Fascinating email from TPM Reader JO, whose personal bio is tailor-made for TPM:
I’m a critical care nurse working in a COVID ICU. I’ve practiced nursing in a variety of settings, from helping to run an Ebola Treatment Unit in Liberia to coordinating mass vaccination campaigns during the H1N1 pandemic. I’m also a former political professional who really appreciates your insight and analysis.
One thing that I feel is really missing from the public discussion about COVID is the surprisingly high rates of (likely) permanent disability among those who become critically ill.
Most non-medical people seem to discuss outcomes as if they were a binary, rather than a spectrum; what percentage live, what percentage die. That binary is not reflective of the clinical realities we’re facing.
I don’t think it’s terribly well understood why there’s such a high rate of organ damage among COVID patients, though there seems to be a developing consensus that microthrombotic complications play a big role.
But whatever the cause, it’s important to understand this: while most COVID patients don’t need ICU care, a troublingly high number of those who do end up in kidney failure or with profound neurological deficits. Several patients at work have been off all sedation for almost a week, and show no signs of waking up — I doubt that they ever will. And people with kidney failure may need dialysis for life. When the discussion is limited to false binaries of deaths vs recoveries, these cases get left out of the dialogue.
I’m a clinician, not a researcher. I don’t have hard data for you, on this particular matter. But you can bounce this off clinicians at any busy COVID unit in the world and I’m confident that they’ll tell you the same.
I’m not going to speculate about the numbers, but I will say this. If you had a crystal ball, and you told me that when this was over the number of cases that lived but with severe and profound disability would be more than 5 times the number of people who died, I would not feel surprised by that prediction. And that’s not a trivial number.
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