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Op-Ed: COVID-19 survivors — PTSD, delirium, and more as infections rise

ICU survivors have experienced delirium, hallucinations, and horrible nightmarish visions. This may well be explained to a point by oxygen deprivation, but the psychological and physiological damage is acute. As the pandemic gets more severe, these cases will multiply accordingly.
The New York Times explored this horrifying range of experiences in depth in a recent article. You need to read this awful range of tales from survivors in their own words to fully appreciate the misery and the risks involved. Many of the experiences were life-threatening, and most were truly appalling.
The experience has been reported by many coronavirus patients. There are no numbers to work with, but what’s being called “hospital delirium” is a grim thing. Cases of people removing ventilators, and similar dangerous semi-conscious events, seem to be common enough.
A world of hyper-traumatized COVID-19 survivors?
That, however, isn’t the whole story, or anything like it. The ever-increasing numbers of people in ICUs may well become a global population of highly traumatized people.
PTSD (Post Traumatic Stress Disorder) is one of the descriptions being used by professionals, and it’s not an expression used lightly in medical environments. It’s one of the toughest, hardest to manage physical and psychological conditions known. It’s also a very long-term condition, putting enormous strain on sufferers and their families.
Trauma, which is a generic word, also comes in levels of difficulty at the best of times. Some people recover pretty much OK. Others don’t, and may require ongoing treatment for years. The psychological stress from the cases reported is obviously severe, so it can’t be assumed that recoveries will be quick and easy.
While it’s unclear what percentage of people have had these experiences, the large numbers of recovered people will inevitably include many who’ve had these terrible issues. That means a further massive strain on medical resources, worldwide. Some specialist services are being put in place, but who knows what the demand will be?

The global COVID-19 pandemic

The global COVID-19 pandemic

Physical issues
The physical side of oxygen deprivation caused by respiratory infections is no joke, either. Blood clots and even brain damage are possible, depending on the degree of deprivation. That could equate to an unholy mix of physical and psychological damage for survivors. These types of damage can be hard to detect in people who are already very sick.
People with respiratory conditions aren’t usually fountains of information when they can barely breathe, let alone move. It’s possible that many patients experience serious things while unable to communicate, so doctors and nurses can’t see the problems.
This in turn means that “physical issues” are also likely to include things like the ability of survivors to live normal lives. Given the gigantic numbers of people hospitalized already, it’s a big issue. The wounded could outnumber the dead. It’s also a statistical certainty that ongoing after care and pretty strict case management and monitoring in ICUs will become essential.
It’s too early to know whether actual incapacity and to what degree is yet another issue to be addressed. This information is only now filtering out of the overloaded hospitals. Incapacity may be physical, mental, or both. There are a lot of gaps in information to be filled, hopefully ASAP.
What to do about it?
The only working option here is that people seem to be having a common bandwidth of physical experiences which directly relate to the traumas. There are enough similarities to at least get a basic profile of high-risk patients. There must be physiological markers which can indicate risks of severe trauma. Oxygen levels are definitely one of those markers, but other basics, like blood pressure, heart rate, adrenalin levels, etc. could also help.
The best option is to come up with a prevention measure or preferably several to shut down these very negative effects of hospitalization when discovered. It’s either that, or a world full of traumatized people.

Written By

Editor-at-Large based in Sydney, Australia.

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