NEW YORK (NYTIMES) - Late one night, after a test confirmed the stealth invasion of his cells by the new coronavirus, Mr Dale Grizzle was seized with a violent fit of vomiting in his hospital room.
Until then, Mr Grizzle, 69, of Rydal, Georgia, had maintained his trademark good spirits.
Like most people who have contracted the virus, he had experienced mostly mild symptoms.
But in that moment, Mr Grizzle, a retired house painter with 13 grandchildren, found himself unable to fend off the darkness. "I got to thinking about, 'Is my life going to end here?'" he recalled in a recent interview. "'Is this going to be it?' I had severe anxiety."
Anxiety is exactly what many Americans are feeling as a virus that has infected nearly 100,000 people and claimed more than 3,000 lives across the world over the last eight weeks finds its first footholds in the United States. With health officials preparing the public for a widespread outbreak here, six Americans who have already tested positive for the virus spoke to The New York Times about its predictable and unexpected consequences.
Some, like Mr Mark Jorgensen, 55, of St George, Utah, have experienced no physical discomfort from Covid-19, as the disease brought on by the virus is known.
Others cannot shake its signature symptoms, such as Mr Carl Goldman and his two-week-old cough.
Isolated in hospital rooms, quarantine units or their own homes, some early Covid-19 patients turned to prayer or meditation. Many expressed new appreciation for FaceTime and other video-call apps that let them stay connected to loved ones. And some found comfort among other members of the fast-expanding group of Americans in similar straits.
With a potentially fatal virus hijacking their respiratory tract, small pleasures, like tasting a favourite food or catching a glimpse of a family pet took on heightened meaning. The notion of communal responsibility for public health gained new resonance. And some who divulged their disease to friends or clients had an inkling that it could become a new marker of identity. "They go, 'Hey, I know someone with coronavirus!' Like it's a badge of honour," noted Mr Rick Wright, of Redwood City, California.
But that didn't stop them from despairing over their own status as a reservoir of infection, or fearing ostracism. Nor did it make the defining uncertainty of the disease, which had never been seen in humans before it was detected in China in December, easier to bear.
They worried about dying. They worried about living, with unknown debilitating effects on their bodies. They worried about the tests required to prove that they were virus-free - the nasal swabs that made their eyes water and the throat swabs that made them gag.
It is one thing to be sick. It is another not to know your chances of getting well, and to know that calculating those chances depended on how many others were sick, and to know that no one knew that, either.
Alone on that night in mid-February, Mr Grizzle said, the fear that gripped him eased as he prayed. The next day, he texted Mr John Haering, who, like himself, had contracted the virus on the Diamond Princess cruise ship last month as it was docked in Japan.
The two men, who had met on the ship with their wives, were among some 40 American passengers admitted to hospitals in Japan. Mr Grizzle had been escorted off the boat on Feb 11.
"What's the word?" he typed to Mr Haering two days later at 7.11p.m.
"Hey Dale," came the reply. "In hospital too. Hate it already."
Before the ship entered quarantine-mode, when the couples thought their cruise was coming to its regularly scheduled end, they had vowed to stay in touch.
But not until their wives were evacuated to a 14-day quarantine at a California military base while they remained hospitalised in Japan did Mr Haering and Mr Grizzle actually lay plans to take their families on another vacation together.
"We want to sit in the beautiful, un-diseased waters of the Caribbean," Mr Haering said during a joint interview with Mr Grizzle over WhatsApp.
"We just want to float around," Mr Grizzle added.
It was a welcome distraction. Both men had recorded 40 deg C fevers. Each received CT scans of their lungs that revealed pneumonia. Both were haunted by the death of a doctor in China who had been reprimanded for trying to alert people early on to the viral outbreak.
Mr Haering, like Mr Grizzle, also suffered some combination of gastrointestinal distress and existential angst. The coronavirus death rate, they knew, was about 2 per cent, which sounded low. But then, the world's case count kept mounting. So did the cruise ship's. With over 700 infected passengers and crew members, the odds didn't look as good. And they were worse for people over the age of 60.
"You start thinking, 'Oh my gosh, do they really not know anything about this? Could I die?'" said Mr Haering, who is 63.
A recently retired operations manager for Union Pacific railroad, Mr Haering said his fever had broken even before he reached the hospital. That soon made him eligible to take the first of two tests that would need to come back negative for the virus in order for him to leave.
"Have you ever had a nose swab?" he texted Mr Grizzle on Feb 21.
Mr Grizzle, whose low-grade fever was lingering, had not. But he did have what he knew Mr Haering craved: a hamburger. The food at their respective hospitals had provided much conversational fodder, and Mr Grizzle had just learnt how to order in. He texted back a photograph.
"I love french fries," Mr Haering replied, with a touch of envy. "Were they still warm? Salty, I hope." "Let's live it up a little," Mr Grizzle replied some time later. "Can I call?"
They celebrated the negative test result that Mr Haering's wife, Melanie, had received at the base in California, and the consistent reports from Mr Grizzle's wife, Sherry, that she had virtually no symptoms despite being hospitalised for the virus, first in San Francisco and then at a hospital in Spokane, Washington.
When Mr Haering did get the all-clear on Saturday to return to his home in Tooele, Utah, Mr Grizzle insisted that he was happy for his friend.
"We kind of have developed a brotherhood," he said. "A brotherhood of the virus." Mr Haering texted him a photograph of his dinner on Friday night as he awaited a flight. It included warm, salty french fries.
"Now that's what I'm talking about!" Mr Grizzle replied. "That's a great-looking plate."
The doctor from San Mateo County's health department was waiting on Mr Rick Wright's front porch in Redwood City when the ambulance dropped him off.
From 10m away, the doctor indicated that Mr Wright was to read the paperwork he had left before entering. Following instructions, Mr Wright entered his home and called the doctor, who spoke to him from his car parked outside.
He was not to go outside. He was not to accept visitors.
The distancing protocol made sense for someone with a highly infectious disease for which there is no treatment. And Mr Wright has tested positive for the virus three times since mid-February. First, when health officials seeking to assess the contagion on the Diamond Princess first swabbed his throat and then twice more during his eight-day stay at a Northern California hospital.
Yet Mr Wright, an insurance broker who learnt of his first result only after returning to California on a State Department flight with his wife, Kathy, is among the as-yet-unknown number of coronavirus carriers who remain the picture of health.
"I feel great," he said from his living room, where he must remain until he tests negative twice within a 24-hour interval. "It's so bizarre."
It was the dread of making someone else sick that kept Mr Wright sane. Because the virus is spread through respiratory droplets, coughing is thought to be its primary vector. But healthy people have also been a source of infection, studies have shown.
"I don't want to be giving people the coronavirus," he said.
Mr Wright had left his laptop at home when he went on vacation. Still, in the hospital, he resisted turning on the television until it was time for the 5pm news. Instead, he read books on his Kindle and texted friends. He called Kathy multiple times a day, and the couple video-chatted in the morning and before going to bed.
"You look forward to going to bed because it's one more day behind you," said Mrs Kathy Wright, 60, who was waiting out her own quarantine period nearby at Travis Air Force Base after testing negative.
When health officials decided he could practice "self-isolation" at home last week, they told him they would alert him as soon as his latest test results came back. To be released from quarantine, he would need to have two negative tests in a row. That has not yet happened.
Before returning home on Feb 26, Mr Wright contacted his neighbours. No one, he said, made him feel like a pariah. But he is ready to be free. On Tuesday (March 3), a county health official came to his door to take another nose and throat swab.
"Still here," he texted.
Mr Carl Goldman's cough is still with him. "It comes back more pronounced than normal when I'm talking," he apologised in a telephone interview this week.
The co-owner of a local news radio station in Santa Clarita, California, Goldman experienced the classic symptoms of Covid-19: high fever, a dry cough, tightness in the chest.
On Feb 22, he celebrated his 67th birthday in the biocontainment unit at the University of Nebraska Medical Centre, built after the anthrax scares of the 9/11 era and later used to treat Ebola patients.
"My medical team brought me a cake with an unlit candle taped to the box," Mr Goldman wrote on his coronavirus recovery blog. "It is against regulations to light a candle here in Nebraska Medicine."
But he is recovering, as he reported to the other dozen Covid-19 patients at the medical centre during a telephonic town hall.
Held at 3pm daily, the virtual meetings are designed as a hedge against the psychological deterioration that previous research has documented in patients whose condition requires isolation, said Dr David Cates, a clinical psychologist at Nebraska Medicine who runs the meetings.
One day last week, a patient originally from one of the countries where the virus recently started to spread, joked that it could not be pinned on him: "I moved here 30 years ago," participants on the call recalled him saying. Another told the group that she relieved her stress by drawing.
And when Mr Goldman felt well enough to transfer from the biocontainment centre to the centre's more dormitory-like quarantine unit, he announced his determination to reduce stress by resuming his daily exercise routine, which would require him to walk the length of his room - 14 paces - until he reached 10,000 steps.
That brought a smile to the lips of Ms Charlene Thorburn, 78, a retired secretary from San Diego. Though her symptoms were negligible, as were her husband's, she said, she was never sure if they would grow far worse. The group discussions helped her realise that others were also wondering about the scope of the illness, the possibility of treatment - and how fast it might be spreading.
"You find out what you're thinking is not so strange," Ms Thorburn said, "because everyone else is thinking the same."
Two of the Covid-19 patients at the centre were released on Sunday, another on Tuesday. A third, whose condition worsened, was transferred to the biocontainment unit. The town halls, Ms Thorburn said she has been told, will continue until everyone departs.
"Stress is not a good thing to have," Mr Goldman admonished recently, "if you're trying to fight and keep your immune system up."