66-year-old UCSF medical director Dr. Coleen Kivlahan is one of 60 UCSF medical professionals who have been infected with the SARS-CoV-2 coronavirus, but she's the only one who has not recovered and who continues to test positive for the virus nearly 90 days after she believes she caught it.
As Kivlahan tells the Chronicle this week, "I belong to the very small club of persistent positives," and it's a club no one, including Kivlahan, wants to belong to.
Kivlahan was likely exposed to the virus on March 3, when she took time out from her administrative and faculty duties at UCSF Medical School — where she is executive medical director in charge of primary care — to see patients in the urgent-care clinic at the Parnassus hospital. She was treating some of the first patients in San Francisco to show symptoms of COVID-19, including a persistent cough and fever, and though she and the patients were masked, she believes her exposure to them was the likeliest culprit.
Three days later, on March 6, she attended one of the medical school's first strategic meetings about the pandemic along with 100 of her colleagues, and that afternoon, she began having symptoms — chills, a fever, and then a dry cough like one she'd been hearing in her patients.
Her bizarre case unfolded over weeks in which she tested negative for COVID-19 not once but twice. She and her husband were both treated for bronchitis and human metapneumovirus, a common upper respiratory infection — he also tested negative for COVID over several weeks — and it wouldn't be until her symptoms had faded and then returned in a second wave on March 25 that she would finally test positive.
And it was only then, three weeks into her illness, that she had the tell-tale symptom — a loss of taste and smell. According to Kivlahan, she has had the fictional scent of a forest fire surrounding her now for over two months.
Though she came close to checking herself into the hospital on March 31, she did not, and she has been able to ride out the slow course of the disease at home. She's grateful that she never had to be intubated, but she remains weak and short of breath, with a cough and an elevated heart rate. And her case is an outlier to be sure — from the few studies we have of recovered COVID-19 patients, we know that some percentage of patients continue to test positive for as many as 30 days while being asymptomatic, but Dr. Kivlahan still has symptoms and is still coming up positive on nasal swabs after 85 days. Saturday, she says, will be 88 days since she was likely infected.
Somehow, her husband was either never infected, or was not tested properly when he was — and the couple are now part of a couples study at UCSF about COVID cases where one person tests positive and the other doesn't.
Below is a January 2018 PSA from UCSF that Dr. Kivlahan did encouraging people to get flu shots.