Jen Bollig is living with the guilt that she almost deprived her five children of a mom because she didn't get vaccinated and reduce her COVID-19 risk.
But at least she is living.
The 47-year-old Cushing, Minn., woman is recovering from severe COVID-19 after a one-month hospitalization that included placement in a medically induced coma and on a heart-lung bypass machine at HCMC in Minneapolis because she was too weak to breathe.
Odds of survival are 50-50 when that level of treatment is needed, and Bollig on Monday said she wanted to use her fortune to encourage others to get vaccinated and avoid the pain and fear she has endured. She hopes to be discharged from the hospital this week and get through a couple of weeks of rehabilitation before returning home next month, when her family has planned a delayed Christmas celebration.
"I don't want to see what happened to me happen to anybody else," she said.
Public health officials are hopeful that COVID-19 vaccination progress has helped turn the tide against Minnesota's longest and perhaps most frustrating pandemic wave — one fueled by the fast-spreading delta variant. The state's reported positivity rate of COVID-19 diagnostic testing dropped back below the 10% high-risk threshold for widespread viral transmission, and COVID-19 hospitalizations declined from 1,678 on Dec. 9 to 1,485 on Friday.
Doctors and nurses urge people to listen to Bollig's advice and get vaccinated because holiday gatherings are presenting new opportunities for infection and the concerning omicron variant emerging in Minnesota.
"The courage to speak up and say, 'Hey, that wasn't a great decision I made' or 'I regret it?' For people that are still hesitant, I would hope that would go a long way," said Dr. Matthew Prekker, an HCMC critical care specialist who treated Bollig.
Bollig and her husband always get seasonal flu shots but were against COVID-19 vaccinations from the start. She said they didn't feel they knew enough about the vaccine, and that political leanings probably influenced them a bit as well.
By fall, their two oldest, adult children had been vaccinated, and they decided that Jen should get the shots because her asthma and diabetes elevated her COVID-19 risk.
But it was too late by Nov. 11 when Bollig went to CentraCare Long Prairie hospital with COVID-19 symptoms. She started to panic as breathing became more difficult, texting a message of love and pride to her 17-year-old son in case she didn't survive. She texted a selfie from her bed to a relative before she was intubated for placement on a ventilator.
"That's one of the last things I remember," she said.
Breakthrough infections in fully vaccinated Minnesotans have been occurring with greater frequency this fall because of waning immunity in the earliest recipients of the shots, but unvaccinated people remain at the greatest risk of severe illness, hospitalization and death. At HCMC on Monday, 23 of 38 COVID-19 patients were unvaccinated, including three of the four patients on ventilators.
Bollig initially was transferred to St. Cloud Hospital for placement on a ventilator, but a complication made it hazardous to continue with the high-pressure settings needed to maintain adequate oxygen intake. She was transferred Nov. 19 to HCMC and placed on extracorporeal membrane oxygenation (ECMO), a mechanical form of blood oxygenation that took the pressure off her lungs entirely so they could heal.
Prekker said it is considered "the last line of life support," and that survival odds have paradoxically worsened in 2021 even as doctors have gained more experience with the use of ECMO. One possibility is that steroids and other treatments are preventing some patients from needing ECMO — leaving it for only the most severe cases.
Bollig's underlying health conditions were a concern, but Prekker said she had the advantage of early and timely transfers for care right when she needed it. She was removed from ECMO in six days, compared with other COVID-19 patients who remain on it for weeks.
"I was just happy that we at Hennepin could be available when St. Cloud called and she needed that help," he said. "We got the ECMO to her fast enough that it wasn't a case where irreversible lung damage had set in."
Prekker and others warned that the danger of hospital overcrowding with COVID-19 and other patients is that care isn't always available right when patients need it. Only 24 of 1,012 staffed adult ICU beds were open in Minnesota on Friday, although that was an improvement from 12 earlier that week.
Rationing of medical care is commonplace under crowded conditions, said Kelley Anaas, a critical care nurse at Abbott Northwestern Hospital in Minneapolis. Some patients are waiting for hours or days in emergency departments for inpatient beds to open up. Others are receiving less attention from nurses who have been assigned extra patients out of necessity.
"The bar is no longer set at, 'Did I progress the plan of care and make my patients a little better today?' The goal changes to, 'Try to keep up and try and keep them breathing.' That is rationing care," she said.
Bollig said she regained consciousness and awareness Dec. 12 after the ventilator was removed and her lungs started working on their own with the help of supplemental oxygen. She was relieved to learn her husband, father and remaining three unvaccinated children had received COVID-19 shots while she was sedated. But not all the news from the month she missed was good.
"I don't know if I should tell you this," she recalled her husband saying about their beloved Minnesota Vikings. "We beat the Packers but we lost to the Lions."
Recovery has been simultaneously fast and slow. Two weeks after being extubated, Bollig was sitting up in bed — warmed by the fuzzy purple blanket a daughter got her as an early Christmas gift — and talking and laughing with minimal shortness of breath.
But she had panic attacks when therapists tried to get her to stand and move a few steps from her hospital bed to a chair.
"My chest gets tight and it's really hard to breathe," she said.
An exhausting switch from bed to a wheelchair this week was a small victory, but Bollig said she knows she needs to overcome her fears and walk more to regain her strength and coordination.
Bollig dreams of another family vacation like a recent road trip along the entire Florida coast. She wants to see her three children who are too young to be allowed in the hospital and her cat, who keeps wandering around the house looking for her in vain.
"I just want to be home," she said.