Close advisers to Baltimore Mayor Catherine Pugh said Tuesday that she is still recovering from a serious case of pneumonia that has sapped her strength and forced her to convalesce at home, under doctors’ supervision, since late last month.
“While her well-known tireless energy has been diminished by this illness, her doctors are confident she will recover her health and strength in due course,” said Pugh’s personal attorney, Steven Silverman, in the first update on her condition in more than a week. “I know she is grateful for the good wishes of concern and support that she’s received.”
Pugh was admitted to Johns Hopkins Hospital on March 24, just as a scandal related to $500,000 in sales of her “Healthy Holly” children’s books to the University of Maryland Medical System, where she sat on the board, was gathering steam.
She took a leave of absence — which she attributed to her illness — on April 1, after it was further revealed that she had also collected hundreds of thousands of dollars for her books from various entities doing business with the city, including Kaiser Permanente.
Many in the city have offered their well wishes to Pugh, as Silverman mentioned, but some have expressed skepticism over the timing of her leave. It came after Gov. Larry Hogan called on the Maryland state prosecutor to begin a criminal investigation and some other elected officials urged her to resign.
Calls for her resignation have mounted this week, after Pugh’s office put out a statement over the weekend saying she intended to resume her duties as mayor once she recovered.
Every member of the City Council except Bernard C. “Jack” Young, the council president who is acting mayor during Pugh’s leave, has called for her to resign, as has the city’s House delegation in Annapolis.
Those closest to Pugh say her deteriorated health, not the scandal, truly is the driving factor behind her decision to cloister herself from the public, and that she is serious when she says she will return.
“She’s recovering day by day,” said James Bentley, her spokesman. “She's focused on getting healthy, and remains committed to Baltimore.”
Bentley declined to discuss the specifics of Pugh’s condition. He said he has not discussed with her the controversy swirling around her book sales. Silverman also declined to address specifics of her condition.
Young said Pugh called him Monday morning to share her intention to return “as soon as she’s released from her physician,” but “sounded like she’s still just as sick as she was the first time I spoke to her.”
“I told her I was keeping the city moving on the right track,” Young said.
Jim Smith, who has announced that he is leaving his position in the administration as chief of strategic alliances, said his departure is to allow Young to pick his own leadership team. Smith said he expects Pugh’s leave to be “protracted” because of her illness and the cloud she’s under because of the state prosecutor’s investigation.
Smith said he has checked in on Pugh at her house and that she is still quite sick. He said they didn’t talk about the scandal, but that he offered her some advice, which he wouldn’t share, about what she should do next.
Andre Davis, the city solicitor and a top adviser to Pugh, said he had nothing to add on the topic of her health, other than that he and others in City Hall are “concerned that she focus on getting better.”
Getting healthy after a pneumonia diagnosis is no sure thing, particularly for older patients or those with other, complicating medical problems — as was made clear this week by the death of Maryland House Speaker Michael Busch from pneumonia diagnosed after he underwent a follow-up procedure to his 2017 liver transplant. Busch was 72.
Pugh, 69, has not publicly faced serious medical challenges before now. She has said she jogs multiple times a week and eats a healthy diet — and that her enthusiasm for healthy living is part of what propelled her into children’s publishing. The “Healthy Holly” series is all about exercise and eating well.
What Pugh is now facing medically is unclear, in part because neither she nor her advisers have provided specifics as to the nature of her pneumonia — a disease that can be bacterial, viral, or even fungal.
Typical symptoms include coughing and fever, while more serious cases can lead to a shortness of breath and dangerous lung conditions. Fluid can build up in the lungs as the immune system rushes to respond to infection. Doctors can detect abnormalities in chest X-rays, and diagnose from there — often prescribing antibiotics in the case of bacterial infections.
Every year in the United States, there are about 600,000 hospitalizations for pneumonia in the 65-and-older population alone, with a mortality rate in that age bracket of up to 20 percent, according to Dr. Paul Auwaerter, clinical director of the division of infectious diseases at the Johns Hopkins University School of Medicine.
Younger people tend to fare better in recovery than older people, and “certainly leading a healthy lifestyle gives people more stamina and reserve to fight serious illness,” he said. But symptoms and recovery time can vary greatly among patients, said Auwaerter, who spoke in general terms about pneumonia and not about Pugh’s illness specifically.
The American Lung Association says some people with pneumonia “feel better and are able to return to their normal routines within a week,” while others “can take a month or more.”
Auwaerter said that once people seek treatment, and particularly if they are hospitalized, they are on average “feeling better within 48 to 72 hours,” though it “might take five to seven days” for them to bounce back completely.
But recovery can take longer than that, too, he said, particularly if there are complicating factors — including stress.
Pugh has been dealing with a barrage of criticism of late, which continued Tuesday when Young met at the U.S. Capitol with members of Maryland’s congressional delegation.
Members of the delegation declined after the meeting to address media questions on whether Pugh should step down, but Rep. Andy Harris of Baltimore County, the delegation’s lone Republican, said in a later interview that the city needs a new leader.
“There are enough questions — legitimate questions cast about this — that I think the mayor probably can no longer be an effective leader of the city,” Harris said. “It would be hard to be the leader that Baltimore City needs at this point in time, and they really need some leadership.”
Baltimore Sun reporters Luke Broadwater, Jeff Barker and Doug Donovan contributed to this article.