Distinguished University Professor, School of Public Health
A professor of epidemiology, Monica Swahn was closely monitoring the unfolding pandemic when her father fell ill with COVID-19. Here, she remembers him and discusses his death against the backdrop of various global responses to the crisis.
AFTER TWO WEEKS ON A VENTILATOR for COVID-19-related health issues, my dad died on April 20 in Stockholm, Sweden, his home for most of his life. One month later, he would have turned 75 years old.
He lived an exciting life. In semi-retirement, he managed a business in Pattaya, Thailand, and lived in a beautiful condo close to the beach. He soaked up the sun, exercised and ate the best foods. He regularly traveled to Stockholm to visit friends and family.
In January, when I last saw him, he hadn’t yet decided where he would be on his birthday, May 19, but most likely it would have been in Thailand. I was pondering the possibilities of an exotic celebration of the occasion, maybe even on the beach. But then everything changed.
The day the World Health Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern, Jan. 30, I flew from Sweden back home to Atlanta. On that flight, I prepared my lecture notes and class activities for the following week. As a professor of epidemiology, I teach a global health class to graduate students, and I wanted to make sure to update them on the latest developments. This was big. We were all wondering if the COVID-19 epidemic was going to become a pandemic.
Every week in class, we started with a discussion of COVID-19. At that time, it never occurred to me that the virus would strike and end my dad’s life or that it would result in such a health crisis for the U.S.
I felt so bad. I had told my friends as late as early March that while COVID-19 was likely to become a pandemic, it should not be a major concern — at least not to those of us in the U.S. — because we have the infrastructure for testing and contact tracing, two key tools for containing the spread. This is basic epidemiology.
I had worked at the Centers for Disease Control and Prevention for nearly 10 years. I knew the agency’s strengths, and I thought we were in good hands. For years I trained epidemic intelligence officers or, as we like to call them, “disease detectives.” I knew we could do this.
But, when COVID-19 cases were first identified in the U.S., we did not undertake broad testing protocols, nor did we implement contract-tracing strategies. We simply focused on the cases that came from abroad. We did not address the community spread until much later, until the virus was spreading all over the country.
With horror and fascination, I followed the dramatic increase in cases in the U.S. and elsewhere, realizing that, with our limited testing, we were missing most cases.
We could have been a success story. We should have been. It never had to be this bad.
My family in Atlanta was fine, but in Stockholm, my dad got a cough. His partner was concerned. He had a hard time walking. He was disoriented. He seemed to have a fever and kept coughing.
We ordered him an ambulance, but he refused care. They said his vital signs were fine and there was nothing they could do. And, perhaps, at that moment, that was true. But he deteriorated fast.
When we ordered him a second ambulance, he showed the emergency staff he was too fit to go with them. He actually did a few squats, his signature move, in a defiant way to show them he was in great shape. And he was. He took meticulous care of his physical health and kept a diary of his exercise routine. In his younger days he competed as a weightlifter and even ranked in the top nationally. Yet, he ended up taking the ambulance to the hospital and was placed on a ventilator shortly thereafter.
At first, he seemed to respond well to the treatment, but things changed. After two brutal weeks with some of the best medical care available, he died.
In class, we discussed the COVID-19 strategy used in Sweden. As a Swede, I found it interesting to compare and contrast strategies used in various countries. When I found out my dad had been diagnosed with COVID-19, I was concerned for him and concerned about how many people he may have infected before getting treatment, given Sweden’s more lax approach. Luckily, it seemed his friends did not get sick.
I don’t want my dad to be forgotten, to be just one of the many unexpected deaths due to COVID-19. These deaths are all tragic, and so many of them could have been avoided.
My dad was born in Finland in 1945, just as World War II was about to end. He was strong. He worked hard. He loved driving his car and listening to Elvis and Bob Marley. He loved watching movies. He loved the beach. He was stubborn, terribly stubborn, and he was full of Finnish sisu (a cultural concept incorporating characteristics including courage, willpower and tenacity).
He lives on in me and my younger brother.
Photo by Meg Buscema