he was in the hospital to the point even the breathing machine wasn’t adequate anymore. This is definitely the worst-case scenario.”

Dr. Dipanjan Banerjee, a cardiologist and advanced heart failure and ECMO director at Queen’s, said the overall survival rate while on the ECMO machine is about 50% for COVID-19 patients.

“It goes to show you how sick patients can be,” he said. “It’s not just the numbers of patients you get (with COVID-19), but how sick they get and how long they stay in the hospital. Influenza patients don’t stay in the hospital for a month. We had been in meetings multiple times a week to talk about what would happen if all the beds and ventilators were full. At what point we’d have to take patients off ventilators, which are terrible decisions we’d have to make.”

One of their own

Nua’s wife, Tanya, said the worst part for her and their 21-year-old son, Noah, was not being able to be by his side, as visitors aren’t allowed with infectious disease patients.

“You can only do so much from far away. You can’t just hold the person’s hand, talk to him even if he can’t hear, with the hope that maybe you can reach him somewhere and bring him back,” she said. “You just don’t know what’s going on in his mind. Is he having nightmares? Will he remember why my son and I aren’t there? Without all of the prayers he had I don’t think he probably would’ve survived this.”

She credits the doctors and nurses at Queen’s who “never gave up” and went above and beyond, researching different treatments even after their shifts were over and keeping in constant contact with the family.

“It’s a fight that they were all fighting. They weren’t willing to let him go at all. They just treated him as though he was one of their own,” she said.

Don’t take a chance

As the state reopens, Nua is cautioning people rushing to go back out into society.

“It can go sideways real quick. Don’t be so impatient to risk your health and your life just to get out. I understand people got to work and I understand people got to eat, but it’s a whole other animal,” he said. “I understand being in quarantine sucks, but it’s better than staying in the hospital … not knowing if you’re going to live or not. I just happened to be fortunate that I was one of the only patients and all the machines were available to me at the time. We don’t have enough machines for everybody. If they have to pick and choose … who’s going to live and die, would you want to take that chance just to go to the beach?”

His wife added: “It is absolutely not a joke. It almost took the love of my life away. It does not discriminate.”