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This blog was written in response to an article in the Independent by James Moore, see https://edition.independent.co.uk/editions/uk.co.independent.issue.100420/data/9457591/index.html

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This is a very interesting piece by a writer with first-hand experience of having been treated and discharged from an intensive care unit. James Moore raises some really interesting issues. In the UK and other countries there will soon be many thousands of people who have been in ICUs, many of whom will have been artificially ventilated. Recovering from this experience will be hard work and probably it will have lifelong effects. As James Moore points out, future epidemics may also set off traumatic recollections.

Recovery after being in intensive care includes not only the physical aspects, which in themselves will be quite gruelling when a person has been so severely ill, and may be complicated if the person has sustained damage to any of their internal organs (lungs, liver, kidneys, or even brain if they were short of oxygen for any length of time). But there's also the mental side of recovery. Most of all, we try to make sense of our experiences, This may be very difficult as if a person was under heavy sedation and on a ventilator, they may have no recollection at all and they will have a permanent gap in their memory as to what happened to them. What they may recollect are some of the events leading up to their admission, as they became progressively more and more unwell, and may well have thought they were going to die.

They will also doubtless have strong emotional reactions. These will vary between different people as to which is felt most strongly, but there is likely to be a mixture of powerful feelings. This may include relief at having survived and delight in being with family again. However, there may be some harder emotions, for example feeling guilty at having survived when others have died. There may also be anger and a sense of injustice - why me? Why did I suffer so much when others only had mild symptoms? And there may be frustration and grief if there are lasting symptoms that prevent the person from getting back to their normal life in some way. It may also be that their relatives and friends simply expect them to be cheerful and grateful at having got out of hospital and underestimate the struggle they are having.

Of course, many people who survive severe illness with covid-19 are likely to recover well, but as I have outlined above, there may be many challenges and these will for some people manifest themselves as anxiety, depression or post-traumatic stress disorder, or else through misusing alcohol or drugs, or having difficulties at work or in relationships.