‘I was in a coma fighting for my life in ICU with Covid while my twin brother just had aches and pains’

29-year-old took part in trial to see why disease hits some harder

Twins Callum and Sam Spence at Sam's home in Ballsbridge. “I thought I had said goodbye to the person I care about the most,” says Sam. Photo: Frank McGrath

Sean Duke

Callum and Sam Spence are twins, aged 29, but the way Covid affected them was very different.

They were both infected last Christmas, but Callum ended up on a ventilator in the ICU fighting for his life, while Sam was at home with aches and pains.

The nightmare began on St Stephen’s Day, recalls Callum, when he first felt feverish and had cold sweats. “I had a test which was confirmed on New Year’s Eve as positive. I had lost my smell and taste. I was short of breath and totally uninterested in food.”

His parents and twin were then tested, and they all came back positive. It was quickly clear, however, that Callum was faring worse and by New Year’s Day he was struggling to take a breath. Callum called the GP and was sent for an X-ray at St Michael’s Hospital, Dún Laoghaire. He was transferred to St Vincent’s University Hospital (SVUH) where he was placed on oxygen before being sent home with a prescription for steroids and antibiotics.

At home, Callum’s condition worsened again and on January 7 he was back in the emergency department at SVUH. He was now shivering so hard that his mother couldn’t understand what he was saying when he called her. He was admitted onto the ward and the next day was transferred to the High Dependency Unit and placed on a continuous positive airway pressure (CPAP) machine.

Three days later, Callum was moved to the ICU. He was now so tired from lack of oxygen and food that he agreed immediately to the move. He then spent 10 days there, seven in an induced coma and three awake. He has hazy memories now of texting friends and family from the ICU, telling them he was about to be put into a coma and wasn’t sure if he’d make it. “I texted them that I loved them.”

His text was devastating for his family. “When Callum messaged the family WhatsApp group to say he was being put on a ventilator I broke down,” says Sam.

“Our mum was beside me and was remaining very positive, but I remember saying to her, what if this doesn’t work? There is no escalation point beyond ICU and a ventilator.”

Sam sent a message back to Callum saying that he loved him, that he should rest up and they’d talk soon. “But in my head, I wasn’t sure that would happen,” says Sam, who then rang his twin’s closest friends, explained the situation and asked them to send messages of support.

“When we got the call to say he was on a ventilator I cried and was inconsolable,” says Sam. “I thought I had said goodbye to the person I care about the most.”

This was also taking a horrific toll on the twins’ parents. The twins’ father, who had been hospitalised with shortness of breath and a fever, was also a patient at SVUH. He sat beside his son as he was placed into a coma. Meanwhile, their mother, who was suffering Covid symptoms that felt like a nasty migraine along with fatigue, managed to keep calling the ICU at SVUH every seven hours.

When Callum finally woke up, he was delirious – a condition that afflicts two-thirds of patients coming off ventilators. He recalls wild hallucinations, even thinking the nurses were trying to kill him. He also recalls trying to ‘escape’, but it took him 10 minutes to swing one leg over the bed railing. A nurse he got on well with saw what was happening and stopped him. Callum felt guilty about this when the delirium subsided.

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He was vomiting. He was also suffering from acute pancreatitis, possibly due to the effect of the steroids needed to keep his airways open. When the physiotherapists came around, he made another escape attempt, but just fell limply back on top of them. He used a bedpan, and when he finally managed to go to the bathroom with the aid of a Zimmer frame, he felt victorious.

As Callum improved and looked around the ward, he saw he was the youngest person there, by far.

“I felt like a millennial cliché, glued to my phone and counting the seconds until the 10am WhatsApp with the family,” Callum says.

He said that in some ways, he had it easier than his family. “They couldn’t control what happened and couldn’t visit me at all after I left the ICU,” says Callum. “Sam, my twin, found the phone calls from ICU to update them the hardest. He expected each one to be the one to tell them I hadn’t made it through the night.”

Callum was signed up for a clinical trial investigating the genetics of Covid-19, and why it hits some worse than others, but was unaware of it at the time as he was in a coma.

“My twin agreed, on my behalf to the UCD-Edinburgh study – why Covid affected me worse than others,” says Callum. “My mum was jokingly annoyed that I had him (his twin) down as my next of kin on the relevant documents.”

Then when he went to the ICU, a research team visited Callum and explained the REMAP-Cap clinical trial. This time he was able to give consent to take part on his own behalf. This was a global study investigating community-acquired pneumonia.

“Patients suffering from pneumonia are given combinations of antibiotics, steroids and antiviral drugs to figure out which is the best combination,” says Callum.

“As part of that I think I received tocilizumab and dexamethasone. The teams involved in REMAP-Cap saved my life and with my data will continue to save more.”

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