WEST PALM BEACH, Fla. — This month marks one year since Dr. Vladimir Laroche experienced the darkest times of his life.
"When I get out from the ventilators (and) open my eyes, it was three months later," Laroche, who was a doctor with FoundCare at the time he became ill with COVID-19, told WPTV.
He went into the hospital battling COVID-19 in early March 2020, when the first cases in Palm Beach County were just surfacing. Laroche's brother, Paul Laroche, did countless Zoom interviews with WPTV on Laroche's progress as the weeks turned into months.
"It certainly was at a point where there was not really a lot of clarity about how or what the treatment protocol was," Paul Laroche said.
Vladimir Laroche said when he was in the hospital, there was only one treatment that people were talking about.
"It was the Remdesivir," he said.
But at the time there were no studies or data on how COVID-19 would respond to Remdesivir. Finding the right time to use the viral inhibitor was the key.
"I quickly saw the trend," infectious disease specialist Dr. Leslie Diaz said. "Once you used it when the patient was already progressed, it just didn't make a huge difference."
Diaz said she started using it early on, even though hospital protocols were against it.
"And then new data came out that says if you use Remdesivir early enough, that's when it makes the biggest difference," Diaz added.
But Vladimir Laroche did not receive Remdesivir until May. In April, his brother made a plea for convalescent plasma while his brother was intubated and fighting for his life.
"This is his last chance," Paul Laroche said during an April 9, 2020, interview. "This is his very last chance."
Testing for COVID-19 wasn't readily available at that time, but through the power of social media, Paul Laroche found someone who had recovered from the virus in Miami and was eligible to donate plasma. For the Catholic family, the timing was divine intervention. Their prayers were answered on Easter weekend.
"I was maybe the second physician to use it [plasma] here in the state of Florida, and we used it up front," Diaz said. "Again, plasma, they say that if you use it early on with mild-to-moderate disease, you'll make the biggest difference."
Vladimir Laroche received two infusions of convalescent plasma from people who had recovered from COVID-19 and carried the virus antibodies. But complications from the virus led him to remain intubated for three months.
When he left the hospital in July, his brother went big. A mariachi band waited for Vladimir Laroche outside St. Mary's Medical Center, where he had been undergoing rehabilitation. Even after being wheeled out of the hospital to the sound of high-pitched vihuela, it would still be a tough road ahead.
The doctor had to learn to walk, write and speak again. He said that when he left the hospital, he lacked the strength to open a water bottle.
Nearing one year later, how the medical community treats COVID-19 has evolved.
"Now we're up to the JAK 1, JAK 2 inhibitor, which is a pill that's used for rheumatoid arthritis," Diaz said. "It's called Baricitinib and we use it in combination with Remdesivir, and that showed an improvement in symptom progression and an improvement in the days they were in the hospital."
Monocolonal antibody treatment is also used now, Diaz said, in an outpatient setting, but only for COVID-19 patients whose oxygen saturation is at least 95 or higher.
"It's an antibody that neutralizes the spiked protein so the virus cannot attach to the H2 receptor in the different areas of the lung and other organs," Diaz said.
But when it comes to patients being admitted to the hospital with oxygen levels decreasing, there isn't one magic combination.
"You really have to kind of throw everything at them," Diaz said.
Diaz added that mutating strains of the virus are also a concern.
"We don't have anything different in the protocols of medications to combat that, and this is the reason why it's so important for everybody to get vaccinated yesterday," Diaz said.
Vladimir Laroche does not know if he would have responded differently to treatment protocols now. What his brother does know is that, through the dark times and this journey, they raised awareness and helped many sick patients receive plasma donations.
"You've impacted so many people while you were in coma," Paul Laroche said to his brother. "I think all these things sort of needed to happen. I mean, he needed to go through what he went through in order for us to be where we are today."