Here in Baltimore, Our City of Perpetual Recovery, Steve Dixon and Antoine Kittrell have been through a lot together. They are friends. They are survivors. They have now twice recovered from threats to their lives — first from addiction to heroin and now from the virus that has killed more than 134,000 of our fellow Americans in less than six months.
Dixon and Kittrell work in Baltimore methadone clinics at the front lines of the opioid crisis — America’s other health crisis — trying to help people through the recovery both men achieved two decades ago. They got clean in the late 1990s, went to college and became addictions counselors.
“We’ve been friends for 22 years,” Dixon says during a midday chat on the porch of Kittrell’s home in Reservoir Hill. “We met in a 12-step program. There were three of us — me, Antoine and Roger Parham — and every day at 6:30 a.m. for 19 years, the three of us spoke by phone. Every day.”
Parham died of cancer in 2018, but Dixon and Kittrell maintained their brotherly connection — until last month, when both became ill, tested positive for the coronavirus and had to be hospitalized for more than two weeks each. Kittrell went to Mercy Medical Center, Dixon went to Sinai Hospital.
Because of several underlying health problems, Kittrell’s condition was particularly bad, and his risk of death high, according to Dr. Majid E. Cina, one of his physicians at Mercy.
“They said I was very, very, very — they used three verys — sick,” says Kittrell.
“And I was told I was very, very sick — two verys,” says Dixon.
Dixon is 60 years old, and Kittrell 52. They work with addicts in separate methadone clinics in the city, and that’s where, Dixon says, he likely became infected with the coronavirus.
“Some methadone clients have not taken COVID-19 very seriously,” he says. “Some refuse to wear masks and practice social distancing. Some are not capable of practicing certain behaviors because they may be homeless and living in very uncomfortable conditions.”
Kittrell became ill first. On June 2, he says, he had severe gastrointestinal problems, a lesser known symptom of the virus that causes COVID-19.
Three days later, feeling ill and fatigued, Kittrell went to Mercy, where doctors quickly assessed him as a high-risk patient because of existing health conditions, among them high blood pressure and a lung disease that made breathing difficult and required an air-pressure device to help him sleep.
The Mercy doctors were “highly concerned” that Kittrell could die from the disease, Cina says. So they offered to enroll him in a convalescent plasma program, part of a trial being conducted at hospitals throughout the country by the Mayo Clinic.
The concept is old-school: People who recover from COVID-19 have antibodies, the proteins that fight off infections. Through blood banks, including one in Delaware, they donate their plasma to patients who contract the disease. “We’re essentially borrowing the weapons the immune systems of recovered patients have generated,” says Cina.
Kittrell, in Mercy’s intensive care unit, started receiving plasma transfusions on June 7.
Four days later, a “very, very sick” Steve Dixon showed up at Sinai Hospital. He had a fever and cough, required oxygen and had a troubling chest scan. He started receiving the same plasma treatment the next day, according to Dr. Nilesh Patel, one of the physicians registered with the Mayo Clinic to offer the therapy.
“The first day they gave me a 30-minute IV that looked like a bag of mustard,” Dixon says. “It was a person’s plasma who had defeated COVID-19. Their antibodies were released into my system to fight this awful virus.”
Patel says Dixon needed medications to slow the spread of the virus, and other physicians — Yuan Qiao, Joshua Birnbaum, Jeremy Gradon and Ian Hoffman — were involved in recommending additional drugs and monitoring his progress.
“Mr. Dixon was a patient with good will power who wanted to try everything,” Patel says.
Dixon needed additional oxygen but never needed to go on a ventilator.
Nor did Antoine Kittrell at Mercy.
“He started to turn a corner for the better on June 16,” says Cina.
“I had called my brother to tell him where my [life] insurance policy was,” Kittrell says. “I prayed to God that I did not want to die, I was not ready to go. It was very scary, thinking about going to the other side.”
But, when he started to breathe easier, Kittrell says, he stopped thinking about death. “I started to accept that I wasn’t going to the other side.”
Both he and Steve Dixon credit the plasma therapy for their recoveries. But Cina and Patel emphasized that the treatment is still experimental, though promising, as indicated by a Mayo study published last month.
Clearly, says Cina, Antoine Kittrell would not be alive today had he not gone to the emergency room.
Cina discharged him on June 22. Dixon walked out of Sinai on June 24.
Kittrell is still recovering at home and hopes to return to the methadone clinic soon. Dixon has already returned to his. “Back on the front line of the opioid crisis, assisting with that battle,” he says. “We still talk to each other every day, and we are grateful to our medical teams and to the Mayo Clinic.”