HIMy patient has spent nearly a month on a ventilator, his lungs are so painful that every attempt to make him breathe on his own has failed. And then, finally, he got better and the tube came out – he only needed oxygen from the mask. Now, he breathes without difficulty himself.
But that is far from the whole story. Once out of the ventilator, our patient – a man who was previously healthy in his 40s – was for the time being unable to speak apart from sounds that were sometimes incomprehensible. He also cannot move his arms or legs. Thankfully, he has recovered from some of his ability to talk and move, but we still don’t know how long the deficit is.
What we believe is that he is not alone. Most of the COVID-19 sufferers never require hospitalization, those who have the most severe forms must use a ventilator to enable them to get enough oxygen. Even people in this group who are lucky enough to survive the brush with a ventilator face a long road to recovery. Some will suffer permanent disabilities ranging from neurological damage to kidney failure to post-traumatic stress disorder.
In March, The president announced that “hospitals and health care providers who treat patients with uninsured corona virus will be replaced by the federal government.” This, he assured the country, “must alleviate the concerns that uninsured Americans might have about seeking coronavirus treatment.”
Unfortunately no. Since this announcement, the federal government has not explained much about what the President promised. Congress also did not specifically set aside funds for this purpose. And specifics are very important – they will mean the difference between families who are able to care for their loved ones and the prospect of financial ruin they must try.
Our national attention has been fixed on the hospital where we now treat the sickest COVID-19 patients. But one of the biggest questions for those who survive is whether government assistance will end with their release.
There are many reasons to suspect that a large number of survivors will need significant ongoing medical care once they leave the hospital. COVID is a complex disease affects many vital organs of the body – some suffer from kidney failure, stroke, and heart damage, in addition to the more familiar respiratory symptoms of COVID.
Survival for some of these patients requires not only excellent hospital care but also outpatient and intensive home care, in addition to a large number of drugs and procedures. Stroke sufferers may require significant rehabilitation or even home care depending on the severity of their deficits. Patients with heart failure may need an implanted pacemaker or defibrillator. Many victims need respiratory therapy, at least temporarily, because their lungs are struggling to recover from a viral attack.
This is above the symptoms that we know affect the high percentage of ICU patients regardless of their illness – especially the weakness that the ICU gets due to prolonged immobilization, cognitive dysfunction, and post-traumatic stress disorder. Studies show that at least a quarter of patients who use a ventilator for more than one week experience severe muscle weakness that can take months to complete – meanwhile they may need significant support even for basic daily activities such as dressing and eating alone. Meanwhile, they will need rehabilitation, and for many people, mental health care as well.
Even in ordinary times, our patchwork health protection system means millions of Americans face unimaginable choices between paying rent and food or paying for life-saving medical care. Tragically, that amount will certainly swell up right when uninsured can have profound consequences.
Because most Americans receive insurance through their employers, losing a job will mean losing a lot of their health insurance too. A recent study by Urban Institute and the Robert Wood Johnson Foundation It is estimated that seven million Americans who were previously covered through their work will lose their entire health coverage due to unemployment due to this pandemic. The only reason the number is not higher is because some of those who are newly unemployed will be able to get protection through the Medicaid or Affordable Care Act (ACA).
Without health insurance, some Americans can expect to pay for the expensive care needed to recover from prolonged ICU care even in the best medical conditions, especially if there is permanent damage to their kidneys, brain or lungs.
If the Administration and Congress are serious about caring for those affected by this pandemic and ensuring that their path to recovery does not bankrupt them, they must make this commitment clear and concrete. And journalists must demand specifically what will be discussed and what will not.
While our patients remain in the hospital, a constellation of exceptional expertise is being prepared to help him. Nutrition experts carefully follow their diet. The speech pathologist helps us determine what he can eat while minimizing the risk of food aspiration. The physical therapist tries to help him regain the use of his limbs.
A number of hospitals in New York have marked a milestone in the journey to recovery. One of the hospitals where I work has started playing songs through a loudspeaker to record the release of a stable COVID patient – recently, the song was “Here Comes the Sun” by the Beatles or the theme of the film. Rocky.
In this time of fear and suffering – the hoarseness of this note above the hospital’s public announcement system is a rare ray of hope. This is an indispensable reminder for all hospital staff who have risked their own lives that sacrifice is not in vain. Our patients have struggled through unimaginable suffering – we now cannot leave them as soon as they get a letter out. If not, the hope chord will indeed ring.
to request modification Contact us at Here or [email protected]