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A year into pandemic, a Minnesota doctor remembers his first COVID-19 case

Mayo Clinic's Dr. Casey Clement recalls that first diagnosis. It was the beginning of a long year.

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Dr. Casey Clements, an emergency medicine physician, who diagnosed the first case of COVID-19 in Rochester, Friday, Dec. 18, 2020, on Mayo Clinic's St. Marys Campus in Rochester. Mayo Clinic's "super six" were the first at Mayo Clinic to receive their first dose of a COVID-19 vaccine. The "super six" consisted of Registered Nurse, Abigail Carter, a Medical ICU nurse; Registered Nurse, Meera Patel, a Medical ICU nurse; Adam Skow, a respiratory therapist; Registered Nurse, Madeline Weiman, a Medical ICU nurse; Dr. Sean Caples, a pulmonologist and critical care medicine specialist; who all five treated a patient with the first suspected case of COVID-19, which turned out to be negative; and Dr. Casey Clements, an emergency medicine physician, who diagnosed the first case of COVID-19 in Rochester. (Joe Ahlquist / jahlquist@postbulletin.com)
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ROCHESTER, Minn. — Little is known about the first person in Olmsted County to be diagnosed with COVID-19.

What is known is this: The person was in his/her 50s. The person had recently returned from a trip abroad and it's believed a traveling companion exposed them to the virus.

The person showed up at Mayo Clinic on March 9, 2020, complaining of gastrointestinal illness.

Dr. Casey Clements treated the person, thus diagnosing the first COVID-19 case in the county. Today, a year after that diagnosis, Clements recalls certain details: How carefully and meticulously he put on protective personal equipment to ensure every inch of his body was covered before seeing the patient.

It was a strange, surreal moment. A nurse watched as Clements donned each article of clothing — powered air purifying respirator, surgical gown, long gloves that reached halfway up his forearms and shoe coverings — to ensure there were no gaps.

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Today, Clements is so practiced in putting on a less cumbersome version of PPE that he puts it on and off dozens of time a day with a Houdini-like ease.

"Now, we do it like a hundred of times a day," Clements said.

After sending the patient's samples to the state health department for testing, Clements got a call the next night. The test had come back positive for coronavirus.

Graham Briggs, the county's director of public health, made the news public at a March 12 news conference the next day. The deadly coronavirus was officially here.

"It was a weird transition from feeling very alone and getting the phone call and caring for this patient to all of a sudden, in less than 24 hours, the whole place is talking about it through news conferences and stuff," Clements said.

The county's Patient No. 1 did recover, but many have not.

A year later, 2.5 million worldwide are dead, more than half a million in the U.S. There have been more than 6,500 deaths in Minnesota and 88 in Olmsted County.

An exhausting experience

Clement's animated conversational style is edged with a hint of fatigue. He is tired.

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"This has been the hardest thing that probably anyone in health care has ever dealt with in their careers," Clements said. "It's the worst medical disaster in a century. And I don't know that people understand how hard this has been."

Clements doesn't know the number of people he's treated for coronavirus. Too many to count.

What made everything so stressful, particularly in the early months of the pandemic, was the hectic pace of change at Mayo as knowledge of the virus evolved. The more that was discovered, the more it dictated changes in protocol at Mayo. And those changes, especially in the spring and early summer, were almost a daily occurrence.

"It's the uncertainty of it, and then the change that just continued to come and come and come," Clements said. "And then to compound that with the difficulty of worrying about our own safety and our family's safety. It has just really exhausted everyone that I know who works on COVID units."

Clements has heard people downplay the disease as one that primarily affects the elderly. Their loss is seen as less consequential, the thinking goes, because they didn't have long to live anyway. As someone who knows friends who have lost elderly family members to the disease, that thinking offers little consolation to them, he said.

"It doesn't help them, because maybe my family member was older, but they still would be here with me (were it not for the disease)," Clements said.

Spreading the virus

So much has been learned about the virus in the last year. The proliferation of vaccines and therapies offers the prospect of a return to normalcy, whatever that looks like. Still Clements finds it necessary to say, "this is an extremely deadly and contagious disease."

The fact that many people don't show symptoms or don't get sick from the virus is what makes it so insidious, so easy to spread. If it killed most people it infected, it would be easier to contain.

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The virus became a media phenomenon for many, something that happened to other people — until they got it or discovered someone they knew got it. That mindset, as understandable and forgivable as it was, gave the virus a boost.

"This pandemic is being driven by spread in 20- to 50-year-olds. That's what the evidence shows," Clements said. "They're not the ones who are going to be at mortal risk from it. Whereas they are going to make their neighbor's grandmother sick indirectly."

A team effort's finest hour

The pandemic has shined a light on the work and sacrifices of doctors and nurses. But Clements said it's critical to honor the health care workers whose contributions have been vital but perhaps not as visible. He includes cleaning staff and supply chain and food service workers among the unsung heroes.

It has been a team effort, and without them, the fight against the virus would not have been as successfully waged. It has been their "finest hour."

"I hope never, ever, ever to do this again. Thank you," Clements said. "(Even so), this was an opportunity to stand up and actually take charge and do the right thing. And, by far and away, the vast majority of people have done that."

Matthew Stolle has been a Post Bulletin reporter since 2000 and covered many of the beats that make up a newsroom. In his first several years, he covered K-12 education and higher education in Rochester before shifting to politics. He has also been a features writer. Today, Matt jumps from beat to beat, depending on what his editor and the Rochester area are producing in terms of news. Readers can reach Matthew at 507-281-7415 or mstolle@postbulletin.com.
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