Joe Tannous survived coronavirus. He has a warning for us all
Joe Tannous spent 10 days on a ventilator in an induced coma. But nothing could have prepared him for what comes after COVID-19.
Joe Tannous missed the last week of March. He did not witness those discombobulating days when the menace of Covid-19 meant the sealing of state borders and the closure of playgrounds. He can give no first-hand account of the social and economic upheaval that erupted then, when hundreds of thousands lost their jobs, when Depression era-like lines wound around the blocks surrounding Centrelink offices nationwide, and when those who still had work were ordered home.
While the nation held its collective breath as inconceivable and difficult political decisions were made, Tannous was at first breathless and then unconscious. At 49, he was one of the earliest, most serious, and most unexpectedly critical victims of a virus that would choke the globe. Nothing in his background suggested he might so nearly succumb. A non-smoker with no underlying medical issues, he was healthy and he exercised regularly. Yet here he was in late March in an induced coma, isolated from the bulk of humanity for their sake as much as his, a tube down his throat about the best chance he had of reaching his 50th birthday the following month.
The story of Joe Tannous’s near death begins inconspicuously and in the midst of a typically busy week. Although the world had been watching the spread of a new coronavirus for a couple of months, life in the second week of March had yet to change dramatically in Australia.
A lobbyist and former member of the state executive of the NSW Liberal Party, Tannous spent that seemingly unspectacular week moving from meetings to dinners and business lunches in Sydney and Melbourne, using public transport and Ubers, taxis and commercial flights between appointments. On Tuesday night, March 10, he attended a Liberal fundraising dinner in central Sydney. A fastidious man, meticulous about his dress, Tannous was one of the first to arrive at the charity event and he soon sighted Home Affairs Minister Peter Dutton. “We were some of the early birds.” The pair shook hands – they had not previously met in person – and talked until more guests, including Prime Minister Scott Morrison and several cabinet ministers, appeared.
The following day, the World Health Organisation declared Covid-19 a pandemic. And the day after that Tannous was at Bankwest Stadium in Parramatta where, amid a crowd of more than 21,000, he watched the National Rugby League’s season opener. “You wouldn’t have thought there was a problem in the world because the stadium was full. Everybody was having a laugh,” he recalls. His younger brother Pierre, who was also at the game, remembers one other detail: that night his older brother had a slight cough. It was so minor that it failed to register with Joe as his busy week merged into Friday, March 13, and he boarded an interstate morning flight.
By now, the Department of Foreign Affairs was advising Australians to consider their need for overseas travel and there were 140 cases of Covid-19 in Australia. Tannous spent several hours in Melbourne, where the Grand Prix was belatedly cancelled just before the first practice session. On his afternoon flight to Sydney he exhibited the first clear symptom of the virus that would nearly slay him. “He had a dry cough when he got in the car,” says his partner Kirsti Hitz-Morton, who collected him at the airport and drove him to his home nearby. “It was a Friday night and we were both exhausted and we poured a glass of wine and sat down to watch the news.”
As the 6pm bulletin began, word was breaking that Dutton had tested positive to coronavirus. “It was only something that happened to people overseas. We laughed because we didn’t think it was possible,” says Hitz-Morton. “I joked – and I feel terrible about it now – and I said, ‘Goodness, was he at the function on Tuesday night with the PM? Were you sitting with him?’ And he said, ‘I was sitting with [finance minister] Mathias Cormann, but I shook his [Dutton’s] hand’.”
“I didn’t think for one minute about getting coronavirus,” says Tannous, “because everything I had read about it [suggested it was affecting] the elderly: people over 70, people with pre-existing conditions, people like my parents, and my aunty and uncle.” So when he developed a fever later that night, and even as he began vomiting on Saturday and had sporadic headaches, neither he nor his partner was particularly alarmed.
By Sunday morning he had deteriorated. “I knew then that it wasn’t just man-flu. He wasn’t himself. And the coughing had got worse,” Hitz-Morton says. He’d received an email from the Liberal Party on Friday night advising that the home affairs minister had tested positive, and as news about testing increased over the weekend, Hitz-Morton urged him to be checked. “I actually did it because I thought it was the right thing to do, not because I was convinced he had it,” she says.
Tannous could sense his health worsening. “When I was talking to people on the phone I was coughing [so much] I couldn’t finish the conversation.” On Sunday night he went to St George Hospital, a large public facility a few kilometres away. His nose and throat were swabbed, and he was sent home alone to await his results.
That call came two days later on Tuesday, March 17: he was positive and should immediately quarantine. Anyone he’d been in close contact with since the previous Thursday should also be tested. “I felt a lot of weight that I may have infected a lot of people that were close to me and who I love, like family,” he says of his response to the news. “Kirsti, for example; she works at a school so she’s got 500 boys. It made me think, oh God, what’s going to happen? Are we going to feel ostracised?”
Late that afternoon he emailed Hitz-Morton, who was at work and unable to answer her phone. “I was mortified,” she says of the news. “Because I was worried I had it. I thought, ‘Oh my goodness, I have been here now for two days and I’ve potentially infected my entire community’. I wasn’t even worried about Joe because he’s strong and he’s fit.” She contacted her boss and left work immediately to be tested at Balmain Hospital. Then she returned to her own home to isolate.
Tannous spent the next few days alone, contacting anyone he’d recently been near. His tally came to almost 40 people. He told them all that he had contracted the virus and urged them to be tested, a process he found understandably burdensome. “I had to ring clients. I had to ring my three kids, even though I hadn’t come into contact with them. And the people I’d been out to dinner with. I had to get the health department details of the Uber driver, the flight to Melbourne,” he says.
“I sat alone for I think two or three days while other people were getting tested feeling that emotional burden: ‘F..k, what have I done? Does anyone have an underlying issue that I’m unaware of? Is anyone going to be on a ventilator?’ I was thinking about everybody else. And the person that was most impacted was me.”
Tannous was especially worried about his adult daughter Stephanie, who is pregnant. And he was keenly aware that he had just spent an intimate weekend with his partner. “I was concerned for her. What would people think of her that her partner has given her Covid-19 and she’s potentially infected others?”
Awaiting her test result in isolation across the harbour, Hitz-Morton, who was working remotely, was also becoming anxious, although she had no symptoms. She phoned Tannous regularly and sensed his physical health was worsening. “The cough became more frequent and he was less sprightly, so he was quite lethargic. I could tell from the tone in his voice that he just wasn’t himself.”
Tannous had started the week with mild symptoms; at its end he was feverish and couldn’t sleep. “My head was so hot I would get ice blocks to reduce the temperature, and then eat the ice blocks because I was so thirsty, so I could get some sleep.” He also lost his sense of taste. “I remember ordering Uber Eats McDonald’s for lunch and I couldn’t taste it. I just thought it was a bad batch.” On Saturday morning, March 21, he was coughing so badly he could barely talk. “I texted Kirsti and said, ‘Can you call an ambulance? I can’t breathe.’”
Paramedics were at his home within minutes, their entry delayed as they donned special protective gear outside. “It was new to them too,” says Tannous, who remembers “sitting on the lounge waiting for them, trying to breathe and trying to focus my mind on other things. I just thought it would be something minor, they would check me out and say it’s OK.”
Instead he was taken back to St George Hospital, where he hoped his partner could meet him for moral support. But even that once standard assumption was now impossible. Hitz-Morton still faced more than a week of quarantine – even though her own test result, delivered the previous day, showed that, to her utter astonishment, she had not contracted Covid-19.
His chest tight, struggling to breathe deeply, Tannous was seen by emergency staff and soon admitted. It was Sunday morning, March 22 and Australia was awakening to an increasingly restrained world in which even non-essential domestic travel was being prohibited.
Tannous was the first patient admitted to St George Hospital’s new Covid-19 ward. Despite his laboured breathing, in some ways he did not appear ill. “He looked well. He was on a phone call. And he didn’t look breathless talking,” says Dr Yizhong Zheng, the on-call respiratory specialist. In fact, Tannous was much sicker than he imagined. He had severe pneumonia and, as blood tests and X-rays soon revealed, he was rapidly declining. “By the time I went to see him,” says Zheng, “within probably four to six hours his oxygen requirements were already increasing.” While he was one of the earlier cases of a virus that was still little known in Australia, overseas experience suggested “he was going to start to go downhill, even though he was talking on the phone, even though he most probably didn’t feel worried at that stage”, Zheng says.
Later that day Tannous was moved again, this time to an isolated room within the intensive care unit. Separated from the rest of the ward by a protective glass shield, and with only minimal and vital staff allowed near him, here he could be better monitored.
From his bed, Tannous spoke to his partner via WhatsApp video every hour. Quarantined at home, it was the only way Hitz-Morton could see him. “It brings a connection,” she says, “but also gives you that visual image of how sick someone is.” Already short of breath, Tannous’s voice was further muffled by the oxygen tubes running into his nose. “So the conversation was quite slow, and his eyes were heavy.” Still Hitz-Morton was not overly concerned. “I was actually quite relieved. I remember friends and my adult kids saying, ‘He’s in the best place. This is where he has to be and you don’t need to worry about him anymore.’”
With great stealth, the virus was ravaging Tannous’s body. He had severe pneumonia. He was breathless. His temperature had soared to 39.3 degrees. His liver function was slowing. And the amount of oxygen in his blood – normally at a range of 75 to 100mm of mercury – was at a dangerously low 49. Throughout the day groups of medical staff gathered to discuss him. Unable to have visitors, Tannous kept his extended family (he is the eldest of five children) informed from his bed. “I was WhatsApping them saying, ‘I’m in ICU, I’m on oxygen.’ I said I would be OK’. ”
His younger brother Pierre had raced to the hospital as soon as he heard his brother was there. “And they obviously didn’t let me in. The hospital basically just said, ‘He’s being monitored, he’s in a room, you can’t really see him’, and they just told me to go home,” he says. “I didn’t even get to give him the chance to know that someone was there worrying about him.”
In an isolated room inside ICU, Tannous was deteriorating. Without enough oxygen, he was at risk of cardiac arrest. Litres and litres of oxygen were being pumped into his body, but he was still ailing. On Sunday morning, he spoke to his partner again. “He said, ‘It’s not working. I’m a bit worried and they’re worried.’ ”
“To be honest, at that point I didn’t know what day of the week it was,” Tannous says quietly. “What I do remember is they said, ‘Look we have put 60 litres of oxygen in, it’s not working… They came back, a group of them, some of them were outside the glass. A handful came inside. I thought, ‘Why’s there so many of them?’ They said, ‘We’ve tried everything. We’re going to have to intubate you and put you on a ventilator.’ And I just looked at them, stunned. And I said, ‘I’ve got three kids. I’m going to be a grandfather. I’m going to be 50 on Anzac Day. Am I going to be OK?’ And they said, ‘We’re going to do our best.’ ”
He was about to be placed in an induced coma. He had no idea what intubating meant or what being placed on a ventilator involved. “I just wanted to talk to my family and let them know,” he says softly, and begins to cry. Over the next few minutes he contacted those he most loved. “He said, ‘This is like the last resort. They’re going to intubate me and they think this will work,’” says Hitz-Morton. “And I remember saying, ‘That’s good, because you know what? It’s what you need now. In 24 hours you’ll be back.’” Just then medical staff returned to his bed and he ended the call. “The very last message, literally before he was wheeled away was, ‘I love you and I’ll see you on the other side.’”
By noon on Sunday March 22, just over 24 hours since arriving at emergency, Tannous was sedated, and a tube with a balloon at one end was placed through his mouth and into his trachea. The tube was attached to a ventilator – essentially a breathing machine to inflate his lungs. In the absence of any suitable medicines, his body would have to fight the virus that was killing him.
His memories of what followed are both hazy and specific. “I didn’t ask too many questions. I think I just prayed,” he says. “I remember a nurse coming in and putting a mask on me, and I felt like I was choking. And that was to knock me out. And he said, ‘Count to 10.’ And then when he put it [the mask] on, I said, ‘F..k mate! Take it off! Please!’ And that’s all I remember.”
He was unconscious for the rest of March. Specialist staff monitored his lungs and heart and tended to his inert body, cleaning his teeth and his mouth, feeding him through a tube, emptying his bowels, suctioning his airways, applying drops to his closed and unblinking eyelids. “We treat all of our patients as if they’re awake,” says ICU nursing manager Clare Loveday. “You’re still talking to them and saying good morning because under all that sedation people can still hear in some form.”
But while he initially improved with the help of a ventilator, within a day he had again deteriorated. “It was a very confronting sight to walk in and see someone basically lifeless with all these tubes hanging out of them,” Pierre recalls.
Although only one visitor was allowed, the hospital agreed Pierre could share those brief visits with the third brother, Richard. On Monday March 23, through a pane of glass, Pierre saw his eldest sibling for the first time, lying on his back, unconscious. “Even Richard, who’s older than me, he struggled with it,” he says. “One night, as we were leaving the hospital, I took him to the emergency department because he was having an anxiety attack about the way his brother was.”
The tubes protruding from Tannous told only part of his story. His body was struggling to overcome the virus and its inflammatory effects. “He wasn’t improving. Things were getting worse,” Pierre says of the conversation he and Richard had with medical staff on their brother’s second day in an induced coma. “They basically said to us, ‘At this stage, it’s 50/50’. ” They summoned a Maronite priest, who came to the hospital on Tuesday morning to pray for him. They called Hitz-Morton, still home in quarantine, to say her partner’s life was in the balance. But in their calls to their parents, in their 70s and both with health issues, they were mostly vague. They did not tell them their firstborn may not live much longer. “We just didn’t seem to be winning,” says Loveday. Even on a ventilator working at its highest level, Tannous was still deteriorating.
Then, he miraculously plateaued. There was no news either way for days, just a monotonous regularity to the multiple messages the brothers sent Hitz-Morton from ICU: “No changes, no updates.” His fevers wavered. Doctors found white spots on his lungs and hoped they were not a sign of infection.
On Saturday, March 28, the brothers sent Hitz-Morton a longer message: “They won’t consider removing the tube until all signs are better, not until Tuesday. Attempting to get off the ventilator.” Eight days in, Tannous’s chest X-rays were improving and so were his oxygen levels. His sedation levels were reduced and slowly, when doctors deemed his lungs strong enough to work again on their own, he was allowed to wake up.
Finally, on Tuesday, March 31, medical staff began the delicate process of disconnecting him from the ventilator and removing the tube that had kept him alive. “I remember a nurse asking me to squeeze their hand and that they were going to remove the tubes… ‘You’re almost there Joe’, I heard Pierre saying through the intercom, ‘Come on buddy, you can make it,’” Tannous says of his few memories of that time. After 10 days, he opened his eyes. “I looked up and it was showing April 1 and I remember thinking, ‘Where have I been?’ ”
He had lost 12kg. He was so weak he could not stand or write. Because a tube had been in his throat for so long, he could not speak or swallow properly. Yet from the other side of the glass that separated him from the rest of the world, there was jubilation. “It was just so good. Everyone was so excited,” says Loveday as she observed Tannous conscious and breathing on his own. “It’s one of those diseases that can go really badly for some people. And there’s been so much talk about so many deaths. To actually get someone completely through this really gave us a great sense of satisfaction. And relief.”
With her own quarantine finally over, Hitz-Morton was able to visit her partner the following day, April 2. He’d been moved back to the Covid-19 ward by then but was still isolated. “I saw him through a piece of glass. And we both cried and blew one another kisses. It was awful. Just that he was so close but in a way so far away. I could see him but I wasn’t allowed to touch him.”
Over the following days Tannous’s voice gradually returned, although it would remain husky for months. By Tuesday April 7, having tested negative repeatedly, he was discharged from hospital. After weeks of being surrounded by intensive medical expertise, he was going home with no medications, advised to rest and given exercises to improve his strength. Although he had been shown great care in hospital, says Hitz-Morton, “they didn’t prepare us for what lay ahead”.
When Tannous returned home, he did not considerthere would be another chapter to his story, this one uncharacteristically tearful. “There were nights I just cried. I was very emotional. That went on for weeks.” His response was partly in gratitude for the countless messages he discovered had been sent while he was sedated. He heard from colleagues after 15 years. Strangers had set up prayer groups. A client sent him six boxes of fresh produce. “That made me cry… How do you thank people like that? Overwhelming,” he says. “I’ve been around politics for 30 years. You get cynical; there’s always a motive. So I took that cynical view that some of these relationships are transactional, some are based on alliances. This experience has taught me that I need to give people the benefit of the doubt. There are a lot of decent human beings.”
But his gratitude was mingled with the realisation he had become uncharacteristically anxious. Usually adept at handling stress, he became fearful of leaving home. A gastric issue – which he later learned was gastritis, a common occurrence in people who have been critically ill – led to his first panic attack.
“I was anxious to get in a car and drive any distance because I didn’t want to be away from the hospital if something went wrong. I was anxious at my partner’s house because I wanted to be close to the hospital. I was anxious on my first drive to go and see family members when the restrictions were lifted because they live out west and I thought, ‘Oh my God, I’m not going to be able to breathe as I’m driving’.”
In the meantime, he slowly regained strength and was able to take short walks. Then, during his first week back home, his phone rang. A nurse who had been in contact with him days before he left hospital had tested positive. Tannous and Hitz-Morton, who had moved in temporarily to care for him, would have to isolate again. “Because they couldn’t guarantee us. There was no guarantee you couldn’t get it again.”
There is a solitariness to much of Tannous’s experience. As the first Covid-19 patient at St George Hospital he was the first to be intubated and ventilated. “In the hospital you’re left alone. Your food is left outside. And I understand now why. But… I felt like I was in prison.” Until he was declared virus-free, no nurse could place a reassuring hand on his shoulder. In ICU, even nursing manager Clare Loveday mostly refrained from entering his isolated room. “I would chat to him through the glass or the intercom just because we’re trying to minimise the chance of contact.”
In the months since he became ill Tannous has met no other survivors, so there has been little chance to compare his experience or his response. “Who are you going to share notes with? I don’t know anyone else.” He was feeling so anxious at one point that he called Lifeline and again was confronted with the singularity of his circumstances. “They were nice and said, ‘We’re getting calls. But it’s not our area.’ ”
Everybody, he adds, is still learning. There are so many unexpected elements to his experience, chiefly that no one near him has contracted the virus. Not his partner – “we had slept together and I was kissing her. And she tested negative. And I just can’t believe it.” And, as far as he knows, none of his 40-odd closest contacts.
Two months home from hospital, in early June,the lingering scratchiness in his voice is almost gone. He still has no idea how or where he caught Covid-19 – “it could have been any one of a number of people” – or why he was so badly affected. This was supposed to be a virus that struck the weakest, the elderly and those with poor health. And yet Tannous nearly died. “He’s not one of the ones that we would expect,” says respiratory specialist Yizhong Zheng. “As to genetically why he was more predisposed, we don’t know at this stage. And I don’t know whether we will find out.” And a recurrence? While Tannous now has some antibodies, Zheng says: “I think it’s too early to say yes or no confidently.”
Compared with many other countries, Australia’s battle with Covid-19 has been mild, and for those whose health has not been directly affected by the pandemic it can be easy to see some responses as being overreactions. But for those who have felt its impact most intensely, surviving Covid-19 is nothing minor. As Tannous’s speech pathologist Julia Maclean says: “It’s really hard for him because even though we’ve been really lucky as a country in terms of numbers, he hasn’t been. So when we’re all saying how lucky we are and that our numbers are so good, that’s not been his experience.”
“There are a lot of unknowns,” Tannous says. “The fact that someone as healthy as I am without any pre-existing condition can cop it to the extent that I did should be a warning.”