Editor’s note: After this story was published, Angela Sarwar told The Daily Memphian on Monday she changed her mind and has received the first dose of the COVID-19 vaccine. The Daily Memphian has published a separate update to this story. 

A week before his 40th birthday, Tony Sarwar won first place in a statewide bodybuilding competition. A week after, he was fighting for his life and his wife was fighting an infuriating bureaucracy to get him on a medevac flight that would cost more than $50,000.

Collierville couple changes mind, decides to get COVID vaccine after St. Lucia ordeal

Yes, this is a COVID story, but it’s one set in paradise. Just ask the Sarwars, a couple well known in Collierville for their popular restaurant, Tony’s Trophy Room.

The Sarwars, despite being unvaccinated, traveled to a country with a Level 3 advisory warning during a pandemic. Last week, when Angela talked to The Daily Memphian about her experience, she insisted she wasn’t going to get the vaccine.

“I’ve never had a flu shot in my life either and no one makes a big deal about that,” she said last week. “I trust my immune system and trust my body to do what it’s supposed to do for the most part. I feel like if I’d just gotten some Tylenol and rest I would’ve been OK.”

Tony sees it differently. He thinks that bodybuilding puts strain on his body and that he needs the protection of the vaccine; he believes he’ll get it when he’s able. His condition was more critical, and he later discovered that he also had a condition called rhabdomyolysis, which is usually caused by muscle injuries from trauma like crash injuries.

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The trip was part of an annual ritual for the couple.

“For each of our birthdays, we take a trip to some place we’ve never been,” Angela Sarwar said. “For mine this year, we went to Montana, to Glacier Park. We usually stay in the country for mine and go out of the country for his.”

For Tony’s birthday, they picked a Sandals resort on the Caribbean island of St. Lucia. It was a splurge; Angela picked a villa with a private pool and butler service. With four kids and a busy restaurant to run, they were ready for a break.

They had gotten negative results on COVID tests taken a few days before they left for the trip, as required. Yet Tony was sick almost as soon as they arrived.

His legs were hurting so badly that even as the couple was getting a tour of the villa, he was drawing a hot bath.

“I thought maybe my legs were just cramping a little, being stuck on the airplane for a long flight,” he said.

“My wife had scheduled a massage, a couple’s massage, and that was good, but from that point on, the trip just went south,” Tony said. “From then on, there was not a moment of vacation.”

After three days of fever, cold sweats and prolonged muscle spasms, the resort’s nurse diagnosed Tony, who maintains a regimented bodybuilding diet that includes up to two gallons of water a day, with dehydration. 

As the Sarwars tell it, the misadventures begin there.

“The nurse tried to give me an IV and he missed my veins,” Tony said. “I have no idea how you miss my veins. He leaves the IV in my arm and it starts to swell.”

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A doctor eventually got the IV in the other arm, but with the tube wrapped with a bandage to seal a leak. The events might have been comical if the stakes had not been so high. One health care provider suggested perhaps Tony was cursed, and should wear Angela’s lucky charm necklace, a suggestion the couple found charming in the middle of the frustration. 

Later, on the way to a private birthday dinner on the beach, Tony collapsed, unable to walk, his legs rigid.

The butler helped get Tony back to the room and before he left, reminded the Sarwars that the next day would be the last full day before their departure. They would need to have their COVID test to be cleared for travel. Sure, they said. No problem.

‘You don’t want to go to the hospital’

On Aug. 9, the couple went for their next COVID test, done on the resort property, then returned to their villa, where they soon got a call telling them to stay put, that someone was coming to see them.

“I hung up the phone and said, oh my God, what if we’re positive? Why else would they make us stay?” Angela said.

“We knew the moment we opened the door. There were two people in masks, gloves, fully covered. They said we would be quarantined between 10 to 14 days and they were going to have another doctor come give us another test. I started crying immediately. I said, I have four kids, I can’t be here another 10 to 14 days. It was such a crushing feeling.”

And then they gave them some advice:

“They told us, ‘I promise, you want to stay with us. Whatever you do, you don’t want to go to the hospital.’”

But it wasn’t so simple. They both tested positive on the second test and the doctor gave them a phone with her number programmed in it. If they needed medical attention, they were to call her. 

“And then we had to leave our villa,” Angela said. “They took us to a generic hotel room and it was fine, but we couldn’t leave. They taped the door any time they came in and left and we couldn’t break the seal.”

That was on a Monday. Angela started to feel sick, Tony was getting worse, and they called the doctor repeatedly but got no answer. When the hotel employees called to tell them they were bringing food, the Sarwars asked them to call the doctor. Angela called the resort nurse on duty, who told them she wasn’t allowed to interact with them as they had COVID.

The only access to drugs they had were what Angela had in her purse: Emergen-C, Robitussin, vitamins. “Mom stuff,” she said. 

She called the American Embassy in Barbados and they said they couldn’t help, that for medical help, the Sarwars should call the local hospital.

Angela took to social media while she tried to get their doctor. What she hoped to find was someone on the island who might bring medication and a thermometer and just leave it at their door. What she found was a medic stationed in Iraq who specializes in survival and was willing to help.

“She was an angel. She said, ‘Angela, this is a serious situation. I’m going to send you some things that I promise will save your life,’” Angela said.

She texted breathing exercises to help keep Tony’s chest open, things you might do to increase oxygen intake at a high altitude, and told Angela, “No matter what, I need you to stay positive until you’re back on U.S. soil.”

Meanwhile, Tony’s urine was alarmingly dark, even though he was taking in plenty of fluids. Angela was sick; they were both feverish.

On Thursday, after contacting the ministry of health, the doctor showed up; they said she told them she didn’t answer the phone because she hadn’t been on call. And she said it was time to go to the hospital for lab work, though they understood they’d get tests and go back to the hotel.

An ambulance, which the Sarwars say was dirty, rusted and unsanitary, took them to the hospital, which is supposed to be a respiratory center.

“We get to the hospital and they have no room for us,” Tony said. “Somehow, someway they get us to the maternity ward. This was supposed to be the only place you can go if you have COVID.”

They went to Victoria Hospital in Castries, the island capital, and they describe a dire situation, with about 20 patients in a wing with one nurse, no air conditioning, no toilet paper or drinking water. And once they were there, no one wanted the Sarwars to leave.

“We both passed out from the heat and the fever,” Angela said. “At some point that first day, they told me I needed an IV and antibiotics, but they mostly ignored Tony even though I kept telling him that he’s the one who needs help.”

When Angela awoke, she asked for water and was told there was none available; the hotel sent some after a phone call.

The local newspaper on St. Lucia, The Voice, recently published a story about improving what a local politician called “unacceptable conditions” at the hospital, though it doesn’t detail what those conditions are.

Angela says there were no doors in the doorways, only metal slats on the windows; dogs and chickens in the yard, a cat roaming the hospital; and what she says was request by a doctor for personal payment in order to administer tests.

Angela started making phone calls.

“I said, ‘I’m done. We’re leaving.’ 

‘I can’t find anywhere to go’

The story sounds horrific, perhaps unbelievable. But it’s not to Vicki McKnight, who works for All Care Medical Transportation in Tampa and took Angela’s phone call.

“This is not the first story I’ve heard,” said McKnight, who is a flight coordinator. “I have hundreds of stories like these. I tell all my friends and family and everyone I know: Do not travel outside of the United States (right now). Because of COVID, it’s a nightmare.”

When Angela first reached All Care, Vicki didn’t have a plane available.

“I said, you don’t understand, I have four kids at home and this is my husband. I need to save him,” Angela remembers.

Vicki told her to stay by the phone, and she started making calls. When a plane was secured, the relief lasted “about one second,” Angela said.

First, the hospital would have to release them and the doctor and the nurses told them they wouldn’t approve it.

Then they were told the evacuation would cost $31,000, which they secured via a credit card from Tony’s mother. 

Angela thought they were on their way, but All Care told her there would have to be an accepting hospital at the other end of the flight. 

There was nothing in South Florida, the closest U.S. landing spot.

“They either didn’t have room or as soon as I would say COVID, they would say no,” Angela said. “So I find a medevac company, I get the money, and I can’t find anywhere to go.”

She called her mother, who is the fire chief in Pittsburg, Texas, Angela’s hometown; she arranged for a room at East Texas Medical Center there. In going from Florida to Texas, the air ambulance price increased to $53,000.

By the time the plane and additional funding was secured, the plane that had been scheduled to arrive at 7 a.m. the next day had already gone to pick up another family. A new flight was scheduled for 10 p.m. instead, and with further delay came doubt.

What if it was a scam? What if Angela spent that much money and no plane was coming?

Angela said the doctor again said she wouldn’t approve them leaving. 

“That put me in full panic. Can she do this? I called the medevac company and (was told) they can’t keep you against your will.”

But that doesn’t mean they let go easily. McKnight, of All Care, says it’s about money. The hotels get to keep billing you if you or even your belongings are there, the hospital and doctors charge you or your insurance.

“They’ll keep you as long as they can, and if you have COVID, it’s even worse. I used to travel abroad, I used to go on cruises, but I won’t leave the U.S. now,” she said. 

‘You can’t make it make sense’

And he has no real idea why they were treated as they were.

“No one had an answer. Everyone had a little authority and they wanted to exert that little bit of authority,” Tony said. “But what they had was no solution.”

Angela has no answer either.

“You can’t make it make sense,” she said. “You don’t want to treat us, you have nothing to treat us with, but you want us to stay.”

And they tried. The plane arrived on the island and an ambulance came. Angela saw it pull up and be turned away. She was on the phone with the medevac company, which had been told by the hospital that everything was fine, they were only waiting on paperwork.

But they were still telling the Sarwars they couldn’t leave, that it was not approved.

The gate was locked with a chain and there were guards at it; the Sarwars couldn’t just walk out and meet the ambulance in the street.

Two hours after the first ambulance left, a fire truck showed up, escorting another ambulance. The gate opened and it pulled in and Angela ran out, pushing Tony in a wheelchair, nurses yelling after her that they couldn’t leave.

But they did. They made it to the airport, where they were once again stopped by a local official.

“I couldn’t believe it. The ambulance driver and the (official) were arguing and finally he just floored it and there we were,” Angela said. “They loaded Tony up and immediately started treating him.”

McKnight was running point.

“It took about four hours,” she said. “It was like an escape, like they were having to break out of jail instead of leaving a hospital.”

In Texas, Tony spent five more days in the hospital. Angela says she will never lose the gratitude she has for that care.

“Left and right, mask or no masks, vaccine or no vaccine has consumed all of us since this started, but to these people, these nurses, none of that matters. Let me tell you, it touches you in a way you didn’t know you could be touched, and by people you don’t even know.”

It’s not over. The Sarwars have medical insurance and had travel insurance for the trip. So far, no medical claim has been filed by the hospital in St. Lucia, and there’s been no word on whether the travel insurance will reimburse them for the air ambulance, though the policy says it will.

Tony weighed 240 pounds in January and deliberately cut down to 207 for his competition July 31.

“I didn’t think I could lose another ounce, but I left the hospital at 180,” he said.

They have nightmares.

“Little triggers can take you back to those moments. For me, if I get hot or I can’t breathe, it freaks me out, it takes me back to that moment,” he said.

“It’s going to take a while for us to recover from this.”