New Yorker: The Challenges of Post-COVID-19 Care

The below is from this article in the New Yorker:

But when the infection is bad, it’s really bad. For reasons that aren’t entirely clear, covid-19 patients who need to go on ventilators generally need them for much longer than people with other respiratory problems. For patients with severe emphysema, the average duration of mechanical ventilation is about three days; for those with other acute respiratory distress syndromes, it’s around eight. At our hospital, most of the covid-19 patients who have needed ventilators have needed them for weeks. Extubation has been no guarantee of liberation: often, we’ve had to reinsert the tube within days, if not hours.

Prolonged intubation creates all sorts of problems. While patients are intubated, they need powerful sedative medications; many also receive paralyzing drugs to keep their reflexes from fighting the ventilator’s tube. (Some must be physically restrained to prevent them from pulling out catheters and tubes in their delirium.) Patients who survive intubation often find themselves profoundly debilitated. They experience weakness, memory loss, anxiety, depression, and hallucinations, and have difficulty sleeping, walking, and talking. A quarter of them can’t push themselves to a seated position; one-third have symptoms of P.T.S.D. A 2013 study of discharged I.C.U. patients, many of whom had been intubated, found that, three months after leaving the I.C.U., forty per cent of them had cognitive test scores one and a half standard deviations below the mean—roughly equivalent to the effect of a moderate traumatic brain injury. A quarter showed cognitive declines comparable to early Alzheimer’s disease. The longer patients were in the I.C.U., the worse the consequences became.

Read the whole thing.

One of the many early items of information I read back in February was that the post-infected uncertainties were many. That patients who experienced the disease would experience a mixture of auto-immune deficiencies as well as neurological issues. The disease doesn’t just “go away”. Its ability to prolong and deplete the body of its normal health for the patients’ life could be scarier than an already scary disease.

Yesterday, it was my godson’s birthday. I went to a Walmart on the way to his home to buy and drop off a present. I pulled into the parking lot, and I gasped. “Holy mother fucking shit!” The parking lot was packed and the line to go in was not there. That means every car represented at least ONE person inside, and the likelihood was that it equaled far more … especially in the south where families are abundant.

I was in a catch 22 because I didn’t want to go empty handed to my godson’s birthday drop off … I had driven about 40 minutes to get there. I donned my mask, rushed in, found a John Dear tractor toy, checked out and hosed myself in disinfectant at my car. We are in trouble here should an outbreak occur. Now I’m wondering if it would be safer to go back to Chicago.

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