In the middle of a pandemic the priorities are obviously to limit the death toll and give people with the most serious cases the best chance of survival. But I think it’s worth raising the question of the aftermath, because it is going to require both thought, and planning, and the sooner that starts the better.
Let me explain: I experienced an uncomfortably close brush with death nine years ago now, having been involved in a serious road accident. It involved me spending several weeks in a coma under heavy sedation.
Reading the reports, and writing about what’s currently going on in the aftermath of a nasty Covid-19 case, I might have known there’d be some blowback from that and it duly hit me like a spiked morning star to the head the other night, leaving me shaking and dealing with heart palpitations.
An extended spell in an ICU is a shattering experience at the best of times, by which I mean when the health service is under only its standard level of strain and you spend it in a normal hospital with a normal recovery period afterwards (so a gradual transfer to a high dependency unit, then a normal ward and so on).
The realisation that you’ve bumped uglies with the grim reaper is not easy to handle. Then there’s the delirium. It took me years to unpick what were memories and what were graphic and vivid hallucinations created by my sedated, drug-addled brain. This is an under-reported phenomenon. Thousands of people will now be experiencing their own versions of it.
After you’re out of the woods there’s also the emotional wrench of getting used to a body that doesn’t work as it did before and adapting to a new set of circumstances. It’s a slow and ongoing process.
It isn’t yet clear for how long the most seriously affected Covid-19 patients will be affected physically, in terms of reduced lung function, or by the secondary complications they may experience from the illness. But I imagine they will need rehab.
In my experience, physical therapy was relatively (and I use the word relatively advisedly) easy to access once I’d left hospital. But, again, of course, that was then. There was no sudden rush of patients in need of help.
The mental trauma, however, was something else entirely. I had some informal support from a counsellor who more normally handled bereavement (the symptoms in terms of grief and shock weren’t all that dissimilar). Beyond that? It just wasn’t there.
Dealing with the aftermath is going to prove every bit as important as dealing with the crisis itself
My poor GP was left grinding her teeth in frustration when she tried to access help for me. At one point I was offered counselling at a facility accessible only via a flight of stairs which I couldn’t climb because I can’t walk. To the back of the queue you go!
Later on, I received a short and unsympathetic call from a mental health hospital saying I’d get an assessment when one was available, after which I might get six sessions with a therapist if I was lucky.
Things only changed for the better when I got lawyered up, a claim was lodged, and a first-rate practitioner, to whom I still speak, was obtained through what’s known as the “rehab protocols”.
That, of course, is not an option open to Covid-19 patients. It’s not an option for the NHS staff who’ve been treating them either. They too may need to call upon mental health services to cope with, for example, post-traumatic stress. Take it from me, dealing with it is extraordinarily difficult, even with support. Without it? I worry.
Going private is always a possibility for those with the resources to do that, but not everyone has them and even those that do can find them crimped by a serious illness. It underlines the point that this vicious infection is not the great leveller some have claimed it to be.
All this explains why we need to start thinking seriously about how to handle the next stage.
It would be a tragedy if, after deploying all those resources with the aim of keeping people alive, after the feats of heroism that have been witnessed, people succumb to mental trauma in the weeks and months that follow. Ditto their medical teams.
Dealing with the aftermath of this crisis is going to prove every bit as important as dealing with the crisis itself. And it is going be with us for much longer. It will require not just more resources, but also the sympathetic and compassionate deployment of them. Britain hasn’t always been terribly good at that. It’s something that needs to change.