Mark Fratrick was cleaning out two sheds on his properties in Taos County this summer when he took a breath that nearly killed him.
Either through a surgical mask he wore as a precaution, or when he might have lapsed and taken it off, Fratrick inhaled one or more viral particles that would gradually open the capillaries surrounding his lungs, allowing them to fill with fluid.
He didn’t have SARS-COVID-2, the new strain of the coronavirus that so many people across the globe have already caught in 2020 – or fear catching. Fratrick had contracted hantavirus, a rare and far deadlier virus that thrives in the hot, dry, dusty American Southwest.
Over the next few weeks, he became the sickest he had ever been in his life.
Lying in a bed at University of New Mexico Hospital in Albuquerque with a pounding headache, a scorching fever and struggling to breathe, he wrote out his will on his cellphone.
He also looked up articles about the virus he thought might kill him.
“I knew about hantavirus and that’s why I always wore a mask,” Fratrick said in mid-September. “I knew the kill ratio was like 32 percent. So 1 out of 3 people that get it die.”
After the virus had run its course, the UNM doctor who treated Fratrick told him that the strain he had kills 45 percent of the people who catch it.
“That’s a little better than a flip-of-the-coin chance of me surviving,” Fratrick said, choking up during a phone interview. “That hit me like a ton of bricks.”
Fratrick’s sister, Michelle Fratrick, was working as a nurse in a wing at UNM hospital in the 1990s, when the virus was first recognized during an outbreak in the Four Corners region of the state. She worked in extracorporeal membrane oxygenation, a process by which a patient’s blood is pumped out of their body, reoxygenated and then pumped back in. The hospital has since become a nationwide leader in treating hantavirus.
Some of the patients she had seen were from Taos. Some of them died, so she had warned her brother repeatedly over the years that people in Northern New Mexico were at risk of being exposed to hantavirus.
But when Fratrick called her to say he wasn’t feeling well on Aug. 4, she said it wasn’t immediately obvious that’s what he had.
Initially, he said he felt like he had a headache, body aches and a fever. Still, she knew he had been working in his sheds. Since Fratrick didn’t have a sore throat, they thought it was unlikely he had coronavirus. Since he had been working in his sheds, hantavirus seemed like a possibility. Fratrick knew it, too.
“Patients get flu signs and symptoms initially,” she said. “They sometimes have a little rally – like they feel a little bit better – and then it develops into a cardiopulmonary syndrome. Then they deteriorate really quickly.”
Fratrick’s girlfriend, Tina Petersen, a pediatric hospitalist who also works in Albuquerque, saw that process unfold firsthand.
“You know when you walk into a room as a physician and you’re like, ‘Sick. Not sick’?” she said. “My sick meter was off the register. I was like, ‘You are sick.’ I thought it was viral, seriously viral. I thought it might have been some kind of encephalopathy or meningitis with the headache, which you can get with any viral illness.”
Petersen monitored Fratrick at his home in Taos, giving him Tylenol and Ibuprofen. When his symptoms had only worsened by the morning of Aug. 10, she insisted on taking him in for a medical workup.
Fratrick wanted to go first to Taos Urgent Care, where they told him his blood saturation level was 82 percent – dangerously low.
“At that point it was clear there was something pretty bad going on,” Petersen said. “Because he had no respiratory symptoms. Nothing. He wasn’t breathing fast. He didn’t look great, but his skin wasn’t white. His lips weren’t blue. I was completely shocked when I learned it was 82 percent. From there, we went to the hospital.”
At Holy Cross Medical Center, Fratrick was given a rapid test for coronavirus, which came back negative. Then his blood was tested, showing that his platelet count was low and his hematocrit level was high.
“Those two right there are fairly confirmatory for leaning toward hanta,” Petersen said.
Knowing the virus could take a patient suddenly from stable to “nearly dead,” Peterson said she and Fratrick’s sister were adamant he go to UNM Health Center.
’It was a nightmare’
Within a few hours of his arrival at Holy Cross, Fratrick was flown by helicopter to Albuquerque, where a room in the intensive care unit was already set up and waiting for him. He tested positive for hantavirus.
He was prepped for ECMO in case his blood oxygen level dropped too low. For the next seven days he didn’t eat any food or drink more than a sip of fluid.
He also didn’t sleep. Instead he performed breathing exercises he had learned in a singing class he took in college to help expand his lungs. He watched his oxygen levels rise and fall on a monitor next to his bed.
“It was a nightmare,” he said.
Petersen came to visit him every day. He told her that he wouldn’t go through ECMO, that he’d be leaving the hospital alive. He kept his doubts to himself.
In fact, when Dr. Trenton C. Wray, the specialist who treated Fratrick, came to tell him he was being sent to tell him he was being sent to a step-down medical unit at the end of the seventh day, that the virus had run its course, he was in disbelief.
For his first bite of food more than a week, his brother brought him a slice of Dion’s Pizza. The sensation was so overwhelming, Fratrick said tears ran down his face and his legs twitched.
A cautionary tale
There have only been 728 cases of hantavirus reported as of 2017 in the United States since it was first recognized nearly 30 years ago, according to the Centers for Disease Control and Prevention (ECMO). Fratrick is the only person in New Mexico to have an identified case so far in 2020. Two people from McKinley County died of it last year.
Fratrick, his sister and Petersen want the public to know that they should always take precautions and seek proper medical care right away if they think they might have been exposed to hantavirus.
“If there’s any possibility it’s hanta they should really be on the phone to UNM,” Petersen said. “It really is the place to go. I would say it’s the center of excellence for treatment for diagnosis and treatment of hantavirus. We’re trained as physicians to resuscitate with fluid, but in this one situation, which is a rare situation, that’s not what you do.”
Scientists came up to Fratrick’s property to catch mice since he got sick. Several of them tested positive for hantavirus.
Fratrick said he’s since learned that a respirator mask is necessary to prevent inhaling the virus particles. He plans on taking additional precautions in high-risk areas, such as using a shovel to clean, instead of a broom that can kick up dust.
After he was released from UNM, Fratrick said his primary care doctor told him that he wouldn’t be able to do heavy exercise for up to two years. He’s currently on oxygen as his body recovers from the virus.
Despite all the serious illness they’ve seen in the medical field, Michelle Fratrick and Petersen said watching a loved one nearly die from a virus was a very different experience.
“To me it’s a true testament to his strength,” Petersen said. “He breathed his way to being well. As you lie in bed for five days your lungs start collapsing more and you’ve got to get that fluid out and he just did it. No matter how tired he was, he’d just take those big deep breaths.”