Paul Stewart thought he’d caught a bad cold.
In the third week of March, he came down with a sore throat, mild fever, cough, chills and body aches. The coronavirus was just starting to spread across Illinois, shuttering schools and workplaces, including the clinic in DuPage County where he worked as a rehabilitation technician. It didn’t occur to him that he might have the virus, even after a co-worker tested positive. Paul’s symptoms came and went, and on some days he felt well enough to go on a 5-mile run.
Then his father started coughing.
Paul, 55 and twice divorced, lived with his parents in the house he grew up in. He assumed his father, Robert, 86, a tough former pro baseball player, Army veteran and cancer survivor, had picked up his cold. But the bug seemed to take over Robert’s body, wrecking his appetite and pummeling his lungs.
Before dawn on April 2, Paul woke to another of his father’s coughing fits. He helped Robert to the bathroom, where his dad passed out. Paul dialed 911.
A paramedic, dressed in full protective gear, told Robert he needed to go to the hospital. Robert quietly acquiesced. At the front door, still in bare feet, he paused and looked back at his son.
“I love you,” Robert said.
“I love you, Dad. Everything’s going to be OK,” Paul replied.
At Central DuPage Hospital, his father tested positive for the coronavirus.
The news made Paul realize that he may have had the virus too. As his father’s condition deteriorated, Paul began to wonder if he was to blame.
The weight of coronavirus guilt
That haunting feeling afflicts untold numbers of Americans who believe that in the fog of the coronavirus’ early spread across the country, they unwittingly infected the people they loved the most.
While it is often impossible to know exactly how the virus passed from one person to another, many survivors hold themselves responsible, questioning decisions they made in the days when they had little information, could not get tested and were not yet subject to strict social distancing and mask measures.
These experiences hint at the unanticipated scope of the suffering caused by the coronavirus.
“The mental health consequences of all this, beside the deaths and physical aspects, are profound,” said Dr. Michelle Riba, a professor of psychiatry at the University of Michigan Medical School. “We’ve never been through this in our lifetimes, so we are learning as we go.”
People who develop mild symptoms, or none at all, are convenient pathways for the coronavirus’ spread, because they don’t know to take steps to avoid passing it on to people who are at risk of life-threatening complications, researchers say.
Paul believes that is what happened to him and his father.
“Could I have been more careful with what I thought was the common cold?” he said in a recent interview. “If you felt the way I did now, you would not expose people to that. But there just wasn’t enough information then. That’s what I’ve struggled with.”
He has not been tested for the coronavirus; he asked about getting a test but was told that his relatively mild symptoms wouldn’t be considered serious enough to meet the stringent requirements. His mother and his girlfriend, meanwhile, developed only minor symptoms.
In the hospital, Robert’s lungs began to fail. Doctors said there wasn’t much more they could do to stop the virus’ assault on his body. They began palliative care, easing his pain with sedatives.
Visitors were not allowed, but Robert and Paul spoke frequently by phone, including some FaceTime chats. Robert seemed at peace. Married for 60 years and deeply religious, he said he’d had a good life. Paul never heard his father speculate on how he got the disease or the possibility that his son had given it to him.
Paul told his father he believed he was the likely source.
“I’m sorry, Pops,” he said.
On April 9, after Robert had been in the hospital for a week, they had their final conversations. Paul thanked him for being a good parent. He assured his father that he would take care of his mother, and help pay the bills.
“Thank you, son. You are a wonderful son and I’ll see you in heaven someday,” Robert replied.
Later that afternoon, the hospital called Paul to say he could visit his father the following morning. As he was preparing to leave, his sister called with a palliative care nurse on the line. Robert had died.
“I just killed my dad,” Paul told his girlfriend after hearing the news. “I gave this to my dad.”
She told him he was not responsible because he didn’t know if he had the virus, and he never intended to harm his father. His sister and his mother also reassured him.
But he could not let it go. A few relatives questioned why Paul didn’t call an ambulance sooner. He overheard his mother defending him on the phone.
“It’s an odd feeling, like you’re not at peace,” he said. “You can’t get rest because you’re still dealing with the guilt.”
‘I couldn’t keep my family safe’
The coronavirus feeds on families. As researchers track its spread across the world, they have found households are a common source.
To be the person who introduced the virus into a family carries a heavy emotional burden, even if the risk wasn’t clear at the time, experts say.
“You can’t use the facts you have now to go back and judge yourself back then,” Riba said. “In retrospect it looks easy now, but it wasn’t easy back then. People were getting on planes, still going to events and restaurants. They didn’t know.”
This guilt is not limited to cases in which a family member fell gravely ill.
“I couldn’t keep my family safe, and that’s your No. 1 job as a parent,” said Carianne Ekberg, who believes she passed the virus to her husband and their two young children in early March after coming down with what she initially thought was a bad cold or allergies.
She suspects she picked it up while getting a manicure with her 5-year-old daughter near their home in Gig Harbor, Washington. Midway through, the nail technician told her that a recent customer had just told them they’d come down with the virus. Ekberg left in a panic, showered and disinfected her family’s car and home.
Ekberg, 37, a social media consultant and Air Force reservist, said she called her doctor and a public health worker, and both told her that she probably wasn’t exposed to the virus, to be careful and to quarantine herself if she got sick. She stopped seeing relatives and canceled a trip to the East Coast, but did see two close friends while observing social distancing recommendations.
Ten days passed, and then she developed overwhelming fatigue, nausea, coughing and shortness of breath that lasted two weeks. A few days into her symptoms, her children developed low-grade fevers and runny noses, and her husband felt tightness in his chest. They’ve all since recovered.
“The guilt you feel when you infect your family, especially your children, is serious,” she said. “Even if you didn’t know you had COVID or you couldn’t help getting it, you still feel guilty and anxious and panicked at the first sign of a fever, cough or runny nose.”
Ekberg has found comfort in speaking to other coronavirus survivors. She participates in a weekly Zoom forum hosted by the YMCA of Pierce and Kitsap Counties. She also runs a Facebook group for parents seeking advice on dealing with school closures.
“You can’t blame yourself forever, but while you’re going through it you have to find something that will keep you focused on something else,” Ekberg said. “Because you are not going to recover yourself unless you have a positive mindset and are doing things to get well.”
Ekberg’s outlook fits the advice from experts, who say there are many paths to managing this kind of remorse. They include helping others, focusing on work, exercising and talking to someone — friends, self-help groups, a religious leader or mental-health provider.
“Giving yourself a break is hugely important,” said Dr. Ronjon Banerjee, a psychiatrist and assistant professor at Mount Sinai Hospital in New York, where a growing number of his patients are health care workers. “Some have infected family. They feel guilty. Others feel shame. Others feel they have no power or control. They feel hopeless. Talking about it can help make sense of it and how to regain control.”
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Jane Weinhaus is a talker, and she says that has helped her cope with her belief that she infected her husband, two adult sons and a daughter-in-law. She spent time with all of them before falling ill, and all ended up testing positive and getting pneumonia. Weinhaus, 63, spent more than a week on a ventilator.
A suburban St. Louis preschool teacher with a busy social life, Weinhaus has retraced her steps from early March to figure out how she may have been infected, and who else she could have exposed. The list is frightening: She went to work, out with friends, attended a bat mitzvah and a wedding, sat shiva with a friend’s family, ate dinner with her 90-year-old father, babysat grandchildren.
“To think I could have given them something that could have killed them, that I could have exposed so many people...” Weinhaus said before trailing off in tears.
She watches news of people who died on ventilators and wonders why she survived.
She has decided to make her work the reason.
She has been teaching preschool for 25 years. During her recovery, she has joined Zoom meetings with her 2-year-old students, and hopes to return in late August, provided her school is allowed to open.
“I will go on and make a difference in the life of a child,” she said. “That is my calling. That gives me purpose.”
After his father’s funeral — limited to 10 people — Paul continued to wrestle with regret.
He went into “playback mode,” wondering if he could have done more to keep his father from getting sick. Should he have quarantined himself in his bedroom? Been more aggressive in sanitizing their home? Taken his father to the hospital earlier?
“I think about it every day. Could I have been more careful?” he said.
There is one piece of information that might help him come to terms with what happened.
Because he never got tested, Paul still doesn’t know definitively that he had the coronavirus. But he plans to get an antibody test, which could provide the answer. He expects it to come back positive; his girlfriend has already taken the test, and she has the antibodies.
“I definitely want to know,” Paul said. “It’s important to me so I can close that chapter out in my life.”