Elderly Patient Recovers From COVID-19 In Mexico

Case highlights need for oxygen, global vaccine equity

Posted on Mar 23, 2022

Límbano Castro stands outside his home in Chiapas, Mexico.
Límbano Castro survived COVID-19 after nearly a month in the Center for Respiratory Diseases, which is staffed and supported by Compañeros En Salud in partnership with the Ministry of Health. Photo by Paola Rodriguez / PIH.

Límbano Castro is 75 years old and has run a laundry business for several years, using the two washing machines at his home, in addition to selling snacks and decorations.

"Before [COVID], one was free to go out on the street, walk and see whoever one wanted,” he says. “But with the arrival of COVID two years ago, it was no longer like that."

Castro, like many others in Chiapas, Mexico, saw his community devastated as the pandemic swept through the rural, coffee-growing Sierra Madre region, where tests were not widely available until January 2021. When long-awaited vaccines became available in March 2021, he felt hopeful.

He received a one-shot vaccine that month. But he never received a booster.

While Mexico has a stockpile of vaccines, the country didn’t have enough booster doses, according to its president, until January 2022—several months after wealthy nations such as the U.S. had begun to rollout their booster programs.

That meant Castro, like millions of patients in low- and middle-income countries, lacked access to the same level of protection as those in wealthy nations. Such disparity came with consequences.

The cough began in October. At first, Castro thought it would last just a few days. But as time went on, the cough only got worse, along with a general malaise. It was then that his children took him to the Center for Respiratory Diseases at the community hospital in Jaltenango.

Compañeros En Salud, as Partners In Health is known locally, has worked in Mexico since 2011. Since 2020, Compañeros En Salud has staffed and supported the Center for Respiratory Diseases, a 6-bed center that provides antigen tests, consultations with doctors, and bedside oxygen for patients struggling to breathe. It’s part of Compañeros En Salud’s comprehensive COVID-19 response in Chiapas, where 1 in 3 families live in poverty and the nearest clinic can be hours away.

Last year, the team administered 2,820 antigen tests and treated 85 patients at the respiratory disease center.

At the center, Castro was tested for COVID-19 and his diagnosis, confirmed: positive.

Doctors gave him medication for his fever and sent him home to rest. But Castro's condition wasn’t improving. By day nine, his breathing had become more and more difficult, his cough had worsened, and his lungs had weakened. Fearful, his son rushed him back to the center for respiratory diseases, where Castro learned that he needed to be hospitalized—immediately.

"I didn't want to stay hospitalized, because I didn't want to be away from my family,” he recalls. “It's terrible to be in a hospital."

COVID-19 remains in the body for approximately 10 days, after which most people with mild-to-moderate illness no longer have a viral load that allows them to infect others; however, complications and lung damage can cause problems even months after infection—especially for those with preexisting conditions.

Castro had suffered from hypertension and diabetes for several years, but had gone untreated. Now, facing COVID-19 and pulmonary fibrosis—a condition where the lungs became damaged and scarred—he was struggling to breathe.

He would need bedside oxygen.

For patients with severe COVID-19 or other respiratory illnesses, medical oxygen can mean the difference between life and death. It’s one of the last lines of defense against COVID-19, a virus that attacks the respiratory system and, in its most severe form, requires intubation.

Hospitals typically provide medical oxygen in three ways: oxygen plants, oxygen tanks, and oxygen concentrators (bedside or portable machines). Castro received oxygen through a concentrator and was constantly monitored by doctors and nurses.

"Much of a patient's recovery is centered on three important pillars: a good response from the medical team, support from family members, and the cooperation and patience of the sick person," says Dr. Carlos Popoca, a doctor with Compañeros En Salud who treated Castro while he was hospitalized.

Despite the constant attention and care of Compañeros En Salud staff, Castro’s life was in danger.

"I thought I wasn't going to make it out of there alive," he recalls. "I was afraid I would never see my children again...or my granddaughters."

But Castro and his family didn’t give up. And neither did Compañeros En Salud. After nearly one month in the hospital, he recovered and was able to return home.

The care didn’t end there. Doctors followed up with Castro after his release—three times per week for the first two weeks—teaching him how to breathe again and helping him strengthen his lungs through breathing exercises.

While Castro has since recovered, his month-long stay in the hospital, on oxygen, could’ve been avoided, doctors say, had boosters been available earlier in Mexico.

“Vulnerable populations, or those with difficulties accessing medicines and vaccines, are the ones who are the most damaged and hit the hardest with the disease,” says Popoca.

That applies not only to COVID-19 patients, but to those with other respiratory diseases, such as tuberculosis.

“Castro is one of the success stories. They really thought he was going to pass away,” says Popoca. “Many patients decide to leave [because] they want to die at home. He believed in us.

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