A southern Alberta mother and father are grappling with the sudden, unexplained death of their 17-year-old daughter, and with few answers, they're left wondering if she could be the province's youngest victim of COVID-19.
Sarah Strate — a healthy, active Grade 12 student at Magrath High School who loved singing, dancing and being outdoors — died on Monday, less than a week after being notified she'd been exposed to COVID-19.
While two tests came back negative, her parents say other signs point to the coronavirus, and they're waiting for more answers.
"It was so fast. It's all still such a shock," said Sarah's mother, Kristine Strate. "She never even coughed. She had a sore throat and her ears were sore for a while, and [she had] swollen neck glands."
Kristine said Sarah developed mild symptoms shortly after her older sister — who later tested positive for COVID-19 — visited from Lethbridge, one of Alberta's current hot spots for the virus.
The family went into isolation at their home in Magrath on Tuesday, April 20. They were swabbed the next day and the results were negative.
'Everything went south, super-fast'
By Friday night, Sarah had developed fever and chills. On Saturday, she started vomiting and Kristine, a public health nurse, tried to keep her hydrated.
"She woke up feeling a bit more off on Monday morning," Kristine said. "And everything went south, super-fast."
Sarah had grown very weak and her parents decided to call 911 when she appeared to become delirious.
"She had her blanket on and I was talking to her and, in an instant, she was unresponsive," said Kristine, who immediately started performing CPR on her daughter.
When paramedics arrived 20 minutes later, they were able to restore a heartbeat and rushed Sarah to hospital in Lethbridge, where she died.
"I thought there was hope once we got her heart rate back. I really did," recalled Sarah's father, Ron.
"He was praying for a miracle, and sometimes miracles don't come," said Kristine.
Searching for answers
At the hospital, the family was told Sarah's lungs were severely infected and that she may have ended up with blood clots in both her heart and lungs, a condition that can be a complication of COVID-19.
But a second test at the hospital came back negative for COVID-19.
"There really is no other answer," Ron said. "When a healthy 17-year-old girl, who was sitting up in her bed and was able to talk, and within 10 minutes is unconscious on our floor — there was no reason [for it]."
The province currently has no record of any Albertans under the age of 20 who have died of COVID-19.
According to the Strate family, the medical examiner is running additional blood and tissue tests, in an effort to uncover the cause of Sarah's death.
'Unusual but not impossible'
University of Alberta infectious disease specialist Dr. Lynora Saxinger, who was not involved in Sarah's treatment, says it is conceivable that further testing could uncover evidence of a COVID-19 infection, despite two negative test results.
However, she hasn't seen a similar case in Alberta.
"It would be unusual but not impossible because no test is perfect. We have had cases where an initial test is negative and then if you keep on thinking it's COVID and you re-test, you then can find COVID," she said.
According to Saxinger, the rate of false negatives is believed to be very low. But it can happen if there are problems with the testing or specimen collection.
She says people are more likely to test positive after symptoms develop.
"The best sensitivity of the test is around day four or five of having symptoms," she said. "So you can miss things if you test very, very early. And with new development of symptoms, it's always a good time to re-test because then the likelihood of getting a positive test is a little higher. But again, no test is perfect."
Sarah deteriorated so quickly — dying five days after she first developed symptoms — she didn't live long enough to make it to her follow-up COVID-19 test. Instead, it was done at the hospital.
'An amazing kid'
The Strate family now faces an agonizing wait for answers — one that will likely take months — about what caused Sarah's death.
But Ron, who teaches at the school where Sarah attended Grade 12, wants his daughter to be remembered for the life she lived, not her death.
Sarah was one of five children. Ron says she was strong, active and vibrant and had plans to become a massage therapist after graduating from high school.
She played several sports and loved to sing and dance as part of a show choir. She was a leader in the school's suicide prevention group and would stand up for other students who were facing bullying.
"She's one of the leaders in our Hope Squad … which goes out and helps kids to not be scared," he father said.
"She's an amazing kid."
Sarah would often spend hours helping struggling classmates, and her parents hope her kindness is not forgotten.
"She'd done so many good things. Honestly, I've got so many messages from parents saying, 'You have no idea how much your daughter helped our kid,'" said Ron.
"This 17-year-old girl probably lived more of a life in 17 years than most adults will live in their whole lives. She was so special. I love her so much."
ABOUT THE AUTHOR
Jennifer Lee is a CBC News reporter based in Calgary. She worked at CBC Toronto, Saskatoon and Regina, before landing in Calgary in 2002. If you have a health or human interest story to share, let her know. Jennifer.Lee@cbc.ca
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