COVID-19 recovery: our experiences.

Two Sundays ago, a gentleman with severe post-Covid pneumonia arrived at our gate. He drove himself in but was too weak to get out of the vehicle. We rushed over and on seeing his condition suggested he rather go straight to hospital. But alas, he was terrified of these institutions and begged not to go back there. (PTSD after COVID hospitalisation is not uncommon, see: https://youtu.be/0FB23XsIoZc) At this stage he was so weak that he could not walk. Moving from the car to the wheelchair and into the bed exhausted him to the point that he lost his ability to speak due to shortness of breath. His oxygen saturation was only 73; well below what it should be! We steamed him immediately and stayed with him, monitoring his vitals. Food was not an option as he was nauseous and had no appetite, but we were able to re-hydrate him. His emotional needs were as prevalent as his physical needs. His isolation and lack of human interaction caused such anxiety that panic attacks abounded. We knew that he was no longer contagious but just to be sure, a COVID test confirmed he was negative.

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I sat with him for a long time, just holding his hand listening to his pulse. It was a powerful reminder that sometimes, just our presence is enough. I gathered that he had no family in Johannesburg and told my staff that from now on we are his family. While the amazing team of doctors we work with changed his medication and monitored him physically, it was our job to support him on all the other levels. Benjamin grew stronger daily. There were times that we were checking on him every 15 minutes, and luckily his oxygen saturation kept climbing. After two days, I went into his room and told him I wanted to move his car to the undercover parking. I took the keys and told him that I’m glad he trusts me, as I am a dreadful driver. He laughed, and just like that, I knew he had turned the corner. He stayed with us for just over a week, regaining his strength, sense of humour and literally catching his breath. He phoned me a couple of days ago to let me know that he is doing really well and will go back to work next week. He thanked me and his “guardian angels” for helping him through the worst time of his life.

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At our other facility, Sunninghill Guest Lodge (not the Recovery lodge) we have been offering isolation and quarantine facilities for the Netcare staff, and the general public, for over a year. We have had the privilege of walking the road with guests who have isolated with us, where symptoms were mild to severe. Knowing help is nearby makes one’s recovery journey stress-free and, as many patients are deeply affected by the isolation , staying with us reduces this anxiety. We are delighted to say that none of our staff have ever contracted the virus. Our protocols are strict and hygiene exceptional, but we still manage, despite the hazmat suits, visors, gloves and masks, to remember that we are looking after a person who is more than just their contagious illness.

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We know that within five to seven days the virus that produces Covid 19 is eliminated from the body, but many professionals are still unsure of the timelines around COVID 19’s full recovery. Since the virus is novel and due to the limited research available, , recovery, just like the illness itself, is individual and therefor variable.

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Professor Puren is quoted in an article “ What are your expectations around recovery from COVID-19? “ (https://www.discovery.co.za/corporate/covid-19-expectations-around-recovery) as saying that recovery is measured by looking at one’s fever. If over a period of 24hours you have not had to take medication to reduce a high temperature you are officially “recovered”.

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Over the past 12 months we have had people with absolutely no symptoms, enjoying the “holiday” binging on Netflix, whilst others have shown severe symptoms. The only commonality between our guests was that they were all different. Some coughed but had no fever, some had a fever and loss of taste and smell, while others just had awful body aches. Some people literally skipped out of the facility after their 10 days and some were too weak to walk down the stairs without help.

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The timeline of quarantine creates a false expectation that once the isolation “sentence” has been served, the person will be fully recovered. But this does not seem to be the case at all. It was reported that even people whom only suffered from mild symptoms took weeks to recover and that often, even months after the illness, they battle with fatigue, coughing, anosmia and shortness of breath. In several cases, the lung epithelium gets destroyed or damaged and this needs to grow back, which can be a lengthy process. The loss of taste and smell is one of the first symptoms many people experience and often the reason to rush and get tested. In these cases, olfactory mucosal cells which have been damaged need time to regrow.

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The lingering of this dreaded illness commonly adds feelings of tremendous guilt and inadequacy on an emotional level, as people recover at their own pace. As a society we do love to compare, even something as intangible as this, and your slower recovery in comparison to that of your colleague’s speedy one can contribute to you experiencing anxiety and depression. It has been noted that with some people who have long stopped being contagious, but still have a lingering cough, experience feelings of rejection and stress, as there is a stigma around COVID-19 recovered patients.

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In the same article, Dr Geraldine Timothy said, “From a clinical perspective, we are learning more about COVID-19 every day and don’t have a full list of how it can affect the body in the short and long term. So, it’s very important that those who have experienced moderate or severe cases of COVID-19 to continue to be managed by their attending doctor and continue to be vigilant for months and years after recovering from COVID-19, understanding that there are potential long-term consequences that we have not yet determined. Think about rheumatic fever. When the disease first originated, no one knew that within 15 or 20 years, patients who recovered from it could present with valvular disease, which is life-threatening. I must stress that we must all always check in with our doctor at any point if there are symptoms in the immediate, short or longer term that are worrying us as they could be related to our having had COVID-19.”

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The time-frames of the different severities of COVID19 is often documented as the below:

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Mild COVID-19 illness: Around 80% of people who have contracted COVID19 will be asymptomatic or present with very mild symptoms. It is common that these individuals make a recovery between seven to ten days. People can expect the process to be on a par to recuperation of other respiratory viral infections such as the flu.

Moderate COVID-19 illness: Research shows that people who experience alarming symptoms which forces them to the emergency room or to be admitted to hospital have moderate COVID-19 and therefore the individual will recover slower and the patient is likely to experience fatigue, coughing and shortness of breath for a substantial time.

Severe COVID-19 illness: In these cases, patients often get ventilated and are transferred to ICU (intensive care unit) The affected body systems will take much longer to recover. The time of recovery can last anything from several weeks to months. We need to keep in mind that in severe COVID19 illness the lungs are damaged, multiple body systems affected and the patient would have become weak. The Mayo clinic reports that imaging tests taken months after severe COVID-19 regularly show damage to the heart muscle. They also state that COVID-19 can cause strokes, seizures and Guillain-Barre syndrome as well as increasing the risk of developing Parkinsons or Alzheimer’s. Regaining optimum health will not be a speedy process and can take months.

Post COVID syndrome: Also know as Long COVID. If the effects of COVID-19 still persist more than four weeks after you’ve been diagnosed with the COVID-19 virus you’ll be classified as suffering from Long COVID. Symptoms that are commonly experienced are fever, anxiety and depression, muscle pains and headaches, continued difficulty in breathing and shortness of breath, coughing, joint aches, chest pain, memory loss, sleep and concentration problems, fast or pounding heartbeat, anosmia and light-headedness.

This virus affects each person who contracts it differently, but one thing is for sure, it has affected the entire world whether you get it, had it or will never get it.

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